High-tech and high-touch: it doesn't just happen.
Subject: Nursing (Practice)
Nursing (Forecasts and trends)
Nursing (Technology application)
Patients (Care and treatment)
Patients (Methods)
Patients (Forecasts and trends)
Patients (Technology application)
Author: Richie, Fern
Pub Date: 03/22/2012
Publication: Name: Tennessee Nurse Publisher: Tennessee Nurses Association Audience: Academic Format: Magazine/Journal Subject: Health care industry Copyright: COPYRIGHT 2012 Tennessee Nurses Association ISSN: 1055-3134
Issue: Date: Spring, 2012 Source Volume: 75 Source Issue: 1
Topic: Event Code: 200 Management dynamics; 010 Forecasts, trends, outlooks Computer Subject: Technology application; Market trend/market analysis
Geographic: Geographic Scope: United States Geographic Code: 1USA United States
Accession Number: 283984736
Full Text: "Isolated, invisible, and discounted." Sharon Adkins, MSN, RN, Tennessee Nurses Association Executive Director, remembers with anguish the 24 hours she spent hospitalized following a surgical procedure. During this time, a nurse never touched her. She says the nurses were very proficient with their use of technology-the pumps, the monitoring devices, and such. "Already feeling vulnerable," Adkins said, "the lack of human connection closed the door" on her asking questions about her post-operative care. "It would have been so easy to touch, to meet such an essential human need," she notes.


She is quick to add that nursing practice has been revolutionized by the impact of technology. Technology has enhanced nurses' ability to be more efficient, to make procedures less invasive, more comfortable and private, and more cost-effective. But how can nurses remain person-focused amidst all the technology that makes our work so much more efficient and effective?

Not all patients experience these feelings of isolation and being discounted. Leo Lindsay, MSN, MPH, RN, a TNA District 3 member, shares a story that is in stark contrast to that of Adkins'. Poised to undergo a second operation for retinal detachment, he was comforted by the nurse anesthetist who told him she would be holding his hand throughout the procedure. "Eye surgery is pretty intimidating," Lindsay recalls, "and this nurse's approach worked for me for two reasons."

He goes on to say that the anesthetist told him to squeeze her hand if he began to feel pain, and that she would respond by adjusting the anesthesia via the technological apparatus. Her approach was a very effective pain management strategy, but this human connection of holding Lindsay's hand also comforted and relaxed him. This interactive process-nurse and patient working together-leaves the patient with an entirely different perspective on the outcome of the nursing care they received.

It is important to note that patients (and their families) support and expect nurses to be proficient in their use of technology in the health care setting, but they also expect nurses to be the caring interface between technology and the patient. Indeed, many recent innovations challenge nurses to think of new and different ways to practice the art of nursing. Nurses believe that healing requires human touch, if not literally, then in the nurse's bearing witness to the patient's experience, to our being present to the patient. We know that we are fully present to patients when they express that they feel understood and supported. When we factor in the inherent risks of potentially dehumanizing effects of technology, it becomes even more important that nurses address the personal component. A walk down a hospital corridor reveals nurses gazing onto computer screens-noting pertinent lab values, checking physician orders, entering vital signs and other clinical data. But, are we likewise looking into the eyes of our patients? Looking to detect any sign of anxiety, fear, helplessness, or despair?

Some would contend that it is an either-or dilemma-nurses must focus on the emerging technology at the expense of the humanistic element of nursing. This suggests that technology and humanism are diametrically opposed to one another. Nurse Edwina McConnell rejects this notion and emphasizes that health care technology is inherently neither "good" nor "bad." She points out that the nurse is at the midpoint of this technology-humanism dualism, but that facilitating the coalescence of these doesn't just happen nor does it come easily. McConnell writes that it requires both caring and expertise, and is facilitated by education, clinical practice, research, and administrative considerations. What might some of these be?

The American Association of Colleges of Nursing has developed Guidelines for Incorporating Technology into Professional Nursing Education to address the importance of nurses gaining knowledge needed to use devices, as well as the clinical judgments and skills inherent in their safe and appropriate use. Further, nursing education must address ethics and values as they relate to information processing and the delivery of care.

Nurse managers and administrators are responsible for fostering the environments in which patient-centered and technologically competent nursing care can be provided. Systems in which communications between administration and staff incorporate humanistic ideals of respect, trust, and autonomy will contribute to the nurse-patient relationship. Ongoing staff development must be a priority to help nurses not only become and remain competent with the technology we use, but also become more adept at identifying and meeting emotional needs of the patient.

McConnell reminds us of the importance of integrating the patient's perspective and lived experience with technology as a component of nursing research regarding technology and nursing practice. The use of including patients in technology assessment research is increasingly emphasized and will serve to promote a more humanized delivery of nursing care based on research findings.

Nurses must always remember that the patient's well being drives the choice of technologic intervention. Psychological, as well as physiological conditions, in conjunction with relevant policies as procedures, must be examined in light of these choices.

Psychologist Barry Schwartz asserts that practical wisdom is the master virtue essential to solving problems and conflicts in the workplace. He identifies the "moral will to do the job right," and the "moral skill to figure out how to do it right" as essential traits that must be developed for those of us who care for other human beings. Schwartz challenges us to look to wise teachers for mentoring. Who in your workplace seems to integrate both technology and humanism in ways that work for both patient and nurse? Who shows both the moral will and moral skill to achieve the very best outcomes for patients? Are these persons celebrated for their successes? What can we learn from them? How can we provide a more seamless delivery of nursing care that incorporates technology and attention to the human needs? If you have thoughts about these questions, the Tennessee Nurse wants to hear from you. And if you know of nurses who are good role models for integrating technology and the human element or care, please let us know who these are! We want to identify and celebrate them via the Tennessee Nurse! Please forward your comments to cglass@tnaonline.org.

by Fern Richie, DSN, RN, APRN-BC
Gale Copyright: Copyright 2012 Gale, Cengage Learning. All rights reserved.

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