Essential task or meaningless burden? Nurses’ perceptions of the value of documentation

Abstract

Given the substantial increase in the documentation required of nurses in recent years, this article explores nurses’ perceptions of the value of documentation, and, subsequently, attempts to explain a puzzling tendency, whereby some nurses attach little value to arguably useful forms of documentation. We use data gathered from individual interviews with nursing leaders and focus-group interviews with frontline nurses at two wards in a Danish hospital. Our thematic analysis shows that nurses are divided between a positive view of documentation as something essential, and a negative one of it being a meaningless burden that distracts nurses from their ‘real’ work, contradicts their professional identity, and does not benefit the patient. However, except for some cases where the same information is registered twice (‘double registration’), we find no objective criteria for determining which types of documentation are perceived positively or negatively, as even arguably useful types are sometimes considered meaningless. We interpret this as being because of conflicting concepts of value: utility vs meaning. Using an existential theory of meaning, we argue that documentation’s practical utility alone is not sufficient to provide meaning. We thus suggest the need for finding a balance between: a) adjusting documentation requirements, b) adapting the nursing profession, and c) changing nurses’ perceptions of the value of documentation.