The role of physical design and informal communication

However, when asked if all of this socializing impacts the ability to focus on the
tremendously important responsibility of dispensing meds, the interviewees did report
that it is sometimes a problem:
“That’s the pros and cons of being in that med room, is that, you
have that space but at the same time if you’re not in the interaction,
it’s frustrating because you can’t concentrate.”
Interviews also revealed that the kitchen (for preparing/accessing patient snacks and
drinks) is a space commonly used for social interaction for the same reason – it is an
enclosed space where staff cannot be seen or heard by patients and visitors.
Unfortunately the kitchen is one of the “backstage” areas where the researcher did not
follow the GN, so this information was not captured by the CWM tool. A final note
about the med room is that while it is a hub for social interaction, it is also where the
GN did one third of her non-interactive tasks. Observation revealed that the GN often
did not participate in the socializing that was occurring, but rather kept her head down
and her back to the others as a signal that she was concentrating.
Table 9 shows that little interaction occurred at the charge nurse desk.
However, this is an inaccurate representation because, as explained previously, the
relocation of the charge nurse from Desk B2 to B1 resulted in unreliable data
collection when it came to recording the actual location of the charge nurse desk.
Fortunately, field notes revealed that there was actually a fair amount of interaction
that occurred around the charge nurse. Because the charge nurse always has in front
of her a pile of patient charts that she is updating and because she has information
about the status of all patients, including doctors’ orders, test results, etc, nurses often
hover around the charge nurse desk because it’s the primary source of information.
While not reflected in the CWM tool data, “Seeking Advice,” “Being Taught,” and
“Validation” often occurred at the charge nurse desk. Importantly, these activities
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