Record‐keeping and routine nursing practice: the view from the wards

Abstract

This paper examines general nurses' views of the nursing record and its routine usage in contemporary hospital practice. It draws on ethnographic data generated on a surgical ward and a medical ward in a single District General Hospital in the United Kingdom (UK). A key research finding was ward nurses' equivocal attitudes to the nursing record. On the one hand, because of its links with the nursing process, the nursing record was highly valued as a symbol of professionalism and ward staff were loathe to criticise it directly. On the other hand, however, the nurses in this study clearly found it difficult to reconcile their professional ideals with the ways in which the nursing record was routinely employed on the wards. In this paper it is suggested that at one level, nurses' ambivalence towards the nursing record reflected the distortion of its founding philosophy by the new managerialism in the contemporary UK health care context. At another level, however, there are also difficulties which arise from the tension between the assumptions about the nature of nursing work which underpin the nursing record and the workplace reality on hospital wards.

Negotiating the role of expert carers on an adult hospital ward

“…Historically, one of the main obstacles to nurses achieving professional status is that most nursing tasks are undertaken by unqualified caregivers: paid auxiliaries and care-assistants or unpaid carers. A further difficulty relates to the fact that although at one level certainly nurses' knowledge is global and generic compared with the local knowledge of expert carers, contemporary nursing ideology also lays special claim to an individualised and holistic approach to care based on the nurse-patient relationship (Salvage 1992).`Knowing the patient' is an important element of nurses' occupational identity and central to their sense of professional competence (Allen 1998). In negotiating the caring division of labour on the wards, nurses are caught between the dual pressures of the need to recognise the expertise of established carers and their aspirations to accomplish profession (Dingwall 1977).…”

Understanding emotional responses to anticipated change: the case of introducing electronic care plans in hospitals

“…Finally, both the international nursing literature (e.g., Allen, 1998;Devers et al, 2003) and the Norwegian policy documents (KITH, 2003) have pointed at two potential benefits of adopting nursing care plans, both paper based and electronic: They improve efficiency as well as quality of nursing work.…”

France’s transition to academic nursing: the theory–practice gap

“…Their shift to higher education was imposed in 2009 with pressure from the European Bologna agreements, attempting to harmonize graduate education across the European Union as well as support a more rational system to accredit health professions [5,6] . Yet the implementation of a more "academic" training system for nurses and allied health professionals in France was significantly hindered by concurrent hospital reforms that resulted in increased patient loads, turnover and administrative tasks [7][8][9][10] . While the educational reforms were driven by an aspiration by the French nursing community to gain more recognition of the profession's scientific and clinical legitimacy, the transition occurred too rapidly, without giving the actors involved time to prepare for such drastic changes.…”