A comparative study of ICU patient diaries vs. hospital charts.

Intensive care survivors often suffer from memory disorders, and some go on to develop anxiety, depression, and posttraumatic stress. Since the 1980s nurses have written diaries for intensive care patients to help them understand their illness and come to terms with their experiences after discharge. The central question we posed in this study was: Why do nurses write diaries in addition to conventional charting in the medical record? To answer this question, we compared intensive care diaries and hospital charts using textual analysis and narrative theory. The aims of our study were to compare patient diaries and hospital charts to explore (a) what each documentation instrument has to offer patients in their quest to make sense of their illness, and (b) why it is worthwhile for nurses to sustain the practice of writing diaries. The study findings show that the diary is coherent, personal, and supportive, whereas the hospital chart is fragmented, impersonal, and technical. The diary tells a comprehensive story that might help the patient to construct or reconstruct his or her own illness narrative.