In the summer of 1975, my career in healthcare began. My parents said, “get a job” and directed me to work at the hospital to test-drive the healthcare industry and of course, make money.

I really didn’t want to work in a hospital. Most of my friends were working as waitstaff or sales associates in local stores. They received some healthy tips or nice discounts on clothing. How great is that?

At that time, I had significant eczema on my hands. I tried to interview at several restaurants and stores but the hands were not exactly appealing to customers or restaurant patrons. So back to the hospital I went to apply for a job.

The hospital hired high school students in vintage positions of nursing aides and ward clerks. My sister was already working there so perhaps there was some influence. But somehow they looked past the hands, I was hired and I completely a short training for both jobs.

Now, the most technology I used as a nursing assistant was a rolling blood pressure cuff.  We were in high cotton because we didn’t have to carry our cuffs around in a little zipper bag. Some rooms even had them attached to the wall. IVs were glass, thermometers were glass, and bedpans were metal. All paperwork was done by hand and we had a celebration when the ward clerks got their first manual addressograph machine to imprint patient information. I’m sure some readers can relate…

To connect with a patient, there were no barriers. I could sashay into the room in my white uniform dress or bell bottom white pantsuit, complete with white hosiery and shoes, move directly next to a patient bed, greet them, look them right in the eye, smile, feed, bathe, take vital signs, give enemas, empty bedpans and tuck them in my nicely creased sheets. I was able to meet my first dream of being a waitstaff by serving my patients’ needs and creating comfort. I found my calling.

New decade, new job, new technology, the 1980s. I attended nursing school and later transitioned into respiratory therapy. Patient rooms included more equipment – spirograms, ultrasonic nebulizers, IPPB machines and the new CPAP apparatus. To even get near a patient, you had to move your own equipment plus any other technology that the patient needed and was left in the room.

My first ICU experience with high technology beyond an Ohio ventilator was in a 50 bed open heart recovery room. 44 open beds and six private rooms. Curtain separated the patients and we had to navigate around intra-aortic balloon pumps, IV pumps, dialysis and an array of monitors. And then of course the EKG or RAD tech would come in and add to the mix. They really had it tough.

Fast forward into the 21st century, and direct care givers are pushing a computer into a patient’s room. As a patient, when we walk into an Emergency Room, the receptionist and the intake/triage nurse may be strategically placed in front of or beside a computer. The computer screen may actually be facing away the patient. As an inpatient, the first thing a patient may see is a COW (computer on wheels) or a portable vital signs machine. It can be possible that a caregiver may not even touch a patient as our EMR and technology sometimes requires more input and time than the patient can deliver verbal output. Just as a desk in an interview creates a barrier and defines space and authority, so does equipment in a patient care setting. 

Thoughts to Build On

What is the first thing your patient sees as a first impression? You or a piece of equipment?

Throughout the interaction, is your patient focusing on you or the equipment?

How is the computer or equipment creating a barrier? Are you less than one arm’s length? across the room?

If you use a computer for EMR input, how are you balancing data entry and demonstrating compassion?

How are you demonstrating caring, communicating and connecting with the patient around your equipment?

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