The Impact of Charting on Nurses: Balancing Patient Care and Documentation

From a record perspective, charting has long been considered the backbone of nursing practice. It serves as the official log of patient conditions, interventions, and outcomes. It acts as both a clinical tool and a legal safeguard. Every shift, nurses dedicate hours to documenting their assessments, medication administration, and interactions. While this process is essential, the way charting is structured - particularly in the age of electronic health records (EHRs) - has created new challenges for the profession. For many nurses, documentation has shifted from a supportive task to a significant source of stress and burnout. Aka it's lame.

The critical role of charting in healthcare is undeniable. A well-kept chart provides the next nurse or physician with the information they need to make safe decisions, reducing the risk of medical errors. Accurate and thorough documentation protects patients and safeguards staff. In the event of a legal dispute, a detailed record is often the strongest defense that care was provided appropriately. Beyond individual care, aggregated data from charts allows hospitals and researchers to monitor outcomes, identify trends, and drive quality improvement initiatives across entire health systems.

At the same time, the burden of documentation has become one of the most widely discussed problems in nursing. Recent surveys show that most nurses feel they spend more time documenting than they do with their patients. The American Medical Informatics Association reported in 2024 that more than three-quarters of clinicians worked longer than intended because of charting requirements. This extra time often comes at the end of already exhausting shifts, pushing nurses to stay late or finish work at home. The cost is not only professional dissatisfaction, but also personal time, family balance, and mental health.

Research has drawn clear connections between documentation burden and burnout. A 2022 study led by Gesner and colleagues found that nurses who reported higher charting loads also showed greater signs of emotional exhaustion and depersonalization, two hallmarks of burnout. Similar work has highlighted the ways poor usability in electronic health record systems contributes to stress. Nurses often describe EHRs as cumbersome, requiring countless clicks, redundant data entry, and navigation through poorly designed interfaces. A 2020 study demonstrated that low satisfaction with EHR usability strongly correlated with diminished well-being among clinicians.

Beyond burnout, charting can create a heavy cognitive load. Nurses are expected to remember patient details, complete complex assessments, and simultaneously navigate digital systems - all while responding to immediate bedside needs. A 2024 study by Asgari and colleagues confirmed that EHR use increases frustration and physical demand, intensifying the mental strain of daily work. This strain not only affects nurse morale, but can increase the risk of mistakes in high-stakes clinical environments.

Despite these challenges, it is important to recognize that charting also provides genuine benefits. Electronic systems have reduced many errors that once occurred with paper documentation. Features such as medication barcode scanning & automated alerts for drug interactions or allergies have improved patient safety. Standardized charting improves communication across disciplines and ensures that all members of the care team are working from the same information. And as stated above, thorough documentation remains a professional safeguard.

The key, then, lies in finding balance. Charting should not disappear—it is far too central to safe, accountable healthcare—but it must be made less burdensome. Some health systems are working with EHR vendors to streamline workflows, eliminate unnecessary fields and incorporate features such as voice-to-text documentation. Others are experimenting with team-based approaches, allowing scribes or non-clinical staff to manage parts of the documentation process so that nurses can focus more of their time on patient care. National organizations have also begun pushing for policy changes to reduce redundant charting requirements, arguing that documentation should add value, not consume valuable time unnecessarily.

Training and support are equally important. Nurses who receive thorough orientation on new EHR platforms report less frustration and more efficiency in their charting. Continuous support, rather than one-time training, can help nurses adapt to updates and reduce the anxiety that comes with technological change. At the cultural level, healthcare organizations must also recognize the hidden costs of documentation. Overtime spent finishing charts is not simply “part of the job”—it is a contributor to fatigue, turnover, and the ongoing nursing shortage.

Ultimately, the conversation about charting is about more than software and workflows. It is about respect for the time, energy, and well-being of nurses. Excessive documentation demands erode job satisfaction and take nurses away from the bedside, where they provide the compassionate, skilled care that patients need most. Conversely, when charting is streamlined and supportive, it becomes a valuable ally. It helps nurses communicate, protect themselves, and improve care across entire systems.

The future of charting must be shaped by the voices of nurses. Their insights into what works, what is redundant, and what adds value are essential for designing systems that truly support practice. If healthcare leaders can listen to those voices and create documentation processes that are efficient, meaningful, and humane, charting can reclaim its place as a cornerstone of quality care—without being a source of daily exhaustion.

Sources

1. Gesner E, et al. Exploring the Relationship Between Documentation Burden in the Electronic Health Record and Burnout in Nurses. Applied Clinical Informatics, 2022.

2. Yen PY, et al. Nurse Stress and EHR Use: A Mixed-Methods Study. Journal of the American Medical Informatics Association, 2020.

3. De Groot K, et al. Measuring Documentation Burden: A Scoping Review. JAMIA, 2022.

4. Gardner RL, et al. EHR Usability, Nurse Satisfaction, and Burnout. JAMIA Open, 2020.

5. Kroth PJ, et al. Electronic Health Record Usability and Stress in Clinicians. Digital Health, 2023.

6. AMIA. Survey Underscores Impact of Excessive Documentation Burden. 2024.

7. Asgari Z, et al. Cognitive Load and Frustration in EHR Documentation. JMIR Medical Informatics, 2024.

8. Harris DA, et al. EHR Burden and Burnout in APRNs. Journal of the American Association of Nurse Practitioners, 2018.