What the nursing workforce of the future could look like

The nursing profession is changing rapidly in response to challenges presented during and exacerbated by the pandemic, as well as to advanced technologies that are increasingly integrated into the healthcare system.

The nursing workforce of the future is one in which technology, like artificial intelligence (AI), can work in tandem with nurses and new job functions like virtual nurses can play a critical role in patient care.

“A lot of this technology does provide alternative ways to utilize nursing knowledge […] to help newer nurses and patients in a different way,” Jennifer Mensik Kennedy, president of the American Nurses Association, a professional association, told Healthcare Brew.

AI’s upsides and downsides

AI is already employed in health systems to do things like identify which patients may be at risk for certain diseases, she said. And while AI can be a useful tool to help reduce the workload of nurses, Mensik Kennedy added that it’s important to remember the technology is an addition “as opposed to a replacement for the care that patients need.”

Health systems can inadvertently create AI policies that are “counterintuitive” to patient care, she said. For example, one hospital, which she declined to name, used an AI program that harnessed data from patient labs and vital signs to detect if a patient is at risk for sepsis.

In one incident, the AI detected that a patient was at high risk for sepsis, but the algorithm didn’t take into account that the patient had cancer, which causes an elevated white blood cell count—a trigger for the AI’s sepsis warning, Mensik Kennedy said.

“The policy that the hospital had was that the nurse had to implement the protocol regardless, even though the nurse’s judgment was saying this patient doesn’t have sepsis,” she said.

The nurse ultimately provided the patient with unnecessary medication to prevent sepsis—and that was costly to the health system, Mensik Kennedy said. That’s why it’s critical for health systems to develop AI protocols that leave room for a nurse’s judgment, she said.

“It’s really going to be part and parcel that nurses are trained to not just follow what technology says because technology isn’t perfect,” Mensik Kennedy said. “Nurses need to be able to know when to say, ‘This patient’s outside of the predictive analytics on this one.’”

Nurses also need to be involved in the development process for new technology, she added.

“Nurses need to be involved in researching how these technologies impact patient care, too,” she said. “Being part of those teams and creating the new technologies is really important because that nurse is the person who really actually understands that patient interaction the best.”

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A new type of nursing job

New nursing roles are popping up as technology becomes more integrated into the profession.

For example, nurse informatics is a newer job function that combines nursing with computer science. Nurse informaticists teach other providers how to use new functions in electronic health records (EHR) or other technology that’s been adopted into a health system. Some even specialize in simulation and virtual reality, according to Laura Fero, dean of nursing and chief academic nurse at AdventHealth University, which is part of Florida-based AdventHealth.

“Technology has really influenced the specialty areas that advanced practice nurses can go into,” Fero said. 

Another newer job function for nurses is virtual nursing. AdventHealth has employed virtual nurses, who are meant to work in tandem with bedside nurses in the hospital setting. A virtual nurse appears on a TV screen in a patient’s hospital room to speak with the patient.

At AdventHealth’s hospitals, virtual nurses greet patients upon arrival, take a patient’s health history and input it into the EHR, and check on patients every hour throughout the night. The virtual nurses also make sure all the proper labs and medications are ordered, and that any test results are ready for a physician to review.

“It does reduce some of that workload intensity,” said Britney Benitez, AdventHealth Central Florida’s VP and chief nursing officer. 

Looking beyond tech

In addition to being tech-savvy, the nurses of the future will need to double as “care coordinators,” Mensik Kennedy said.

“As the baby boomers are all in Medicare age and are getting older with complex illnesses, what we see is even a greater need for the nurse in the role of the care coordinator,” she said. “When we talk to patients, what they often say is, ‘I’m just confused about what I should be doing,’ or ‘I need someone to help me.’”

So, nurses will likely need to be equipped to help patients navigate the increasingly complicated healthcare system.

The nursing workforce of the future will also need to be trained in culturally competent care, Mensik Kennedy added. “It’s gonna be vitally important that nurses are educated to ensure that they can take care of all people and not just certain groups,” she said. “We can’t not teach [diversity, equity, and inclusion] to nurses. This [is] something that’s going to become even more important as our country becomes more diverse in future decades.”