The integration of care ethics and nursing workload: A qualitative systematic review

Denise Waterfield, Susan Barnason

Research output: Contribution to journalReview articlepeer-review

6 Scopus citations


Aim: The aim of this review was to explore literature from January 2017 to December 2021 for specific aspects of care ethics related to nursing workload in the acute care setting. Background: High nursing workload is associated with adverse outcomes for nurses as well as patients. Nursing workload goes beyond patient-to-nurse ratios and encompasses patient, nurse and organizational factors. Evaluation: This qualitative systematic review was conducted according to the Joanna Briggs Institute Manual for Evidence Synthesis. The four features of care ethics related to nursing workload guided the review of qualitative studies in MEDLINE, CINAHL and PsycINFO, and synthesized findings were presented in the four phases of caring. Key Issues: Key issues include ethical dilemmas, time pressure, shared moral burden and managerial support. Conclusion: To reduce nursing workload, a care ethics perspective can provide solutions through fortifying interprofessional relationships and enhancing empathetic actions. Implications for Nursing Management: Situational, individual and team approaches to management allows for incorporation of personal values and ethics of care to support patient-centred care. Leadership initiating conversations and being proactive about workload can lead to an improved work environment for both the nurse and the nurse manager.

Original languageEnglish (US)
Pages (from-to)2194-2206
Number of pages13
JournalJournal of nursing management
Issue number7
StatePublished - Oct 2022


  • culture
  • decision making
  • ethics
  • nurse manager
  • workload

ASJC Scopus subject areas

  • Leadership and Management


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