Is Technophobia a Nursing Diagnosis?

The technological advances of the past decades have had a major impact on every aspect of our society, and nursing is no exception. Some specific examples of the technological advances and their impact on nursing practice, such as the use of IV pumps in the place of counting drops timed by the second hand of the nurse’s watch, the development of CADD/PCA pumps to administer patient controlled analgesia, and the increased use of technology at the bedside, from digital thermometers to other patient assessment tools, have had a tremendous impact on the way in which nursing care is provided at even the smallest home-town hospital.

I have observed that while many nurses who received their training or formal education prior to the development of the digital age have incorporated advanced technology into their personal lives, they maintain a sense of resistance to the use of these same advances in their professional lives. For instance, a nurse might use an ATM machine rather than visit a bank teller, without thinking twice; she might use her cellular phone on a regular basis rather than seeking a pay phone, and she might be comfortable using the self-check-out lane at her local grocery store. All of these are the result of technological advances that did not exist decades ago. This same nurse however, may be prone to resistance in the use of nursing related technological advances, such as computerized medical records or wireless point-of-care assessment and documentation tools. 

To illustrate this with an example from my own experience, I currently serve as a hospital trainer for our point-of-care bar-coded medication administration and documentation system. Prior to making the switch from traditional paper medication administration records to the new medication carts with computers, and handheld PDA’s with scanning devices, we provided each nurse employed by the hospital with 8 hours of class. We implemented the new system in such a way that every nurse administering medications had a trainer directly at his or her side to provide 1:1 assistance and additional training. During the first three weeks of using the new program, I worked 7 days per week for 21 days in a row, from 6:30 am to 11:30 pm ( we run 12 hour shifts) in order to train each nurse on our unit. If I had a nickel for each time a nurse told me that she “didn’t like computers” the pile of coins would have greatly exceeded the overtime pay that I earned in that time period.

Several months after the initiation of the program, I continue to struggle with educating nurses who have a negative mind set against the technology itself. Their statements that the use of bar-coded medication technology hinders their ability to provide hand’s on patient care is one that I attempt to counter on a daily basis, by pointing out that the scanning of a patient’s arm band to verify the correct patient, scanning the medication bar code to verify the correct medication, and then re-scanning the patient arm band to confirm the medication administration are essentially the same steps that they should have been taking all long in reading the band, reading the med order and the med label, and reading them all again. I state emphatically that this digital confirmation does not decrease patient contact, rather it allows for an increase in conversation with the patient, while the scanner does all of the reading and verifying. In this particular instance, although I receive feedback that technology has a negative impact on the nursing process, I believe that stated drawback to be unfounded. This is an example of how a technological advance actually allows the nurse to spend MORE time completing an assessment and providing interventions to her patient, and not less. I view the fact that medication administration is now recorded in a digital real-time format that allows not only for the availability of that information to all necessary members of the treatment team while decreasing the amount of time required to document medication administration as a significant improvement in nursing process. Considering that it has been estimated that nurses spend as much as 50% of their time gathering, coordinating and documenting information, than surely any technological advances that lead to a combination and simplification of a portion of these activities has to lead to an improvement in quality of care.

Having said that I feel one of the major drawbacks to the use of technology in nursing to be nurses resistance to that technology, I believe that the only method by which that drawback can or will be overcome is to continue to educate nurses, both previous and coming generations, in technological advances as they occur. By providing not only application-specific education to meet the needs of particular job requirements, but by incorporating computer education into both program curriculae and continuing education, we can bring even the most computer-phobic nurse into the 21^st century.