Where is the Bedside Nurse?
The landscape of nursing has evolved dramatically with the introduction of innovative technologies. As nurse researchers invested in patient outcomes, we have observed a troubling trend: many newly graduated and experienced nurses are increasingly disengaged from direct patient communication. This raises the critical question, “Where is the bedside nurse?”
Historically, nursing was built on human connection. Florence Nightingale emphasized the importance of empathy, communication, and patient-centered care. The bedside nurse was a caregiver, advocate, and source of comfort. Today, this role is under threat, with potentially profound implications for nursing practice and patient care.
The Rise of Technology
Technological advancements, including electronic health records (EHRs) and computerized physician order entry (CPOE), have revolutionized healthcare delivery. However, these innovations often come at a cost. Nurses now spend more time interacting with screens than with patients, with documentation overshadowing direct care (Pratt et al., 2021). Mobile computers, though essential for best practices, can serve as physical barriers that diminish patient engagement, devaluing the intangible benefits of one person soothing another in crisis.
Increased Workload and Burnout
Another factor contributing to the erosion of the bedside role is the increased workload and burnout among nurses. Staffing challenges, higher patient acuity, and growing healthcare demands have left nurses with little time for meaningful patient interactions. The pressure to complete tasks efficiently can lead to a mechanical approach to care, where speed takes precedence over quality interactions (Forde-Johnston et al., 2023).
Educational Gaps
Nursing education may also contribute to this issue. While curricula emphasize critical thinking, clinical judgment, and technical skills, communication and bedside manner often receive less focus. Simulation labs are invaluable, yet they cannot fully replicate the nuances of real-world nurse-patient interactions (Moore et al., 2020).
Reclaiming the Bedside Nurse
Addressing this issue requires a multifaceted approach. Healthcare institutions must recognize the healing power of authentic communication in the nurse-patient partnership and its impact on patient satisfaction. Streamlining documentation processes can free nurses to engage more genuinely with patients.
Nursing education programs should emphasize the importance of human connection, integrating patient-centered care into curricula to better prepare new graduates. Continuing education and professional development can further enhance communication skills for practicing nurses.
Implications for Nursing Practice
- Integrating Technology with Human Touch: Ensure that nurses are proficient with technological tools to minimize frustration and allow more time for patient interaction.
- Addressing Workload and Burnout: Address staffing constraints promptly to enable nurses to spend adequate time with patients. Implement support systems like peer groups and wellness programs to mitigate stress.
- Enhancing Nursing Education: Incorporate comprehensive training on communication, empathy, and patient-centered care into nursing curricula. Provide ample clinical rotations for real-world patient interaction experiences.
- Creating a Patient-centered Culture: Develop policies that prioritize nurse-patient communication, such as protected time for uninterrupted patient engagement. Recognize and reward nurses who excel in bedside care.
- Balancing Efficiency with Empathy: Collect and act on patient feedback regarding nurse interactions to continually improve bedside care.
Conclusion
As healthcare becomes increasingly complex, it is essential that technology and efficiency do not replace the human connection at the core of nursing. By fostering environments that value and encourage genuine nurse-patient connections, we can ensure that the bedside nurse remains an integral part of the healthcare system, maintaining the heart of our profession.
Correspondence concerning this article should be addressed to Beth E. Jameson, Center for Nursing Innovation and Research, Morristown Medical Center, 95 Madison Avenue, B06A, Morristown, NJ 07930. Email: beth.jameson@atlantichealth.org
References
Forde-Johnston, C. Butcher, D., & Aveyard, H. (2023). An integrative review exploring the impact of Electronic Health Records (EHR) on the quality of nurse–patient interactions and communication. Journal of Advanced Nursing, 79, 48-67. https://doi.org/10.1111/jan.15484
Moore, E. C., Tolley, C. L., Bates, D. W., Slight, S. P. (2020). A systematic review of the impact of health information technology on nurses’ time. Journal of the American Medical Informatics Association, 27(5), 798–807. https://doi.org/10.1093/jamia/ocz231
Pratt, H., Moroney, T., Middleton, R. (2021). The influence of engaging authentically on nurse-patient relationships: A scoping review. Nursing Inquiry, 28, 1-15. https://doi.org/10.1111/nin.12388
