Healthcare practices have been transformed over the past decades in large part due to advances in tech and nursing. In addition to advances in equipment and knowledge, providers began to implement more technology into their daily tasks including electronic health records (EHRs). And then unexpectedly, the COVID-19 pandemic ushered in sweeping changes. From increased virtual visits to additional monitoring and data, healthcare teams are tasked with striking a balance between providing patient care and using data and technology to enhance that care.
A recent Elsevier Health/Ipsos Clinician of the Future report shows the line between technology’s advances and burdens to healthcare providers. While technology can actually reduce time for finding trends or receiving urgent alerts, many clinicians who responded to the report are concerned that the additional technology could end up taking more time out of their already packed days–and away from their patients. In fact, the report states that 69% of U.S. nurses say they believe the volume of patient data available is overwhelming and that training will help reduce that burden.
“Technology must support nurses in selecting out what the crucial facts they need to pay attention to right now, how the status of the patient has changed, and what action is needed,” says Marion Broome, PhD RN, FAAN, Ruby F. Wilson Professor of Nursing at the School of Nursing, Duke University. The Clinician of the Future research says 51% of U.S. nurses believe the widespread use of digital health technologies will enable positive transformation of healthcare in the next 10 years, but 79% also say this will be a challenging burden on their responsibilities.
Although tech-literate nurses might have an easier time adapting to the tech and nursing advances, all nurses require the dedicated time and skill to apply the data. “The biggest challenge for nurses is interpreting the massive amount of data each patient generates,” says Broome. “They are expected to look for trends, understand how their status has changed over time, know whether to worry or get a second opinion. It’s important that nurses anticipate issues before things get out of control.”
Nurses who work in patient care settings feel these impacts directly, says Broome. “In patient care settings, technology has a tremendous impact,” she says. “Nurses are required to do a lot of the information intake and assessments. There are policies in each system around the timeframe they have to do those – usually within 24 to 48 hours of admission. Some of the admission questions are hundreds – 150-200 last I looked. When caring for patients, it falls on nurses to document all of their care, anything they do for the patient – medication, dressing, communication, discharge planning – just the entire thing.”
Often the EHR, a huge benefit to organize patient records and allow access among providers, is a responsibility of the nurses, says Broome, especially in acute care settings. “With EHRs, there are lots of alerts–recommendations for care, medication interactions, planning, etc., that pop up,” she says. “Any interactions or calls between the physician and family must be documented–there’s a burden involved. Depending on the hospital, you’re often caring for 4 to 8 patients. Many nurses will talk about the EHR as an additional patient. And it’s not like they’re sitting at a computer most of the time! They are with the patient.” Reliable voice recognition is a tool many providers would welcome and that could help reduce the burned on documentation.
And although the majority of tech and nursing practices use the same EHR platforms, many nurses will need to adapt to varied technology from the first day on the job. “Think of the kind of care required for COVID-19 patients,” says Broome. “There are patients who require 10-20 intravenous solutions (i.e., drips). Every single drip is delivering a different medication and using different pumps. And those pump settings are managed by nurses. Then, when patients are in the ICU, nurses are expected to understand respiratory settings. While it’s the primary responsibility of a respiratory therapist, it’s critical nurses be able to use that technology.” Nurses have to be fluent in each unit’s technology so they are alert to changes.
The report offers insight for tech and nursing in the future, noting that nurses believe the three most valuable capabilities right now are critical thinking, clinical knowledge, and communication skills. Over the next 10 years, they anticipate a shift that prioritizes technology literacy, clinical knowledge, and critical thinking.
According to the “Clinician of the Future” report, in the next 10 years, doctors and nurses anticipate a health care system where technology is infused throughout patient care–from the technology companies as key stakeholders in managing healthcare systems to clinicians who will base the majority of their decisions using decision support tools that utilize artificial intelligence or even the patients who will engage with chatbots at higher rates.
Broome says the report highlights challenges, offers solutions, and highlights some areas of concern that deserve careful attention. “A challenge,” she says, ” is moving forward with technology, while considering major concerns around tech literacy, loss of empathy, and making sure health care becomes more inclusive, not less, are critical.”
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