Digital displacements in patient-professional relations

Compassionate nursing care and the use of digital health technologies: A scoping review

BACKGROUND

Compassion is an essential component of quality patient-centered care and a core value in nursing practice. Although much work has been done to enhance nurses' informatics competency, there is limited understanding of how nurses can use, express, and preserve compassion when they use digital health technologies in the provision of patient care.

PURPOSE

This study aimed to explore the nursing literature on how nurses provide compassionate care when they use digital health technologies. A secondary aim was to identify best practices that could be used to guide nursing education and practice toward enhancing compassionate care in digital environment.

METHOD

A scoping review was conducted to address the following research question: What is known about compassionate care in relation to the use of digital health technologies within the nursing literature? A comprehensive search strategy was applied to CINAHL Plus with full text, Ovid Medline, Ovid HealthStar, Embase, APAPsychINFO, Scopus, and ProQuest Dissertations and Theses. In addition, a search of selected organizational websites and a hand search of reference lists of included studies were conducted. The eligibility of articles was determined by two reviewers independently. Descriptive and content analyses were applied. Findings were presented narratively and in a tabular format.

RESULTS

Twenty-eight articles were included in this review. Most of this research was published between 2004 and 2020, using mostly qualitative methods. Narrative results were organized into three themes: 1) evolving understanding of compassionate nursing care in relation to use of digital health technology, 2) compassionate nursing care in relation to the type of digital health technology, and 3) strategies and interventions to improve education and competence relevant to digital health and compassionate nursing care.

CONCLUSION

The use of technology influences how nurses do their work and interact with patients. As advances in digital health continue to evolve, future research should aim to expand understanding of compassion relevant to digital health by articulating its characteristics and associated competencies for nurses to further enhance their ability to provide compassionate care when digital health technologies and services are used to support care delivery.

TWEETABLE ABSTRACT

A scoping review that identified how nurses can provide compassionate nursing care in technologically rich practice environments.

Temporal patient trajectories: long stories in short admissions

Purpose

The purpose of this paper is to explain how trajectory management in hospitals is challenged by the introduction of accelerated discharge schemes. The patient trajectory is formed by short stays within health-care organizations, which requires a substantial effort for professionals to be successful in clarifying each patient's medical situation. The patients, at the same time, often have complicated illness stories, and professionals only see a limited part of the patient's trajectory.

Design/methodology/approach

This paper is based on extensive ethnographic studies in a newly established cardiac day unit introducing same-day discharge schemes for patients with ischemic and arrhythmic heart disease.

Findings

The findings demonstrate that the patient trajectory becomes a “temporal patient trajectory” and encounters a short-term reality, where tensions arise between admission time and the trajectory as a whole. In managing temporal patient trajectories, formal organizing and patient experiences intersect in events that emerge from conversations and span past, present and future in relation to patient treatment. Professionals engage in articulation work to maintain coherence by allowing patients to hold different events together over time.

Originality/value

The paper provides new insights into the challenges of managing trajectories in same-day discharge schemes where the pressure to move quickly and ensure patient discharge is intense. The paper offers a novel theoretical perspective on trajectory management as an ongoing temporal process. The analysis displays temporal tensions between patient experiences and the accelerated discharge scheme and how professionals manage to overcome these tensions by bridging the patient's long illness story and the short trajectory within the cardiac day unit.

Dislocated dialogue: An anthropological investigation of digitisation among professionals in fire safety

Like many other industries worldwide, the Danish architecture, engineering and construction industry is currently undergoing digitisation of knowledge, processes and standards. While digitisation promises great improvements in terms of efficiency and effectiveness, not everyone is convinced that digitisation will always lead to the hoped for benefits. In this article, I explore a number of prominent concerns that Danish fire safety professionals have raised with regards to ongoing efforts to digitise their knowledge and expertise. The focus on digitisation is deliberate, as I suggest that scrutinising the implications and concerns raised by professionals in digitisation can help us foresee unintended, potentially dangerous, consequences, of digitalisation. In building on anthropological fieldwork, I argue that professionals are concerned about digitising fire safety, and its potentially dark results, because they worry that digitisation may dislocate ‘mētis’ from ‘techne’, and that digital outputs may be misunderstood or not applied correctly. Such a turn of events could lead not just to material losses (e.g. destroyed buildings), but to the loss of human lives too. This ‘ concern’ with life and death thus appears to underpin the fire safety professionals’ belief in the importance of dialogue in organizationally complex circumstances, and their hesitance to engage with digitisation. On this basis, I propose that by shifting from a resistance and apprehension framework to a concern and dialogue framework, we may be able to foster more empathetic, productive and understanding collaborations within and across organisations during both digitisation and digitalisation.