news views Summer 2015
A Publication of the Department of Nursing and Patient Care Services University of Maryland Medical Center
Innovations and Leadership in Tele-ICU Nursing Anita Witzke, MS, RN, Director of University of Maryland eCare
The concept of telemedicine originated nearly 50 years ago with the National Aeronautics and Space Administration’s (NASA) use of satellite applications to provide medical care to individuals in isolated areas of the U.S., where it was difficult to access them using traditional means (Bashshur & Shannon, 2009). The 1990s saw a significant increase in the use of health information technology (HIT), and since then it has grown exponentially due to the American Recovery and Reinvestment Act passed by President Obama in 2009.
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his Act included a $19 billion program encouraging the expansion of technology and its applications to health care (Ball et al., 2011). When considering possible applications for telemedicine, one cannot overlook the potential that exists in the intensive care unit. Life-threatening events in the critically ill do not follow a 9-to-5 schedule, and immediate treatment is crucial to achieving positive outcomes (Gajic & Afessa, 2009). Creating an environment that optimizes resources, observation, and treatment has been the hallmark of intensive care units over the last six decades. Dating back to the days of Florence Nightingale, it has been a priority to group the most vulnerable patient populations together to allow for
increased vigilance (Munro, 2010). The care of critically ill patients in a specialized manner by specialized physicians and critical care intensivists has been proven to provide the safest and highest quality of care. Unfortunately, there is a shortage in the number of intensivists in the U.S., with the highest number practicing in urban and metropolitan areas (Halpern, Pastores, & Greenstein, 2004). Therefore, many critical care patients in rural areas do not receive the benefits of having this specialized care. However, with the growth of biomedical and information technologies, innovative ideas like the tele-ICU have been able to bring experienced critical care teams to hospitals and patients, no matter where they are located. continued on page 14.
Lisa Rowen’s Rounds: In Different, Not Indifferent Have you ever noticed that when you are receiving your annual job performance appraisal, you focus on and even perseverate on the feedback you consider negative? This is human nature. Most people remember negative feedback or events more strongly and in more detail than those that were positive. This may be due to the fact that our brains process positive and negative information in different hemispheres. Because negative emotions generally involve more thinking, we process this information more thoroughly than positive emotions. Consequently, we tend to ruminate about unpleasant or negative events, information, and feelings more than happy or positive ones.1 Lisa Rowen, DNSc, RN, CENP, FAAN, Senior Vice President of Patient Care Services and Chief Nursing Officer
I will admit I have been contemplating a comment recently made to me by a patient: she said the nursing care she received here was “indifferent.” I cannot stop thinking about this comment, how she must have felt as a patient and how it made me feel as a nursing leader. If you look up the word indifferent you will find this meaning: • having no particular interest or concern, apathetic; • having no marked feeling for or against; • not mastering one way or the other, unimportant, immaterial; and, • being neither good nor bad but mediocre. Mediocre? Is our nursing care mediocre? It’s difficult for me to believe this. I see and hear about amazing care here every day. Sadly, I also see and know of pockets of nursing care that are sub-optimal, apathetic, and continued on page 6.