Participants

Rationing of nursing care, based on a dominating view, occurs when resources are not sufficient to provide necessary care to all patients. Several reasons have lead to this phenomenon such as staff reductions, the increased demands for care due to the technological advancements, more treatment options, more informed service users, all demanding more time and attention from care professionals. Rationing of nursing care may also occur due to particular approaches to care professionals’ clinical judgment and knowledge in allocating the resources and the wider value basis of the society on care. Evidence indicates that the prevalence of rationing is quite high among nurses in acute care hospitals internationally (55-98%) and is consistently associated with negative patient, nurse and organizational outcomes. Fundamental patient needs may not be fulfilled, while patient outcomes include patient falls, nosocomial infections, decreased nurse-reported care quality and decreased patient satisfaction. Nurse and organisational-related outcomes include increased staff turnover, decreased job and occupational satisfaction, and increased intent to leave nursing. Within the limitations of scarcity, nurses’ decisions may also challenge their professional values leading to role conflicts, feelings of guilt, distress and difficulty in fulfilling their role in a morally accepted way.