God is great, beer is good, and people are crazy

Insanity is doing the same thing over and over again and expecting different results.
- Albert Einstein

Results from a multi-center nursing "time and motion" study show that nurses in acute care settings spend about 35% of their time documenting care, 17% on responsibilities related to medication administration and monitoring, and 21% coordinating care. I've heard Marilyn Chow, one of this study's lead authors present these data before, and she included them in a presentation given last week in an IOM webinar on the Future of Nursing.

I don't think anyone is particularly happy with these statistics. (Although it remains unclear what patients actually think since high profile evaluations, like this one from US News and World Report, measure nursing care by how mom-like the experience of being cared for is.) Real patients--that is, those who have had the experience of being hospitalized and understand that the circumstances that land them there necessitate far more than a chipper smile and a well-timed fist-bump--might be able to evaluate nursing care using different metrics. But, for now, it appears we're living with "% of patients whose nurses were ALWAYS polite and communicative." Sigh. (Can I just say that when I'm an inpatient, I appreciate polite and communicative behavior on the part of all of my caregivers?)

It's hard to look at Chow's data and not be struck by a significant mismatch between intention and outcome. Surely this is not the best use of valuable, high cost resources.

But what makes Chow's presentation worth studying is that, beyond Slide 4, she gets out of the box, tossing out fresh ideas about how nurses will nurse in the future. And why they should. Plus who will benefit. And how technology will enable it. Review the 11 slides in this presentation for inspiration.

If you think I'm crazy, remember what Einstein said.