Imagine you are 90 years old, a grandmother of three, and your husband is also old and sick. You need help with almost everything, getting out of a chair, going to the bathroom, getting dressed, eating, and remembering your medications. Despite advances in life expectancy, aging is not exactly kind and you feel like a burden to your husband and the healthcare professionals who care for you.
Now imagine being offered a robot that could help you with many of these things—from walking you to the bathroom to keeping up with doctor’s appointments. This robot’s advanced artificial intelligence (AI) could learn your preferences, know your date of birth, and remember your name. Sounds great, right? You’d no longer feel like a burden to your partner or have to rely on caregivers to help you shower.
This scenario may seem like the beginning of a science fiction movie, but it is closer to reality than you might think. In Japan, a 2018 study found that older adults living at home would prefer a robot caregiver over humans.
Japan’s “super-aging” society, where the proportion of older people is growing faster than anywhere else in the world, has put enormous pressure on the workforce. Technological advances are stepping in to address these challenges, but they are also creating problems for the world’s largest health profession: nursing.
It is perhaps understandable that the idea of robot nurses raises concerns in a profession based on the concept of ‘care’, which is often associated with human relationships.
A recent study from Australia found that educating nursing students about the potential of technology raised fears and concerns about care becoming less personal. The authors suggested that nurses should be prepared to “redefine their nursing identity” and called for a “paradigm shift in what nursing is in a digital world.”
These tensions were also on display in April 2024, when hundreds of American nurses protested the use of AI in hospitals. The protesters argued that AI tools are untested, unregulated, and undermine the value of nursing practice.
One nurse said that “no nurse should be replaced by a robot,” a sentiment that highlights a fundamental problem in healthcare today: nurses are unsure of their role in a digital world.
This uncertainty seems to have led some nurses to reject technologies – AI-based tools and robotics – that could improve patients’ lives. The key question highlighted by these tensions is: What does it mean to “care” in the digital age?
A universally accepted concept of caring may be difficult to define, but those who use the term often focus on the humanistic and emotional components of caring. In the influential nursing book Nursing as Caring: A Model for Transforming Practice (1993), caring is defined as: “An essential characteristic and expression of being human. The belief that all persons, by virtue of their humanity, are capable of caring.”
This definition seems to rule out “care” provided by new technologies, such as robots, as truly caring. But most people would probably agree that denying access to chemical technologies, such as life-saving medicines, would be considered unjustified and “uncaring.”
The potential of new digital technologies, such as robotics, to fill roles traditionally performed by human nurses appears to elicit a different response from nurses. This may be due to previous understandings of care as distinctly human-centered, and because the work that robots can perform, such as providing social support to older people, is considered “human nature.”
While robots and AI appear to be effective in Japan, the global nursing profession may need to rethink the role of technology in healthcare. As people live longer and become more dependent on healthcare professionals, the shrinking share of working-age people in many developed countries struggle to meet the demand for care. Digital technologies can help alleviate this challenge, but resistance to robotics and AI in nursing further exacerbates the problem of overburdened healthcare services.
Historically, however, the healthcare sector has been slow to adopt new technology. In the UK, for example, the Health Secretary had to ban the use of fax machines in 2018-19, years after the advent of email. The deadline to phase out fax machines in 2020 was also missed, with hundreds still in use until 2022.
In the case of robots, similar restraint may not be acceptable to the growing number of people who could benefit from these technologies, especially as the quality and capabilities of these technologies continue to increase. The future of nursing lies in integrating human compassion with robotic efficiency so that everyone gets the care they need.
Florence Nightingale, arguably the founder of modern nursing, described her vision of the essence of nursing care in her book Notes on Nursing. However vague, one thing was clear within this vision: nurses must focus first and foremost on the needs of the patient and set aside all other concerns.
I do say that these women had the true calling of nurses – the welfare of their sick was paramount, and only secondarily was the consideration of what their “place” was to do – and that women who wait for the housekeeper to do this, or the cleaner to do that, while their patients are suffering, do not have the qualities of a nurse.
That was 164 years ago.
As we enter a new era in health care, one characterized by highly capable machines, it is critical that the nursing profession does not allow itself to be hampered by a crisis of professional identity or confusing notions of care that impede technological advances.
Nightingale suggests that we should not wait until our patients suffer. By embracing innovation while maintaining the core value of nursing – putting the needs of the patient first – we can ensure that her vision continues to evolve and meet the needs of the patients of today and tomorrow.
This article is republished from The Conversation under a Creative Commons license. Read the original article.
Matthew Wynn is not an employee of, an advisor to, an owner of stock in, or a recipient of funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond his academic appointment.