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Resource allocation and rationing in nursing care: A discussion paper

journal contribution
posted on 10.07.2019, 00:00 by PA Scott, Clare HarveyClare Harvey, H Felzmann, R Suhonen, M Habermann, K Halvorsen, K Christiansen, L Toffoli, E Papastavrou
Driven by interests in workforce planning and patient safety, a growing body of literature has begun to identify the reality and the prevalence of missed nursing care, also specified as care left undone, rationed care or unfinished care. Empirical studies and conceptual considerations have focused on structural issues such as staffing, as well as on outcome issues – missed care/unfinished care. Philosophical and ethical aspects of unfinished care are largely unexplored. Thus, while internationally studies highlight instances of covert rationing/missed care/care left undone – suggesting that nurses, in certain contexts, are actively engaged in rationing care – in terms of the nursing and nursing ethics literature, there appears to be a dearth of explicit decision-making frameworks within which to consider rationing of nursing care. In reality, the assumption of policy makers and health service managers is that nurses will continue to provide full care – despite reducing staffing levels and increased patient turnover, dependency and complexity of care. Often, it would appear that rationing/missed care/nursing care left undone is a direct response to overwhelming demands on the nursing resource in specific contexts. A discussion of resource allocation and rationing in nursing therefore seems timely. The aim of this discussion paper is to consider the ethical dimension of issues of resource allocation and rationing as they relate to nursing care and the distribution of the nursing resource. © 2018, The Author(s) 2018.

History

Volume

26

Issue

5

Start Page

1528

End Page

1539

Number of Pages

12

eISSN

1477-0989

ISSN

0969-7330

Publisher

Sage Publications, UK

Additional Rights

CC BY-NC 4.0

Peer Reviewed

Yes

Open Access

Yes

External Author Affiliations

University of South Australia; Cyprus University of Technology; Oslo Metropolitan University; VIA University College, Denmark; National University of Ireland; University of Turku, Finland; City University of Applied Sciences, Germany

Era Eligible

Yes

Journal

Nursing Ethics