| Description |
Standardizing hando#11;s is recommended to improve communication, with electronic tools as the primary approach. However, nurses continue to rely on paper tools they call \brains." Therefore, the purpose of this dissertation is to develop a deep understanding of nurses brains in the context of a medical oncology unit. A grounded theory approach was used to explore nurses paper brains. Seventy-three hours of #12;eld observations in a medical oncology unit led to 13 purposively sampled nurses who were shadowed for a single shift and interviewed. The data corpus included images of paper brains, transcribed interviews, #12;eld notes, and analytic memos. Consistent with grounded theory techniques, the data were coded and collected into categories of similar ideas. Concepts emerged from further analysis and interpretation of codes and categories. Results were indicative of four major aspects of nurses' paper brains. Brains provide cognitive support through broad structure and synthesized content, are a representation of nurses' personal and professional identity, are a tangible representation of nurses' patients and hold \the story of the patient," and are living objects that traverse a life cycle during each shift and evolve during the course of a nurse's career. Because brains are indeed cognitive artifacts, any electronic design will need at minimum six traits: accuracy, e#14;ciency, reliability, informativeness, clarity, and malleability. However, given that nurses' paper brains extend beyond purely cognitive support and embody a living nature, the development of a successful electronic brain is unlikely given the current state of technology. Paper brains support nurses' work beyond simply cognition. Standardized designs that ignore the full purpose of paper brains are doomed to fail. Changes to hando#11; tools without nurse input may be seen as personal attacks and decrease morale. Administration should be mindful of potential unintended consequences of changes to clinical practice, as standardized brain design may need to be updated to continue being e#11;ective. The importance of paper brains in nursing practice should be re ected in nursing education via didactic training in their development and use. Future research is recommended to assess generalizability outside a medical oncology unit and for different patient trajectories. |
