I have been a nurse for 28 years and have seen many changes during this time — some positive and others not so much. One of these is the lost art of the narrative. When I was a young nurse, we met our patients, assessed them and gathered their “story.” We then documented this story in a narrative note that everyone else could read to learn more about the patient.
This narrative note has been lost in the new, quick version of charting — “clicking boxes.” I fear we have lost so much by no longer gathering the story of our patients, how they feel and what that means to them.
Gathering a story is about getting personal, asking questions, then writing those reflections for everyone to read and understand. Is there anything more personal than healthcare, than nursing? It takes only a few minutes to ask patients about their story, to get to know them and build an experience. This experience is long-lasting for both the patient and the nurse.
I was reminded of this when reading In Shock by Dr. Rana Awdish. She is a physician at Henry Ford Hospital in Detroit and writes of her medical journey from a patient perspective and how it has influenced how she practices medicine.
One anecdote really hit home – the story of a woman with HELLP syndrome. Here’s an excerpt from the book:
I stared at the team. There were five residents, a medical student and a critical care fellow. They, like most of our trainees, had chosen to travel long distances from disparate locations to avail themselves of an “interesting case mix” as it was portrayed in our residency brochures and website. An inner-city hospital with advanced subspecialty services that took care of the sickest of the sick. They wanted to see as much as they could of every type of disease, to soak in the exposure like vacationers in the sun, before launching into practice.
I looked again at the patient, then back at the team.
“What did she name the baby?” I asked them.
They stared at me blankly.
“It seems like something we should know, doesn’t it?” I asked curtly. The team looked decidedly uncomfortable now, unsure of what to expect next. I wanted them to see her as the mother of a baby whose name they knew.
“The baby’s name is Charlotte,” her nurse answered.
I heard a colleague say recently she asks patients for their “story” and their “symptoms.” I like this simple way to remember the value of the “old” way of doing things.
Let’s all work to click the boxes while still listening for the story.