I remember “The Jetsons.” I thought it was so cool how the family spoke to each other on the television. There will be some time before we have our flying saucers fold up into our briefcases, but I think we are farther ahead than the show’s creators would have dreamed possible. Look at us now, with our Skype visits to family and friends, to our Zoom meetings and movies streaming on a 6” screen.
Then, I think of “Star Trek: Next Generation” and how the doctor had a wand she waved over the patient to know their status. I thought that was pretty amazing. The wand was attached to a holographic computer that showed vital signs, internal issues and chances of survival.
When I was looking for an otoscope for next semester, I found everything from the standard wall-mounted otoscope seen in every clinic, but Amazon has one that syncs with your iPhone (there’s even a subcategory for those types of Otoscope). There are some that help you remove ear wax. I couldn’t help wondering if there was a limitation on what you can buy on amazon. Apparently, nothing with a heart-beat. However, you can get a really nice steak…
Currently, I can buy a watch that monitors my heart rate, performs a basic EKG, tracks my sleep patterns and reminds me to make time for mindfulness. Instead of dragging a dinamap machine around everywhere, there are handheld devices that nurses can use to get BP, HR and O2 saturation (also available on Amazon-no joke).
What is good about this? These technologies are easily portable, easily interface with phones and patient records. Patients can better monitor their own health care. Systems can economically provide technology which (could) make work easier for providers.
What are the potential pitfalls of this technology? Patients have the numbers at their fingertips without any real critical thinking that foundation to what they are seeing. Providers can give patients parameters for at-home monitoring, but unless you really understand what the numbers represent, there is room for miscommunication and poor use of technology.
Working in San Francisco I observed medical technology get thrown around like fashion. I took care of a family where the child had asthma and the parents had paid for an at-home O2 monitor (expensive at the time), which had allowed for them to diligently make note of their child’s fluctuation in O2. The parents became so focused on the number, they forgot the child.
Mom- Well he dips to 89% sometimes.
Me- When do you notice this?
Mom - Well, it's especially bad after he runs or he’s been crying- look he’s dipping to 89% right now!
Me - Well, it might be the crying and stress from putting the IV in. Does his saturation return to normal once he rests or gets a couple of puffs from his inhaler?
Mom- Yes, but sometimes not for more than 5 min- look he’s dipping to 88%.
Me - (looking at the patient who is snuffling in bed, with perfect cap refill, clear lung sounds and plenty of tears)- Hm. Does his lips turn blue?
Me -Does he audibly wheeze?
Me- Um. Well, let me get the doctor. (Trying desperately not to say STOP LOOKING AT THE MONITOR AND LOOK AT YOUR KID!!!!!!! Or visibly facepalm in front of her.)
Moral of the story: Monitors are as good as their numbers. Children are particularly vulnerable to forgetting they are in the bed. Kids vitals can look fantastic, but they are pale, quiet and far-away- that’s when they are about to crash. Conversely, their vitals can look horrid, but they are running around playing. There is more to taking care of patients than the monitors. Hand-held, at-home devices are wonderful for conveying important information when having a telehealth appointment with a provider.
Much is being said about wearable technology as the future of healthcare, that nurses need to know how to interface with, “increased patient engagement (in technology)...” (Risling, 2017). Again, this gets back to the nursing standard of understanding your patient, so communication is clear, use of the tools is understood and outcomes are worth the effort of utilizing technology.
Another point to consider is establishing responsibility for knowing how to use the new technology. As rapid fire technology is advanced in healthcare, limited education is provided to nurses how to use and trouble-shoot new equipment or software. Potential diversion of scarce nursing resources could occur if nurses are spending the bulk of their time mitigating issues with multi platform technology rather than what’s happening to the patient. STOP LOOKING AT THE COMPUTER AND LOOK AT THE PATIENT.
Honestly, the train has left the station. We are heading into a world where wearable technology will be the norm, so we have to brace ourselves for what that will look like for nursing. Do I believe electronic health records are a vast improvement over paper charter? Absolutely. As long as we all keep in mind that technology is a series of 1s and 0s and not a person, who deserves as much attention as our smartphones.
Risling, T. (2017). Educating the nurses of 2025: Technology trends of the next decade. Nurse Education in Practice, 22, 89–92. https://doi.org/10.1016/j.nepr.2016.12.007