Technology - friend or foe?

Medical science these days has a lot of impressive machinery designed to keep people alive and make life easier for personnel. In many cases, it is a modern marvel and really does save lives. And yes, it can certainly make our life easier!

But - have we lost that "nursing sense" in the process of creating, and using, these technological miracles? Do we rely too much on what the screen says, instead of using our own assessment skills, and our very own, highly tuned senses? Have we forgotten about, or ignored, our own intuition because "the machine said so?" What has happened to hands-on nursing? I know I have been worried about a patient before even beginning my obs, and I'm usually right. You can often see just by looking if they are unwell or not - the machines should be used to confirm your suspicions, not just as a routine thing because you have to do obs 4 times a day. Have we taken the "nurse" out of nursing?

A few recent cases spring to mind that make me wonder about all this technology.

A patient with an irregular heart rhythm would always show up as bradycardic on the obs machine, whenever her obs were taken. EVERY TIME. Another nurse initiated a "rapid response" as the heart rate was in the red zone on the chart - those who use SAGO charts will know what I mean. This meant interrupting the doctor at his rooms, meaning he would need to come over to the hospital and assess the patient. Upon palpation, the patient's pulse was of an acceptable rate - its irregularity tricked the machine, as is often the case. The doctor was not impressed. It is also difficult to get accurate blood pressure readings on such patients. One thing I always do is to check any anomalous readings manually - and I notice that not all nurses do this. It's one of the basic things I've been taught along the way, and it surprises me that not everybody does it. Machines are renowned for being inaccurate the further away from normal things are. And besides, if you really want to be sure of something, do it yourself!

Another case was a patient with abdominal pain who was x-rayed, and that x-ray interpreted at the time to show faecal impaction, despite the atypical symptoms and the doctor thinking otherwise. This patient was then subjected to various methods to "get things moving" so to speak, which are not pleasant. The next day when the official report arrived from the radiologist, it described no impaction. It was a normal x-ray. The patient's carer was most upset, as you can imagine. I do not know what the eventual diagnosis was, but they left the hospital most disgruntled about getting two different stories, and being subjected to treatment which really was unnecessary. While this case was a more difficult one to understand without the use of technology, it highlights that once again, intuition is lost to technology, and is not always correct. It is open to interpretation, like everything else.

Have we lost our intuition, and our holistic assessment skills? Surely we can see if things look good or look bad? They spend three years teaching us about critical thinking, judgement and assessment skills, yet once we go out in the field, in many cases this is all forgotten, and the easy route of using the machine rather than our brain takes over. We are still the ones who have to figure out what those numbers mean for our patients, and it's this part of the equation that makes the difference between nurse, and skilled nurse. We can all push a button, but can we all put the pieces together to form the right picture? And can we all gather the RIGHT information to build that picture? I hope so, because people rely on us to get it right.

Are all these machines better than doing it the old-fashioned way? I truly wonder. I'm sure it's possible, on some wards, to get through an entire day without even touching a patient, and that truly scares me.