Rationing of Nursing Care and Professional Environment: Exploration of Nurses’ Views

Abstract

Introduction: Rationing of nursing care is an important factor linked with patient safety and quality of care. Aim: The investigation of nurses’ perceptions about rationing of nursing care and the possible relationship with their professional practice environment. Method: This was a correlational descriptive study with data from 393 nurses (response rate 55%) included in the analysis. The participants were drawn from the surgical and medical wards of all the state hospitals of Cyprus. The data were collected between October 2010 and May 2011 and the participants received two questionnaires: the Basel Extent of Rationing of Nursing Care (BERNCA) instrument and the Revised Professional Practice Environment (RPPE) scale. Results: The tasks being rationed mostly were: ‘mouth or dental hygiene’ (31.5%), ‘reviewing patient documentation at the beginning of the shift’ (31.2%), ‘coping with delayed response from the physicians’ (30%) and ‘providing emotional or psychological support to patients’ (29%). Around a fifth of the participants (20.4%) admitted not adequately monitoring confused or impaired patients. The regression analysis indicated three professional environmental factors accounting for 18.4% of the rationing care variance. These factors were: teamwork, leadership and autonomy, and communication with patients. Conclusions: The nurses acknowledge the existence of rationing of care in basic nursing tasks. The association between professional practice environment factors and rationing suggests that further research is needed on how to address the problem and identifying ways to improve the provision of nursing care.