uu.seUppsala University Publications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Why not use the phone: Digitalisation and nurses’ communication in a large hospital
Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Department of Information Technology. (HTO)ORCID iD: 0000-0001-8426-2275
Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Department of Information Technology, Division of Visual Information and Interaction. Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Department of Information Technology, Computerized Image Analysis and Human-Computer Interaction. (HTO)ORCID iD: 0000-0002-8240-0942
2019 (English)In: Abstract Book. Work 2019: Real Work in the Virtual World, 2019Conference paper, Oral presentation with published abstract (Refereed)
Abstract [en]

When comes to digitalization of nurses’ work, electronic patient records and medical technology have been in focus. This paper looks at something that has been seen as more peripheral but that, nevertheless, has a profound impact on nurses’ daily work, in particular in large hospitals: internal communication that is mediated by computer systems.28The paper is based on fieldwork and group interviews in one large hospital in Sweden. The focus of the research project of which this paper is a part is the impact of digitalization on nurses’ work environment. Both certified nurses and assistant nurses took part in the fieldwork and observations.Computer mediated communication has increased rapidly in healthcare. Electronic patient records are one form of such communication: different professions treating the same patient use ito store information and retrieve information about the treatment process. This communication tool is mainly used by the healthcare professions. However, to communicate with different service functions in the hospital, the nurses were obliged to use a number of different systems.By the participants in the study, the obligation to use these messaging systems was taken up as a major stressor and their efficiency was repudiated. These complaints were illustrated by absurd or dramatic examples. Also during the fieldwork, problems with using the messaging systems became evident. While both design and functionality problems with the systems were exemplified, the complaints were frequently concluded with a question why these systems should be used at all. A common opinion, concerning communication with service functions, was that the systems were used to make the work of the service units easier, but that they disrupted the core task of the hospital, the medical carework, in a way that should not be permissible. The nurses thought that using the phone to order internal services was a much more efficient communication channel for them. In particular, they were indignant when service functions seemed to show no understanding for a patient’s situation.Computer-mediated internal communication in a hospital can be seen as positive in that it structures information flows and task allocations, it secures quality by producing traces that can be used for verification in case mistakes are made, and it produces information that can be used in administrative processes, for example when calculating resource allocations. However, introducing these communication systems does not take into account the practicalities of carework. Effective use of such systems count on a different temporality than what is prevalent in the everyday work of nurses.The temporality in nurses’ work implies that work pace is high, work is often disrupted and can only partially be planned, several work processes exist in parallel and prioritisations often have to be made on short notice. Even a well-functioning structured messaging system (in contrast to the problematic ones that these nurses had encountered) requires a form to be filled in with certain information, which sometimes is necessary and sometimes may be superficial, and, thus, generally requires writing time. There is normally a time interval between sending the message and getting a confirmation (if a confirmation is received at all), which implies further mental overload and difficulty to prioritise. Some information, for example related to the urgency of the message may not have a proper place in the form, or may not go through with sufficient emphasis. In such conditions a telephone is more suitable. Often the nurses used both a messaging system and a telephone in parallel, when this was possible, i.e. they sent the required message but made a telephone call to get a confirmation and to possibly give information that was not easily put in the form.The introduction of computer systems for internal communication in a hospital is yet one step of trying to transform care to production, in terms of new public management. Computer mediated communication systems contribute to the efforts to transform the interactive, unpredictable and individual conditions of care, to predictable, impersonal and scheduled conditions of production. Nurses, who are responsible for the care (rather than doctors, who are responsible for the more limited concept of treatments) are the ones whose everyday work is most affected by this. Their apprehension that in the mandated communication patterns the concerns of administration were prioritised above the concerns of care was reasonable. The concerns of administration fit much more nicely in the structured way of producing care that is the political vision of today’s healthcare. However, the while following the mandated routines would make the communication in the healthcare organization more streamlined, without nurses’ concerns and their pushing the boundaries, it would make hospital care less effective and cause patients more suffering.

Place, publisher, year, edition, pages
2019.
Keywords [en]
nurses, computer-mediated communication, temporality
National Category
Communication Systems Work Sciences
Research subject
Computer Science with specialization in Human-Computer Interaction
Identifiers
URN: urn:nbn:se:uu:diva-400778OAI: oai:DiVA.org:uu-400778DiVA, id: diva2:1382404
Conference
WORK2019. Real Work in the Virtual World
Funder
Forte, Swedish Research Council for Health, Working Life and WelfareAvailable from: 2020-01-02 Created: 2020-01-02 Last updated: 2020-01-02

Open Access in DiVA

No full text in DiVA

Authority records BETA

Golay, Diane

Search in DiVA

By author/editor
Salminen-Karlsson, MinnaGolay, Diane
By organisation
Department of Information TechnologyDivision of Visual Information and InteractionComputerized Image Analysis and Human-Computer Interaction
Communication SystemsWork Sciences

Search outside of DiVA

GoogleGoogle Scholar

urn-nbn

Altmetric score

urn-nbn
Total: 29 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf