Technology and the Nursing Shortage

The ethical concern I have identified is two-fold dealing with technology and the nursing shortage. My concern is how to implement and employ costly technological advantages to improve workflow processes, efficiency, and utilization of nursing services in reaction and preparation to the current and future nursing shortages.

Though my literature review is limited in focus, the consensus is apparent that nursing, as well as healthcare, needs to embrace technology. Current and past statistical analysis indicates there will be an ever increasing need for nursing care and a decreasing workforce to pull from. According to Simpson there was a predicted "shortage of one-half million nurses in the United States in 2006" (2005, p. 32). In 2005 - 2006, The Virginia Nurses Association projected an astronomical "490 percent increase" in vacant nursing positions over the next 16 years (p. 1). With such gloom nursing shortage predictions, it is of necessity we must focus on better utilization of these precious resources instead of only on how to increase the amount of resources. Technology can help to bridge this resource gap.

Evidence gathered from multiple avenues suggests the use of technology has become almost a necessity in order to cope with the healthcare crisis. In all areas of nursing and around the world a cry is being reverberated to supply nurses with the support needed to answer the call for care. Bower and McCullough suggest the focus should sharpen on supplying better, necessary tools in order to leverage available resources and "bring significant support to a limited number of nurses" (2004, p. 200).

Simpson relates that financial and clinical technological support can improve efficiency in home care by simplifying operational methods, reducing costs, improving compensation and patient care (2005) while Plawecki and Plawecki suggest technology as a method "to accurately monitor and document patient care" (2007, p. 4) in order to best protect from litigation.

Villeneuve, the Canadian Nurse's Association (CNA) scholar-in-residence suggests that we are not tapping the technological resources currently available to our profession (2007). He explains that we are all aware of the shortage, but it is time we took action to mobilize appropriate resources, i.e. technology, and do something about the problem (Villeneuve, 2007). In the United States, The Joint Commission (TJC) recommends using technology as a means to improve workflow throughout healthcare (Courtney, Demiris, & Alexander, 2005).

There is little to disagree with because throughout the scope of my review the general consensus is in agreement that technology is, at least in part, the answer to the nursing shortage crisis. Furthermore, I believe strongly in the ideas put forth by Courtney, Demiris, and Alexander that technical knowledge, skills, and attitudes will be the major determining factor in nursing acceptance of technological innovation (2005). Though Bower and McCullough are correct in stating that technology saturation will be a costly venture (2004), the human obstacles may prove to be the greatest to implementation and the healthcare makeover.

As a pioneering member of the nursing informatics profession, it is often difficult to know exactly which way to turn and what is the best course of action. This simple review reminds me of the many contributions I can make to significantly impact my profession in informatics, nursing, and all of patient care. Simpson's example of the e-prescribing ability to prevent greater than 3 million adverse drug events and using scheduling programs to save nurse managers the time they spend on manual processes (2005) are excellent examples of innovations I am and can be a part of. As my organization proceeds through bar coding at the bedside implementation, I gain a new breath of fresh air by re-identifying with the purpose for my efforts.

Two other areas I became more aware of through my investigation are my role in acceptance and in protection. Courtney, Demiris, and Alexander's emphasis on the importance of helping nurses to gain the necessary knowledge and skills, helping them to become aware of the benefits, and helping to mold the new culture of care brought about through technology (2005) encourages me to remember the larger impact of my daily routine. I am further reminded by Plawecki and Plawecki that computer documentation systems can help streamline documentation so that nurses are able to record more in less time (2007). This reminds me that my job is never done and I must always seek to improve the process for nursing and patient care.

There is no doubt that enormous changes related to technology and the nursing shortage will occur over the next several years. As the percentage of hospitals utilizing bar-coding at the bedside increases, I foresee a lessening of adverse drug events and less patient injury. Hospitals and other healthcare organizations will become increasingly technologically dependent leading to better utilization of nursing resources, improved patient care, and an overall decrease in costs as the benefits of technology overcompensate for the cost of implementation.

Sadly, though, progress does not come without a price. I expect to see a new wave of litigation related to computer documentation and the imperfections we have yet to discover. Of no surprise, there will be confidentiality issues and enormous need for security to protect patient data. Though there will be need for increased technological education, implementation, maintenance, and security resources, healthcare will welcome an overall improvement in care and cost savings as a result of coming of age in a technologically demanding world environment.

In summary, I will refer to statements of clarity and vision made by Simpson and Plawecki and Plawecki respectfully. Simpson concisely sums up the changes that are to come in stating that "technology is nursing's future - it's up to nursing to embrace it" (2005, p. 34). Plawecki and Plawecki echo the foresight of Simpson by telling us that "integrating technology into care regimens is inevitable" (2007, p. 4). I observe the coming of age of this projected future and inevitability on a daily basis. Fortunately, I have placed myself on the forefront of the wave in an effort to help lead our profession into the new horizons and emerge as leaders in a new healthcare environment.

References

Bower, F. L. & McCullough, C. (2004, Jul/Aug). Nurse shortage or nursing shortage: Have we Missed the real problem? Nursing Economics, 22(4), 200-203.

Canadian Nurse's Association. (2007, February). Toward 2020 - Encouraging discussion on future directions. Canadian Nurse, 103(2), 12.

Courtney, K. L., Demiris, G., & Alexander, G. L. (2005, Oct-Dec). Information technology. Nursing Administration Quarterly, 29(4), 315-322.

Plawecki, L. H. & Plawecki, H. M. (2007, September). Guest editorial. Your choice: Documentation or litigation? Journal of Gerontological Nursing, 33(9), 3-4.

Simpson, R. L. (2005, December). Is nursing ready for 2006? Nursing Management, 36(12), 32-34.

Virginia Nurse's Association. (2005, Nov - 2006, Jan). A call to action ... Virginia Nurses Today, 13(4), 1, 21.