This Gets My Attention

By way of a tweet from @JaeSelle, I found this post from Sarah Cowherd (@SarahBethRN), where Beth relates the story of using an iPhone application during one of her shifts. She’s writes that she is then approached by her supervisor who tells her:

Sarah, you need to put your phone away while working. It really looks bad, and not to mention you are not focused on patient care.

Sarah was using Medical Lab Tests, an iPhone application, in the care of her patient.

Now this is very interesting.

Sarah’s view of patient care as a “new young nurse” is that technologies like iPhone tools can be used in the ordinary course of care provided to patients. Sarah has a perfectly caring view of technology – that mindful use of technology can enhance the recruitment of knowledge and the delivery of care.

Sarah’s supervisor’s view of patient care is that the caregiver’s eyes and other natural faculties of attention are what define care, and that technological devices are likely distractions – and thereby weaken patient care.

Niether of these nurses are wrong. They each beam their perspective based on their own backgrounds. The technological and cultural conditions in which Sarah grew up were different from her supervisor’s.

And yet we know the “right” answer. We know that technologies won’t go away. We know that technologies – ventilators, stethoscopes, palpation techniques, medications – are vital to health care.

Sarah’s supervisor is right, in a sense, to claim that a nurse or a doctor using an iPhone “really looks bad”. Patients do want to know that their caregivers care and pay attention to them. My sense is that Sarah’s supervisor cares deeply about patient care, but that she just hasn’t had the nudging needed to know that an iPhone isn’t a toy to everybody.

She hasn’t been shown – vividly – how re-purposeful these technologies can be.

What…we’ve…got…here…is: Failure to communicate!

Or rather: connect.

We have a disturbing disconnection between the past and the future (which is now). It’s disturbing on these levels:

  • Technological literacy and competence is core to nursing and medicine. Core.
  • Willfully disregarding the cultural ramifications of technological disruption within Healthcare is tantamount to inattention to patient care
  • 21st Century nursing and medical educators have a duty to instill and encourage the proper use of technologies clinically
  • Hospitals have an obligation to create environments that foster innovation, problem-solving and patient communication and education for this century

Sarah’s story may seem like a small one on the surface.

But this problem goes deep. Deep. Deep Deep DEEP.

This partially explains why we still have paper medical records and can’t have ubiquitous, invokable and secure medical data in the year of our dear lord Two…..Thousand…….and……..Ten.

This mentality has cost all of us dearly.

Now Josh raises a good point about form: the iPad may alleviate clinical concerns about how providers look to patients as they access information through a plate of glass. That the iPad’s size and design creates a mutual ambiance between patient and provider. (Something to think about in healthcare technology innovation.)

Nevertheless, we need a way to solve this problem. This failure to connect the “old” world with the “new”. (They’re really the same worlds – just different experiences and lenses.)

We need education here.

We need more nursing and medical students to express their views without fear of retribution from those ignorant of their world.

We need more hospitals and schools to get more involved with today’s technology – and not just setting up a Twitter account and a Facebook Page. I mean, really ripping it up and taking the time to understand – at a fundamental level – just what’s happening in the world today.

I often hear “Oh, well, Healthcare always has a lag”.

Screw the lag. That’s no excuse.

Baby steps aren’t going to do it. Not anymore. Not today.

This gets my attention.

I hope it gets yours.

I hope it gets the attention of those nurses who’ve been abused and disrespected and shit upon for thirty years while undyingly giving dignity to the dying, who – after feeling abandoned – walled themselves off from the world around them.

I hope it gets Sarah’s. I hope you wish her the best in her career. I hope you Like her.

Because Sarah represents the bright future of caring nurses who just want to bring Healthcare into the 21st Century.

Is that too much to ask for?


0 Replies to “This Gets My Attention”

  1. Very powerful and well written article Phil. The first time my PCP walked into the exam room carrying an iPad, with my annual lab panel results onscreen, I was both amazed and delighted. If he had been carrying an iPhone, with head bent over and two thumbs on the device, I too would probably have had a less enthusiastic first impression – at least until it was explained to me what he was looking at.

    Your point on form and design of technology in the healthcare provider environment is very perceptive, and key to general widespread acceptance, IMO. For the provider, design that allows for ease of access, ease of information retrieval, and ease of data entry I (like a piece of paper), but is secure and scalable (not like a piece of paper), is paramount. For the patient, design that doesn’t get in between (physically or perceptually) himself and the provider is critical, as you described.

    So much continued reliance on paper in 2010 in medicine is hard to accept, but easy to explain given the context of the players involved (throwing payers and patients into the mix here too). But the light seems to be showing at the end of the tunnel, finally, at least from my experience . Looking forward to reading observations and thoughts on this from your perspective in 2011.

  2. It needs more discussion for sure. Amd its a top unoversal in all workplaces–the generational tech gap–early adopters are alien and socially disconnected in the opinion of sage elders It always gets down to “how you communicate it”. Proactive communication will help shephard acceptance of tech habits–vs having to react/explain. @SarahBethRN and compatriots will conquer acceptance obstacles by proactively sharing their care philosophy and tactics–with supes and patients. Whenever we are on defense/forced to explain, we feel/appear guilty or full of excuse rather than being leaderly. Early adopters might seek supervisors, show, teach and share prior to that awkward moment when the assumption is made that caregivers are distracted by their phone–rather than the a leaderly caregiver who knows how to supplement best care practices with technology.

    1. Agree that the problem spans across industries.

      Technological disruptions always create gaps. It’s just now the gaps are widening faster than those created over the last few thousand years.

      I can’t imagine what the gaps will look like in 10 years.

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