Perceptions of nursing workloads and contributing factors, and their impact on implicit care rationing: A Queensland, Australia study

Hegney, Desley; Rees, Clare S.; Osseiran‐Moisson, Rebecca; Breen, Lauren J.; Eley, Robert; Windsor, Carol; Harvey, Clare

doi:10.1111/jonm.12693

Cited by 64 publications

(71 citation statements)

References 34 publications

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“…In work undertaken by Hegney et al. (2018), nurses identified lack of support from managers when they reported their concern at not being able to complete care as a result of reduced budgets and lower staffing levels.…”

Section: Discussionmentioning

confidence: 99%

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Nurses’ views on workload, care rationing and work environments

et al. 2020

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Aims The article examines nurses’ experiences to institutionally enforced choices they must make regarding what patient care will be left undone. Cognitive dissonance theory is used to discuss how missed care is reconciled with the nurses’ sense of professionalism and feelings of compassion. Background Research into missed nursing care and care rationing is increasing, with an awareness that it impacts on nurses’ coping ability. Methods In‐depth video and telephone interviews were conducted with four experienced nurses who were asked to describe how they made choices regarding required patient care and how they managed care under workload pressures. Results Thematic analysis of interview narratives revealed four key themes describing the experiences of nurses managing their work: compromising care; incongruity between professional standards and organisational resources; emotional exhaustion; and depersonalization. Conclusions Nurses expressed concerns that their professional values regarding patient care are being lost in a quest to achieve financial targets. It raises questions regarding ethical and psychological dilemmas created for workers by work intensification. Implications for Nursing Management Financial effectiveness negatively impacts on nurses’ emotional and clinical well‐being cannot be easily dismissed, given that cognitive dissonance arises from attempting to provide quality care of patients whilst meeting organisational financial targets.

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Section: Discussionmentioning

confidence: 99%

“…Supporting this view, Hegney et al. (2018) found that managers felt vulnerable due to conflicting loyalties between meeting organisational requirements and the need to support staff. As Bill said, budgets are the main focus, which unavoidably takes the focus away from actual ‘care’ and orientates it towards ‘efficiency’ .…”

Section: Discussionmentioning

confidence: 99%

Nurses’ views on workload, care rationing and work environments

et al. 2020

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“…Studies performed so far demonstrated that nursing care rationing is a serious issue, present in Western European states, 2 4 5 8 9 the USA 10 11 24 27 and Australia. 12 All these countries are highly developed and have incomparably higher healthcare spending than Poland, 39 possibly suggesting that problems with resource allocation or staff shortages may be less severe there than in Poland. Therefore, the development of a Polish version of a questionnaire measuring the PIRNCA was warranted in order to investigate this issue in Polish settings.…”

Section: Discussionmentioning

confidence: 99%

“…required by a patient, to an extent depending on the patient's condition as determined in the Nursing Diagnosis Process. 1 Sadly, multiple studies on nursing conducted in recent years [2][3][4][5][6][7][8][9][10][11][12] demonstrated the occurrence of the phenomenon of the non-performance or incomplete or delayed performance of tasks involved in providing holistic care for a hospitalised patient.…”

Section: Introductionmentioning

confidence: 99%

Polish adaptation and validation of the Perceived Implicit Rationing of Nursing Care (PIRNCA) questionnaire: a cross-sectional validation study

et al. 2020

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ObjectivesTo develop a Polish adaptation of the Perceived Implicit Rationing of Nursing Care (PIRNCA)questionnaire.DesignCross-sectional validation study.SettingsNurses working in surgical and cancer wards in Poland.ParticipantsA sample of 513 professionally active nurses was enrolled in the study.InterventionTo complete a Polish translation of the full original PIRNCA questionnaire.Primary and secondary outcome measuresThe primary outcome was translation and adaptation of the full original PIRNCA tool and its validation to the Polish conditions. The secondary outcome was determination of relationships between sociodemographic variables, nurses’ assessment of patient care quality and their overall job satisfaction on the one hand, and PIRNCA scores on the other.ResultsThe respondents’ mean score was 1.27 points (SD=0.68) on a scale from 0 to 3. Cronbach’s alpha for the entire instrument was 0.957. All items of the questionnaire were found to have a positive item-total correlation. The developed linear regression model showed that nurses’ assessment of patient care quality and their overall job satisfaction were independent predictors of PIRNCA scores (p<0.05). 94.15% of nurses reported rationing at least one of the 31 care activities.ConclusionsThe present findings indicate a high level of reliability and validity of the translated PIRNCA questionnaire, fully comparable to that of the original. The questionnaire can be used for the assessment of PIRNCA in Polish hospitals.

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“…This could be related to working in specialty units requiring direct patient care and involving fewer patients than in wards and outpatient units. These data must be interpreted with caution because staffing levels and skill‐mix result in implicit care rationing (Hegney et al, ). The current study could not reveal any significant relationship between QNWL and other work characteristics, such as working overtime, method of rotating shifts, compensation for rotating shifts, being certified, current position and leadership position.…”

Section: Discussionmentioning

confidence: 99%

Quality of nursing work life among hospital nurses in Saudi Arabia: A cross‐sectional study

et al. 2019

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Aim This study measures the levels of QNWL and determines the relationship between QNWL and nurses' personal, family and work shift factors. Background The nursing profession in Saudi Arabia (SA) is diverse, with many challenges during nursing practice. Therefore, examining QNWL is important for managers because it has become an essential subject in current nursing practice. Methods A quantitative approach utilizing a cross‐sectional design with 400 nurses recruited randomly through a multistage cluster sampling plan. Results The overall level of quality of nursing working life among nurses was moderate (mean = 165; SD = 26.8). Bivariate analysis showed that non‐Saudi nationality, higher age, more work experience, married status, full‐time employment, rotating shift and specialty units were the significant factors contributing to higher QNWL scores (p < .05). Conclusions The study provides initial understanding of the quality of work life among nurses working in the Madinah region. It reveals a moderate level of QNWL and a significant association between personal, family, and work shift variables and QNWL. Implications for Nursing Management The findings will be of interest to all management levels to support nurses through adequate staffing with defined criteria that dictate the nurse–patient ratio for adequate QNWL.

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Perceptions of nursing workloads and contributing factors, and their impact on implicit care rationing: A Queensland, Australia study

Cited by 64 publications

References 34 publications

Nurses’ views on workload, care rationing and work environments

Nurses’ views on workload, care rationing and work environments

Polish adaptation and validation of the Perceived Implicit Rationing of Nursing Care (PIRNCA) questionnaire: a cross-sectional validation study

Quality of nursing work life among hospital nurses in Saudi Arabia: A cross‐sectional study

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