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Robots Become Nurses’ Valuable Assistants

Let’s be clear about one thing: Robots will never replace nurses. Even the most optimistic roboticists recognize that no combination of metallic parts, microchips, and binary files could ever replace the empathetic touch or clinical intuition of a human nurse.

But researchers who believe that R2-D2 and C-3P0 of “Star Wars” fame and the rogue humanoids in the movie “I, Robot” are more than just fantasy say robotic devices will one day help nurses work more efficiently and may even help them remain in the profession as they age.

“Robots are going to be your friend,” says Charlie Kemp, PhD, assistant professor in the department of biomedical engineering at Georgia Tech and Emory University and director of the Center for Healthcare Robotics in Atlanta. “There is an enormous opportunity for robots in health care, with many ways for them to increase efficiency and quality across the board. Helping nurses do their job is one of those ways.”

Robots have difficulty operating in complex and unpredictable work environments such as hospitals. Current research focuses on designing robots that will do many of the routine and often mundane — but essential — tasks associated with nursing care, such as feeding and lifting patients. Future robots may one day be able to take and monitor patients’ vital signs instead of a nurse, but they are far from having a nurse’s ability to synthesize the information, clinically assess what it means, and physically take action. Instead of acting on their own, robots will serve as assistants and enable nurses to lend their expertise to remote areas without physically traveling to those locations.

Already, courier robots resembling small, mobile cabinets or carts are ferrying linens, medications, laboratory samples, supplies, and other equipment throughout hospitals without bumping into patients, visitors, or healthcare staff. They go by the names TUG, RoboCart, and HelpMate.

The U.S. Department of Defense approved a contract to develop a multitasking robotic nursing assistant (RNAs). The robot would be able to lift combat-wounded soldiers out of bed, deliver supplies, and offer telepresence capabilities for off-site healthcare staff.

“The nurse would guide the robot and tell it when to start and stop,” says Aaron Edsinger, PhD, a roboticist working with the companies designing the Phase I prototype for the Army.

Jessica Pedersen, owner and chief operating officer of RE2 Inc., says she would like RNAs to be able to autonomously navigate hospital or nursing home halls when summoned by a nurse. Other researchers are exploring whether robots can help people who have had strokes perform their physical therapy more effectively to improve their muscle strength and flexibility.

The arena in which healthcare robots have been most successful thus far is the OR and includes the use of the well-known DaVinci surgical robotic system. Robotics help surgeons perform laparoscopic and thorascopic surgeries and, in recent years, heart surgery. The advantages of using robots in surgeries includes decreased pain, faster recovery, shorter hospital stays, fewer complications, and reduced costs.

However, Penelope, the surgical robotic assistant who debuted with promise in New York in 2005, was never integrated into the elite world of the surgical suite because it was shunned by nurses and doctors and because of technical difficulties, says creator Michael Treat, MD, chairman of RST Inc. and associate professor of clinical surgery at Columbia University. He is working on a new role for Penelope in central supply where it could be programmed to wash, sterilize, and count surgical instruments. Treat anticipates Penelope will be more welcome in central supply but is still hoping it will eventually find its place in the OR.

Researcher Judith T. Matthews, RN, PhD, a nursing professor at the University of Pittsburgh, is determining whether robots can make life easier for residents in long-term care facilities and the elderly and disabled who are living at home.
“This is about robotic assistive technology to help older adults and persons with disabilities manage their everyday lives,” says Matthews. “That’s a role nurses typically don’t play. These are not devices that could in any way replace nurses. That was never our intent.”

Her past research includes a robotic assistant called Pearl and a robotic walker that looks like a traditional walker with a touch screen attached to it. Both robots could navigate on their own in an indoor environment, she says. Future protoypes could be used as “wayfinders” in continuing care facilities when a resident may know where he or she wants to go but not how to get there.

At this point, there are no future research plans for Pearl. “She is an old robot now,” Matthew says. “Much more work needs to be done to make a truly usable robot for someone’s home,” Matthews says.

Linda Hollinger-Smith, RN, PhD, vice president of the Mather Lifeways Institute on Aging in Evanston, Ill., believes robotic assistive devices will be integrated into long-term care in 15 to 20 years, which will coincide with a burgeoning population of elderly baby boomers. Robots, she says, may help offset a worsening shortage of nurses and nurses aides projected for long-term care.

At the Center for Healthcare Robotics in Atlanta, Kemp is researching how robots can help people with their activities of daily living, from picking up dropped objects to feeding them to giving them a sponge bath. He has developed a mobile robot named E1-E with an arm equipped with sensors that is attached to a vertical lift. The arm can reach the floor or high shelves. One project in particular is using the robot with people who have amyotrophic lateral sclerosis (ALS).

“Ordinarily if someone with [advanced] ALS drops something on the ground, the object will stay there until someone else comes along,” Kemp says.

E1-E can be directed to retrieve the object by having the patient point to the object with a laser pointer that is used much like a computer mouse, says Kemp. The inspiration for the robot came from helper monkeys and service dogs who care for people with spinal cord injuries.

Debi Sampsel, RN, MSN, executive director of the Nursing Institute of West Central Ohio, believes robots have a place in health care and that the futuristic blend of nursing and technology offers a solution to today’s nursing shortage. Sampsel says aging and physically impaired nurses can extend their careers by partnering with remote presence robots, such as the RP-7 from InTouch Health that is already being used by physicians.

The RP-7 is a wireless, mobile robot whose “head” is a flat-screen monitor. It operates under the direct control of a nurse or other healthcare provider seated at a control station and using a keyboard and joy stick. It moves untethered, allowing the nurse to interact from anywhere with patients, family members, students, and hospital staff. The healthcare provider is able to see the patient and the patient is able to see the healthcare professional’s face projected onto the monitor, which is positioned where the robot’s head would be.

“Remote presence robots hold out hope for extending career opportunities for nurses who might otherwise leave the profession,” says Sampsel, who has spent years exploring potential solutions to the aging workforce.

Sampsel was co-principal investigator for a Nursing Institute study on the role that the RP-7 will play in nursing. The study involved eight programs of nursing from rural, community, and urban settings in west central Ohio and took place at Wright State University in Dayton. A human patient simulator served as the patient while the faculty member, located in a different part of the building, conducted class via the robot.

In remote robot form, the faculty member was able to move about the skills lab to view the actions of the students. She also was able to debrief the class and talk to individual students who needed further assistance. Additional proposals exploring the use of the RP-7 robot in the clinical setting have been submitted to the National Science Foundation, Sampsel says.

Will robots ever have the capabilities of the androids depicted in science fiction?
“Robots at this point can’t think like a person, and it could be a very long time before they do,” says Kemp. “But I think they’re going to eventually be better than science fiction because they’re going to lend real value to nursing.”

Treat says the relationship between Luke Skywalker and R2-D2 in Star Wars correctly depicts the way in which healthcare providers will one day interact with robots. “R2-D2 doesn’t replace Luke, he assists and cooperates with him. They are complementary. That’s the way it should be.”

See the CE module on this topic, “Robots Join the Surgical Team” at http://www.nurse.com/CE/CE460.

By | 2008-03-10T00:00:00-04:00 March 10th, 2008|Categories: Philadelphia/Tri-State, Regional|0 Comments

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