Discipline of Blogging

I want to become a better writer. One of my motivations for creating this blog was to practice writing. Part of the discipline of writing is to write when you may not otherwise feel like writing. So it is today.

I used to write more in my previous jobs - they were technical documents, such as system specifications and design documents. I wrote more email. In nursing school I wrote copiously - papers, care plans, study guides, and other assignments. I never thought I'd miss writing because I used to dislike how much writing I did. Now, I find a do miss it a little.

As a hospital staff nurse, I don't write much at all. I write notes on patients' charts, yes, but that writing is extremely functional, curt, and efficient. There are some creative aspects of the writing - using the fewest words that stuff the most information in. Creativity cannot outweigh functionality and I see the only real purpose of creativity is to demonstrate that I actually thought about what I was writing. This would be creativity in stating the same thing using different words and adding little personal bits that show I was talking about this specific patient. I must not include opinion or speculation and to the best of my ability, I must defend all my actions legally with these words. The words must prove that I followed the hospital's standard of practice in the unlikely event that I will have to defend myself (and the hospital) in court.

I hope I never end up at a deposition. It will be scary, embarrassing, and it could end my nursing career.

The only place I (consciously) indulge in opinion in my notes is when I write discharge notes. I want to write all my notes in the computerized charting system, yet one part of our nursing documentation remains on paper. It is called the "Interdisciplinary Plan of Care," or IPOC. Supposedly, all disciplines within the hospital are supposed to consult this thing and document on it. In reality it's a piece of paper there for the regulatory boards benefit and for the pleasure of the executives of the hospital. Nurses fill out this paper on admission, and it is here that we are to document every time we teach something to a patient. Thus, when we go over the patient's discharge instructions, we are "teaching," and we document it on that sheet.

As a result, I have to write two notes on discharge: one on the electronic record, one on the paper IPOC. I resent having to write on the paper. In the electronic record note I usually write something like this:

Patient discharge teaching completed. See IPOC for details on individualized teaching topics.

This is my way of saying "I did the teaching, but nyah, nyah, you have to go look at the paper chart to find out what that teaching was. If I can't document it here conveniently with the rest of my discharge documentation, then I'm not going to make it convenient for you, the reader, to get to it either."

It's a moot point, because who the hell reads my charts and my notes after discharge? No one.

But maybe one day, if I am unlucky, someone will read it. On that day it will give me personal satisfaction and hopefully not impact the deposition.

On a related topic, I was recently reading Oprah's magazine, and in it there was an article about Ben Affleck's recommended books. He recommends Strunk and White's "The Elements of Style." I haven't looked at that book in ages. I think I should look it over again. I feel rusty and out of practice. I certainly don't think Ben Affleck has the answers to life's questions...his article merely reminded me what a good resource it is. Who couldn't use a little reminding not to write too much?