I like to cook. I find cooking to be an expression of love for my family, of passing along meals I enjoyed as a child and exploring new cultures through food. I wasn’t always a good cook. I casually watched my mom and grandmother cook, but didn’t actively engage in meal prep. It took years for me to become proficient with spices, ingredients and heat to make meals. It took learning new tools to make prep easier (like really good knives). It took adaptability and patience to create meals I was proud of.
I use cooking as a way of illustrating novice to expert (though I am no Julia Child). Yes, nursing requires the understanding of ingredients in patient care, but modern nurses must also understand tools available to them to more accurately care for patients and more effectively communicate to the care team. Computers are everywhere. From the tiny digital display that tells my Instapot how to cook- to my phone, which keeps me from losing my mind or causes it depending on the moment- as a society we understand computers as a tool and an integration of life.
Most major health care systems currently use computer charting of some sort. In every aspect of nursing from homecare to the ICU, technology is accessed in some form. Many hospital departments use technology to inform care. I think of an ICU where a patient can be on a cardiac monitor, intubated and on ecmo. Probably that pt is having BG taken in regular intervals. Probably i-STAT is updating labs. The patient is hooked up to 10+ drips, which are being monitored with a pump. I think of the pediatric patient who can now be managed at home with portable oxygen, feeds and suction.
At this point in nursing, the expectation is not comfort level with technology, rather in nursing familiarity with charting formats or computerized pieces of equipment. Nursing responsibilities with technology often span far beyond EMR and handheld devices. Honestly, working in pediatrics, I cannot remember all the times I’ve had to figure out a DVD player or video game used for distraction - or why a monitor isn’t working in the middle of a code - or why the ECG won’t link with EPIC, which is hauntingly like when I burn the cookies because I forgot to set the timer. Understanding all the tools in the toolbox for nursing, including technology, allows a nurse to critically think at peak level, elevating practice to expert. Like cooking, adaptability to different technology is a key component to professional success today.
Applying technology to advanced practice adds another layer to the lasagne. As we move through our education, technology leaps and bounds around us. We will be the APRNs that take care of patients who are savvy to their vitals signs because they are wearing smart watches that tell them their health (Archibald & Barnard, 2017). Consequently, our knowledge base, communication clarity and comfort with tech will aid in maintaining patient trust.
It is important to keep in mind the slow adaptation of technology, not to mention the skepticism, by rural communities. Often, technology can’t be accessed in more remote parts of the country, so lack of exposure combined with a natural proclivity to self-reliance results in a slow adoption of technology based medicine(Greenberg et al., 2017). Interpersonal communication plays a much larger role in effective treatment rural residents.
During Daniel Kraft's Ted Talk about apps for the future of medicine, I remembered how fast people spoke with his urban enthusiasm. I was reminded of the years I spent in tech saturated San Francisco, buoyed by the utter superiority in the newest digital offerings and skeptical there were people uninterested in all updated software. Then, I thought about how far 750 miles really is from silicon valley and wondered how well Daniel Kraft would go over in Wendell, Idaho. I don’t think there’s an app that fixes holes in floors caused by lead balloons. The point is, technology is flash and fast and interconnected to more technology. Quiet, solid and independent spirits with earth under their fingernails live in mountains and fields. There was nothing in the talk the bridged the gap between urban tech-driven medicine and rural health.
People who are working on AI robots to replace nurses (Locsin & Schoenhofer, 2019) are necessarily where the technology is. Living in the soup of technology, it is easy to forget that not everyone loves gadgets with apps. Not everyone needs to have the latest. Not everyone believes in the cult of technology. When annual storms knock out power, sometimes for months on end, you have to know what to do when the electricity shuts off. Rarely does it have to do with the latest apps on their phone.
Is it possible that nurses will be replaced by robots someday? Sure. It’s also possible that a robot will be able to clean the kitchen and wash the freakin’ dishes after I’m done cooking, so I have energy to do homework with my kids and finish chart notes. Now, there’s tech.
References:
Archibald, M. M., & Barnard, A. (2017). Futurism in nursing: Technology, robotics and the fundamentals of care. Journal of Clinical Nursing, 27(11–12), 2473–2480. https://doi.org/10.1111/jocn.14081
Greenberg, A. J., Haney, D., Blake, K. D., Moser, R. P., & Hesse, B. W. (2017). Differences in Access to and Use of Electronic Personal Health Information Between Rural and Urban Residents in the United States. The Journal of Rural Health, 34, s30–s38. https://doi.org/10.1111/jrh.12228
Kraft, D. (2017, June 15). Transcript of “Medicine’s future? There’s an app for that.” Www.Ted.Com. https://www.ted.com/talks/daniel_kraft_medicine_s_future_there_s_an_app_for_that/transcript?language=en
Locsin, R. C., & Schoenhofer, S. O. (2019). Robots, Caring, and Nursing in a World of Advancing Technology. International Journal for Human Caring, 23(2), 109–111. https://doi.org/10.20467/1091-5710.23.2.109