Technology-mediated awareness: facilitating the handling of (un)wanted interruptions in a hospital setting

Abstract

Introduction: Nurses' work in hospital departments is highly collaborative and includes communication with a variety of actors. To further support nurses' communications, wireless phones, on which nurses receive both nurse calls and ordinary phone calls, have been introduced. However, while they ensure high availability among the mobile nurses, these phones also contribute to an increased number of interruptions.

Purpose: This paper aims to discover whether all interruptions caused by the wireless phones are unwanted. Further, it investigates how nurses handle these interruptions in a hospital setting in order to construct a foundation for guidelines to use in designing these types of systems.

Methods: Qualitative and ethnographically inspired fieldwork, including workshops with both ordinary and student nurses from a Norwegian hospital, was undertaken. Patients from two hospital departments were interviewed.

Results: Nurses struggle to handle interruptions caused by the wireless nurse call system. Deciding whether to abort an activity or not to respond to an interruption is regarded as stressful. The decision is further complicated by the complex nature of the interruptions. At the same time, patients anticipate that nurses are able to make these judgements with limited information. Nurses' work is highly collaborative, and nurses depend on one another to carry out their work and manage interruptions.

Conclusion: The dual nature of the interruptions is complex, and whether an interruption is wanted or unwanted depends on many factors. Nurses manage interruptions mainly by making their own activities visible and monitoring colleagues' work. Therefore, nurses' awareness of colleagues' activities is a key factor in how they handle interruptions in the form of nurse calls.

Keywords: Awareness; Collaboration; Communication; Interruptions; Qualitative research.