The technology involved in nursing today would likely surprise even the most devoted gadget freak. Nurses must increasingly master a host of complex technologies, from "smart" medical devices to tablet PCs.

"There's no way to get around it," says Carol Bickford, PhD, RN, BC, a senior policy fellow in the department of nursing practice and policy at the American Nurses Association. "You need to know the tools, and new ones are coming in right and left."

Nursing Tech Types

The technology nurses encounter on the job falls into two broad categories -- clinical and other information systems, and smart medical devices, often with integrated computer chips and screens. Specific technologies include:

• Clinical Information Systems: These systems bring together an organization's patient records, lab results, pharmaceutical data, medical research resources and other information, providing nurses and other caregivers with integrated, PC-based tools to help them input and retrieve information.
• Electronic Health Records: Patient records in this format provide instant access to a patient's medical history, improve communication between caregivers and offer flags and alerts to prevent conflicts over prescriptions and tests.
• Drug Retrieval-and-Delivery Systems: These utilize several technologies, including bar codes and automated dispensing machines, to ensure patients receive the correct medications and dosages.
• Tablet Computers, Wall-Mounted PCs and Mobile Carts: These computer-based tools allow nurses to enter and retrieve information housed in a facility's information system without leaving the bedside. The systems can operate wirelessly and connect to databases containing care guidelines and other clinical resources.
• Medical Devices: Devices such as infusion delivery systems and ventilators often have "brains built into them," says Joyce Ramsey-Coleman, vice president of nursing and patient-care services at Children's Healthcare of Atlanta. These electronic brains assist nurses by flagging problems and helping to avoid errors.
• Personal Digital Assistants: PDAs with add-on software can help nurses research conditions and check medication doses.

Furthermore, wireless tech integrates information from disparate sources and delivers data faster, so nurses don't need to be tied to a specific workstation to get the necessary information.

Boon and Burden

While nurses acknowledge the advantages of using technology, they also say training is sometimes inadequate, IT systems occasionally force them to rethink how they do their jobs, and technological snafus can impede their work.

But without a doubt, the introduction of new technologies may bring considerable changes to nurses' day-to-day work. Consider the experience of Texas's Baylor Medical Center at Waxahachie after touch-screen computers were installed in the emergency department. The system has helped improve efficiency and patient care in a number of ways, says Mike Behning, RN, the emergency department's day supervisor. With the system in place:

• Nurses don't have to find a doctor to get a patient's chart.
• Charts are easier to read, minimizing potential errors.
• Lab results are available in real time.
• Various departments communicate better.

"Because of the time that is saved by using this system, it gives the nurses more time for more personalized care," Behning says.

But new technologies don't always result in more time for patients. Bar-code scanning, Bickford notes, can serve as part of a check-and-balance system for catching errors, but the bar-code systems aren't always convenient and can take up nurses' time. The same goes for automated medication systems, which may be designed more for the convenience of the pharmacy than for use during nurses' daily duties, she says. "Many times the technologies are imposed on nurses," Bickford explains. "There has not been thoughtful consideration about the work processes or the business processes."

Bickford expresses concern about losing the "sounds and touch" of nursing when dealing with screens and nursing equipment. While technology can improve patient care, she acknowledges that "sometimes it's burdensome."

A Career Survival Skill

Nurse recruiters and hospital administrators say a nurse's technological expertise isn't a crucial factor in hiring. One exception is in nursing informatics, a specialized field focusing on the input, distribution and management of nursing data and information. Nursing informatics specialists typically need IT experience.

Still, Bickford says that technology is now unavoidable in nursing. "You have to be able to survive with the technology," she adds.