Lack of time and support possibilities
Despite nurses asking more about patients’ social background than
doctors, they felt unable to register social information adequately
since competing medical information had to be recorded within certain
time limits:
“And we really do try to
document everything [in the medical record], but I just feel
we drown in it”. (N3:3).
Lack of time reduced HP’s primary focus to handling immediate situations
in their daily work: “Because of the system [time] we
are forced to walk with blinkers” (D1:5). HPs described how
doctors previously dictated information about patients, they now had to
write patients’ records themselves. Pressure of time meant entering only
essential information – which did not include social information unless
it affected immediate treatment. HPs would characterize social
information as ‘other stuff’:
“It is also about getting through the day, and you don’t have so
much time for other stuff.” (D5:2).
Unsure how to respond or where to find support, lack of time led HPs to
avoid exploring patients’ difficulties.
Shortage of time also led HPs to rely on their own observations of the
patients’ needs rather than asking the patients and recording
information based on the patients’ own words.
“But time is just so pressurized that it is hard to do it[writing in the medical record] systematically. It is
something you must sense with the patients” (D1:2).