Wednesday, January 28, 2015

Narrative Notes are not Dead!

Now that charting is electronic, a lot of Nursing students skip straight from not knowing information to being presented with checklists and drop-down menus. In the past students had to understand, remember and recall information just to complete a chart. Now, it's become an exercise in choosing the best answer from the options. 

Because of that, our students are often missing a huge opportunity to exercise their knowledge. 

While we completely support the move to EHRs for future practice, we also think it's important to remember what made great nurses in the past and keep the parts of education that reinforced important skills. 

For example, let's not forget the power of a narrative note. An easy way to integrate narrative notes into your modern curriculum is to require narrative assessments from your students before moving to the check box/drop-down charts in your EHR system. 

We make that easy by providing a "Nursing Notes" section in EHR Tutor that is basically a big, free form text field. Simply have your students record their first 2 or 3 head-to-toe assessments in the Nursing Notes section. When grading students' work, allow students who have accurately and descriptively recorded an assessment move on to the standard Assessment flowsheet. For those students who still seem to be missing some key terminology or piece of the thought process, keep them in the Nursing Notes section until they demonstrate a true understanding of the nursing process and terminology. This is also a great way to pinpoint which students need a little more help and exactly where in the thought process they are getting stuck. 

Not only will narrative notes help students think through their assessment instead of simply choosing the best option, but it also prepares them for a situation in which technology fails them (power outages, internet problems, login issues, etc.). 

Yes, it's time to move into the future. But let's not forget our pasts.