Citation:

Interview with Patti McClelland, Hist 150 Honors Spring 2021, Conducted by Haley McClelland, March 9, 2021.

Overview to Interview: 

In this interview, my grandmother and I discussed how technology has changed in the nursing field. She has been in the nursing field for about 30 years so the timeline we are referring to is the late 1980s/early 1990s, until today.

Some of the things that were normal practice when she first became a nurse were the traditional white cap and uniform, pharmacy runners (someone whose job was to deliver and bring medicines to and from the pharmacy), kardex (a card that had spaces for the type of medicine needed and any additional information), and eight hour shifts instead of 12-hour shifts. Some of the advancements talked about are computers on wheels (COWs), machines to monitor blood pressure, heart rate, and stats being digitally documented. My research during this interview talked a lot about Artificial Intelligence (AI), Virtual Reality (VR), and the Internet of Things (IoT).

She worries about nursing losing the personal touch because of the new technology in the field. While there have been lifesaving advancements, she has seen some nurses lose their personal connection with patients. Overall, the technological advancements in the medical field have saved many lives and primarily have had positive effects but it is important that nurses maintain personal connections with patients and their families.

Biography:

My grandmother, Patti, has been a nurse for almost 30 years. Even though she has been in the nursing field for a while, her jobs have changed fairly frequently. She has done multiple things, such as working in schools, home health, hospice, teaching, etc., so she has been able to watch technology grow in multiple ways. Her and my grandfather got married young and then she worked in a bank and had my dad and uncle. Shortly after is when she started working as a nurse. She went back to school a few years ago for her masters and even after she retires, she plans to teach or stay in the field some other way.

 

Transcript:

Haley 0:03
Alright, so today I’m going to be interviewing my grandmother, who has been a nurse for many years. And we’re going to talk about the technology changes within her nursing careers. So could you walk me through your nursing career in which jobs you’ve held?

Patti 0:20
Sure. So when I was a nursing student getting ready to graduate, I did an internship in pediatrics in the local hospital. And then when I graduated, I did an externship with that same unit so I worked inpatient as a pediatric nurse. After I worked there for a while, I became a pediatric office nurse manager and worked in that office for several years. After that, I became a school nurse and worked in elementary school for many years, and also, at that same time, worked part time inpatient child, adolescent psych. I started becoming a camp nurse in the summertime when I was off and still do that to this day. When I decided that I was ready to work with adult patients after 16 years, I went to work inpatient at VCU Medical Center on a gastrointestinal unit, and also worked as a liver transplant coordinator. I completed my master’s degree and then became a nursing instructor and a program administrator at a Career College. I’ve also done home health and hospice home nursing. And now I am back in to the school setting as the school nurse on the elementary school level.

Haley 1:55
So you really have worked in all different types of nursing careers and have kind of made a full loop back around to the to the pediatric side. So why did you decide to become a nurse and what job or jobs have you felt the most passionate about?

Patti 2:13
Um, you know, I don’t really know why I decided to, become a nurse. I never thought of myself doing anything but becoming a nurse. When I was in high school, before I was old enough to get a job, I became a volunteer at the hospital as a candy striper [a volunteer who helps nurses in a hospital] and had the opportunity to work in several different departments and just really loved the, the intensity of the hospital atmosphere and being able to care for people and help people and so I couldn’t imagine myself doing anything other than being a nurse. With that being said, I was not able to complete that desire for many years. I worked in banking, actually, for 15 years. I got married and then we moved and then I had a baby. And once all that was done, then I was able to go into nursing. So I actually did not start my nursing career until I was 38 years old.

Haley 3:17
So you really, really have had so much experience and you’ve been, you’ve been a mom, you’ve worked other jobs, you’ve been a nurse, what were some of the obstacles, if any, that you faced in the process of becoming a nurse and in day to day life at the same time?

Patti 3:36
Well, I think one of the things was just keeping, first of all, keeping that dream in front of me, because I knew that nursing was ultimately what I wanted to do. And it seemed like, every time I got into a nursing program, or started a nursing program, something came along that prohibited me from being able to do it. So I just kept that dream in front of me and I also had the support of my family because they knew that that was what I always wanted to be. My husband and even my kids knew that nursing was really where my heart was. So I think with their support, the support of you know, your granddad saying, “I don’t care if you never do a day in nursing, I want you to go to nursing school and become a nurse because that’s what you wanted to do.” So, um, you know, life happens and things happen but I think just being able to know where my heart was and being able to do that was, you know, was the huge benefit for me.

Haley 4:40
We definitely do have a really supportive family which is great and we’re very lucky for that but I guess some people don’t have such a strong support system. So in what ways do you feel the obstacles you faced, or haven’t faced, have changed or stayed the same for other people who want to become nurses. Anything added? Taken away?

Patti 5:03
Well, you know, it’s really interesting. Um, and I guess, you know, I saw this when I was in nursing school, when I was in nursing school at community college. Like I said, I was in my 30s, there were nursing students that were 19, I had, you know, 19-20 [year olds]. And then I also had someone in my class that was like, 60, at the time. So I think one of the things I learned there is that you’re never too old to pursue something that you want to do and that most of the people that have become nurses have obstacles to overcome to get to that profession. And I think that’s a big part of the profession is being able to realize that people have tough times, and to be able to help them through those tough times when they’re dealing with, you know, health issues. And then as an instructor, I saw the same thing. Most of my nursing students were, you know, they were moms, they were single moms, some of them were homeless, some of them had children, I had one who all lived in one room and yet, these, you know, these women became successful because they knew what they wanted to do with their lives.

Haley 6:18
I think that’s one thing I’ve definitely noticed about nurses, and I have a lot in our family, that they’re very determined, so they’re definitely going to do everything it takes to achieve their goals. But I really liked the point that you brought up about just the different ages. And that kind of brings us into the main point of technology, because everybody of different ages has different experience with different types of technology. But what was technology like when you first became a nurse, in general, and in the nursing field?

Patti 6:54
So it’s interesting, because I actually, you know, I had to sit and think about when I was in nursing school, and one of the things I remembered is we did not have the computer at that time [laughs]. So like, we had to do these case studies of patients and they were like 100 page, written case studies. Or we had to do charts, and they were handmade charts. It wasn’t something that you just whipped up off the computer, every thing was handwritten. And I will tell you, I still have those in a folder because they took so much time. I just always wanted to hold on to them. So we did not have the computer, we had typewriters but we just hand wrote the things that we had to do. We had overheads that we took notes from. The teachers presented on overheads up on the screen. Like I said, no computers. We did, most of everything was handwritten. All of our tests were handwritten and then we handed them in and they were graded individually by hand. Sometimes we did have the Scantron that they could put those through but that was not, that was not the norm. So when I first started nursing, you know, everything was pen and paper for the most part, when it came down to doing things like that.

[We began to talk over each other]

Haley 8:24
Go ahead.

Patti 8:25
No, I’m sorry. Go ahead with your next question.

Haley 8:28
Oh, I was just going to say I definitely have a lot of respect for that because I know even in my classes now, I, I type everything. And I do all of these Excel spreadsheets and create charts and I find them difficult, challenging, and I like to save them because they took me so much time and I can’t imagine doing them all by hand. So you definitely, you mentioned just the computer in general, but what are some, what are some of the changes you’ve seen in the last however many years [30 years] and when did they happen?

Patti 9:04
So um, you know, when I first started nursing, like I said, we didn’t have the computer so all of our charting, again. was done by hand. We got verbal orders from the physician over the phone, and then they had to be written and sent to the pharmacy with a runner [someone who’s job was to deliver and bring medicines to and from the pharmacy] and then the runner would bring the medications back up to us. So there was a lack sometimes before you could get medicines. We actually mixed medicines on the floor instead of having the pharmacy do that. All of our medications were hand written out. We use like a kardex [a card that had spaces for the type of medicine needed and any additional information] like they used to have in the library many years ago to keep track of the medicines that were given. Everything, like I said we had to have have a second hand watch to count people’s heart rate and respirations. You didn’t have a machine that did that for you. So those were the things when I first started out in nursing. Also, we worked eight hour shifts, not 12 hour shifts, and we had to wear the complete whole white uniform with the nursing cap and, and that, you know, scrubs and all were only people that worked in the operating room, so we even presented differently back then as nurses. [To summarize: nurses did used to wear the traditional white cap and uniform. The only people who wore current day scrubs were people who worked in the operating room] So over the [began to talk over each other].

Haley 10:38
Oh keep going, keep going

Patti 10:40
No, that’s okay, go ahead.

Haley 10:42
No, keep going, it’s okay.

Patti 10:44
So over the course of time, like over those, you know, the past almost 30 years actually, um, you know, bit by bit changes would come in, and we started to get, computers started to come in, but they weren’t really what computers are now. They were big, bulky computers that took up a lot of space. Now, everybody that works in the hospital, or works most places, have their own little private computer. We call them COWs, computers on wheels, that you just roll around in and out of patients rooms. Some of the rooms even have them there so it’s like right at your hands right now, but it wasn’t that way before. Even as far as the equipment that you use, now, we had to do everything manually and now you can hook a patient up to a machine that’s going to monitor their blood pressure, their heart rate, their respirations, their oxygen level. And that’s continuously monitoring that and it can kind of let you know when something wrong has gone wrong with your patient where we had to go in and visualize that all the time. We didn’t have something that beeped to tell us “uh oh, we need to go in and check on them, something’s going on.” A lot of the things that have come out lately, I would say in the last five to 10 years, are medication pumps that can be set with all the, the type of medicine, how quick you want the medicine to go in, how many drops it goes in, where we used to have to manually count those drops and all. So that’s a big safety feature that’s good. Um, scanning, now we scan wristbands, so we make sure we have the right patient, the right medicine. Those, again, are good safety things that have come into play in the last couple of years. We can text message a physician and he can, from his little handheld computer, put a medication in for a patient and we can have it for them in like less than five minutes, instead of waiting hours, sometimes. We can get quick results of labs and imaging, you know, that just pops right up on the computer in front of you. There are special teams now that are in the hospitals that actually. What they do is they monitor patients’ vital signs and labs and all the things that are going on with the patient and it kind of can give them an idea of if that patient is going to be going into, some sort of a cardiac event or a seizure event or something so that we can help to prevent that before it happens. Where years ago wasn’t until the patient was actively, you know, dying or something like that before we knew that we had to do something for them. So technology has definitely played a huge role in the nursing field. It’s made many things easier for nurses. Sometimes it seems more complicated than just going in and being able to do it yourself. But you know, I think technology, and I can’t even imagine what the future is going to be, I just hope they don’t make robots to take over nurses because I think you need the human touch there [laughs]. But um, it definitely has come a long, long way over my last 30 years.

Haley 14:35
These are all really, really interesting points. And I feel like the biggest thing I took away from all of that was that the most important factor was time saving because that’s so incredibly significant, especially in the medical field because it’s a matter of minutes or seconds sometimes. So what do you feel is the biggest or most significant change or development that has really helped with either time or something else.

Patti 15:04
Well, Haley, like you said, I think that the, the biggest thing, like I said is the fact that we have the equipment that can monitor the patient, that can give us the information as to what’s going on with the patient as far as like, what their lab work looks like, what their CT scan looks like so we can begin treatment faster now than we could years ago. And also, the ability to work, as a team, is something else that’s changed over the years. You know, many years ago, the doctor was considered like almost a god. And, you know, the nurses and everybody else were peons, where now, there’s such huge collaboration between everybody. And you know, we can call a doctor and say, this is going on and these labs came back and their vital signs look like this. And I think, you know, perhaps they need a certain medicine, or could you come take a look at them because something just doesn’t look right? So I think the combination of all that has really given us a better handle on better management of our patients.

Haley 16:27
Yeah, I definitely agree. With so many of my family members being in the medical field, you definitely hear a lot about that teamwork, and how so many people are under the wrong impression that, you know, the doctors do it all. But really, the nurses do a lot of the heavy lifting as well. But, so you’ve mentioned all of the really helpful, awesome things, but what’s the most harmful thing, if anything, that technology has brought to the nursing field.

Patti 17:01
So I think what I see is the most harmful thing. And, um, is that it, somehow it has taken away some of the personal touch, because we’re not in with the patient in their room and in with them as frequently as we would have been before because they have monitors that are monitoring them. And um, so I feel like it has taken away some of that. And I feel like with new nurses who have never worked without the technology, it’s almost a disadvantage to them, because they don’t get to develop that personalization, sometimes, with the patient, as we did years ago, when we had to go in and physically put, you know, more hands on the patient as, as they do now. It can kind of make you be a little lazy. Um, I don’t know that lazy is the right word, but, you know, it’s like, “oh, well, they’re fine. I haven’t heard their alarm go off.” Or even you know, we have alarms on beds now. So if the patient starts to get up, and they’re not supposed to, the bed alarms, you know, if their medicines finish, that pump alarms, if their vital signs go wacko, that alarms. So you’re kind of like, well, they’re good, I haven’t heard anything. So I think it’s taken away from some of the, the actual face to face, hands on [experience] with the patient.

Haley 18:36
Yeah, I definitely agree. And I can, even from personal experiences going into a doctor’s office or a hospital or whatever, there’s just a very big difference between the nurses and doctors and staff who are very hands on and attending, tending to you all the time and seeing what you need. And then the ones who do just wait for the signals to go off and you can definitely feel the difference as a patient. And, just going back to what you were talking about with your students and teaching, what have you noticed about teaching and how your students have adapted? I know you said all ages, [stumbled over words], how do they all react to different technological advancements?

Patti 19:23
Yeah, you know, again, once again, we’re still seeing that age range. So we have the students that come in that only know computers, even to this day, and then we have, you know, older women who have always wanted to be a nurse or now they are the sole breadwinner in the family, and they need a job that they’re going to be able to support their family with. So um, you know, there’s still that wide age range in there. I think the younger generation obviously is more tech savvy, so they tend to depend on the computer to do the work for them, where someone you know who’s a little older, that’s not as tech savvy, you know, they want the hands on experience, or they want to take the 500 notes on index cards. They want the book in their hand, they don’t want the E- book. So it’s really a challenge both ways, especially when you have a class of 25 students and you’ve got this age range in there. What I have seen is that they learn from each other. The young people are willing to help the older people and the older people are craving the young people to help them. There sometimes takes time for a level of respect to be developed on both sides, because the older people are like, “oh, the young kids think they know everything” and the young people, say “oh what do they know.” But I’ve never really, in the classes that I’ve taught and the situations I’ve been in, I’ve never seen any, like real animosity, I’ve always seen them come together because they’re there for the common cause.

Haley 21:22
Yes, I definitely agree and, and just in life in general, there’s always that level of respect. And it definitely has to go both ways, because different generations know different things and have different advice and we can all be helpful to everyone. And lastly, what, in what ways do you feel people need to act in order to protect the, the work ethic and just the hands on experience with patients and just teaching you know, all, all around?

Patti 22:01
Well, you know, when I, there’s, there’s a lot that goes into that, um, you know, I always say, you know, you can be book smart, and you can know everything that’s in the textbook, that’s written, but if you don’t have compassion, and you cannot exhibit that, you know, caring, then you’re not, then nursing is probably not the profession for you. Um, so I feel like you have to be able to maintain, you know, a balance of being able to use all this technology, but also keep the personalization there. Um, you know, nursing is the most trusted profession in the world and it has been for many years. And I think after last year, and this year, it’s really topped out as far as they can go. People trust their nurses more than they trust anybody, but you have to be able to build that trust with not just the patient, but the family, because many times the family is who you’re dealing with more than the patient. And you also have to be the advocate for the patient when the family doesn’t know how to be, or when the patients don’t have family there. You have to advocate for what you know, what you feel is best for the patient. And that may be going to a doctor and saying “I don’t think this is the best procedure for the patient” or “I think they need this type of medicine” and that sort of thing. So I think, to me, the most important thing is relying, you know, being able to maintain that balance. Not getting lazy with using the computers to monitor your patient, but going in and doing that face to face with them on a regular basis, even though it may take more time than what you have allowed to do it. Sometimes you think “well, I’ll be in a room for five minutes” and you’re in there for two hours. But that’s kind of the way it goes. Teamwork is just absolutely the most important thing in nursing. You have to be able to work as a team, you know, if you’ve got your patients under control when somebody else’s like drowning to go and say what can I do for them? How can I help you? And the other thing too, is like realizing that every role in nursing is important. You know, you have your care part, or you have your RNs, you have your LPN. It doesn’t matter what degree you have, you’re all there for the common purpose of taking care of people and not to abuse or misuse them. When I would teach new graduates when I worked at VCU, I was the primary preceptor for new graduate nurses. And I would tell them that, like, their nurse’s aide was their best friend, and they should never abuse them because they’re like their right hand all the time. And I would actually make them work the last five days of their training without a nurse’s aide to realize what it’s like to not have them. So there’s just, you know, there’s just so many aspects that come into bringing all that together. The technology is great, I think we’ve been able to save lives with the technology we have today, but we also have to keep that human touch there.

Haley 25:51
I definitely agree and I feel like all of this was so educational and it’s, it’s not really stuff that you know, you go over in general education classes in college. It’s things you learn in the real world and people need to hear this type of information. Did you have any last thoughts or anything you wanted to add today?

Patti 26:16
No, I, you know, I can’t imagine myself doing anything but, but being a nurse, and I feel very grateful that I’ve been able to be a nurse over a span of almost 30 years where I’ve seen these changes, you know, that we’ve talked about. And I know that there’s a lot more that’s going to come in the next 20 to 30 years as far as technology and advancement. I think nursing is a great career. It’s, it’s not easy, but it’s, but it’s so rewarding. And I just hope that as things progress in the future that we don’t ever lose the real art of nursing, you know. Nursing is an art and a science and I hope that we never lose that, the ability to see that. One of the things that I always remember, I read [it] years ago, is that whenever you walked in a patient’s room, or you walked in to take care of a patient, you were walking on holy ground, and that holy ground is the ground of that patient that you’re there to care for.

Haley 27:36
I agree, it’s one of the most important jobs, if not the most, that exist. And it, like you said, it’s definitely not easy, but it’s rewarding. So I, I respect anyone who has the motivation and ability to be able to do it, because it’s definitely not my forte [laughs], but I have a lot of respect for all nurses and anyone in the medical field, really. But I really appreciate you talking with me today and I think this will be a very educational video for people to listen to.

Patti 28:16
Well, I hope so and I’ve enjoyed it too. As you can tell, I have a passion for nursing and I could go on and on and on and so I just feel blessed that I’ve been able to be in this profession, [and] that it’s given me the ability to work in all the different jobs that I’ve, you know, talked about and that it’s something that I can continue to work at even, you know, as I look towards semi retirement or retirement. You know, I could always do teaching and, and that sort of thing to help to continue to bring up the next generation of nurses.

Haley 28:53
Yes, and thank you so much again, and I will talk to you later.

Patti 28:59
Alright. Thank you, Haley.

Haley 29:01
Thank you.

Transcribed by https://otter.ai

 

Research:

Through my research I learned about how the medical field is advancing through Artificial Intelligence (AI), Virtual Reality (VR), and the Internet of Things (IoT). These are all technological advancements using computers to get things done quicker, better, and more efficiently. It was brought up that education on all of these things is extremely important before it is actually used, that way it’s done correctly. Another article explained how technology affects nursing. My grandmother talked about many of them, but some examples include monitoring, medications, health records, beds, reduced errors, communication, and telehealth. Because the nursing field faces daily life or death situations that have to be handled in a matter of seconds, all of these things are important and are helping to save many lives. Another website I was looking at while doing research listed five more ways technology is helping the nursing/medical field. These are electronic healthcare records, communication systems, diagnostic tools, treatments, and online education. Some of these are similar to things already stated, but this brings up the importance of how patients are treated on a day to day basis. New sicknesses and issues are being discovered every day and without the tools to find solutions, there would be many more tragedies. It’s important for everyone to be educated and continue their education because of how often things change.

 

Bibliography:

Whende M. Carroll, MSN. “2020: Emerging Technology in Global Nursing Care.” HIMSS, 8 Feb. 2021, www.himss.org/resources/2020-emerging-technology-global-nursing-care.

“How Technology Has Changed the Role of Nursing.” NurseJournal, 8 Feb. 2021, nursejournal.org/articles/technology-changing-nursing-roles/.

Walden University. “Five-Tech-Advancements-That-Are-Changing-Nursing.” Walden University, Walden University, 26 Feb. 2021, www.waldenu.edu/programs/nursing/resource/five-tech-advancements-that-are-changing-nursing.

 

Technology and Interview Process:

This interview took place on Zoom. I had called my grandmother a few weeks prior in order to ask her to be my interviewee. A few days before, I sent her the consent form and letter over text message. During the Zoom meeting, we both turned our cameras off to get the best sound quality possible. I recorded from Zoom and saved it to my cloud to upload to Otter AI. I did have to make quite a few grammatical edits, but other than that, it did a great job and there was very little work on my end to transcribe.