Technology has strongly influenced the way that nurses practice today. From the bedside to the operating room - and beyond, a nurse's practice is dependent on his or her ability to change and adapt to new technologies that are linked to patient care. No one would argue that the electronic healthcare record has improved patient care, safety and communication. But we have yet to see where 3-D printers or stem cell cloning will take us in the next ten years.
Please read The Impact of Emerging Technologies on Nursing: Warp Speed Ahead, and decide for yourself where the future of nursing will be in five, ten or twenty years? The future of healthcare will depend on the ability of nurses to integrate the art of healing with new technological advances.
Questions
Select two technologies that you use on a daily basis in your practice. Explain how your ability to work as a nurse would change if those technologies were suddenly taken away from you.
Discussion Question
In keeping with the theme of technology and healthcare, does technology dehumanize patient care? Please read Worries and Insights About Nurses and Technology. Perhaps charting in the future should include drop down boxes where nurses document their humanity when giving patient care. A charting future that could include writing nurses up for not documenting such things as; compassionate hug given after injection, warm smile given upon entering patient's room, or held patient's hand and cried after discussing test results.
Please share your thoughts, feelings and experiences. Comment on the article, or share your own drop down boxes for your chart of the future!
Please send all answers to melissa.luebbe@ctca-hope.com. Remember patient privacy when commenting!
So, may I say I fear for my future when I am at the mercy of our healthcare system. All those high tech items discussed in the first article-yikes! Although some were fasinating and exciting, the robot thing scares me to death! To be bathed and handled by a robot?!?!? As for the comfort seal, I would much more prefer a real live therapy dog or the like, not a mechanical toy. The comment from the 2nd article about nurses under the age of 30 "losing it" if the computers crashed is disturbing. In nurses defense, we did and are not designing this dehumanizing way of performing. I believe it is mainly due to fiscal issues that healthcare has become so messed up. My thought as I went through my Holistic Nurse training was that the future in nursing should be in specialties. For example, is there a possibility of having clinical nurses who just take care of pt's clinical needs and deal with all the technology etc then having a holistic nurse that attends to the patients spiritual, emotional, and environmental needs etc. It has been my personal experience as a patient and caregiver that these 2 entities are rarely effectivly executed in our current healthcare state:-(
ReplyDeleteI do think although we keep having more and more technological advancements, there are some things that should never be replaced by a robot. A bathing robot is definately impersonal and takes away from the connection patients have with their nurses and I do not think some of these duties should ever be fulfilled by a piece of technology.
DeleteJulie, I do like your idea of having a clinic nurse and a holistic nurse in medicine. That would create balance in an unbalanced medical system!
DeleteSarah
Julie, interesting idea about a holistic nurse and clinical nurse. You are right, although there are rare occasions when a nurse gets to treat the "whole" person, most of the time we only have time for the clinical aspects.
DeleteI worked at a hospice company that had the seal and it was used for nonverbal patients with advanced dementia. I have never cried so hard in all my life. There may, even be a you tube video. I found it!!!!
Deletehttps://www.youtube.com/watch?v=2ZUn9qtG8ow
this patient didn't speak any longer listen to her talk with the paro. So cool! this company no loner exists it was shut down for medicaid fraud but I truly had some amazing experiences there.
I can definately see how growing technologies can be viewed as a barrier to the compassionate care that we are taught and inclined to give. I think it is important to keep in mind that even though we have more technologies to help our job that we do not forget to critically think and use our nursing judgment. We cannot solely rely on technology and have to make judgement based on our assessment and nursing skills. It is also important that we still make connections with our patients and spend the time to talk to them and always remember why we got into nursing in the first place.
ReplyDeleteAmy, I have been on the receiving end of no eye contact and a person or worse, the provider typing on the computer as they spoke to me, turned away from me. What happened to the head to toe assessment? You can get so much just by looking.
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DeleteYes, Amy I had a first hand experience of no eye contact. After my surgery, I was transferred to my room for an overnight stay. At one point, my nurse connected me to their portable vital signs monitor, then suddenly left and went somewhere, I don't know where. Few minutes later, she came back and copied my v/s on a piece of paper, then left again without saying anything. I assumed my v/s were stable then, because I survive and I'm here to tell my story..
DeleteHi Amy, I agree with you that we have to find a way to make connections with our patients (and with each other too!) We can utilize the technologies that are out there and find ways to incorporate them into our practice. We should never lose sight of the human being we're caring for.
DeleteI also have had the experience with no eye contact, actually with a pediatrician who was seeing my child. I felt so frustrated that they spent more time checking off boxes on their computer as they were taking the history rather than actually visually assessing their patient! I have had much better experiences with other providers who bring the computer in the room, but don't open it until the time that they are finishing the appointment. We must always be mindful that we are showing our patients that we are listening and are interested in them!
DeleteI feel that technology can dehumanize patient care if we let it. Health care is ever evolving, and in 20 years there will be even more technology advances so as nurses, we have to evolve also. This means finding ways to keep the compassion and humanity in our practices. I agree with Amy, always engage our brain power when it comes to our nursing practices, but we have to be progressive as well.
ReplyDeleteHi Mary,
ReplyDeleteI agree with you! Technology has offered great medical advances but it also has the ability to rob patients of a nurse's presence, healing touch, or attentive ears. It is very easy to get caught up with the task at hand and remember to then chart the many interventions. Maintaining focus will help us remain grounded and aware of what is important-the patient!
Jessica Mendez
Hello All!
ReplyDeleteWhile technology offers great medical advances, it certainly has the ability and potential to dehumanize patient care. I recall sitting in an exam chair in front of my primary care provider trying to recount the events that led up to a new onset of symptoms, he made minimal eye contact during this encounter. His mere focus was completing the progress note in front of him. I transferred care! This is but one example of how electronic charting has affected bedside patient care.While many positives have resulted from the use of EHRs, other not so positive changes have also surfaced!
Jessica Mendez
Yes, Jessica:-) It is so dehumanizing to have a lap top between yourself and your physician-especially when your answers do not coincide their drop downs:-)
DeleteMy mantra regarding technology is that it is one of my tools in my toolkit to care for patients. It is not my only tool. I think that the art and science of nursing is leveraging technology to improve patient outcomes. How the technology is incorporated, by nurses, is where the dehumanizing of patient care is evolving. We need to step back and recognize when we need to be human, caring and compassionate, this is the art of nursing.
ReplyDeleteSarah
Agreed Sarah! We need to know when it is and isn't the appropriate time to be on our computer in regards to patient care. Some people have that figured out, while others never will...
DeleteAgreed, Sarah.
DeleteAgree Sarah. Technology is a tool. Just like stethescopes, thermometers,blood pressure cuffs. When those things came along they were probably seen as a big technological advance. Our tools change over time but our connection to patients, our critical thinking and the compassionate care we provide stays the same.
DeleteI think that sometimes computer charting can get in the way of caring for the actual patient. I know that there are some nurses that while doing an assessment they are more focused on the computer than the patient just to make sure to get the charting completed "real time." As well as trying to find the most accurate box to check, when everyone is different and their symptoms might not fit in a nice little box. And to be able to meet standards for Joint Commission and whatnot... that's a whole other story of charting to the nth degree just to make sure to C.Y.A.
ReplyDeleteBut at the same time, I can absolutely see the advantages of computerized charting.
I agree Lauren, when the tables are turned and you're the patient, I have had many experiences where the nurses are just checking their boxes and asking endless questions without connecting to you at all. Of course, they are probably low staffed and time-crunched so I understand completely - but we can't lose our focus on our face-to-face interactions or our theurapeutic touch interventions.
DeleteI agree with many of your views, when it comes to providing care for the patient it is important to keep the immediate focus on the patient and not the computer. This only minimizes how the patient feels relative to importance. Many of us can be distracted by tasks and charting and not take into consideration how the patient feels sitting in an awkward silence while we are stuck in a computer screen. It is so important give the patient your undivided attention first, then tend to the tasks and charting, they do not need to watch you chart. Which is why I personally do not chart in my patients rooms, the only reason I bring my computer in an exam room is to scan a med. I have been the patient and know what that feels like to not be the priority.
ReplyDeleteI agree that emerging technology is more evident in healthcare especially in surgery. I remember when I started in surgery 20 years ago, we used to suture the skin to close , now we used stapler or dermabond (skin glue). Laparoscopic surgery is the way to go now, small incision and early recovery. No more big incision example for removal of gallbladder and appendix. Mediacal advances are good but we should still continue to focus on the patient using all the senses to assess patient and their needs.
DeleteAgreed, Jolie. While the computer is useful in the room for reviewing certain information with the patient (med list, recent health issues at prior visits), it can also be a distraction. If I'm focused in on the screen, I am not focused in on them. And they are the reason I am here. I make my notes, and chart later, so I can truly give them my best attention.
DeleteHi Jolie,
DeleteI completely agree with you. I feel like sometimes it even makes patients feel uncomfortable too, like they can't open up. Technology is great, but not always when the patient is present. They need to feel like they are being listened to. In my experience, patients prefer paper and pen when writing down their symptoms, concerns, etc. I think your practice of not charting in the room is great and very appreciated by your patients.
I feel like our institution focuses a lot on documentation and charting in “real time”. The GLC got computers placed in the rooms and we were highly encouraged to use them. I feel as though they take away from personalized care. It does not create a fluid conversation; instead it is segmented and compartmentalized, and prevents from making eye contact with the patient. It is not the type of care I want to provide. I can accomplish all the required charting points by having a genuine conversation. I was assessing a patient this morning, and during our conversation I noticed that she was making less eye contact with me then she was when I did her pre-operative teaching. I switched my assessment to how to she was handling everything and she began to cry – she was home sick and missed her grandchildren terribly. If I had been facing my computer charting, I would have missed the non-verbal queues of her difficulty coping. I know technology has its place in healthcare, but we still need to remember that we are here to provide individualized patient care and you can learn a lot more about our patient if we take the time to speak with them opposed to at them.
ReplyDeleteI agree completely Elizabeth. I chart out of the room for that purpose as well. I can write notes down and go outside and chart. I feel when I am charting on the computer I get so focused I would miss clues from the patient. In addition, When I am the patient, I appreciate the eye contact from any provider. Lastly, I do appreciate the good EHR does meaning that we can read the other team members notes prior to seeing the patient. This allows the flow of communication and continuity of care is enhanced.
DeleteAgree, Elizabeth. Our focus must always be, first and foremost, the patient.
DeleteI know I contrast alot about my prior experience in ER/Critical Care, but I like to share because it is so different:-) In that setting it is usually a very raw and time critical situation-assessments are made and treatments executed, immediately sometimes. Charting and MANUAL drug calculations are done on disposable bed linens, 2 inch tape on your thighs, paper folded 4 ways to create a "chart" with sections etc. Charting was always after pt care was done and it was in triplicate:-). And as far as technology goes, you still have to use your intellect-I had pts endorsed to me many times who were getting a medication via IV pump/device that was wrong! A manual calculation is never a bad idea......
Delete
ReplyDeleteTheresa Minniear-Clinical Research
Does technology dehumanize patient care? I would be more prone to say that low staffing does, honestly. Or, I’d be more prone to say that technology instead decreases critical thinking skills. Machines “beep” when vitals are out of expected ranges, pumps calculate drip rates for you, scanners detect hidden veins for IV insertion, etc. My father retired as a navy nurse, and sometimes I wonder if I were to go head-to-head with him, who would be a better assessor--he would, I believe. I did like that the article commented on one instructor making her students do paper charting for a semester. We are so reliant on technology that we all would get anxiety when/if the systems were to crash!
i agree with you theresa . i came from the country were everyhting is manual . You asses your patient yourself and do not rely on all this machine . i get crazy when none of the computers work
DeleteThis is so true Theresa. We have so many things in place to critically think for us. While it may improve safety, it also helps us lose our basic skills we spent so long learning. We don't always realize how much we rely on technology.
DeleteI don't think robots are the answer in nursing care and again I worry the role of the RN is shrinking. I did appreciate the comment from the instructor who made the student document on paper in case of a computer crash. Thankfully computer crashes are happening less and less but still worthwhile exercise to practice in case of an emergency.
ReplyDeleteI agree. A nurse should know what to do in the case of a computer crash.
DeleteEmerging technologies is more prevalent now but it doesnt replaced the human touch, the caring, the compassion , the listening ears which is what nursing is all about
ReplyDeleteAbsolutely. And for most nurses this comes naturally.
DeleteI do not think technology is dehumanizing patient care. I think it is enhancing it. We can use technology to get a bigger, more complete picture of our patient and their needs. We can collaborate across disciplines in order to holistically care for our patients.
ReplyDeleteAre we too dependent on technology? Probably. We cannot forget to look at what's right in front of us. Our nursing assessment is vitally important in this regard. The old 'head to toe' assessment is still extremely valuable, and should be supported as part of our scope. When we combine our nursing assessment with the information available to us via the EHR, we can more fully serve and properly care for, our patients.
As for "drop down boxes" - I have none. I would only ask that we have sufficient free text areas, where we can more accurately describe a situation/how we dealt with it/patient outcome. Not everything can be pre-programmed.
Great answer Jennifer. I became a nurse in the age of technology and definitely at times experience the nurses that fight it. I think the powers that be should definitely really help bridge that gap. help the nurses who are struggling really get a better education on how the EMR and other new technologies can help them treat the whole patient.
DeleteWhen I was in nursing school, our instructors taught us paper charting and nursing notes. This really made you think about what was going on with the patient. I very much dislike our charting system for inpatient nursing as it is very cumbersome, and repetitive. It takes a long time to chart an assessment and yes we are expected to chart in the room. I think if the institution would ask nursing's opinion we would chart either a nurses note of our assessment or chart simply by exception, meaning, if something is not WDL, state that instead of having to click every box that is WDL. The admission process is also very long with questions we have to ask in the KBC. Most of the questions are irrelevant to the patient's reason for admission. I believe this process certainly takes away from patient care.
ReplyDeleteI liked the part of the article from the nursing instructor who asked her students to use their assessment skills before looking in the computer. From hearing some the safety events, we have some great clinicians recognizing errors of an automated (but run by humans)system. Each time we see a patient, we need to be checking and double checking to be sure all is right and questioning the automated systems. And assessing the patient by actually looking at them. I do think check lists are a good thing too, as they remind us of things we might miss.
ReplyDeleteI like that part of the article too. Personlly, I think everyone in the medical field should have to be a PCT as part of their training, including the doctors. I have been a nurse for over 20 years and things have really changed and keep changing faster and faster. I worry that I can't keep up with the technology.
DeleteThe technology portion of our job is both good and bad. It is nice how it assists us with certain tasks, but I do believe that it has the potential to dehumanize care if we let it.
ReplyDeleteWhen we first moved to the tower, there was a strong emphasis placed on charting in the rooms in front of the patients. I do this on occasion. But it really shouldn't be the first priority when caring for our patients. It makes them feel as though they are a "task" not a human. Our charting system, like Krista said, is very cumbersome and takes a great deal of time. Not to mention it is constantly changing. I have found that I enjoy meeting my patient and assessing them and talking to them first thing without any computer with me. We may hug if I have taken care of them before, we may go over any changes since we have last worked together. I really have been trying to do all of my charting just outside the room and after the trusting bond has begun with my patient. I hate when they feel like they aren't important and I never want them to feel like "another task". Technology is great, but we have to evaluate when it is appropriate for the situation.
I told a patient once "I need to go chart now." She said but you do not chart any longer, implying I do not use a physical paper chart any longer. Yes, true but I will probably still use the term, 'charting' until I retire.
ReplyDeleteWe nurses need to remember to connect to the patient on a personal level. Take our eyes away from the computer.
So true. When I find myself on the other end (as a patient) I often times feel that the physician is not really "listening" to me because they are too busy charting... but in reality I know that it is how healthcare is documented. I try to be extremely conscious of how I interact with my patients when charting and try to make eye contact as much as possible so that they do not feel like I am not "listening" to them.
DeleteI like to look at it from my perspective as well as being a patient. Technology can interfere with our human interactions. Many times we are staring at our screen making sure we document all that we are required to do. I usually tell the patient, "Just bare with me as I enter my charting." I always try to strike a balance making plenty of eye-contact. I try to not let it be a barrier between us. I hope the future brings devices that will chart things automatically for us; like blood pressure going directly from the machine into the chart, or a device that we wear signals that we were in the patient's bay or room and the pump communicates with the computer as well charting when meds were hung, stopped, etc. Technology has to get convenient enough for us to get back to the bedside for that human interaction that is so necessary to care for our patients.
ReplyDeleteI agree with the importance of not having the computer be a physical barrier between you and the patient. I believe it often is. Despite our efforts to make eye contact, we need to be willing to close the computer, sit next to a patient and give them 100% of our attention. There is nothing that can substitute for that human interaction, which I agree is a necessity.
Deletehttps://www.youtube.com/watch?v=2ZUn9qtG8ow
ReplyDeleteI worked at a large hospice company that embraced technology. They bought this robot to use with out nonverbal advanced dementia patients and the results were amazing. Patients who had not verbalized in years light up and begin interacting with this baby seal it was so moving. I, although get super intimidated by new technology, try to stay updated. I love that I have the patient's entire medical record a click away. I love that we have the filters so we can look for consents only or only nursing notes. It can take a five page list of documents to a ten line list. As far as the drop down boxes, I really think we need less drop down and more free text. Here at cancer treatment centers we are so focused on the whole patient but hardly have the chance to document some of these experiences. Working with sexuality concerns there isn't adequate room to chart what we really talk about in Urology.
Does technology dehumanize patient care? I definitely feel that patient care has significantly been dehumanized over the years. I see this as a sad change in bedside nursing. But I am not convinced that we can place the blame solely on technology. In the ideal world, technology should make us more efficient allowing additional time actually spent face to face with the patient. Along with technology there has been a shift in thought processes. I like the part of the article where the author questions if technology interferes with critical decision making. I am of the opinion we have become more dependent on technical support and don’t need to actually think for ourselves. We use calculators, spell check, prefilled templates, alarms, etc. As a society we are not promoting critical thinking skills. We are promoting the use of technology to make things faster and easier. And as a result I do not feel we are making better use of our time. Maybe this is a little strong. Let me ask you this. If you want to communicate with someone are you more likely to go and talk to them or text them? I think we are losing the skill of human interaction. Our patients certainly suffer as a result in my opinion.
ReplyDeleteThe future of health care is going to become incredibly more technologically advanced- especially in the hospital realm where government and insurance companies have a huge influence on how health care is delivered. The idea that technology can help with patient safety and uniform patient care.
ReplyDeleteI think this will open a huge unmet void for humans who want to talk and make eye contact with a provider rather then talking to their provider who is staring at a computer screen. I envision a return to Eastern style medicine with a western flair. Nursing could be at the forefront of this movement. Teaching lifestyle changes, Holistic self care with referrals to other disciplines. I envision naturopathy, acupuncture/ pressure, yoga etc having more of a role as patients request this and studies show that healthy lifestyles will decrease the need for hospital stay and pharmaceutical interventions.
I would like to share my thoughts of the electronic health record for nurses here at CTCA. When I started working at CTCA I wondered why, especially in this setting, we did not have a section in our electronic charting on compassion, patient coping, caregiver coping and support. I am an older nurse who would address those issues when documenting on paper and I found it very helpful having that information available and documented by prior nurses. I think if we were able to incorporate some of the issues mentioned above into our current electronic health record it could paint a clearer picture of the patients support and coping as well as the compassionate care given by the nurse.
ReplyDeleteI agree with you that having the coping section especially with out field is helpful to see a clearer picture of the patient's overall health and state of mind. There are definitely times when having that extra section is very helpful to know.
DeleteWe do have a section on coping and there is always the option of free texting comments if elaboration is necessary.
DeleteIt is really fascinating yet scary to think how this emerging technology in electronic documentation can impact the way nurses will practice in the future. Not only will nurses lose their compassionate caring attitude; moreso, they may ultimately lose their critical thinking ability. My biggest fear is when we will be in a full blown robotic era where nurses will be away from the bedside anymore. Lack of emotions in robots is very concerning, in which robots can and will never replace human caring touch and compassion.
ReplyDeleteNinfa I have the same sentiment.
DeleteMy take on this, is two fold. One, appreciate tremendously the emerging technologies for the accurate data, patient health history from many locations, any changes in documentation of care,evidence based practices' availability 24/7 with built in safeguards for confidentiality & security.So you can give the necessary care with out delay. On the other side, worried of dehumanize future nursing care. Robots to replace or phase us out.As nurses we stand together to continue to implement our basic nursing care, nurturing, compassionate, TLC, human touch. If we show these at all times, I hope & pray that our patients & medical industry will not replace us.
ReplyDeleteIt's hard to say if technology really dehumanize patient care, or is it the low staffing, more patient, or is it how our system works.
ReplyDeleteThere's no doubt that technology will advance from here on. But as nurses, we should learn how to adopt, adjust, embrace and use these technologies and machines to our advantage. A perfect example is talking, listening, engaging, keeping an eye contact and giving our undivided attention to our patients while these machines are doing part of our job like taking vital signs.
So lets go out there, be compassionate, maintain eye contact, listen, use your best nursing judgement and critical thinking skills and deliver the mother standard of care to all our patients and be a mentor, a teacher, a model and share all these things and experiences to our new and young nurses, so they will continue to carry the torch of basic nursing & compassionate care 10, 20, 30...100 years from now. Remember as what Mary said, technology will dehumanize patient care ONLY if we allow it.
I think it is culture, and staffing ratios along with more responsibilities of the nurse. It is hard to say. On a busy day with a patient having an acute critical need, my time is going to be more absorbed than on a day when things sail smoothly. Eye contact, taking a moment to sit at the bedside while talking, touching a hand...etc, can go a long way in making a connection.
DeleteThat is an excellent quote, "Technology will only dehumanize patient care if we let it." We are ultimately in control, not the machines. Our ability to provide the human touch will always overcome the robotic quest.
DeleteI believe low staffing would be more at risk to affect patient care than technologies. Although I believe it comes across differently with how comfortable the clinician is with multi-tasking the face-to-face assessments and technology together... low staffing would be more of concern. The idea of trying to do more and take care of more in the same amount of time is a greater threat to patient care.
ReplyDeleteI agree with many of the posts on here. Technology can dehumanize nursing care if we let it. Technology is always updating and evolving and we have to be able to do so as well. I feel that charting on the computer while in with the patient takes away from being able to connect with the patient and perform a thorough assessment. Making eye contact is so important for both patient and nurse. If we are focused on the charting, we are not making the patient feel important or cared about. The providers that I work with do not take computers into the rooms when they visit with patients but they do write down notes and chart outside of the room. We do rely greatly on technology but we also have to be able to rely on our other skills as well, including our ability to perform head-to-toe assessments. Utilizing both of these will allow us to perform optimal patient care, in my opinion.
ReplyDeleteTaylor, I agree with you about the loss of interaction if we focus on the computer while in the rooms with patients. I like to give my patients a hug and make them feel like I am not only listening but also hearing what they have to say and addressing it before they leave. I think this builds trust and shows the compassion and caring we want to provide.
DeleteComputer charting or paper charting- these are just tools that we have to document what we have done for the patient. Neither gives anymore answers, I still have to use my eyes, ears, hands and heart when I am caring for a patient. The computer doesn't give a hug, the computer doesn't hold a hand and the computer doesn't make a human connection anymore than a chart full of paper did in the past. Making a connection is up to the nurse, regardless of the tools given to get the job done.
ReplyDeleteI definitely agree with this Michelle. Documentation must be done and computers and technology can do a lot but assessment, compassion are things that they can not do.
DeleteEHR are very efficient and help me find patient information/answers quickly. We "look up" patient information prior to seeing each new consult and follow-up patient. Within minutes we can know everything regarding diagnosis, pathology, test results, and plan of care. I can discuss patient care and provide teaching with more accuracy. I think patients have confidence in us when we know their medical details and plan.
ReplyDeleteOn the other hand,as a patient, I am frustrated when the doctor or nurse ask questions and talk to me without looking at me. When they stare at the computer or chart while speaking with me, it is disjointed and cold. I prefer having their attention, look at me...the patient, and have a dialogue with me. Balancing technology and the human factor is essential to maintain patient confidence, trust, and satisfaction.
I totally agree. Although the ehr can be very helpful and provide necessary data,it os the human touch and that one on one that shows and give compassion that counts
DeleteI agree being on the other side of the table brings up a very good point. A lot of times my doctor or nurse just uses the computer to prompt them instead of looking at me or really seem to care about what I am saying. The computer can take away a lot of that human compassion
DeleteI do believe that if you are one to allow care to be dehumanized, it can happen in any way. I think that there are ways to balance charting and real assessments and conversations. I try, as much as possible, to document in the room while with the patient. I feel that I do a great job still making eye contact and being personable while getting my documentation done. I will typically ask the questions that I need to ask and then start documenting while basically re-capping the conversation that we just had. I will often joke, "if only the conversation that we just had could jump into that computer". The patient will usually laugh and some will say "just wait, I am sure that will happen eventually". I really do feel that there is a way to balance technology and human touch and compassion. It is just finding that balance.
ReplyDeleteTechnology will enable healthcare professionals to be more efficient and accurate, ultimately providing the best possible outcomes. As long as we are still able to see patients in person, we will be able to maintain the personalized and compassionate care that we give now--- even more personalized and unique to each patient’s needs.
ReplyDeleteI agree Courtney. Having a comprehensive chart at your fingertips prior to meeting a patient for the first time can be priceless.
DeleteWhile technology is great in some ways I can see how it can dehumanize patient care. As nurses we have to balance the two by staying aware of our patients needs, actions, and non verbal cues. When we dont look at our patients during conversation we can miss a lot of the above mentioned. I prefer to talk with the patients and take notes and then go out and chart so that the patients feel like they have my attention and focus. Computers can not assess a patient visually or emotionally like a nurse can.
ReplyDeleteI agree with you. I have never liked to chart on the computer in the room in front of a patient. I feel when I am with the patient, they have all my attention for that time.
DeleteComputerized charting is good in the sense that all information is at everyone’s fingertips. However, it also dehumanizes the face to face interaction time with patients. If the nurse is looking at the computer screen, they are not able to look at the patient’s face and interpret the non-verbal cues the patient is displaying. I think it would be beneficial if there were more free texts in computerized charting rather than drop boxes. These can be time consuming and may not depict the full story.
ReplyDeleteI agree with you Sheila! My pcp charts while she is seeing me and sometimes I feel like she isn't listening to what I'm saying because she is paying so much attention to her computer screen. Making sure the patient knows you are present and listening to what is being said is so important.
DeleteTechnology is a great achievement in today's health care. Without it our scientific advancements would be very slow and not progressive. With that being said, as a nurse we have to let it assist us, not make us. Technology will never be a listening ear,or a hand to hold. It cannot make us, but should be there to assist with things. I feel that patients would much rather see a face with thoughts and feelings, rather a computer screen.
ReplyDeleteComputerized charting is great because it can potentially eliminate dangerous medical errors, and gets rid of the poor penmanship that goes along with the paper charting. However, in ways technology does "dehumanize" patient care. When charting on the computer with patient in the room, you do lose the much needed eye contact and emotional connection with the patient. When I see patients, I like to spend time listening to the patient, take down notes regarding their concerns, and the computerized charting is done away from the patient outside the clinic room.
ReplyDeleteI do not believe it dehumanizes patient care, it allows better time management. It allows more time with the patient and for the nurses to finish (most of the time) in scheduled work hours. It may take away from a nurse who does not fully understand technology. In the years to come, it seems as if everyone will have to use it some way. Nursing will always be face to face interaction, how much you give as a nurse is individualized.
ReplyDeleteI think technology may dehumanize patients care only if we let it. Technology is a tool that helps to provide better care, prevent error, and organize workday etc. Nursing will always be face to face interaction, compassion, smile, and a tear if needed- no technology will replace that. Nurses will always have to use the “ears and eyes” to fully assess the patient and how much time we give to the patient beyond that is very individualized.
ReplyDeleteI agree Margaret. Technology is just another tool for us to use for better and safer care. A nurse knows when to put those tools aside and listen, touch or just be.
DeleteUsing technology in patient care has pro's and con's. For example, using electronic charting verses paper charting makes finding information so much easier and provides a safer care for the patient. We as nurses just need to remember that patient's are people and we need to balance technology and good communication skills. Remembering that charting is important but ensuring the patient knows you are listening and they are being heard while interacting with them is a fine line that we all need to balance.
ReplyDeleteThe electronic health record makes it so much easier to access and share information about a patient and their care. This is good and bad. We need to remember that the patient we're caring for is more than the information in their EHR. Sometimes the information in the EHR is incorrect and we run the risk of making bad decisions based on the information, if we don't take time to look at and talk with the patient.
ReplyDeleteI am fortunate to have a PCP who talks with me and looks at me during a visit. He reviews my EHR while sitting next to me, we go over things together. I feel like I am more than "just a chart". By going over the chart together, I can correct any misinformation in there.
This technology isn't going away. It can help us improve our patient care, as long as we don't let ourselves get so wrapped up in the chart that we forget we are supposed to be caring for the living, breathing patient in front of us.
As a nurse for 25 years, I can admit I have seen many changes. Some for the better and some for the worse. The EHR has allowed many to be able to view and share the same file at the same time. It also time stamps documents, one of my biggest pet peeves were people documenting at the end of the shift or sometimes the end of the week instead of in real time. I also agree that the practitioner needs to ensure that the patient is at the forefront rather than the charting. As far as do we need to document Compassionate hug giving, I trying think that knowing when that is needed and when that would not be appropriate is what makes a nurses.
ReplyDeleteAgree. We all know that new nurse or practitioner that has multiple degrees that has never touched a patient and can only relate to an iPhone. Sometimes just listening to a patient.... how can we chart that?!?
DeleteTechnology, like science, will always advance and change. I try to embrace using new technology in the hope that it will enable me to take the best possible care of my patients. The fact is there are times we must chart in front of a patient but once completed it is all eyes and ears on the person in front of me. The person not the computer tells me what to chart. I appreciate the teacher in the article who taught her students to assess the patient before opening the computer.
ReplyDeleteyes, i agree with you, Cathy. We as nurses should try to embrace the new technology to give the best possible care to our patients. Also, assessing patient first before charting is a good practice.
DeleteAfter reading the article, Worries and Insights About Nurses and Technology, I am concerned about the compassionate and caring future of nursing. Although technology has made many advances in nursing practice and the medical field, something has to be said about personal touch. At what point does technology advancement hinder compassionate patient care? When treating patients, is more technology always the best choice? As a circulating nurse in the operating room, the use of technology here is completely different than floor nursing. Having worked both as a floor nurse and an OR nurse, I would say the answer differs based upon your department or nursing area. I feel in surgery technology advancement is a huge benefit and we are always trying new equipment. The floor may be quite different however. Too much technology can limit care and create a barrier to human touch and interaction. I feel nurses and compassionate patient care are an essential part of patient healing and recovery.
ReplyDeleteI have worked for 35 years here in CTCA and have seen so many changes. From the paper charting to the electronic charting. I would say it's so much easier with the computer charting because one can see the records of patient that a doctor is looking for. I used to remember going to medical records dept. to look for patient records. Now with a click of my finger, i can find the medical records. Wow, we have come a long way!
ReplyDeleteThanks for sharing your thoughts. I have only been a nurse for about 4 years and have never had to do paper charting, although I would agree the electronic medical record does make many things much easier and safer for our patients. I agree that technology in the medical field and in nursing is definitely a huge benefit although I have noticed it can hinder nurse patient interaction. When is technology too much? Something has to be said about nurses caring and comforting patients. Is more technology always better? For instance robots giving patients baths or giving them there meds would not be better in my opinion.
DeleteI believe computerized charting has enhanced health care. I believe this has encouraged more through documentation. I can also see how it does "dehumanize" as sometimes it seems the nurse is just going through a checklist and not actually using her eyes and core knowledge to truly assess a patient. We must always remember to keep our compassion at the forefront.
ReplyDeleteI'm not sure that technology dehumanizes nursing care as much as low staffing or poor training. If your team will cover each other work together, then you will have a cohesive group. Whether you are using paper or EHR charting... or in surgery using robotic assist. But, if your "team" is just every man for themselves - good luck. It will not matter what systems you have in place. Technology is only here to assist any company in there role it is how we choose to use it.
ReplyDeleteI totally agree. One of the reasons I got into healthcare is my love for the elderly. My mother was a CNA when I was younger and she always took us to functions at the SNF she worked at. I was initially afraid but the love and contact with the residents filled me with compassion and taught me that people love to interact with people and to dance, sing, and tell their stories. You don't get that with technology.
ReplyDeleteTechnology scares me. We rely on it everyday but I think errors with technology can be more serious at times than human error. I also feel that it can place a barrier at times between nurses and patients. Nurses are highly regarded and trusted and I feel if technology continues to take over that patients will loose that connection with us.
ReplyDeleteThanks for sharing. Technology can be scary at times. I am a circulating nurse in the operating room and I don't know what we would do without advances in technology. I feel technology is definitely needed and a huge benefit although needs to go along with nurse interaction and compassion.
DeleteI completely agree. With EHR there is more and more documentation that gets added, and I think you need to manage you time in a way that you may have to cut down patient time in order to allow for more documentation time. I think patient's realize this also. I agree that the more technology that gets added the patient and nurse connection will be lost. It is scary, and I worry about what the future holds in that respect even beyond just EHR.
DeleteWhile I have appreciated the advances in technology, I also have seen how it creates problems. I agree with others who fear what the future may hold, especially with the robotic care of patients. I certainly can understand how they may benefit in certain situations, but will never believe that they can give the gift of humanity. How many times do we find our patients simply need a hug? Or a simple nod of understanding as they share their feelings and concerns?
ReplyDeleteFor me the impact of the advancement of technology is twice as hard for our aging seasoned nurses compared to the new batch of nurses coming in to the nursing profession which we considered the millennials. Millennials of this generation are more adept and savvy with technological gadgets, that no matter what, they can learn the computers very fast and even create their own short cuts or abbreviations in order to be able to chart in a timely manner. But for me, there are also ways in which the seasoned nurses could learn and it just takes time and commitment to it. I have met a lot of nurses who retired early just because they can not keep up with the fast pace changes in the technology especially with computers. Again for me, is that the solution? Some of these people worry so much without even trying and that makes me very sad because these are the experienced people we are losing and who can be a very good resource for some nurses who are just starting like me. As I was contemplating and pondering upon this article, many of us whether we agree or not have lost our personal touch with the patients we take care of because we are more indulge and focus with the task using our finest technology instead of focusing on how the patient feels. In my more than 3 years of practice as a nurse, I have never forgotten the term patient centricity because I feel more than the advancement of technology nowadays, what patient truly needs is compassion, care, and nurturing that these technologies will never be able to provide. At the end of the day, patients will not remember that they got better because of these technological interventions that you've done but what they will remember are the heart and soul you put into your care to make them feel better because to them it makes it more extra special to be cared, love, and be treated with dignity and respect as a human being. For me, technologies will forever change from time to time, but the care and compassion we give to our patients will always be the same no matter what and will forever be remembered.
ReplyDeleteRight on Richie! Once I'm done with the computer in the room, I always (well, you know almost always!) take a minute or two to step away from the computer entirely to talk to my patient, look them in the eyes, and really take that moment to remind them, "I am here, I am your nurse, I am going to take care of you." It may take a little extra effort on our parts, but that little extra is, as you said, what our patients will remember!
DeleteNurses and technology
ReplyDeleteWe have seen in the last decade many things, processes, techniques, equipment even our cell phones have evolved, the pieces of equipment we now use have transformed into intricate; yet resourceful pieces of equipment that have helped us adapt to the new world of nursing. All of the advances are always welcomed and beneficial to all -if -they are utilized properly. Just because technology has “helped us” make our shifts easier in regards navigating a charting system and obtaining, information about a patient -we must never forget that caring for a patient does not originate from a computer system– it comes from the heart. A nurse can be very computer savvy, but if you are missing the true mission of what nursing is all about, we are then destined to become dehumanized.
I also agreed with Karen Acampora’s comment on this article about the decline of the orientation process for brand new nurses, it feels sometimes that we are “rushing” to get new nurses through the training process at some facilities that we are becoming oblivious to the serious consequences this presents. I give credit to Karen A. for expressing her true sentiment about how new administrative and financial changes are affecting staffing ratios.
Hortensia Aiello
I like your comment....even though it feels like we are becoming computer savvy everyday... we need to remember what nursing is all about!
DeleteEmerging technologies is what the future is moving towards, however.... the care, compassion, and the listening that we provide is what really matters, and wont be replaced!!!
ReplyDeleteLisa Hammons
ReplyDeleteTechnology doesn't have to be dehumanizing as long as we take the time to also talk and look at our patients while also documenting using EHR. The vast majority of patients are familiar with technology and a great deal of them are not only familiar with computers and various types of technology, they are also very comfortable with using technology so I think they are less likely to feel as though they are dehumanized as someone who has never been around computers, which would be a rare person to find these days. A simple glance up from the screen to look at your patient as you ask questions shows interest in that patient and should make them feel as though you care. No matter how much technology emerges into nursing, there will always be human touch and interaction.
I think in the times of technology that we live in, there can be a great balance between the use of technology and still having the great warm interaction with patients that those who have been in health care for many years are used to. Even with a computer in the room with the patient and health care worker, this does not mean that one must always be staring into this computer. Whether one may be working in bedside nursing or a specialty, there are still plenty of opportunities to walk away from the computer and documentation and engage in one on one interaction thant can involve the human touch. Caring will still always be there which leads to compassion and empathy and in turn hugs and tears. As a current nursing student, i rarely even bring a computer in the room with me to promote engagement with the patients and a therapeutic relationship.
ReplyDeleteI think now a days everything turn into just a click it will work for you. Technology are good and bad. The most important thing is you communicate with the patient face to face, assessing not only by clicking drop down boxes. Of course using EHR for our documentation is a big help, but we lost our compassion to our patient.
ReplyDeleteThere are definite pluses and minuses to technology. For me, being able to chart electronically is fast and gives me a chance to then spend more time with my patients in their actual care. But, that could also be because I have always charted through a computer, so it is more intuitive. I can chart in the room with my patient and still be able to interact with the patient. I remember when many of my doctors' offices finally went to all electronic charting, and it was like I had disappeared from the room. Everyone was concentrating so hard, noses in the computer and never looked up at me. The longer they use it though, the better they are getting at it.
ReplyDeleteI have noticed a trend where technology is a bit of a hindrance. It feels like so many younger/newer nurses just can't remember or retain so much of what they are learning when new on a unit. It's like they write it down or type a note about what they're learning and poof! it's gone. My husband theorized it's because of our dependence on smart phones; younger people don't remember anything because they don't have to, it's all in their phones. I try to impress upon newer nurses that they also need to build a wealth of information inside their brains because in truth, you usually can't stop to look things up when a patient is crashing.
Also, was anyone else disturbed by the author's almost wistful statement about not wearing gloves. I mean, I understand why the example was used, but wearing gloves all the time when touching a patient is just better on so many level. Just and observation on my part!
Discussion Question,
ReplyDeleteI do not think that technology dehumanizes patient care at all. Technology is constantly improving for the better in my eyes. It helps us as caregivers be more proficient and efficient in our care with our patients. Having to chart so much sometimes can shorten the amount of time we spend with each patient, but I couldn’t imagine not having advances in health technology to improve patient outcomes. If we never change the way we work, things may never get better, and patients may not heal faster and enjoy the benefits that advanced health care can provide.
-Mallory Mukka RN –Breast team
We spend more time charting then we do with patients. I work remote, and although on my end a patient does not know it I really feel it in my per diem job. I work per diem for a home care agency also, and I spend more time charting in front of the patient then I do with their care for many visits. I know my patient's realize that, and I have actually had discussions with some of them about this. The documentation continues to increase, and of course continues to take more time away from our patients. It is unfortunate, but it is a necessary evil.
ReplyDeleteMy goal for this year is to be a better person physically and spiritually. Hopefully in doing so, this will lead me to be a better colleague and RN for my patients. Happy 2017.
ReplyDeleteAnd a special thank you to Kate M. for helping me get this blog to work for me.
Thank you for another great article. Where else could anyone get that kind of information in such a perfect way of writing? I have a presentation next week, and I am on the look for such information.
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