The first RANCARE Workshop of the COST Action 15208 entitled “The ethical dimensions of missed nursing care” took place in Athens, Greece on Wednesday, 7th of February 2018. The event was hosted by the Department of Nursing of the National and Kapodistrian University of Athens (N.K.U.A.), and was organised in collaboration with the Greek Nursing Studies Association (www.nursingstudies.gr). The focus of the workshop was on the WG 3: Ethical Issues of Rationing of Nursing Care.
The workshop was designed to improve nurses’ knowledge on missed care and their professional capacity as care leaders to avoid it, something which is critical to support the individualised nursing care to each individual patient. Forty attendees (participants, speakers and administratives) with academic, research, clinical nursing, medical and economics background from Greece and Cyprus were familiarising with the concept of care rationing, and had the opportunity to debate on the phenomenon.
The Chair of the Nursing Department, Prof Chryssoula Lemonidou, was opened the workshop and warmly welcomed the invited speakers and the participants. A range of excellent speakers, who are top level nurse academics and researchers, addressed the ethical perspectives of nursing care rationing, according to workshop’s agenda. The scientific program was organised in two sections. The first one included the three following presentations:
- “Training and Networking through the RANCARE Action”, presented by Ass. Prof Evridiki Papastavrou, Action Chair, Cyprus University of Technology, Cyprus
- “Seeing Individuals – Implications for care rationing”, presented by Prof Riitta Suhonen, WG3 Leader, University of Turku, Finland
- “Resource allocation – Criteria from a nursing perspective”, presented by Dr Michael Igoumenidis, Technological Educational Institute of Western Greece
At the second section of the agenda, participants separated in two working groups and debated on the previously presented concepts. Further to that, attendees presented their results from the discussion to all the participants. The two groups debated on the questions and scenarios as presented below:
- “What nursing activities need to be developed and priorities set to support individual patients?”
- “What can be done to avoid missed care?”
- “According to a nurse interviewee, VIP patients ‘certainly receive better care’. Can you think of any instances when this would be morally justifiable? How would you propose to confront this injustice, both at the macro- and micro-allocation levels?”
- “Adequate staffing levels are important in reducing missed nursing care. A geriatric ward has patients with greater needs and worse outcomes; a surgical ward has patients with fewer needs and better outcomes. Which ward of your hospital would you rather enhance with an extra nurse?”
- “In most countries, undocumented immigrants are entitled to ‘immediate health care’ only. An undocumented immigrant is referred from the Open Polyclinic of an NGO to the Emergency Room of a public hospital, experiencing an episode of mild abdominal pain and diagnosed with gallstones. He does not require immediate care, but it could get worse if left untreated. How would you propose to deal with such a case?”
The attendees of the workshop relayed positive feedback regarding the program and its faculty. The workshop provided the opportunity for them to build relationships with the experts and to think on the conceptualisation of the care rationing phenomenon. All who attended agreed that it was a highly inspiring event with useful take-home messages on the methodological challenges, as well as on the outcomes of nursing care rationing on patient safety and quality of care. Nurses are dealing with difficult situations every time in their daily practice, and that has an impact on them (moral distress) and on patients (dignity). A goal of zero tolerance of missed care is might a utopian vision in health sciences. But it is important, health care professionals to be concerned and to remember that there is no right or wrong, and that the more they try to understand the concept of missed care the more questions are arising (evidence-based practice). Moreover, participants had the chance to discuss the implications on patients’ and human rights including allocation of care provision (e.g. towards particular age groups), and the ethical and value principles underlying the decision-making process in clinical judgment. What they concluded is that each nurse according to his/her training, values and clinical experience has a different point of view, and that missed care is an important and debated issue.
The workshop closed with the announcing of the opportunities that the RANCARE Action provide to young researchers in regarding with the participation in Short Term Scientific Missions and Training Schools related to methodological, organisational and ethical issues associated with rationing of nursing care. More details for the terms and applications are available on the RANCARE website www.rancare-action.eu.
You can also view the PDF file of the press release here.