Lauren Arora Hutchinson: I'm Lauren Aurora Hutchinson, and
this is playing god? presents...
Narrator: From the far horizons of the unknown come tales of new
dimensions in time and space. These are stories of a future,
adventures in which you'll live in a million could be years on a
thousand maybe worlds. iDeas Lab Broadcasting presents... A World
Without Nurses. Can you hear it? The sound of a modern day
hospital. A hospital of the future, as the entrance banner
reads. The floors are spotless. The patients are smiling, and
the wards are quiet, peaceful, serene, all thanks, of course,
to the powers of automation and AI. It's a far cry from the
sounds of not too long ago. Those bygone days of chaos, when
nurses roamed the halls then primitive machines beeped and
blared for all to hear. Yes, it's amazing how far we've come
so quickly, but few know the story of how we got here. Fewer
still appreciate the crisis that precipitated this modern marvel.
It's a story of under appreciation, over reliance, and
ultimately: human triumph. It's a story that begins in a world
once filled with nurses.
Miss Johnston: Mom, Jimmy, keep up now. We don't want to be late
for our appointments.
Nurse: Hello, and welcome to True Life Hospital. You are
Miss...?
Miss Johnston: Miss Johnston.
Nurse: Yes, Miss Johnston. Wonderful. We spoke on the phone
earlier this morning, yes?
Miss Johnston: Yes, concerning both my son Jimmy and my mother
here.
Nurse: That's right. Well, okay. Nurse Jenny is ready in room
three over there to take a look at Jimmy's fever, and our
respiratory specialist, Nurse Aaron, is almost set for your
mother's follow-up. And how are you feeling today, Miss
Johnston?
Miss Johnston: Well, now that you mention it, I've got a
headache that just won't quit.
Nurse: Oh dear, well, we'll need a bit more information, but I'm
sure our nursing staff can get that cleared up right away.
Miss Johnston: Wonderful, thank you so much.
Nurse: Not at all. Please just take a seat, and we'll be with
you all momentarily.
Narrator: Yes, it was a beautiful thing, you might say.
Teams of nurses at the ready, prepared to help heal whoever
walked through their doors.
Archive: If you really want to be a nurse, you should have a
spirit of service and a sincere interest in human beings of all
classes and kinds. People will depend on you. People will
confide in you.
Narrator: They tended to the sick, aided the frail, and
while, yes, you could say that this sort of thing is as old as
humanity itself.
Cynda Rushton: I mean, there's always been in all communities
healers, people who know how to manage the human experience.
Narrator: As Cynda Rushton, nurse and professor of nursing
at Johns Hopkins, tells it...
Cynda Rushton: It was really during the Crimean War that the
profession and the practice of nursing was created...
Narrator: The year was 1853 and as the battles raged, flocks of
nurses descended upon the front lines, nurses like Mary Seacole
from Jamaica and Florence Nightingale from Britain.
Cynda Rushton: ...to take care of the soldiers...
Narrator: Mary pulled them off the battlefield and bandaged
their wounds, while Florence tracked their treatments and
outcomes.
Cynda: ...and through that experience really noticed a lot
of patterns,
Narrator: like the fact that more soldiers were dying of
illness than injury, and she thought to herself, there's got
to be a better way to do this.
Cynda Rushton: And, we often say, you know, you got a
problem, give it to a nurse, because we'll figure it out.
Narrator: And over the years that followed, Florence did just
that. She formalized the basics, requiring hand washing and
changing bedding. She defined the nurse's role as patient
monitor and advocate. She even established the first modern
nursing curriculum.
Archive: Aided by the medical staff who contribute by lectures
and demonstrations.
Narrator: And as this burgeoning field grew and grew and grew the
demand for specialized nursing skills grew with it.
Cynda Rushton: Because you got to realize that alongside
this...
Archive: It is now possible to make x-ray pictures.
Cynda Rushton: ...there were advances in surgery, advances in
Archive: the electrocardiogram, respirators, blood transfusion
service,
Cynda Rushton: advances in treatment of all kinds of
infectious diseases.
Archive: The healing power of penicillin, enables the
patient...
Cynda Rushton: So nursing practice had to keep pace with
the technology.
Narrator: Nurses developed a revolutionary treatment for
polio, discovered a life-saving fix for jaundice. In fact, by
the 1950s...
Nurse: Thank you for your patience, Miss Johnston.
Narrator: ...around the time Miss Johnston showed up with her
family at the hospital...
Nurse: No problem, no rush at all.
Narrator: ...there were as many types of nurses as there were
flavors at the soda fountain.
Archive: Staff nurses guard and care for the sick on the wards.
Nurses in the operating rooms give emergency nursing service,
and the private duty nurse goes ready to fit in wherever the
patient may be.
Narrator: Yes, in a mere century the field had gone from an
afterthought to a systematized scientific and structured field,
improving outcomes for everyone involved, but while on the
surface things looked wonderful, just below the crisis at the
heart of our story was brewing, gaining strength like a
hurricane cresting the horizon.
Archive: The lights on the hospital call board flash faster
today than they can be answered. Each one is a distress signal
sent to thousands of nurses who aren't there, who don't exist.
Narrator: There simply weren't enough nurses.
Cynda: We had a shortage, yes, because there weren't enough
schools of nursing to meet the demand, and so there was, there
was a push for many, many years to increase the number of
training programs, but focusing on the supply problem alone is
insufficient, because we were also just not providing that
kind of environment that enabled nurses to do what they were
trained to do. There was a lack of support.
Narrator: This was the root of our crisis, and yet we left it
untreated. And so, like a wound covered only with gauze, it
spread, it festered quietly under the bandage until the
early 21st century, when the crisis could no longer be
denied.
Reporters: Hospitals across the country are facing a nursing
shortage. Florida is feeling the impacts of a nursing shortage,
with... The number of nurses not keeping up with the demand.
60,000 positions will be left empty. Burnout and fatigue are
pervasive. The largest nurses' strike in the city's history. If
something isn't done to stem the tide, this could plunge us into
a health care crisis of huge proportions.
Narrator: To meet the moment, hospital administrators did what
they could. They unveiled a series of primitive automated
systems.
Automated Speaker: Thank you for calling True Life Hospital,
where customer service is our number one priority. We're
excited to provide you with our automated over the phone
diagnostic service. Are you calling on behalf of yourself or
someone else? Press one for yourself, press two for someone
else. Thank you. Please hold.
Narrator: Yes, gone were human nurses picking up the phone, but
the price of their replacement was right and proved almost as
caring and capable.
Automated Speaker: Is the issue you're calling about above the
torso or below the torso? Press one for above or two for below.
You've selected above the torso. Is the issue you're calling
about today pain related? If so, rate the pain by entering the
number corresponding with the pain, nine being the highest. If
you are not in pain, press pound. You have entered an
unrecognized response.
Narrator: Getting a diagnosis could take a bit longer over the
phone, sure, and the experience lacked that human touch...
Automated Speaker: Goodbye.
Narrator: ...but the higher ups were happy. This was the new way
of the world, they declared proudly. More automation, more
intelligent systems, fewer humans in the loop. It was
imperfect, they'd admit, but you can't fight the future. There
was, however, a problem.
Sterling A. Wilmer: You love this field, and you love your
patients, and so just being able to be in this space and just
show them kindness and care and compassion and continue to have
the privilege to care for them and their families.
Narrator: The nurses that remained.
Diane Couchman: There's a reason nursing is the most trusted
profession. People who are drawn to it really do care, they're
committed to both the science and the understanding and the
lifelong learning, but they're also committed to the
compassion.
Narrator: Brought up in an old world way of doing things, they
believe there was something about being human themselves
that helped them do their job.
Sharon A. Adamski: I've been at the beginning of life, and I've
been at the end of life, and, you know, there's there's times
when sometimes we're the only person there.
Narrator: And empathy, in particular, many said, was
vital.
Tamara Hill: Wow, so this is very personal for me. I was a
Tyler Silvey: I'll
new nurse here in the PICU, and my daughter was two, and I was a
single mom, and she was helping out in the kitchen, and she
tilted a pot of water. She loved macaroni. And, a pot of water
fell on her arm, and I grabbed her and put her on the bathtub,
and ran cold water, and I called 911, and she recovered, but
there's still a significant scar. So, having to live with
that blame and the shame of it... And when I came back to
Caitlin McGeehan: had talk to
work, I always avoided burn patients, because I just thought
I wasn't going to be able to do that. And one night, we had a
patient come in, a three-year-old burn and my
church nurse said, I know what you've been through, but the
best way for you to get through is you're gonna have to take
this assignment. And, I said, give me five minutes before I
Lauren Geiling: I like to describe my shift as
can take this assignment. And I went to the bathroom, and I
prayed, and I took the assignment, and it was probably
Cynda Rushton: and they were frustrated about having to be
the most challenging, but best experience to be able to share
sheltered at home, where they had to have masks and all these
with the family my experience, and let them know everything was
constraints on their own decision making, and they come
going to be okay... to be on that journey with them,
into a hospital, and who gets the brunt of that is the nurse.
something that I had to experience personally and was
having to still deal with it.
Reporters: Tonight, a nurse is fighting for her life after she
was brutally attacked by a patient at Palms West Hospital
in Loxahatchee. Yeah, she was...
Cynda Rushton: Violence against nurses escalated to really
alarming levels, and what I began to hear from nurses was,
you know, the reason I'm here is my patients. When our patients
turn against us, what is left?
Narrator: It was bad news for all. Longtime nurses retired
from the field. Up and coming nurses left jobs or the
profession entirely. Patients became more frustrated, and
hospital administrators had no easy answers, but then...
Tech Announcer: Hello Silicon Valley, make some noise.
Narrator: ...a technological solution was found.
Tech Announcer: Thank you, everyone, for being here on this
exciting, historic day. After years of development and
research, we here at Med Robotics are finally ready to
unveil to the world our hospital-ready Mark 3 Nurse Bot.
With its humanoid design, the Mark 3 Nurse Bot does everything
you could ask for. It delivers medication, cleans up messes.
Best of all, it doesn't need to sleep or eat or receive a
paycheck. Say hello to your adoring fans, Mark.
Mark 3 Nurse Bot: Hello, I am here, excited and ready to help
you.
Tech Announcer: Alright!
Narrator: Yes, not long after the pandemic subsided, Med
Robotics released its miraculous nurse bot. It looked like a
human, sounded like one too, and while the medical industry could
finally breathe a sigh of relief, some, like Cynda
Rushton, remain skeptical.
Cynda Rushton: If we were able to use technology in its right
relationship to nursing practice, what we could see is
nurses being able to spend the time with their patients: being
able to educate them, guide them, advocate for them, the
parts that really nurses are the best at. That would be my most
hopeful view. What I worry might happen is that organizations
take a replacement view. They say, okay, we can get rid of
half of these nurses, and we can get robots in their place. I
want nurses to be able to do what they do. You know, when
you see the difference you make, you know, with people when
they're at their most vulnerable... I don't think a
robot could do that.
Caitlin McGeehan: At some point, you know, our bodies betray us,
and we are vulnerable to death. Nurses have that distinct
privilege to help people become more comfortable with what it is
to be a human being.
Cynda Rushton: And, if we didn't have that, that kind of care,
that kind of competence, that kind of compassion... I'm not
sure what kind of world we'd have.
Archive: The lights on the hospital call board flash faster
today than they can be answered. People will depend on you.
People will confide in you. An attack on nurses at St. John's
Hospital. If something isn't done, this could plunge us into
a health care crisis of huge proportions.
Narrator: As we now know, the world of today is one of
efficiency and precision. It's a world of automated excellence.
It's a world without nurses. And while we owe a debt of gratitude
to Florence Nightingale, Mary Seacole, Cynda Rushton, and all
the nurses that worked alongside them, a word of caution: don't
romanticize the past. Don't pine nostalgic for the way things
were. Time is a train locked to its tracks. You've got to get on
board, and you'd best keep all your limbs safely inside the
vehicle, because while today is wonderful, tomorrow will be even
better. That is, if you help make it so. Thank you, and good
night. A World Without Nurses is an iDeas Lab original
production. It was written and produced by Simon Adler. The
executive producers were Lauren Aurora Hutchinson and Tony
Phillips. It was mixed by Alex Overington. A World Without
Nurses was produced in association with Maryland's R3
Resilient Nurses Initiative led by Dr. Cynda Rushton and
supported by the Nurse Support Program Two grant administered
by the Maryland Higher Education Commission and funded through
the Health Services Cost Review Commission. Our nurses were
Nurses: Sterling Wilmer, Diane Couchman, Sharon Adamski, Tamara
Hill, Rachel Robinson, Tyler Sylvie, Lauren Geiling, Caitlin
McGann, Daniel McCamey.
Narrator: The producers for the iDeas Lab at the Berman
Institute of Bioethics at Johns Hopkins University include Lyric
Bowdich, Kim Buikema, and Axel Kacoutié. Our production
assistant is Brian Ricker, and our production administrator is
Leah Lord.