The role of physical design and informal communication

there. Close to 40% of “Seeking Assistance” occurred in the corridor which coincides
with observation of the GN frequently exiting the patient room and walking into the
corridor to find a staff member to assist her. The corridor was also the site of 41% of
“Providing Advice,” also confirmed by observation of the GN answering nursing
assistants’ questions outside of patient rooms.
The CWM tool data, observation, and interviews revealed that the med room
served as an important space for social interaction. In fact, 45% of all social
interaction occurred there. The med room is a place where all RNs need to go
frequently throughout their shift, so there was often more than one RN in the room at
once. When in the med room during observation, it was common to see RNs working
while socializing – that is, dispensing meds while making a joke, venting about a
patient’s family member, talking about their kids, etc. There was also a radio in the
med room, and it was on about half the time, almost serving as a signal that this is an
informal place where it is acceptable to discuss certain topics that wouldn’t be
appropriate elsewhere on the unit. It is important to note that the med room is a space
enclosed by four walls and a door, as opposed to being open to the rest of the unit.
According to information obtained in focused interviews, this design is the reason that
so much social interaction occurs there. As one interviewee describes it:
“Everyone thinks that because the door is shut, that it’s like a little
room and no one can hear you. Because it’s the four walls and
you’re in there.”
Another interviewee provides a similar response:
“That’s the only place out of earshot of patients that you can, just
like, say whatever you feel like, you know, you don’t have to
sensor yourself because it’s closed.”
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