Exploring sensitive nursing issues through focus group approaches

Background: Nursing care rationing is an important organisational variable. It includes omissions and seems to be linked to patient safety as well as quality. Nursing care rationing can be a sensitive topic that causes strong emotions. Nurses aren't always willing to share unfinished or omitted nursing tasks. In addition to the adverse consequences for patients, nurses may feel moral distress if they have to ration their care. This paper aimed to examine some of the methodological problems that focus group interviews can present when investigating sensitive nursing issues, in this instance, rationing nursing care. Material and Method: This paper discusses the methodological issues in the context of a study that examined nursing care rationing views among registered nurses who work in medical and surgical units. Between June and September 2011, three focus groups were convened to determine which areas of nursing care are being rationed, and what the causes of this rationing are. There were 17 registered nurses in the group. The discussion began with a scenario that described a typical day on a busy hospital ward. It was designed to utilize group dynamics and participant interaction to facilitate a deep discussion among the participants. Results: The focus group provided security and encouraged exploration of alternative positions. It also facilitated discussion about sensitive issues such as the admission of nursing care tasks that were being rationed. Participation in the group has allowed nurses to hear from others who have had similar experiences, and it has created an atmosphere that encourages honesty and openness. Conclusions: Focus-group interviews are a valuable data collection strategy for sensitive issues in nursing.