The Moral Economy of Nursing Time: Low-Value Nursing Work, Moral Opportunity Cost and Good Nursing.

Abstract

Nurses work within finite time, competing demands and increasingly auditable systems. This philosophical paper asks what care is lost when organisations and nurses commit scarce time and attention to comparatively lower-value work, and when that loss becomes morally significant. It introduces nursing capacity, the moral economy of nursing time and moral opportunity cost to examine that question. Moral opportunity cost is conditional: it applies only where scarcity is genuine, competing claims differ in moral significance and the work performed plausibly displaces the alternative. We argue that visibility asymmetry-in which auditable work is more easily protected than relational or anticipatory care-can make this loss hard to see. The framework positions de-implementation as ethical reallocation rather than mere reduction: capacity released by removing a practice should be protected for higher-value care or rest and recovery, with safeguards against burden shifting. The paper offers a vocabulary for examining allocation systems, rather than individual nurses alone, as subjects of nursing ethics.