Authentic intention: Tempering the dehumanizing aspects of technology on behalf of good nursing care

Abstract

The nursing profession has a responsibility to ensure that nursing goals and perspectives as these have developed over time remain the focus of its work. Explored in this paper is the potential problem for the nursing profession of recognizing both the promises and pitfalls of informational technologies so as to use them wisely in behalf of ethical patient care. We make a normative claim that maintaining a critical stance toward the use of informational technologies in practice and in influencing the thought patterns of the younger generations of nurses is a moral imperative of the discipline, because without this practice can become subverted from professional goals in various ways. We use a synthesized concept we call “intentional authenticity” derived from the writing of Heidegger and Feminist care ethics to provide a foundation for the development of nurses who understand the importance of the nurse‐patient relationship and how the unthoughtful use of informational and other technologies can militate against effective or good nursing care.

Influences of the culture of science on nursing knowledge development: Using conceptual frameworks as nursing philosophy in critical care nursing

“…For example, it is understood that critical care nurses care both for the critically ill patient and their family members (Ågård & Harder, 2007; Al‐Mutair et al., 2013; McConnell & Moroney, 2015; McKiernan & McCarthy, 2010). However, in technologically driven, efficiency and task‐orientated acute care environments such as critical care units, it is challenging for nurses to provide person‐centred care (Cuchetti & Grace, 2020; Sharp et al., 2018). Furthermore, although McConnell and Moroney (2015) note that critical care nurses may believe that a patient's admission to an ICU does not significantly impact the lives of the family members, it is widely acknowledged in the literature that a patient's critical illness often negatively affects family members’ physical, emotional, psychological, social and financial well‐being (Burns et al, 2018; Harvey & Davidson, 2016; Needham et al., 2012; Svenningsen et al., 2017).…”

“…The technological environment of critical care has been described as extremely impersonal, stripped of humanity (Pelletier 1993, as cited in Cuchetti & Grace, 2020; Johnson, 1999). The increasing use of technology and rationalization of health care along with nursing's efforts to attain legitimacy as a profession by aligning with medicine and its mechanistic approach have resulted in a progressive creep of dehumanization of critically ill patients (Cuchetti & Grace, 2020; Herdman, 2004; Mandal et al., 2020). According to Yeo (2014), if the natural sciences continue to exert dominance in the science of health care, then the associated increasing use of technology in the care of patients will result in nurses “becom[ing] cogs in a machine, divested of care” (p. 247).…”

“…According to Yeo (2014), if the natural sciences continue to exert dominance in the science of health care, then the associated increasing use of technology in the care of patients will result in nurses “becom[ing] cogs in a machine, divested of care” (p. 247). The end result being an increasing social and emotional distance between nurses and the individuals under their care, both the critically ill patient and their family, as technological data are given precedence over knowledge gained through human connections (Cuchetti & Grace, 2020; Timmins, 2011; Yeo, 2014). Furthermore, not only are nurses affected by the critical care environment in this way, the critically ill patient may also become dehumanized and objectified through the eyes of family members (Burns et al, 2018).…”

“…In response, Cuchetti and Grace (2020) and Watson (2005) call on nursing to bring forward a humanity into healthcare practice where nurses see past protocols and diagnoses and instead see the patient and their family members, meeting their needs for hope and human connection, to be with them and see their humanity. The simple need to feel hope has been expressed by family members of critically ill patients as important and crucial in giving them strength (Löf, Sandström, & Engström, 2010; Wallin, Larsson, Rubertsson, & Kristoferzon, 2013).…”

“…This may be increasingly evident within the context of critical care nursing where there is significant use of and reliance on technology. In this environment, the critically ill patient is at risk of becoming invisible or dehumanized to the nurse who preferentially focuses on the technology surrounding the patient, or the science of nursing, rather than seeing the uniqueness of the patient and thus considering the interpersonal aspect or art of nursing (Cuchetti & Grace, 2020; Stayt, Seers, & Tutton, 2015). Adding to the complexity of this reality of nursing practice are organizational constraints including low staffing levels, the increasing acuity of patients, and an increasing delegation of administrative duties, such as auditing, to nurses which further obstruct the delivery of person‐centred care (Sharp, Mcallister, & Broadbent, 2018).…”