Rationing of Nursing Care Within Professional Environmental Constraints

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Abstract
The purpose of this study was to examine rationing of nursing care and the possible relationship between nurses’ perceptions of their professional practice environment and care rationing. A total of 393 nurses from medical and surgical units participated in the study. Data were collected using the Basel Extent of Rationing of Nursing Care (BERNCA) instrument and the Revised Professional Practice Environment (RPPE) Scale. The highest level of rationing was reported for “reviewing of patient documentation” (M = 1.15, SD = 0.94; 31.2% sometimes or often) followed by “oral and dental hygiene” (M = 1.06, SD = 0.94; 31.5% sometimes or often) and “coping with the delayed response of physicians” (M = 1.04, SD = 0.96; 30% sometimes or often). Regression analyses showed that teamwork, leadership and autonomy, and communication about patients accounted in total 18.4% of the variance in rationing. In regard to application, the association between the practice environment and rationing suggests improvements in certain aspects that could minimize rationing.

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