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Do nurses have too much paperwork?

Do nurses have too much paperwork?

Many frontline jobs, especially those within healthcare and the emergency services, have seen the amount of paperwork needed for the job increase immeasurably. In recent years, there has seemed to be an ever-increasing number of complaints from doctors, nurses, paramedics, police officers and firefighters, all of whom argue that the amount of time they get to spend actually doing the job for which they are qualified is diminishing.

The argument for paperwork is that it’s proven to help the job at hand; providing a comprehensive document there ready and waiting should action need to be taken. This documentation can also stand up to scrutiny in the case of any complaints and provide material for auditing or monitoring purposes. It also covers hospitals, which often want to go above and beyond the requirements which are truly necessary in a bid to give themselves added 'cover' against negative eventualities.

So where is the fabled middle ground, and does it even need changing? Is the current system one that's shackled by too much bureaucracy, or one that needs a paper trail to provide an answer for the barrage of questions offered by the public, media and governments?

How much is too much?

A study undertaken last year by the Royal College of Nursing discovered that, in Britain alone, some 2.5 million hours a week is spent on non-essential paperwork and clerical tasks. Using the minimum starting salary for a registered nurse of £21,388 as a guide, this means non-essential paperwork is costing the NHS around £53.47 billion every single year.

This, of course, is assuming that paperwork comes out of a nurse's daily hours. Many of those within the profession, however, argue that they end up putting in countless additional hours or working through their breaks in order to get everything done. Whilst this means a smaller bill for the NHS, it ramps up the pressure and workload nurses face, thereby discouraging younger people from taking the profession up themselves.

Circumstantial evidence also suggests that some nurses are even taking a pay cut and heading back down the employment ladder to become general healthcare assistants, simply because it allows them to - rather ironically - nurse more.

Drastically reducing paperwork overnight, however, would hardly instill confidence in a media which has already trained its sights on the medical profession. Despite the collective sigh from nurses it may generate, others may fear that less paperwork is equal to heightened patient risk. So a solution other than 'remove anything non-essential' is needed.

Work smarter, not harder

The old adage of working smarter not harder is one that - whilst effective - requires a herculean amount of creativity, imagination and knowledge of the subject matter. Systems that have been in place for generations will need to be changed, whilst that is on top of the creative thinking needed to devise a system that will impact the work life of millions of people but, crucially, has not been thought of or tried out previously.

Harder than it may first appear, then.

Thankfully, the ever-improving world of technology has helped countless businesses across the world manage to work smarter, without requiring wholesale revolution or the birth of a million-dollar idea. Now, the most recent of these has come in the form of a £100 million 'Nursing Technology Fund'.

Unveiled by David Cameron in the latter half of 2013, the Nurses Technology Fund was aimed at helping nurses work more flexibly and increase patient safety. This, in turn, would create a better patient experience and - crucially - reduce paperwork.

Quite simply, it provides NHS trusts the opportunity to apply for cash which would then be put toward tech which they believe would make the job much quicker and more efficient. The tech in question is open to individual needs, provided sufficient proof can be provided that it would help streamline the documentation process.

So-called 'digipens' are expected to be the most common tech innovation for which NHS trusts apply. They work just like a traditional pen, but have an on-board computer that memorises and stores each stroke, scribble and sentence. Then, this information can be used to automatically digitise the writing, meaning that nurses don't need to spend twice as long typing up that which they have already written by hand. By sending this information wirelessly, it can also mean written notes cannot get lost, thereby needing re-writing and potentially opening up the risk of making mistakes or omissions.

Money will be divided up into a £30 million pot for the financial year 2013/14, with the remaining £70 million being distributed during 2014/15.

Alternative solutions

When looking outside of tech innovations, it goes back to the aforementioned issue of needing a stroke of genius in order to revolutionise the working practices in Britain's largest employer. There is, of course, the issue of ramping up funding for the NHS - although this throws up issues of practicality and privatisation, which is another argument for another time. With these two out of the question, an entire revolution may be needed - as well as a change to the status quo in which the media hounds organisations for the amount of paperwork but is then equally rabid when it comes to healthcare failures.

Pipe dreams and perfect worlds aside, it looks as though tech provides the most tangible way of driving down the time that nurses spend on paperwork. It has its issues, and those will surely be documented in glaring fashion when problems arise, but until then it seems like tech could improve productivity, make nurses' lives easier and make for much more nursing in wards up and down Britain.

Achieving this in a way that allows nurses to work in a similar way to that which they already do - and to use gadgets with which they may already be familiar - will certainly be a positive in most people's books.

With all this considered, it may not be a case of whether nurses have too much paperwork after all. Even if the time spent filling out forms was not overly long, any method that allowed this to be condensed further still - then get back to helping on the ward - would surely be welcomed by nurses and patients alike. With this train of thought, even just  minutes of paperwork is too long if there's a way of reducing it to five.

Tech seems to be a way of helping kick start the reduction in time spent filling out forms, but there should always be consideration given to what more could be done.

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