Miss Tsering Lhakyi Sherpa, is a registered nurse. She is currently pursuing her bachelor’s degree and she works in a long-term care facility. She works with a mostly older population and provides them medicine, rehabilitation, dialysis preparation, and post dialysis assessment. She also assists with physical therapy and performs respiratory therapy. The patients she works with are mostly older population, who are chronically ill or require vent for food or air. What makes her work different from geriatric nursing is that she also works with the young adult population and, most of them are diabetic patients. Unlike geriatric nursing, which helps the older population of 65 and above, her work does not have an age restriction, except for pediatric.
According to Sherpa, there is a high demand for male nurses in all fields of nursing. We know that there used to be a stereotype that nursing jobs are for females. At present, there is a large ratio of females to male nurses, but hospitals and other health facilities are looking for more male nurses. I asked her for the reason there is increase in the need for male nurses. Sherpa said, “There are some works that are more suitable for male to perform as a nurse, and it would be really easy for us if there are some physically strong male to help with some patients.” I asked her if the patients would prefer the female as their nurse rather than a male nurse. She said, “No, they don’t. Being a male nurse would not affect, the preference of the patient for receiving treatment”.
We talked about some trends that may impact the practice of nurses. Telemedicine is a method of remote communication between the patient and their health care provider. It can be used as a remote cardiac monitor to check the vital signs of patients, even if the patients are in their own home. Telemedicine can also be used for prescribing medicine and informing the patient about the report of the test which could be blood work or any result of the test remotely using a phone call, or video call (Morley et al, 2016). I asked her thoughts about it and if it is feasible (Salles et al, 2017). She said that currently telemedicine is not used at her work, but she believes that the ability to stay at home while using remote cardiac monitor is very useful because patients prefer to be at home with their loved ones, and the environment would also be calming for the patient. On the other hand, she said that as a nurse she would not be able to perform an accurate assessment of the patient at that moment when they are having remote communication with their patients. She would not be able to know the condition of the patients just from the video, and she would have to rely on the response of the patient’s condition to assume their current condition which may not be accurate. She said, “Of course the use of telemedicine reduces the wait time of the patient time considerably, but on the downside since the purpose of using this technology is to reduce the time, the patient may not be able to get all the information. Also, some patients prefer talking in person rather than using the phone, and the older generation may have a hard time using technology to communicate”.
Nursing started with the nurse going to the sick person’s house to attend them, and at present nurses are bound to the institution to decrease the cost and provide more services at the same place. But slowly there has been an increasing need for home care nursing. I asked her if the trend is going to move backwards towards home care nursing. Sherpa said that home care nursing is more expensive for the patient, and not all patients require home care nursing. Now people have longer life expectancy than before, so they may be inclined to prefer home care nursing, but since it is more expensive the general population will still have to rely on nursing homes and hospitals for health care.
With increasing access to technology and information, patients visit their health care provider armed with knowledge about the symptoms from different sources, which could be from social media to internet website. I asked her how it would impact Sherpa in providing health care to the patients. According to Sherpa, patients who are chronically ill usually come informed about their symptoms. Obviously, patients have the right to agree or deny any treatment. I asked if the knowledge of the patient could force nurses to have an incorrect diagnosis and result in flawed treatment. She says, “Nurses do not fully rely on the patient to assume the condition of the patient because different diseases can have similar symptoms. We conduct various tests to come to a conclusive diagnosis”. Unless the patient required pain medicine, they are not administered medication without conducting other tests.
I asked Sherpa if nurses have more time with the patients because of the use of technology in her field of work. Sherpa accepted that technology could have made it easier for both the patients and the nurses, but at this moment, she also spends most of her time documenting all the care she had provided to the patient. She said that she has to do charting, which refers to recording patient care, vitals, on different platforms, for the purpose of insurance, for the hospital, and so on. She also added that it would be better if the technology is more streamlined so that the data must be entered only once. Also, until recently she had to write a 24-hour report by hand, writing down everything she had done on that day, and on a busy day she has to take care of up to 20 patients, and simply writing down all the information again took a lot of her time. It clearly seems like health care requires a lot of reform, and also need to update on technology use.
Next, I asked Sherpa, if artificial intelligence is used in the field of Nursing and health care. Sherpa said that the health sector is very behind in the application of technology compared to other fields. But she believes that the use of artificial intelligence and machines will definitely improve the Nursing practices and, make it easier for nurses by letting the machine take over the technical work. Machines are also faster and more precise than human, and they can help with measuring vitals, and ambulation, and this will leave more time for nurses to focus on what will make patient health better.
In Ontario, Canada, Mitchell et al (1995) found that only 35% of small hospitals had nursing research journals in their libraries. I asked her if the problem was similar here. Sherpa said that the problem was not with the availability of resources but rather the application of the research. She added that she tries her best to implement the evidence-based research but, the information written in the books assumes that the patient has the full undivided attention of nurse, but in fact, a nurse could be looking after multiple patients. In addition, some medicine requires supervision of nurse after every 10 minutes, but that is not possible because of the heavy workload. Sherpa also said that we cannot give over-emphasis on randomized controlled trials in evidence-based health care. This is because Asians have low tolerance, compared to Caucasians. A dosage of medication that is low for Caucasians could be an overdose for the Asian group of people. The knowledge gained from clinical experience can help a Nurse make a better decision for such occasions. Sherpa hopes that in the future the books available for nursing would give more practical knowledge which could be implemented in the nursing practices.
I asked Sherpa if there is any field that requires more study in the field of nursing which could improve it. Sherpa said that there should be more research done to study the impact of nurse workload on patient care. But to bring this knowledge into practice she believes that there is a need for more nurse leaders, who will speak for the better condition of nurses, which will bring an overall better outcome for patient care.
Sherpa’s future goal is to be a genetic nurse. She said, “I have realized that most of the diseases I studied are related to the gene. Autoimmune disease, obesity, most of the chronic and life-threatening diseases are related to the gene”. She wants to provide care for patients who could be at risk of a genetic condition or are affected by it. Sherpa said that language barrier made it difficult for her in the beginning while pursuing to be a nurse, and if others want to be a nurse then they should not go only for the salary. She suggests that any aspiring nurse should do atleast 4-6 months of volunteering in the hospital to know if nursing is right for them. Finally, she said, “You should be fully committed, and work hard to be and work as a nurse”.
Work cited
Mitchell, A., Janzen, K., Pask, E., & Southwell, D. (1995). Assessment of nursing research utilization needs in Ontario health agencies. Canadian Journal of Nursing Administration, 8(1), 77-91.
Morley, J. (2016). Telemedicine: Coming to Nursing Homes in the Near Future. Journal of the American Medical Directors Association, 17(1), 1-3.
Salles, N., Lafargue, Cressot, Glenisson, Barateau, Thiel, Raynal. (2017). Global geriatric evaluation is feasible during interactive telemedicine in nursing homes. European Research in Telemedicine/La Recherche Européenne En Télémédecine, 6(2), 59-65.
Tenjing Sherpa 