# The Relationship Between the Rationing of Nursing Care, Job Satisfaction, and Burnout Among Nurses in Northwestern Poland

## TL;DR

This study explores how factors like workload and burnout affect Polish nurses' tendency to ration care, impacting patient safety.

## Contribution

The study identifies emotional exhaustion, long shifts, and patient load as key predictors of nursing care rationing in Poland.

## Key findings

- Nurses with higher emotional exhaustion were more likely to ration care.
- Working 12 or 24-hour shifts increased the likelihood of rationing nursing care.
- Job dissatisfaction was a significant predictor of care rationing.

## Abstract

Rationing of nursing care, understood as the omission or inadequate performance of professional activities, is a phenomenon observed in medical care facilities around the world. It results not only in the risk of reducing patient trust and satisfaction with the care provided but also in adverse events that can significantly reduce patient safety.

The aim of this study was to search for factors contributing to the rationing of care by Polish nurses.

This survey‐based study, which involved 528 nurses from northwestern Poland, was performed in 2023. It was performed using a tool of our own design and three standardized questionnaires: the Basel Extent of Rationing of Nursing Care–Revised (BERNCA‐R), the Satisfaction with Job Scale (SWJS), and the Maslach Burnout Inventory (MBI).

The average BERNCA‐R score was 1.52 points (SD = 0.95), which indicates a low level of rationing care by the surveyed nurses. Analysis of the SWJS results revealed that the respondents were rather dissatisfied with their work. The MBI confirmed high levels of burnout in all three subscales: emotional exhaustion (58.33%), depersonalization (55.3%), and personal accomplishment (83.5%). Linear regression analysis showed that in both univariate and multivariate models, the MBI emotional exhaustion subscale score, working 12 or 24 h shifts, and caring for a group of 11–20 patients were direct, independent predictors of rationing of nursing care as measured by the BERNCA‐R. Job satisfaction, due to its statistical significance verified by multivariate analysis, was an independent predictor (p = 0.004).

The phenomenon of nursing care rationing is associated with increased workload, low job satisfaction, and emotional exhaustion.