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).