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When I first shadowed on a post-op floor in Detroit, I was shocked to see how much information nurses had to copy by hand during a shift change. Even new medicine orders and drug administration schedules were being penciled into the margins of already-crammed pages.

In a lot of ways, nurses have it even worse. They're constantly on the front lines they lose so much time in having to rewrite the same information over and over again.

I have a friend who's been a QA engineer at a couple of hospitals. At one hospital, he noted that the doctors would have their ward meeting half an hour before the nurses would have their ward meeting. One nurse would attend the doctors' meeting, and transfer the information. In order to prevent errors from occurring due to being given second-hand (or the 'transferer' not asking the right question for a patient), he suggested melding the two meetings, which were only half an hour apart. The doctors wouldn't move their meeting "because we consult in the morning", and the nurses wouldn't move theirs because "the doctors meeting happens at a scheduled break time". So errors keep on happening...

He had a few other glorious stories of the amazing politics that goes on in hospitals - sometimes it seems like a bloodsport.

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