Nursing and Technology: Uneasy Alliance
or Our Preferred Future?
Katharyn A. May, DNSc, RN, FAAN
Dean and Professor
UW-Madison School of Nursing
Photo: Jeff Miller/University Communications
Nursing always had a complicated relationship with technologies involved in care. On the one hand, some technologies have rapidly become tools of the trade (i.e., clinical information systems, dynamic monitoring technology, lifting equipment). On the other hand, technologies sometimes have distanced or distracted nurse from patient and have created hard edges at odds with artful practice. Back in the 1990s, nursing was described as a "high tech-high touch" profession, but for most of us back then, the phrase was more symbolism than reality.
But "high tech-high touch" is real today. Nurses are now fully in the digital age, and the technology revolution shows no signs of winding down. We already practice in telehealth and eICUs. Reference texts now reside in personal digital assistants rather than on bookshelves, and nurses and consumers alike see the Web as an indispensible tool. Many of us under the age of 30 no longer have telephone landlines in their homes, but rely exclusively on our cell phones. Clinical simulation technology is now a topic of discussion, if not a focus of teaching and learning, in virtually every nursing school across the country.
Despite all of this progress, the real question is how quickly nursing as a profession will shift from passive mode (i.e., knowing good tools when we see them and adapting our practice to the tools, but not engaged in developing those tools or even in deciding how they are to be used) into active mode—figuring out how to adapt technology to our practice and anticipating what new technologies we will need for the future.
This shift has already begun. Web-mediated nursing support for patients and families recovering from major illness or surgery has already been shown to improve recovery and reduce health care costs. Nurses are now exploring how to use gaming technology to get health information to young people and help them make good decisions about their health. Nurses are helping elderly individuals and their family members to use Web technology to stay connected in meaningful ways, rather than just for "keeping watch" or "checking in." Nurses are even testing the effectiveness of virtual technology as an intervention to help adolescents cope with pain and distress associated with invasive medical treatments.
And there are other technologies being introduced into the "health" market. "Smart" housing with remote sensing technology enabling those with physical challenges to live safely on their own is already being built. Clothing and wearable items with embedded sensors to support "body computing" technology is already being mass-produced in running shoes and other kinds of athletic clothing.
The implications for the future of care are truly exciting. But we need to begin to think systematically about how to harness the power of technology and link it up with the power of nursing. One of biggest challenges we face may be nursing's own version of the "digital divide": Some of us are just learning how to surf the Web while others spend free time in their "Second Life" (if you don't know what that is, you are definitely in the first category!).
Put another way, most nursing students today have been wired since birth while most of their faculty are racing to catch up. When I told a faculty colleague close to my age about a cell phone now in use that can test a diabetic person's blood glucose and transmit the result to their care provider, she was amazed. When I mentioned this invention to a nursing student, she wasn't a bit surprised.
The good news is that our nurses of the future are already primed to be active developers and users of new technologies; the bad news is that we aren't talking about this new frontier nearly enough in our practice environments or our nursing schools. But this transformation won't happen by accident. We will need to make it happen, and shape it so that, in our preferred future, nurses develop and use technology in order to make our expertise and intelligence as well as our presence available wherever individuals, families and communities can benefit from it … even when we aren't in the same room, or even the same time zone.
A bold vision? Perhaps. But as a nurse who in her younger days watched nearly every episode of Star Trek, I always envied the tricorder that Nurse Chappell used. Maybe someday, I'll have one of my own.
Dean Katharyn A. May is still a devoted Star Trek fan.
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