7/12/2007
- Ugur Akinci, Ph.D., Nurse-Recruiter.com
Robots
in Hospitals – Trend of Future
Three locust like robotic arms reaching into the chest
cavity of the patient lying on the surgery table hum quietly
while… the surgeon is sitting in a nearby remote-control
booth, directing the delicate operation from a distance
with a 3-D precision that was not possible before…
Or, just look at the 5-feet high porter robot with blinking
lights, moving slowly on its rubber wheels through the
crowded hallways of a hospital… it is quietly waiting
for the elevator to arrive so it can deliver the blankets
it is carrying to the nurse station at the top floor…
Such scenes will become increasingly frequent in the hospital
of the future. But guess what? Such a development was prophesied
over a hundred years ago by the early pioneers of the 19th
century political economy – that in a capitalist
market, any given set of manual skill eventually gets replaced
with machines for higher productivity and profits. And
that creates both new pressures and opportunities for the
workforce to renew itself through new training and career
planning.
The inevitable trend is already visiting our hospitals
in a form that will certainly impact the way our nurses
and healthcare professionals will be trained and employed
in the near future: robots are taking over an increasing
number of functions, ranging from critical surgical operations
to delivery of goods around a hospital.
***** Robots in Surgery
More and more hospitals in the developed world are employing
robots in surgery, including Japan, for example. Iseikai
Hospital in Osaka and Nagoya Kyouritsu Hospital in Nagoya
are just two Japanese hospitals that use these labor-savings
surgery robots.
One unintended consequence is the way the insurance companies
are billed for “services rendered.” Billing
for operations performed by robots are already a topic
of controversy in Japan since they are not categorized
as “regular surgical operations.”
In British Columbia, Canada, a robotic system named Da
Vinci will start operating this Fall to help doctors during
surgeries that require accessing tight areas like the pelvis
or the chest. Vancouver General Hospital is planning to
use Da Vinci in urological (e.g., Radical Prostatectomy),
cardiac (e.g., Mitral Valve Repair) and gynecological (e.g.,
Hysterectomy) surgeries.
Canadian news reports claim that “robot-assisted
surgery offers patients fewer surgical complications, less
post-operative pain, faster recovery times, shorter hospital
stays and
improved health outcomes.” Purchasing Da Vinci,
installing it, training the personnel and maintaining it
for three years will cost the hospital $6.5 million.
Closer to home, did you know that robots are performing
cancer surgeries in Charlotte, North Carolina? CyberKnife,
a $3.7 million knifeless robot, is operating on cancer
patients with precision radiation at the NorthEast Medical
Center. CyberKnife is also used in Mission Health and Hospitals
in Asheville and UNC Hospitals in Chapel Hill.
Other “radiosurgery” machines used in surgery
include the Gamma Knife in Winston-Salem and Greenville
and the XKnife and a Varian device in Durham.
One advantage of such robots performing surgery with high-energy
radiation is that they can remove tumors contained in a
given area or close to critical body parts like the spinal
cord with high precision and reduced side effects (like
fatigue) for the patients. But other types of cancers still
require traditional surgery or a combination of both.
Cookeville (Ohio), Nashville, Memphis, Chattanooga, Knoxville,
Oak Ridge and Franklin (Tennessee) are other cities that
employ robots in surgical operations. Cookeville Regional
Medical Center became the eleventh hospital in Ohio to
buy a Da Vinci. The $1.5 million robots is especially favored
by urologists in prostate surgeries. CRMC officials confirm
that the robot helps “shorter hospital stays, quicker
return to work time and fewer complications.”
In Texas, a heart bypass surgery was accomplished under
two hours thanks to Da Vinci. According to Dr. Lewis Wilson,
a cardiothoracic surgeon at CRMC, the bypass patients of
the Texas surgeon are “back at work in two weeks.”
The below comparison of Da Vinci assisted Gynecologic
Surgery with traditional Open Abdominal Surgery, as provided
by Women’s Specialty Health Centers of Indianapolis,
shows the typical advantages of operations performed
by robots (with the exception of actual surgery time):
Incisions: Five 1-inch incisions versus one 8-to-10
inch incision.
Surgery time: 2-3 hours versus 1-to2 hours.
Hospital stay: 1-2 days versus 3-5 days.
Recovery time: 1-2 weeks versus 4-to-6 weeks.
Pain medication: Motrin/Darvocet
versus Vicodin/Percocet.
With the spreading popularity of such robotic systems,
training of our nurses should also be expected to undergo
respective changes, with new opportunities for career training
and development.
***** Robots as Porters
Another area in which machines are rapidly replacing human
labor is the transportation of various goods around a hospital
to the nursing stations. It is a thankless and physically
demanding job that needs to be taken care of, day in day
out. Perhaps robots will save our nurses from such physical
drudgery and allow them to concentrate on more technical
and “higher value added” assignments -- despite
the ever-present “labor displacement” potential
that all machines represent.
Probably Japan, again, is one country leading the way
in the employment of robots in all kinds of hospital services
including an “android” robot meeting the visitors
at the greeting area and showing them the way to wherever
they want to go around the hospital site. There are hospital
robots in Japanese hospitals which carry food trays as
well as mail, paperwork, luggage, lab specimens, bandages,
X-rays, blankets and linens.
The initial investment could be considerable for some
of these hi-tech workers but they do not eat or drink,
and they usually take only a six-hour break per day. They
do not go out on vacation. They do not take any sick leaves
or personal days off. . Neither do they need any promotion
or health insurance.
According to the Pittsburgh-based Aethon corporation which
makes some of these porter robots, they cost 30% less than
a human courier. There is one (named “Chad”)
in use at the Lehigh Valley Hospital in Pennsylvania and
another one will soon be rolling down the corridors of
The Hospital of the University of Pennsylvania.
Aeton has 150 porter robots operating in various U.S.
hospitals, which is 120 robots more than employed back
only two years ago. The adoption rate is alarming for the
human couriers and sweet music to hi-tech companies like
Aeton.
Some of these robots have TV camera installed on them
so that a doctor can “visit” and “examine” a
patient by remote control. Thanks to the radio frequency
chips that nowadays can be affixed to almost any object,
these robots can also go and find left over or lost equipment
around the hospital. Given the fact that a 500-bed hospital
on the average has 1,500 IV pumps, the savings of such
a capability can be considerable in the long run.
***** Hi-Tech Future and Constant Education
Robots, whether used in delicate surgery or just to carry
goods around the hospital, are here to stay. This trend
will eventually both present new challenges for some of
our nurses as well as providing them with new and exciting
venues to ratchet their credentials to new heights of professional
excellence. That’s why in our hi-tech future, the
education and on-the-job training of our nurses will be
more important than in any other period in our nation’s
history. |
