The one who sees the diabetic foot first: the foot care therapist's case note
Fotterapeuten er ofte den som ser forandringen først – et lite sår, en endret følelse, et rødt punkt. Om observasjonen skal bety noe for pasienten,…
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Tag: record keeping
The most private information in the medical record – the gynecologist's balancing act
Few areas in medicine see the patient share so much, so quickly. The medical record must capture it precisely – while treating it with the care the information deserves.
How the diabetes nurse maintains the connection between check-ups
Diabetes is not followed up in a single consultation, but in a hundred. Every note is a thread in a trajectory that can last a lifetime –...
The pediatrician, the child, and the parent: who should be heard in the medical record?
In the pediatric ward, there are always at least two voices to be heard: the child and the one who accompanied them. The medical record must capture both – without the gaze…
Follow or explain: The new documentation requirement for sick leave – and what it means for you
Graded sick leave will become the norm. And when you deviate from it, it must be justified in the journal. A small sentence in a big agreement – that lands right…
The Support Worker and Documentation: Precise Records in a Complex Daily Life
You work closely with people over time, often in their own homes. Measures, observations, and healthcare must be documented continuously – without the patient record taking up your time...
The Speech Therapist and Documentation: A Journal That Keeps
You treat language, voice, and swallowing – while simultaneously documenting that every hour has meaning. This way, the chart can be precise without stealing attention…
Dental Health in Transition: Why Digital Documentation is No Longer Optional
Your journal now reports data further on its own – and soon it may be written while you still have your hands in the patient's mouth. Dental care...
The psychiatrist and the complex medical history
In psychiatry, the conversation is not just a path to the examination – it is the examination. But how do you document something so nuanced without losing it…
Recruitment in the districts: Can technology ease the job of a general practitioner?
Fewer Norwegians are without a permanent doctor than in a long time. However, in the smallest municipalities, it is still difficult to recruit—and even harder to retain.
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