The conversation went something like this. "Do you believe that robots will ever replace nurses at the bedside?" my neighbor asked. I responded without hesitation, "Of course not, patients are so complex with highly individual needs that nurses assess and address. Robots may be able to assist with monitoring and simple tasks, but not with meeting the patient's and family's individual care needs in times of stress, pain, and uncertainty." "I'm not convinced," my neighbor replied, "especially in light of my experience with two nurses caring for a critically ill relative that I recently visited. They never talked to the patient or me, even when I asked a simple question. They checked the monitors and the gadgets hooked to my cousin, much like a robot would, and scurried out of the room. I guess watching these nurses got me to thinking about robots."
In their exploration of whether humanoid nurse robots can replace human nurses, Locsin and Ito1 challenge us to think about the nature of professional nursing practice. If, on the one hand, nursing practice is viewed strictly as a prescription of tasks and expectations, of simple cause-and-effect phenomena, then it might be possible to program "nurse robot" replacements considering technological advances. On the other hand, they assert that nursing practice is a "dynamic process" including technological knowing, which views the patient as a participant in care, not an object. This dynamic nursing process also includes mutual designing in which the patient and the nurse jointly create the plan of care as they engage in the dynamic patient-nurse relationship. Robots can help with tasks such as lifting, performing laboratory tests, surveying, and keeping the environment clean. Triage robots can be programmed, for example, to collect and collate routine health information from patients to inform clinical decision-making.
I cannot, however, imagine a robot sophisticated enough to perform a "work-around" in a difficult clinical situation, or challenge an errant physician, or differentiate symptom sets based on patients' individuality, or comfort a patient who fears dying. My neighbor's description of nurses caring for his family member was alarming. It reminded me of the tension that has long existed in nursing curricula-the balance in emphasizing expert, technologically driven practice framed by the nursing process, that is, task efficiency and competency, against "caring" by a knowing nurse with insight and empathy for unique and often unpredictable patients and families with nuanced needs that go far beyond the physiological. I concur with Locsin and Ito, "If nursing is to continually 'serve' humanity, ... the science of caring (should) be considered the main character in advancing, affirming, supporting, and legitimizing contemporary and future nursing practice of knowing persons as caring."1(p5) If, however, we accentuate technological prowess as the heart of nursing, will the following question emerge in the next hundred years: "Can robots be replaced by human nurses?
- Gloria F. Donnelly, PhD, RN, FAAN, FCPP
Editor in Chief
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