Secondly, I read a lot of posts about how the midwives were just sat at their desk doing paperwork and chatting. I’d rather not do this, but there is an entire office of people who audit everything I write and tell me off if I’ve missed something. For example, I once received a written warning for not performing a blood pressure check during a woman’s labour - it didn’t take into account that the baby arrived so quickly I delivered it in the footwell of their car.
I think there are some real misconceptions around paperwork in any kind of health setting - imo it absolutely should come second to care of the patients, however most people I know in healthcare also feel like that too, but hands are tied.
Even as a care assistant the amount of paperwork, and the time allowed for fitting it in just doesn't compute. I can only imagine with labour and birth ,health problems and complex medical needs, that is even more true for nurses and midwives.
We are told they are legal documents, they must be clear, concise, person centred, accurate and legible, we can be and are pulled up on notes that are lacking in detail, things that haven't been written down, things written in the wrong way by the CQC, social services, safeguarding etc - "If it's not written down it didn't happen". It's not acceptable to say that X ate all of his dinner, it has to be what he had, how much he ate, where he ate it, if it was fortified, if it had supplements added, and what (even though you've signed the MAR to say it'd been given), if they ate independently, if they needed help and how much. And that's just one person for one meal.
I understand that they are important to provide a whole picture of a person/illness etc, that others rely on them for the health and wellbeing of the person involved, that they are considered proof of what care has been provided, what has not, what has been refused, what has been accepted.
But, you're supposed to do all this while caring for people as well, and there's no crossover to allow for these legal documents to be written to the standard required, unless of course you put notes on a pad and carry it with you and then do it at the end of your shift - unpaid. But woe betide someone needs to see those notes and they're not up to the minute accurate before you've had chance to update them - because you're busy caring for other people - not acceptable. Also not acceptable to be doing notes while someone wants to go to the toilet, or needs clothes changing.
And yes, we chat whilst doing notes - about the person we're writing about usually, gathering information from others who have dealt with them too to make these legal documents accurate.
So in my 'unskilled' and not a professional occupation, there's those pressures - I can only imagine that the pressure and stakes are much higher for nurses and midwives.
And that, is the fault of those who fail to provide enough people to cover the needs of the patients (including the records that must be kept by law) not the people trying to do it.