My robot my caregiver?

The nursing and healthcare workforce is aging. Who will take care of the Baby Boomers when they retire? The answer could lie in the field of robotics. A lot of the legwork is being done in Japan. The carmaker Toyota has created Robaina and Humanoid as robotic nursing assistants.¹ Likewise, their rival Honda has gone ahead with ASIMO (the Advanced Step in Innovative Mobility) robot that can even talk to a patient.¹ Just who is buying these robots? This is not science fiction. Sales projections show that between 2016-2019, 37,500 units will be sold. According to the International Federation of Robotics, this figure will increase by 2038.¹

THE JAPANESE

Japan is leading the push for robotics for two reasons. First of all, there won't be enough grandchildren to take care of elderly Japanese due to the shrinking birth rate in that country.¹ How severe is the situation in Japan? The numbers tell the story. The nation is looking at a projected need for 2.53 million healthcare workers in 2025.⁴ Secondly, Japan has strict guidelines regarding importing workers into their country.⁵

THE SHINTO RELIGION

The mindset of the Japanese also allows for the Shinto religion, which includes the concept of animism.⁶ This involves the idea that humans and non-human objects possess spirits. This philosophy is in line with a robot caretaker more than western cultures, such as the United States. Harking back to the film Frankenstein, there has been a reluctance to accept non-humans in our society.⁶ In the US, the dependence on those who immigrate to this country has historically filled the aide role.

U.S. INVOLVEMENT

Despite the reluctance of the US to embrace non-human technology, there is some encouraging news on this forefront. This involves the National Robotics Initiative which was created in 2011 by President Obama.⁷ Its goal was to develop robots for use in technology, as well as to assist the elderly and the military. Google is leading the charge with purchases of a robotics company and an artificial intelligence firm.¹ A firm called ReWalk Robotics developed in Israel created the exoskeleton or robotic walking assist system.² This will help stroke victims literally get back on their feet. They have a US base as well, in Massachusetts.

Also in the United States, Toyota is leading the pack of developers with the Human Support Robot platform. Quality of life or QOL is the main impetus behind this creation. In the hospital setting, improving QOL has endless possibilities. These include forefronts on the nursing, physical therapy arenas as well as services for the blind. They include robotic leg braces that will give back mobility to paraplegics, as well as helping to return sensory awareness to those with vision problems. Finally, the mother lode in rehab, moving patients from the bed to the chair, a victory for nurses, but especially for those working in neurology with stroke and Parkinson's Disease patients.

NURSING'S CHANGING LANDSCAPE

The driving force for employing robots in the healthcare field is one of need. The nursing landscape is changing. There is a reliance on computer programs like EPIC for nursing documentation as well as medication administration. This is a streamlined process to charting and giving medication which allows for faster documentation and fewer errors. In so far as robotics are concerned, that is the next wave of the nursing landscape. When this technology comes to the mainstream nursing environment, there will be a new mindset about human vs. robot caregivers.8 Concepts such as the notion of what giving comfort to patients means as well as the implications of safety issues will change.⁸

A ROBOT ON YOUR TEAM?

Let's look at a fictional version of the new healthcare team in the future. What if we had a robot on our team? The funny thing is that there is often a lack of communication between RNs as well as between RNs and CNAs (certified nursing assistants). The details regarding patient care are given between shifts, during report. What will happen to the concept of report if one of the caregivers is a robot? The mind boggles regarding the possibilities. Solutions probably lie in the realm of programming. Working out the details to accommodate demanding patients and how the robot would deal with one will be the trick. This is where a human touch will come into play and the robot must be able to deal with the intricacies of human emotion like fear and uncertainty with a patient experiencing their new normal.

REFERENCES

1. Japan automakers look to robots to keep elderly on the move | Reuters

Tajitsu, N. SCIENCE NEWS Japan automakers look to robots to keep elderly on the move Published April 12, 2017. Accessed July 5, 2018.

2. Israel's ReWalk turns focus to stroke victims with cheaper walking device | The Times of Israel Israel's ReWalk turns focus to stroke victims with cheaper walking device

Solomon, S. Published April 9, 2018. Accessed July 5, 2018.

3. Toyota completes first in-home Human Support Robot trial in North America - TechCrunch Toyota completes first in-home Human Support Robot trial in North America Etherington, D. Published Jun 30, 2017. Accessed July 5, 2018.

4. Shortage of nursing care workers | The Japan Times Editoral Published July 7, 2015. Accessed July 5, 2018.

5. Japan Limited Immigration; Now It's Short of Workers - The New York Times Japan Limited Immigration; Now It's Short of Workers Jonathan Soble Published Feb. 10, 2017. Accessed July 5, 2018.

https://www.technologyreview.com/s/421187/why-japanese-love-robots-and-americans-fear-them/

6. Why Japanese Love Robots (And Americans Fear Them) Christopher Mims

Published October 12, 2010. Accessed July 5, 2018.

7. Supporting the President's National Robotics Initiative | whitehouse.gov August 3, 2011 Supporting the President's National Robotics Initiative Kalil, T., and Thorpe, C. White House Blog Accessed July 5, 2018.

8. Erickson, H., Salzmann-Erikson, M. Future Challenges of Robotics and Artificial Intelligence in Nursing: What Can We Learn from Monsters in Popular Culture? The Permanente Journal 2016 Summer; 20(3): 15-243. doi: 10.7812/TPP/15-243