Embracing new technology is critical care challenge
January 1, 2000 4 minutes read
Embracing new technology is critical care challenge
Getting frontline ICU nurses in sync with changing patient-care technology may be the next big frontier in critical care, according to experts.
As many managers are discovering, the effort to get rank-and-file staff up to speed with new developments is proving a lot more vexing than previously believed.
"The nature of critical care medicine is for staff to be proficient with certain types of technology," says Tom Ahrens, DNS, RN, CCRN, CS, clinical specialist in critical care at Barnes/Jewish Hospital in St. Louis, MO. One simple example cited by Ahrens is the use of a Swan-Ganz catheter in hemodynamic monitoring.
"Although this [and other] technology is not new and has been around since the 1970s, all hospitals have it and many do not use it well."
During day-to-day critical care functions, extra time to learn a new piece of technology may not be available for all staff. Many times, the technology is fairly difficult and requires extra time and concentration. "Nurses have many other things to do," says Ahrens. "They are rarely given the opportunity to learn a new technology. They receive no extra time or money to do it. There is little, if any, incentive to try."
Change is sometimes resisted just because the ideas are new and people haven’t had a chance to get used to them or don’t fully understand their implications, Ahrens explains. Often, managers work on implementing the new technology for so long that they assume everyone else understands its capabilities as well as they do.
"I know firsthand from working the night shift that when it comes to technological changes, there are no good support systems or inservices offered at night," says Carol Kenner, DNS, RNC, FAAN, director, education and programs, National Association of Neonatal Nurses’ national office, Des Plaines, IL. "In order to get your staff to buy into it, education is critical for all shifts. Your staff will accept technological change easier if they fully understand the benefits and how it will impact their work."
"The key to getting your staff to accept technology is to prepare the nurses for an upcoming change. Have a classroom dedicated to learning the new technique or task, and incorporate dedicated time in their schedules to practice. That is why effective managers plant seeds’ early, to allow ideas to germinate and become familiar," Ahrens says.
Resisting change won’t stop technology
An effective way to get staff to accept a new form of technology is through peer pressure. "If you have a few key peers who are self-motivated and want to do it well, then peer pressure will usually develop and everyone will eventually catch on," says Ahrens. "You will do it because your friend is doing it and you don’t want to be the only one who can’t conform."
"Nurses play a pivotal role with technology. For example, if a physician needs to know the amount of a patient’s exhaled carbon dioxide, the nurse must know how to manipulate the equipment," says Ahrens. "A physician can’t get information unless the nurse knows how to use the equipment and interpret the data."
Across the country there are wide variations in how hospitals are training their staffs to use new technology and what incentives are effective in encouraging their participation. "To get the staff to become involved, you have to find a way to provide them with an incentive. Whether it becomes part of a performance evaluation or an opportunity for extra money, look for opportunities to inspire your staff," says Ahrens.
"Sometimes we have key people get together for a nice dinner and talk about the plans for the department and what we are trying to do with new technology," he says. "As a thank-you for their participation, we will even give them gift certificates to restaurants to let them know that they are valued and that their thoughts and concerns are heard and appreciated."
A reward system can have a great impact on behavior when altered, but requires considerable thought first. "You don’t want staff to do what will be rewarded and tend not to bother doing what goes unrewarded such as smaller, yet important, tasks," says Ahrens.
As executive editor of the American Association of Critical Care Nurses (AACN), Ahrens’ goal is to try to standardize technology and create a national critical care curriculum. "This is a huge undertaking. We will gather everyone’s individual efforts, and create one unified educational piece that we can all follow," says Ahrens.
"We have to get the best nurses in the country to be major writers of this manual. They know the literature and how to put it into practice. If we are lucky, the program will be up and running in 2001."
Without a strong organization such as the AACN, it would be a major challenge to get everyone to follow suit in creating national standards. "I am pleased that we can finally address this issue," Ahrens says. "Everyone will benefit — the physicians, nurses, and patients — as we all work from the same manual in a consistent effort to provide the best patient care with the best technology available. Without the program, we would have fragmentation indefinitely."
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