How much time do nurses spend on documentation?

Nurses spend roughly a fifth to a third of their practice time on documentation. Time-motion studies cited by Collins and colleagues report that nurses spend between 19 and 35 percent of nursing practice time documenting care ¹. The range is wide, so read it as a span rather than a single figure. A figure from one shift in one hospital will not match it exactly.

Observed time comes in lower than the time nurses report

Observers and nurses do not agree on how long documentation takes. In a Western Australian hospital, observers found that nurses and midwives spent 28.1 percent of morning shifts on clinical documentation ². In the same study, nurses and midwives reported 50.4 percent of their morning shifts on documentation ³. That is a gap of 22.3 percentage points ⁴.

The self-reported figure shows how heavy the work feels to staff. The observed figure is the better baseline if you want to measure a change, because it does not depend on memory. The study covered one hospital, and its figures cover all clinical documentation, not only the free text that a dictation tool could replace.

A system log puts flowsheets at nearly a third of a shift

An electronic health record vendor's time data from one academic health system found that nurses' time in flowsheets averaged 31.11 percent of a 12-hour shift ⁵. A flowsheet is a grid of fields where a nurse records values such as a pulse, a pain score or a skin check. The figure comes from one system's time data, so it shows where the time goes, not how long each field takes.

For a sense of volume, nurses on acute care units at one academic center made between 631 and 875 manual flowsheet entries per 12-hour shift, not counting device data ⁶. Some entries take a second and others take much longer, so the count tells you how many small decisions are recorded, not how much time they take.

What the numbers mean for your shift

Three rules follow from the evidence.

• Expect a fifth to a third of your practice time on documentation across the studies, and check your own shift against that range.
• Expect flowsheets to take a large part of that time, since one system's time data put them near a third of a 12-hour shift ⁵.
• Trust your own log over a headline figure, because self-reports and observations in one hospital differed by 22.3 percentage points ⁴.

The mix probably varies by unit, since the sources we read measured one unit type at a time and did not compare them. Free text is the part that speech suits best, which is why whether nurses can use speech recognition for charting depends on the same split.

Measure your own baseline before you change anything

Measure one typical week before you try a new tool, then repeat the measurement after the change.

1. Log minutes for flowsheets and free-text notes separately, with the shift and unit.
2. Note any charting you do after your shift, so the log captures the time that falls outside the shift.
3. Repeat the same log for a week after the change, using the same method, so the two figures are comparable.

If your electronic health record (EHR) reports documentation time, compare its figure with your own log. The two will often differ, for the same reason the observed and self-reported figures in one hospital differed.

What the sources do not show

The figures in this question come from one hospital, one health system and a review of earlier studies. We did not find a national benchmark for nurses in the sources we read. Use the ranges as context, and use a local baseline to judge any tool.

For the wider picture, see dictation for nurses, therapists and allied health and our overview of dictation for work. For what dictation can and cannot change, read how to dictate SOAP notes and whether therapists can use AI scribes.