David Marshall on the How Technology Has Changed the Field of Nursing but the Human Connection Has Stayed the Same

David Marshall has seen many changes in his 40 years as a nurse, especially in the available technology, but one thing has stayed the same and guided him in his career: the human connection between patients and their providers. David grew up in a small town in Texas, and joined the Boy Scouts when he was 11. The first merit badge he got was in first aid, which is when he saw how he could use his hands to help someone in an emergency. It was at that moment that the spark for wanting to be involved in healthcare in some way came from. Today, he’s the Senior Vice President and Chief Nursing Executive at Cedars-Sinai in Los Angeles.

«The connection to humans, though, hasn’t really changed since I became a nurse more than 40 years ago. That’s really human connection. And the relationships that develop between patients and nurses, I think, is something that we need to focus on, cultivate and maintain.»

On a recent episode of our Healthcare Disruptors podcast, David talked about his main priorities as a nurse leader: quality, safety, financial stewardship, and how technologies have alleviated both the patient and the provider.

Quality

One of the priorities David focuses on in his work as a nursing leader is the quality of care patients can receive. Part of the problem with regard to quality is that nurses are often bogged down with non-care-related tasks that take them away from their patients. However, technologies have helped alleviate some of this burden.

«That is something that we’ve often thought about is how can technology enable, basically allow practitioners to kind of upskill and increase their scope of practice by lowering the burden, lowering the hurdle rate for introduction of new technologies, for example, like imaging, which in the past maybe required a sonographer. Now, through the accessibility, affordability, AI behind handheld ultrasound or point-of-care ultrasound, we’re enabling practitioners like techs in an EMS setting or nurses in an ambulatory setting, or even in a home care setting, to be able to alleviate some of the bottleneck that can otherwise occur at the ER.»

Not only do these new technologies help nurses like David, they help other providers at every step of the care process.

Financial Stewardship

The second focus David describes is the financial stewardship of the healthcare setting, such as Cedars-Sinai or other type of practice.

«Financial issues in healthcare are front and center. Maintaining margins so that we can invest in our employees, invest in technology, and keep the place running… Making sure that we apply the right workforce at the right place at the right time, not overdo it and not underdo it it, that’s another big focus.»

In turn, making these investments in employees, technology, and other resources can help keep overall costs low by decreasing turnover, improving patient care, and making the practice run more smoothly.

The Experience of Patient and Provider

Of course, the patient experience is of the utmost important for any health care setting. But provider experience is important to think about, too. By creating an environment providers such as nurses want to work in and can thrive in can be the key to better patient experiences as well.

«So nurses, advanced practice nurses, all need a place where they can thrive in their practice. And so creating that sort of environment is another day to day focus of mine. Making sure that we invest in our personnel and they have the professional development opportunities that they need to thrive.»

Solutions

All of these priorities go hand in hand with each other. In order to focus on each one, David says we must reframe the way we see nursing and also to listen to them and their needs. After all, they are the ones who will be interacting directly with the environment you put them into, whether it’s a protocol or a new technology they must learn. Allowing nurses to feel like they’re contributing to their experience on the job can be a game changer.

«I think we probably need to change the work of the nurse or to take maybe a design thinking approach to changing the work of the nurse. Much of the work of the nurse is the same today as it was 40 years ago or a little over 40 years ago when I became a nurse. You come in, you get assigned into acute care, at least get assigned a group of patients, and you take care of those for your shift, and then you go home. Nurses, the younger generation today, what they want is flexibility. They want to be seen as contributors. So really, how do we make sure that we are paying attention to those things that nurses want, other health care professionals want, and to make sure that they have the competencies and the supports really to excel in their jobs.»

Conclusion

Although there are always new technologies advancing the level of care and making nurses’ jobs easier, it is good to remember the humans who will use them.