NursingPracticeCOMMENT

“Paperwork is important but some of it must be culled”

The Francis report (2013) has sent the message loud and clear that “statistics, bench-marks and action plans are tools, not ends in themselves;

they should not come before patients and their experiences”. It is my suspicion that patients and nurses have known this for many years.

Twenty years ago I passionately defended the use of nursing documenta-tion in Nursing Times, insisting that it does indeed affect the quality and delivery of nursing care (Charalambous, 1992). I have since extolled the virtues of documenta-tion to student nurses who pass under my tutelage, insisting that we adopt a “master” rather than a “slave” approach and ensure we own it before it owns us. We must use documentation as a tool to help us care for patients rather than seeing it as “just another task” that needs to be completed. I can spend at least an hour of my working day fi lling out assessment tools, signing care plans and evaluating care – but now I wonder: do these things really affect patient care? Has the nursing profession gone full circle again?

I came into nursing to help people, to alleviate their suffering and to offer them comfort – offering a drink to a patient with parched, dry lips; going to a patient who is in pain, on wet sheets and upset. Walking away knowing that they are clean, com-fortable and settled is my bread and butter. It makes me happy to know that I have done a good job.

But then comes all the paperwork that I have to complete. I wonder whether anyone will actually read any of it – unless,

SPOTLIGHT

Kathryn Godfrey is practice and learning editor of Nursing Times. kathryn.godfrey@emap.comTwitter @GodfreyKathryn. Don’t miss the practice blog, go to nursingtimes.net/practiceblog

With a central role, reclaim the ward rounds Nurses are vital to ward rounds. This fact – no news to nurses – has been made formal in the Francis report, with nurses being “a central point of communication between the patient and medical sta� ”.

This will help to make clear to the multidisciplinary team the pivotal role of the nurse in ward rounds. Rounds are often run at the behest of the medical team – at a time that suits them.

Robert Francis QC recommends that ward rounds should be held at a time that is convenient for all professional groups and their attendance needs to be a priority. This is to

ensure a main aim of the report is fulfi lled –

making the patient the priority.

The main recommendations in this area are covered on page 15 and, in a longer article on page 12, our expert author explores

the ward round process and nurses’ responsibilities.

of course, there is a complaint because, as nurses, we all know we have to cover our-selves and if it isn’t written down it could not have happened.

I still extol the virtues of nursing docu-mentation, but call for a cull. We need to master it, we need to take a universal approach and reduce the amount of it so that we can spend more time with patients. Time spent at the bedside is what nurses and patients want – ask anyone.

A large amount of what we do cannot be measured and no price can be put upon it, but interactions are the valuable side of nursing. Holding a patient’s hand to reas-sure them, gaining the trust of a person with dementia so they will allow you – a stranger in a scary place – to help them in the most intimate of ways is a privilege that cannot be described on paper in any way that is meaningful to an auditor or fi nance manager.

So, 20 years later, I still feel privileged to work in a way that is committed to planned, individualised care, but I would love to spend less time with paperwork and more time with patients. Heed my warning: we are in danger of knowing the cost of everything and the value of nothing if we do not take control now and downsize documentation. NT

Liz Charalambous is sta� nurse, Queen’s Medical Centre, Nottingham

ReferencesCharalambous L (1992) Write to care. Nursing Times; 88: 50, 47.Francis R (2013) Report of the Mid Sta� ordshire NHS Foundation Trust Public Inquiry. London: The Stationery O� ce. tinyurl.com/HMSO-Francis2

HIGHLIGHTS

The evidence base of bedside handovers p16

Managing hay fever in exam time p20

Creating e  ective patient information p23

www.nursingtimes.net / Vol 109 No 12 / Nursing Times 26.03.13 11