Alteration to will as an experience of technology and nursing

Abstract

This paper presents one finding to arise from a recent qualitative research study that examined ways of understanding technology in surgical nursing, and examines its implications for nursing and health care practice. Although the research reported identified eight qualitatively different ways of understanding technology, this paper examines the specific experience that technology can alter will (volition). The experience described is a new area of knowledge and is in need of further examination and research. Nonetheless, it is significant to understanding technology, contemporary nursing practice and the provision of health care services. The paper concludes with some suggested approaches for curtailing the experience and a discussion related to challenges that arise from the finding that technology can alter the free will of nurses.

The role of technology in critical care nursing

“…In our ethnography, the allocation of junior nurses to patients being weaned meant that these novice nurses did not gain mastery of the equipment but only learned ‘survival skills’. Gaining mastery or being technically‐competent is a recurrent theme in the nursing literature (Ray 1987, McConnell 1990, Cooper 1993, Walters 1995, McConnell 1998, Loscin 1998, Barnard & Gerber 1999, Little 2000, Barnard 2000, Alasad 2002, Wilkstrom & Larson 2004).…”

“…Technological mastery also gave nurses more control over their work (Alasad 2002). According to Barnard (2000), technology demands levels of attention, time and commitment and can be seen as arduous. However, the literature suggests that tending the machine leaves less time to tend to the patient (Wichowski 1994, Loscin 1998,Barnard 2000).…”

“…Some nurses have used technology to define nursing, whilst others have used the care‐cure distinction to differentiate between the professions, claiming that technology is opposed to humane care and therefore is irreconcilable with nursing (Zwolski 1989, Carroll 1995). As nurses adopted new technologies, it became apparent that much time was spent tending the machines (Barnard 2000) and, as a consequence, nurses found themselves in a dilemma. Nurses, according to Sandelowski (1997), see technology as an adjunct to nursing care and a simple tool to extend human observation.…”

Innovations in inpatient flow and bed management

“…The NHS does not have the capacity or structural readiness for change to happen Wainwright and Waring (2000) The NHS is culturally and politically structured against change Redwood (2000) Technology itself is opposed to the Cultural and Social norms associated with care giving Barnard (2000) Nurses are not empowered to make the changes themselves, reducing the chances that innovative change will embed in individual organizations Hill and McNulty (1998) Variation in outcomes for innovative change programmes derive from within individual organizations which are not receptive to new ideas Pettigrew et al (1992), Pettigrew et al (2001) The NHS consists of micro-systems of culture and social structures which act against each other and act as a barrier to change Nelson et al (2002) Technology has not been adequately aligned to the work practices of nurses, preventing innovation in ICT Hughes (2003), Oroviogoicoechea et al (2006) The NHS target-driven culture, emerging over recent years, is altering behaviours and distracting staff away from improving service delivery Seddon (2008) 3.1 Selecting a DOI framework It is beyond the scope and aims of this paper to provide a detailed review of DOI research in the area of healthcare and information technology adoption. There are many studies that do this; (see, e.g.…”

“…However the hospital senior management chose the PFMS not only to solve information needs issues but as an innovative technology to replace out-dated manual processes (Barnard, 2000). It is also important to note here that having the system on trial without obligation took pressure off the senior management and stakeholders at the beginning of the project and this allowed a full and frank evaluation of its ability to deliver the requisite functions.…”