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Research reveals a chasm between the attitudes of student nurses and their managers on the use of smartphones in practice.
George McNally interviewed by Dallas Bastian
would have to pry it from my cold dead hands.” This was one of the comments shared by the participants of a study on the views of nurse managers and student nurses concerning the use of smartphones and tablets at the bedside.
The research revealed the two groups have conflicting views on the technology’ s use in clinical settings.
Published in Nurse Education in Practice, the study involved semi-structured interviews with 13 New Zealand student nurses, aged 25 – 35 years, and five nurse managers, aged 45 – 55 years.
The authors found that despite both cohorts using the devices as part of their work, the nurse managers interviewed did not approve of student nurses using personally owned handheld referencing technology, such as smartphones, to inform clinical decisions.
Some of their key concerns were safety, security of data and ethical issues.
Student nurse participants said they were unlikely to stop using what they perceive to be a practical and useful tool for novice practice.
Nursing Review sits down with lead author George McNally, a lecturer at NorthTec, a tertiary education provider in northern New Zealand, to discuss the concerns of the two groups and the problems that may arise from these differing points of view.
NR: What did the student nurses tell you about their smartphone and tablet use? GM: I can’ t stress enough how much this younger cohort of student nurses were enamoured by their personal phones. It is a cultural and social norm for them. It is something they perceived as completely harmless, and it is part of their lives – it isn’ t an adjunct to their lives. It is completely part of who they are. Quite a lot of their identity, I think, is tied up with their smartphones and their online personas that they [ express ] through these smartphones. So they were greatly enamoured of their phones and saw it as a completely normal, everyday thing to do to use it for anything and everything at any time.
You found that nurse managers do not trust younger cohorts of student nurses to act ethically when using a personal smartphone in clinical environments. What are some of the issues nurse managers are concerned about? The nurse managers were very well informed of the dangers. They knew exactly what the problems were with personal smartphones and the personal smartphone’ s association with social media. They just didn’ t see that younger cohorts, especially of nurses or student nurses, had the perception of knowing what is work and what is not. It was completely a social and cultural norm for them to have their personal phone and use it whenever, whereas nurse managers didn’ t see it that way. They were acutely aware of the dangers of the security of data, the security and privacy of patients, the dangers of social media postings for the reputation of nursing and the hospital. It was quite a stark difference between the two cohorts.
From the nurse manager point of view, more and more time is being spent policing and administering reprimands for the use of personal phones. It’ s actually eating up some managerial time to police this.
Is there a way forward here that would suit nursing managers and student nurses, and if so, what would that be? I am calling for a pragmatic approach to the phenomenon. What we have at the moment is that personal smartphones are in fact informing clinical practice in a completely unregulated way. We have good regulation for the use of social media. The Nursing Council of New Zealand has an excellent document for guidelines for that, but not for the use of your personal device to inform your practice.
So we don’ t know what they’ re looking at to inform their practice. It could be [ dangerously inaccurate websites or sources ]. What we want them to be looking at is the New Zealand Formulary or a respected resource like our clinical knowledge centres that we have set up online in hospitals. We don’ t want them looking at rubbish, and we have no control over that at the moment. I have evidence of nurses hiding in toilets to look something up. This is completely unacceptable. We need to get on top of the pragmatic approach and on top of the regulation of it.
I think in America they’ re doing this a lot better. Kaiser Permanente is a very large organisation supplying healthcare. It is taking a much more pragmatic approach to it, realising nurses will use their phones, and [ so telling ] them how to use the phones.
Let’ s give [ our student nurses ] an idea of what they should be looking at and which sources of information they should accept, rather than banning it and having it occur covertly instead. ■
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