Digital change is being demanded, but are the nurses ready?

Johanna Kelly, Lead Digital Nurse at University Hospitals Sussex Trust and Digital Pioneer Fellow, shares her experience of becoming a Digital Nurse and her thoughts on what needs to be done to support nurses to innovate and embrace digital.

My first essay at college on social deprivation was handwritten on lined paper, I remember painstakingly counting all 2000 words. Fast-forward fifteen years, my last project is submitted through a plagiarism detector application with an automatic grammar checker. Technology has changed everything in that decade and a half; how we socialise, share, shop and learn. We’ve all adapted in some way, willingly or otherwise. But the NHS has been slower to evolve to meet this new ever-changing digital landscape. Yet change is at our door and it’s knocking loudly; Matt Hancock Secretary of State for Health has set out a digital plan to replace archaic systems and improve integrated care. New roles are being created and a new hybrid language of technology and care is manifesting around nurses like a rising tide. This change is ready for us but are we ready for it?

My digital nurse journey

I stumbled into the role of Digital Nurse following a chance opportunity to be involved in the deployment of electronic observations, moving from paper to iPads. Loosely qualified as the Sepsis lead, I had an avid interest in patient safety and I had more free time than the outreach nurses to get involved. Initially, my role in the project was ensuring clinical guidance adherence, however this quickly evolved to leading the staff training and, before I knew it, I was managing a small team of nurses to deliver the whole roll-out of the project. It worked. We understood the constraints within a busy ward environment, wore uniforms and spoke the same language as the staff on the wards, so we were able to provide confidence in the product and much needed trust in this new digital technology.

To me, this deployment represented the impact of technology and the potential that it has to transform care by reducing the burden on our workforce. It confirmed my suspicion that an effective use of information and digital technologies is likely a critical factor in improving healthcare and developing the digital capabilities in nurses and midwives. It also showed me how much I wanted to continue to drive these transformations and be involved. So, with some slightly sneaky detective work across other Trusts, I proposed to stay on as a Lead Digital Nurse with my small team of digital nurses.

Digital resistors

But this project was far from just a personal journey. It also highlighted the huge inequalities in digital literacy within nursing with varying competence, attitudes, values and behaviours across the Trust. On one occasion I met a nurse that physically ran away from me, bolted down the ward with a distance holler of “I can’t do I.TTTTTTTTTTTTTTTTTTTTTTTTT”. Others thought I was ‘Big Brother’ using the technology to monitor their every move and some, no matter how hard they tried, simply couldn’t grasp this modern technology. A lot of these nurses still actively avoid using any of the systems, finding work arounds, and as a highly resilient and inventive group of people, they can manage this trick for years if need be. But this can’t last forever, the digital road map has a destination and we all need to take this journey.

Opportunities for innovators

The biggest surprise for me has actually been at other end of the spectrum. Daily, I meet lots of incredibly passionate innovators, drivers for change who absolutely want to, and can, make a difference. We all know that the best ideas and the real digital innovation comes from those working in the wards daily, those that are frustrated and want to challenge the norm. Those that see a problem first-hand and, even better, consider solutions. But what platform do these nurses have to voice their ideas or pursue their interests outside a chance encounter with the Lead Digital Nurse?

For medics, applying for a fellowship is quite normal, and often actively encouraged as an added academic bolt-on to their existing role, where they can further develop research or increase skills in an area they are interested in. Consultants can take on additional programmed activities (PAs), leading National audits or improvement projects, even the position of CCIO. From a digital transformation prospective this works well, they remain in their usual clinical teams and so are well-placed to enthuse about digital transformation on an ad-hoc basis. This results in active engagement from peers, reaching a wider, more relevant audience, with interested parties fully understanding the impact the change may have. But for now at least, this is not an opportunity available for nurses.

I Joined the DigitalHealth.London Pioneer Fellowship, a programme ideally placed to support nurses to pursue their interest in digital, as it recognises that many cannot leave or risk their career for a full-time position, secondment or sole educational post. Instead it gives support through learning days which provide guidance, a strong community of practice and a space to finesse skills and improve awareness of one’s capabilities and strengths – something that I have found invaluable in my Fellowship experience.

But not all nurses can have access to this or similar opportunities. There isn’t a set pathway for an aspiring digital nurse, midwife or AHP to follow. Many courses are aimed at healthcare professionals in senior positions, missing the vital visionaries on the ward and creating a further gap in inequalities by upskilling the senior staff who are not ward-based and therefore cannot bring the same insights.

Encouraging innovation

So, what can be done?  Personally, I think we could be doing so much more. I think the most achievable and impactful option would be to reboot and rehabilitate the idea of link nurses and further explore the term ‘Change Agents’.  The link nurse concept is great in theory, however the realities are often nurses spending their own time carrying out audits and updating notice boards or it becomes a lost, downgraded priority in an already busy and stretched environment. I want to encourage my Trust, and other Trusts, to consider creating a defined digital nursing job role with allocated monthly hours, giving them the space and time to develop new skills, be involved in all aspects of digital implementation and be early adopters in their clinical areas. These Change Agents will be in a prime position to identify the nurses struggling to evolve in this digital age and support their peers through in-house training or signposting to nationally supported digital literacy programmes.

Let’s not leave the pathway for our future digital innovators to chance, let’s ensure they are given opportunities to develop in the areas they are passionate about, drive change and acquire skills to progress their careers and help get all our nurses ready for this digital transformation.

To find out more about Johanna’s project whilst on the Digital Pioneer Fellowship, visit her profile page.

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