Nursing, Technology and Artificial Intelligence: The Future is Here!

[jeastridge, BSN, RN]

At a recent family reunion, a relative who has type 1 diabetes showed me her discrete continuous glucose monitor attached to her underarm. “And it displays on my mom’s phone too, so if I have any problems, she is alerted!” The teen quickly and deftly checked her sugar, switched to her insulin pump and punched in the correct numbers to make the necessary adjustments. Her mom seconded the revelation with her enthusiastic approval, “It’s really revolutionary!”

From continuous glucose monitors, to home sleep tests, to remote telemetry to artificial intelligence programs that can predict oncoming sepsis or help to interpret EKGs and radiographic tests, technology continues to make big strides into the healthcare arena. As professional nurses, are we ready? Do we know how we can maximize our influence, improve our knowledge and grow in adaptability so that we make sure the new tech is serving the patient well and not just a fancy, expensive and relatively useless device?

What is AI?

Artificial intelligence (AI) is defined as “the theory and development of computer systems able to perform tasks that normally require human intelligence, such as visual perception, speech recognition, decision-making, and translation between languages.” Predictive modeling and big data analysis are the way of the future — not only will AI insert itself into patient care, it has the potential to effect major changes in the delivery of care.

“If we don’t mediate this technology, someone will do it for us,” says Richard Booth, an assistant professor of nursing at the Arthur Labatt Family School of Nursing in London, Ontario. He goes on to say that we have to be looking ahead and helping to define which roles will be taken over by assistive devices and which nursing roles remain solely under the purview of human nurses. Booth says, “We have to plan our own obsolescence to some extent because some predictable nursing work and activities that aren’t extremely complex will be automated. AI and new technologies hold both pitfalls and promise.

Potential pitfalls include:

Computers compete- Computers and monitors often take nurses’ attention away from the patient. While they focus on the monitors, they may miss important visible and audible clues and make the mistake of putting machine over mindfulness.

Alert fatigue - Machines often cry “wolf,” and falsely alert or have their parameters set incorrectly. So much so, that bedside caregivers often ignore the blaring alarms, confident in their ability to respond should a real emergency occur. We have all been past nursing stations where alarms are going off and because they know everything is ok, the annoying sounds are treated as background noise by necessity.

Machines misread - EKG are “read” incorrectly by the AI in the machine, pulse oximeters go off when the patient is simply cold, false alarms keep us scurrying to respond and sometimes make it more likely that a real problem will go unnoticed.

Promises include:

Machines never get tired. Continuous monitoring of pulse and respiratory rate and pulse ox is incredibly valuable and helpful. Gone are the days of waiting for the q4h vitals in acute care settings.

Machines remember. Whether keeping track of blood sugars or blood pressures of apnea or any number of other parameters, machines are just about perfect with the mundane tasks that humans often are imperfect with: those repetitious and boring but completely necessary levels and numbers that we need to track.

Machines are perfect with some chores - Correctly identifying a patient with a scan, long a source of confusion and mistakes, is no longer so fraught with trouble. Machines never mess up on stuff like that! And they don’t mind recording and tallying up encounters, medications, location, etc.

Machines monitor continuously - The nurse can be free to check on other patients because she can know that the machines will alert her if a critical problem develops.A nurse who has been in practice for 50 years, once told me that when she first started working “on the wards” at night, she sometimes had to bring the patient’s bed out into the hall to be nearer to her so that she could watch for changes in color or respiratory status. Her eyes and ears and touch were the only assessment tools that she had! Thank goodness, we have moved on from there.

Nurses are essential parts of the healthcare team. All the changes in technology and the predictive help of AI will not alter that. But we owe it to ourselves and to our patients to be vocal parts of the change process, keeping up with innovations and monitoring our own responses and our patients’ responses. After all, no technology ever cared.