How many students pulling all-nighters right now in nursing school dream of becoming a device interface when they graduate? What would the course description look like anyway? Maybe something like: Device Interfaces in Modern Nursing — In lieu of automated systems, today’s nurse is expected to spend an inordinate amount of time manually typing and/or writing information down on a sticky notes from medical devices to electronic health records (EHR). While it’s not a course they teach, the task of manually and inefficiently managing data between devices is what nurses are being tasked with in the real world every day, and it comes with high costs.
Healthcare Technology's Role
We need to stop doing all the work the machines should be doing. We’ve done it with toll booths, bank tellers and retail checkout counters; in the case of healthcare, it won’t erase a workforce, but free it. This isn’t to suggest we need a generation of Luddite caregivers. We need nurses now more than ever to interpret data, to understand and engage with new technology, but that technology must contribute to the improvement of quality of care, not take away from it. “The nurses have been our interoperability device interface," said Jean La Valley, a senior technical analyst with Geisinger Health System, in an article with Modern Healthcare. In essence, because we haven’t yet achieved our nation-wide goals of interoperability, the quick (and inefficient) fix has been put it on the nurse’s plate.
In a 2015 survey conducted by the Harris Poll and West Health Institute, 93 percent of nurses strongly agreed that medical devices should be able to seamlessly share data with one another automatically, and 91 percent report that if they could spend less time dealing with devices, they would spend more hands-on time with their patients — delivering more care, more human to human interaction. “Nurses enter the profession because they want to care for patients, not because they are interested in programming machines,” said Patricia H. Folcarelli, RN, in a West Health press release linked to the survey.
Nurses aren’t interested in going on scavenger hunts either. Just as technology must start working for hospitals (not against them) in the delivery of care, we need to phase out all the inefficient legacy workflows in the hospital. The manual process of having dispatchers in departments routing phone calls for service requests conjures black and white images of Ma Bell switchboard operators, not a modern healthcare facility where nurses can get things at the push of a button — especially when something as commonplace as pizza delivery is automated. Along with “device interface”, most aspiring nursing students wouldn’t cite “hunter-gatherer” as a career goal either, but it’s an essential task for them in hospitals with antiquated and/or broken workflow of their asset management. In this type of environment, nurses call and request a device — don't receive it in anywhere near a timely fashion — so they take matters into their own hands, finding the pump or scanner they need by themselves. Because they can't rely on the system to work, they end up hoarding the device, which contributes to the snowball effect of device shortages at the hospital.
Quality of Care
With regards to the delivering quality care, everyone’s a stakeholder; patients and families, their nurses and the hospitals employing them. In her research, Kristen M. Swanson, RN, PhD, found that, “For nurses the outcomes of caring — that is, how it feels for a nurse to practice in a caring fashion — includes: A sense of accomplishment, self-satisfaction and having a purpose to his or her own life.” The inverse of this she states, “Included feeling hardened, oblivious, robot-like, depressed, frightened and worn down.” There are a number of factors that can contribute to nurse burnout, it’s a complex issue, but it’s safe to say that feeling robot-like at your job isn’t a remedy, in fact it’s more like a recipe for error. In the aforementioned Harris Poll, 50 percent of surveyed nurses said they’ve witnessed a medical error because of lack of device coordination. So in effect, the current lack of interoperability between devices and EHR in healthcare has created a double whammy for nurses and hospitals, by taking more time away from caring for patients and creating an environment for increased reporting errors.
According to AMN Healthcare's 2015 Survey of Registered Nurses: 85% of all nurses said that overall they are satisfied with their choice of nursing as a career. Nursing has held the top spot in Gallup’s “Honesty/Ethics in Professions” poll in the last 14 out of 15 years (coming only second to firefighters after September 11th 2001.) That says something profound about how we view the profession. It speaks to the interpersonal, human-to-human contact we have with nurses, and the trust we have that they'll take care of us. You can’t automate that away. You can’t automate holding an ailing patient’s hand at bedside. You can’t mechanize empathy. On the contrary, we can streamline and automate the tedious and inefficient workflows of nursing and the hospital support service departments around them. In just a few years healthcare has taken big strides in the advancement of its information technology; indeed not always to the benefit of patient care. Moving forward, we need more technology in healthcare that allows nurses more time; more time to be with their patients, more time to be nurses.