Nurses in hospitals across the United States feel burdened with the odious task of documentation. Many nurses think documentation takes too much time—time they would rather be spending with patients and families. Every nursing school teaches the importance of documentation and this is reinforced in all acute care settings. Yet the disconnection between documentation and essential nursing practices is disturbing, which leads me to ask, “What is documentation for?”
As required documentation becomes increasingly standardized and focused on auditable performance measures, it moves further away from articulating those aspects of nursing that cannot be made auditable. Nurses find documentation to be an odious task because the documentation process does not ask them to articulate—and so routinely fails to capture—nurses’ concerns for the particular patient.
In this column, I will explore the move toward standardized documentation and argue that making documentation auditable alienates it from the central concerns of nurses. When...