DiversityNursing Blog

Nursing departments are known for their willingness to trial new medical technology. From advanced surgery techniques to virtual reality (VR) systems, nurses get to see cutting-edge technologies before most people even hear about them.

Here are three new advancements nurses will see in the near future:

1. Robot surgery

Today's robots may not look like those popularized in science fiction stories, but they have proven to be very useful. In fact, robots have already proliferated within the nursing field.

One of the most exciting robotic advancements in recent years is the da Vinci robot, a multi-limbed piece of equipment that can perform complicated procedures with fewer invasive cuts than traditional surgical methods.

A trained surgeon is still completely in control of the robot, but because the machine has delicate yet strong appendages, it can cut and stitch within highly confined spaces.

2. Advanced prosthetics

Prosthetics have come a long way since the turn of the century. Today, researchers are developing limbs that can be controlled by the patient's own neural system – exactly as they would control a real appendage.

According to MIT Technology review, researchers at Case Western Reserve University have created a prosthetic arm capable of translating thoughts into simple movements. Currently, the movements are simple, but it is a promising step forward.

Meanwhile, at the Massachusetts Institute of Technology, researchers are producing a line of powered prosthetic legs to help amputees walk again.

To see these futuristic biomechanical legs in action, check out the video below:

3. Virtual reality

VR headsets have already made their way into the consumer market, but there's still so much more that researchers can do with the technology. From VR-assisted physical therapy to augmented reality applications, the possibilities of VR medical technology are limitless.

MedicalFuturist explained that VR applications are helping stroke patients recover their motor skills more quickly. By making repetitive exercises more fun, the program increases patient motivation throughout the recovery process.

Nurses in rehabilitation settings are likely to see VR use become more common over the next few years as the technology becomes affordable.

Every day, technological advancements make life a little easier for patients and the professionals who treat them. The above solutions are already in use today and will only become more prevalent as time goes on.

Scientists have created an "artificial womb" in the hopes of someday using the device to save babies born extremely prematurely.

So far the device has only been tested on fetal lambs. A study published Tuesday involving eight animals found the device appears effective at enabling very premature fetuses to develop normally for about a month.

"We've been extremely successful in replacing the conditions in the womb in our lamb model," says Alan Flake, a fetal surgeon at Children's Hospital of Philadelphia who led the study published in the journal Nature Communications.

"They've had normal growth. They've had normal lung maturation. They've had normal brain maturation. They've had normal development in every way that we can measure it," Flake says.

Flake says the group hopes to test the device on very premature human babies within three to five years.

"What we tried to do is develop a system that mimics the environment of the womb as closely as possible," Flake says. "It's basically an artificial womb."

Inside an artificial womb

The device consists of a clear plastic bag filled with synthetic amniotic fluid. A machine outside the bag is attached to the umbilical cord to function like a placenta, providing nutrition and oxygen to the blood and removing carbon dioxide.

"The whole idea is to support normal development; to re-create everything that the mother does in every way that we can to support normal fetal development and maturation," Flake says.

Other researchers praised the advance, saying it could help thousands of babies born very prematurely each year, if tests in humans were to prove successful.

Jay Greenspan, a pediatrician at Thomas Jefferson University, called the device a "technological miracle" that marks "a huge step to try to do something that we've been trying to do for many years."

The device could also help scientists learn more about normal fetal development, says Thomas Shaffer a professor of physiology and pediatrics at Temple University.

"I think this is a major breakthrough," Shaffer says.

The device in the fetal lamb experiment is kept in a dark, warm room where researchers can play the sounds of the mother's heart for the lamb fetus and monitor the fetus with ultrasounds.

Previous research has shown that lamb fetuses are good models for human fetal development.

"If you can just use this device as a bridge for the fetus then you can have a dramatic impact on the outcomes of extremely premature infants," Flake says. "This would be a huge deal."

But others say the device raises ethical issues, including many questions about whether it would ever be acceptable to test it on humans.

"There are all kinds of possibilities for stress and pain with not, at the beginning, a whole lot of likelihood for success," says Dena Davis, a bioethicist at Lehigh University.

Flake says ethical concerns need to be balanced against the risk of death and severe disabilities babies often suffer when they are born very prematurely. A normal pregnancy lasts about 40 weeks. A human device would be designed for those born 23 or 24 weeks into pregnancy.

Only about half of such babies survive and, of those that do, about 90 percent suffer severe complications, such as cerebral palsy, mental retardation, seizures, paralysis, blindness and deafness, Flake says.

About 30,000 babies are born earlier than 26 weeks into pregnancy each year in the United States, according to the researchers.

Potential ethical concerns

Davis worries that the device is not necessarily a good solution for human fetuses.

"If it's a difference between a baby dying rather peacefully and a baby dying under conditions of great stress and discomfort then, no, I don't think it's better," Davis says.

"If it's a question of a baby dying versus a baby being born who then needs to live its entire life in an institution, then I don't think that's better. Some parents might think that's better, but many would not," she says.

And even if it works, Davis also worries about whether this could blur the line between a fetus and a baby.

"Up to now, we've been either born or not born. This would be halfway born, or something like that. Think about that in terms of our abortion politics," she says.

Some worry that others could take this technology further. Other scientists are already keeping embryos alive in their labs longer then ever before, and trying to create human sperm, eggs and even embryo-like entities out of stem cells. One group recently created an artificial version of the female reproductive system in the lab.

"I could imagine a time, you know sort of [a] 'Brave New World,' where we're growing embryos from the beginning to the end outside of our bodies. It would be a very Gattaca-like world," says Davis, referring to the 1997 science-fiction film.

There's also a danger such devices might be used coercively. States could theoretically require women getting abortions to put their fetuses into artificial wombs, says Scott Gelfand, a bioethicist at Oklahoma State University.

Employers could also require female employees to use artificial wombs to avoid maternity leave, he says. Insurers could require use of the device to avoid costly complicated pregnancies and deliveries.

"The ethical implications are just so far-reaching," Gelfand says.

Barbara Katz Rothman, a sociologist at the City University of New York, says more should be done to prevent premature births. She worries about the technological transformation of pregnancy.

"The problem is a baby raised in a machine is denied a human connection," Rothman says. "I think that's a scary, tragic thing."

Flake says his team has no interest in trying to gestate a fetus any earlier than about 23 weeks into pregnancy.

"I want to make this very clear: We have no intention and we've never had any intention with this technology of extending the limits of viability further back," Flake says. "I think when you do that you open a whole new can of worms.

Flake doubts anything like that would ever be possible.

"That's a pipe dream at this point," Flake says.

The problem of nursing burnout has been in a state of evolution for years. For many of these years, the 12-hour shift was the primary focus. However, 12-hour shifts provide nurses time away from the bedside necessary for rest, family time and self-care, allowing for a rested and refreshed start to new shifts.

Several stressors lead to high levels of pressure and nurse burnout. These include:

• High patient acuity (years ago, these patients would have been in the ICU)
• High nurse-to-patient ratios (not acuity-based)
• Multiple discharges and admissions (many nurses will discharge and admit an entire team of patients during their shift)
• Lack of ancillary support and resources
• Leaders who assume that nurses “can take one more patient”
• Physicians who expect nurses to drop everything and attend to their needs
• Interruptions while on their break
• The expectation that nurses are all-giving.

However, the most important stressor includes an old mindset held by organizational and nursing leadership: Nurses who voice concerns related to patient safety and workload are viewed as complainers. As nursing leaders, we must recognize the demands placed on our nurses, validate their concerns, and through best practices and common sense, use our leadership to provide support.

The most important skill of a nursing leader is the ability to listen to nurses. The nursing leader must be engaged in the discussions and have a physical presence in the department. Engaging with nurses allows for an open dialogue and a discussion of ideas, and provides validation.

Validation, in turn, lowers nurses’ stress levels because they know they are being heard. Open dialogue provides the nursing leader a forum to foster best practices, find workable solutions for departmental issues, and teach leadership skills through mentoring sessions.

Nursing leaders must hold nurses accountable who are not carrying their load. Modifications in behavior by the nurse will indicate action and support from the nursing leader. In addition, nursing leaders must know, understand and demonstrate a deep caring for their nurses. This is why having a presence on the unit is so important. Actions always speak louder than words, and we must model healthy, professional and supportive behaviors for our nurses.

Staff meetings can be of great benefit and should include discussions regarding new organizational policies, processes and outcomes from higher leadership meetings. One way to engage nursing input in staff meetings is to post an agenda and ask for additional items the nurses would like to discuss or present. Allowing nurses to create ideas, and to volunteer according to their interests and passions, fosters a sense of belonging that is necessary for engagement.

Imagine nurses researching best practices regarding care of a complex patient diagnosis new to your unit. The nurses present their research and provide the education to the nursing staff. Recognition encourages more nurses to contribute to improving the unit.

As nursing leaders, we must teach and empower our nurses to lead. Self-care has become a buzzword in nursing. Nurses are expected to care for themselves, but are sabotaged by the stress and the demands of the patient care environment. However, nursing leaders must provide supportive environments that foster self-care. For example, a competent team can handle discharge and admissions paperwork and patient education, allowing nurses to attend to their patient loads.

Finally, and most importantly, nurses need to be told that it is OK to take care of their own needs during their work shift. They need to feel confident that the nurses who are covering their team are knowledgeable and competent.

Self-care is included in many of the BSN and master’s-level nursing programs. Nursing programs are teaching leadership skills focusing on professional communication and how to achieve self-care in the work environment. Using best practice and leadership practices learned in nursing programs, nurses should present new ideas and evidence-based models to their nursing leadership.

By communicating in a professional fashion with the leadership, nurses will feel empowered and validated by having a voice. This new refreshing outlook is a far cry from the old, when nurses were expected to give up their chairs for physicians.

The nursing profession has consistently ranked No. 1 in Gallup's annual poll of Honesty and Ethical Standards in Professions for the past 15 years — which makes the rampant bullying and hazing that persists among nurses that much more surprising.

Judith Meissner, RN, MSN coined the phrase "nurses eat their young" in a 1986 article to describe the hostility young nurses face at the hands of their more experienced coworkers. In a follow-up article published 13 years later, Ms. Meissner said "students, new graduates and even experienced 'new hires'" still suffered intense bullying.

According to a 2017 blog post by Pittsburgh-based Select International Healthcare, roughly 85 percent of nurses have been abused by a fellow nurse and approximately one in three nurses have considered quitting the profession due to bullying.

Here are eight things to know about nurse bullying.

 www.beckershospitalreview.com

This nurse’s drawings are bringing cheer to his young patients at Cook Children’s Medical Center in Fort Worth, Texas.

Edgar Palomo, 27, makes dry-erase artwork on the hematology/oncology floor to lighten the mood for the kids.

“I've always wanted to help people, which led me to nursing,” Palomo, who has been working at Cook Children’s for four years, wrote to ABC News. “I never wanted to pursue anything in art, so doing the drawings helps me to combine the two together in a positive and therapeutic manner.”

He said he’s been doing the drawings for the unit and patients for three years.

“As word of mouth goes around, it's gotten more frequent,” he explained of his elaborate creations. “I take requests from patients, families and staff. It can be a popular movie at the time or it might be something related to a holiday.”

Each drawing takes a few hours to complete, although Palomo said, “My job comes first.”

“I can usually only work on the drawings a little bit at a time when I have some free time,” he said. “And there is not always downtime. Therefore, a drawing can take one to two weeks, depending on how busy the unit is.”

Palomo is happy that his attempt to bring some cheerful color to the floor “can have such a positive impact on the kids.”

“Anything to bring a smile is worth doing,” he said.