Aberrant Work Environments, Rationed Care as System Failure or Missed Care as Skills Failure?

Harvey, Clare; Buckley, Clare E; Forrest, Rachel; Roberts, Jennifer; Searle, Judy; Meyer, Alannah; Thompson, Shona

doi:10.5176/2345-718x_2.1.66

Cited by 9 publications

(13 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This is not new, nurses have always prioritized the tasks they need to do for patients, omitting some, delaying others to be taken up by the next shift or modifying protocols to get the work done in a timely fashion (Harvey et al. ). As Campbell and Rankin () note, rationing care is ‘a professionally sanctioned method of nursing decision‐making’.…”

Section: Discussionmentioning

confidence: 99%

Rounding, work intensification and new public management

et al. 2015

View full text Add to dashboard Cite

In this study, we argue that contemporary nursing care has been overtaken by new public management strategies aimed at curtailing budgets in the public hospital sector in Australia. Drawing on qualitative interviews with 15 nurses from one public acute hospital with supporting documentary evidence, we demonstrate what happens to nursing work when management imposes rounding as a risk reduction strategy. In the case study outlined rounding was introduced across all wards in response to missed care, which in turn arose as a result of work intensification produced by efficiency, productivity, effectiveness and accountability demands. Rounding is a commercially sponsored practice consistent with new public management. Our study illustrates the impact that new public management strategies such as rounding have on how nurses work, both in terms of work intensity and in who controls their labour.

show abstract

Section: Discussionmentioning

confidence: 99%

Rounding, work intensification and new public management

et al. 2015

View full text Add to dashboard Cite

show abstract

“…Distribution of the survey was facilitated through the NZ Nurses Organisation (NZNO) and the Australian Nursing and Midwifery Federation (ANMF). The MISSCARE survey consists of three sections: nursing demographics; responses to 26 common nursing care elements; and an examination of the environment in which care is undertaken (Harvey et al., ; Willis et al., ). The opportunity to expand on questions was offered, with respondents able to make free‐text comments throughout the survey.…”

Section: Methodsmentioning

confidence: 99%

“…We draw on data from a trans‐Tasman study (Blackman et al., ; Harvey et al., ) that used the MISSCARE tool developed by Kalisch and Williams (), modified for the Australian and New Zealand contexts, to explore reasons why nursing care is missed. Missed nursing care is defined as ‘any aspect of required care that is omitted in part or in whole or delayed’ (Kalisch, Lanstrom & Hinshaw, 2009, p. 211).…”

Section: Introductionmentioning

confidence: 99%

Missed nursing care as an ‘art form’: The contradictions of nurses as carers

et al. 2017

Self Cite

View full text Add to dashboard Cite

This article draws on the free-text commentaries from trans-Tasman studies that used the MISSCARE questionnaire to explore the reasons why nurses miss care. In this paper, we examine the idea that nurses perpetuate a self-effacing approach to care, at the expense of patient care and professional accountability, using what they describe as the art of nursing to frame their claims of both nursing care and missed nursing care. We use historical dialogue alongside a paradigmatic analysis to examine why nurses allow themselves to continue working within settings that put their professional/personal selves aside in an attempt to deliver care within constraints that make completing care an impossible task. The findings suggest an ambivalence and conflict confront nurses attempting to provide care within the New Public Management environment. This can be seen in the tensions that draw a line between care as an art, and care as a financial target, juxtaposed with the inherent clash of values arising from the way nursing care is conceptualised within two contradictory paradigms.

show abstract

“…Additionally, RNSs and practice nurses (PNs) suggested that the actual discharge planning documentation did not always contain enough information to inform general practice clinicians, indicating that a verbal handover to the PNs would be more effective in linking patients back to the general practice. Difficulties in communication were also found in other research undertaken to examine missed and rationed care, and the reasons for it determined (Harvey, Buckley, Forrest, Roberts, Searle, Meyer and Thompson, 2015). In a follow-up survey, 26 per cent of the nurses said they would delay patient education for discharge preparation if they were busy, whilst 35 per cent said they would hand this activity over to the next shift (Harvey et al, 2017).…”

Section: Introductionmentioning

confidence: 91%

Development, implementation and evaluation of nurse-led integrated, person-centred care with long-term conditions

Harvey¹,

Sibley

Palmer

et al. 2017

JICA

Self Cite

View full text Add to dashboard Cite

Purpose The purpose of this paper is to outline a conceptual plan for innovative, integrated care designed for people living with long-term conditions (LTCs). Design/methodology/approach The conceptual plan delivers a partnership between the health system, the person with LTCs (chronic), their family, and the community. The partnership aims to support people at home with access to effective treatment, consistent with the New Zealand Government Health Strategy. This concept of people-owned care is provided by nurses with advanced practice skills, who coordinate care across services, locations and multiple LTCs. Findings With the global increase in numbers of people with multiple chronic conditions, health services are challenged to deliver good outcomes and experience. This model aims to demonstrate the effective use of healthcare resources by supporting people living with a chronic condition, to increase their self-efficacy and resilience in accordance with personal, cultural and social circumstance. The aim is to have a model of care that is replicable and transferable across a range of health services. Social implications People living with chronic conditions can be empowered to manage their health and well-being, whilst having access to nurse-led care appropriate to individual needs. Originality/value Although there are examples of case management and nurse-led coordination, this model is novel in that it combines a liaison nursing role that works in partnership with patients, whilst ensuring that care across a number of primary and secondary care services is truly integrated and not simply interfaced.

show abstract

Aberrant Work Environments, Rationed Care as System Failure or Missed Care as Skills Failure?

Cited by 9 publications

References 0 publications

Rounding, work intensification and new public management

Rounding, work intensification and new public management

Missed nursing care as an ‘art form’: The contradictions of nurses as carers

Development, implementation and evaluation of nurse-led integrated, person-centred care with long-term conditions

Contact Info

Product

Resources

About