Virtual approaches to healthcare at-scale are still relatively new for the nursing profession. Equipping the modern nursing workforce for realities they face using new technologies to enhance access requires new thinking around education, writes Professor Ann-Marie Cannaby, senior nurse and member of the clinical advisory board for BT.
Virtual consultations and virtual wards have spread rapidly in the NHS since the onset of the Covid-19 pandemic. They have become a progressively important means to providing access to increasingly in-demand services. Today, clinicians continue to blend such approaches into their everyday practice.
Virtual approaches to care, in their various forms, are now regarded as an important part of NHS recovery initiatives, and also the future of technology in healthcare delivery.
And although remote care provision is not appropriate for every patient, it is likely to become a larger part of how clinical teams, as a limited resource, provide healthcare for people. As the NHS continues to deal with growing backlogs and other strains on services, this is about enabling healthcare professionals to monitor and oversee more patients, whilst also allowing the individuals in NHS care to best maintain their independence, and to live their lives outside of the hospital.
For those who work in the health technology sector, remote or virtual care provision might feel like it has been around for some time. But delivering virtual health and social care at the scale now required to cope with increasing demand and complexity of care, is still new for the NHS, and for nursing as a profession.
It is vital that healthcare professionals are appropriately equipped to practice their profession in this changing environment.
Equipping the workforce
As an experienced chief nurse, a key question for me is how we ensure the next generation of nurses are digitally ready. Nursing education at both an undergraduate and post graduate level needs to embrace and prepare nurses for the demands and challenges we will see in the future.
Digital skills are important for more than chief information officers, digital and IT teams, and even clinical digital leaders like CCIOs or CNIOs. They are fundamental for frontline nurses to be able to deliver safe and effective care.
We need to produce modules for nurses in undergraduate courses that prepare them for the technology they will be expected to use, so they can help support patients in adopting new ways of monitoring and care.
We need to give nurses the confidence to challenge and to work with their technology vendors to provide the right solutions. We need to encourage creativity in this sector. Clinicians at the frontline need to work with technology providers to co-create and design the future of care.
How we assess and care for people virtually brings a whole new set of challenges. We might gain more timely observations, or gain more feedback about observations, movement and daily activities of patients. But clinicians may need to adapt their questioning, less proximity may require more skills. There may be more insights but caring for the person holistically should not be lost. Knowledge, practice and communication skills take years to perfect, as does the ability to instinctively know when something isn’t quite right. Nurses have been trained to observe changes in a person’s recovery, or deterioration, based on physical interaction and often have therapeutic relationships developed in proximity. The question of how we overcome lessened social interaction and the face-to-face contact that has been a fundamental part of nursing, is a significant one to tackle.
How do nurses pick up on cues from patients in a virtual or remote environment? How do we overcome a potentially lessened ability to physically look and listen in virtual care environments that can be more formal? These are questions we need to address.
Delivering care in new ways can help to address challenges and the evidence base in this area is growing. But our new models must allow us to maintain and improve quality of care, and to keep our patients, and their families, at the centre of our practice.
Modernising our approach to teaching
To modernise teaching to respond to these challenges, there are four core areas that need to be considered in undergraduate education and by healthcare providers.
We need to increase knowledge of technology. Whether it’s machine learning, artificial intelligence, data platforms, or a whole range of other digital solutions, there is an ever-evolving health technology market of which nurses need to have an awareness.
We need to enhance the skills of students for digital and technology readiness. This means training and educating with different digital technologies, and allowing students to practice with hardware and software, so that they can gain confidence.
Nurses and students need to practice augmenting their skills. We need to provide the opportunity for nurses to combine technology with their knowledge and practice. In the case of virtual consultations this might mean practising remote monitoring and feedback or monitoring long-term conditions virtually. Students, in their training, need to practice these skills. Considerations and adaptions may be required when caring for people they may not have physically met.
Importantly we need to encourage curiosity for innovation – creating a culture where nurses are excited to review technologies of the future and understand the application of technologies within healthcare.
Modernising our approach to education will be an ongoing process. But in doing so, we have an opportunity to better support the nursing profession at a time of rapid change in healthcare.
Recruitment and retention are not the only workforce challenges
Media headlines continue to highlight that the NHS is faced with substantial recruitment and retention challenges – with nursing often referenced. Technology may assist in enabling access and care to be provided differently. Thinking about the changing nature of professional clinical roles, and how we develop those individuals in order to create a workforce equipped with the right digital skills for a more virtual world, is therefore vitally important.
