PubMed · 5559155
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W J Hartin, L J Goodman. 1971. An improved safety system.. https://doi.org/10.1097/00004032-197101000-00008
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During ambulatory monitoring, physiological signals and other parameters are measured and stored in a portable recorder. To optimise subsequent interpretation, additional information is provided by the subject pressing a button at the onset of any relevant symptoms or events, simultaneously noting these in a personal diary. To distinguish between different events, the subject is instructed to press the event button a specific number of times. Confusion arises when the subject fails to press the button correctly or to record the event accurately on paper. The device described overcomes these problems by providing the subject with separate switches on a single remote unit. Depending on the button pressed, the unit automatically sends a coded signal to the recorder, allowing unequivocal identification of events during data playback and analysis. Although primarily used in urodynamics, this simple device can be used in many other similar recording systems with little or no modification.
As the use of robotic aides increases the possibility of telesurgery, the perioperative scope of practice could include using patients' homes or other nontraditional settings as surgical sites. Even mobile surgical vans could be used. To perform telesurgery, the health care industry actively must define the role of the health care professional with the patient who can make an incision and insert a laparoscope. This may create an opportune time to promote the RN first assistant (RNFA) role--a goal that will involve expanding our state nurse practice acts to allow RNFAs to perform various functions for true advanced practice in nontraditional settings. Additionally, it will mean defining what functions and personnel must be available in these new creative settings. Current experiments have focused on using nonlicensed assistants, which can lead to legal and moral concerns. Legal and moral concerns include not only appropriate personnel, but also patient privacy. In telesurgery, patient information would be transmitted over communication lines, possibly seriously jeopardizing patient privacy. Perioperative nurses must be vigilant regarding patient privacy and continue to be patient advocates. Additional concerns relate to the possible complications or emergencies that can occur in any procedure, such as bleeding, cardiac arrest, or malignant hyperthermia. As this field is being developed, these concerns must be addressed, and possible complications and emergencies must be prepared for. All patients deserve highly trained individuals to care for them. It is a concern that unlicensed personnel are being considered to manage these potentially serious situations. It is now more important than ever that perioperative nurses stay on top of technologic advances. One surgeon stated that perioperative nurses are at a point in history in which they can make a difference--a potentially lifesaving difference. Nurses will have to be comfortable with new technology, know when it is working well, and be able to assess the patient's status critically. The use of robotic aides can decrease the amount of physical work that nurses do; however, they also have the capability to denigrate nurses' positions. If not careful, nurses could lose their focus on the caring aspect of the nursing profession. Although computers remain machines programmed by humans, it seems they more often are masters of information. Today, procedures can be performed in cyberspace as if surgeons were present at the surgical sites. Could robotic aides and computers do a better job than physicians and nurses, causing these health care providers to become extinct? Probably not. Although robots and computers may be able to replicate the knowledge and skill of physicians, patients require human interaction that computers cannot provide. This involves feelings and human communication beyond current technology, despite robotic engineers' continuing attempts to replicate this. The ultimate use of robotics remains uncertain; however, the human touch will not soon, if ever, be replaced by robotic technology. It is now of utmost urgency that all perioperative nurses refine and hone the caring skills that Florence Nightingale instilled to ensure their professional future. Robotics is a new and challenging aspect being added to nursing care. Nurses must take an active role, embrace this technology, and work to maximize their position with it.