Health Technologies

Creating meaningful change: How digital nurses can reduce health inequalities

Beth Allen, oncology staff nurse and digital nurse implementer at The Christie NHS Foundation Trust in Manchester, explains the digital nurse role and how it can help reduce inequalities in cancer care.

To deliver the best care to patients, nurses need to know how to use digital technology.

The NHS Long Term Plan talked about the role of digitally enabled care and how it would become commonplace in the future, and we’re starting to see that become a reality, with digital solutions being embedded at NHS trusts across the country.

I’m among the first generation of digital nurses at The Christie, which is one of the biggest cancer treatment centres in Europe, and is embracing the reality that digital tools can improve care and make lives easier for clinicians.

Part of my role is using digital to help reduce inequalities in cancer treatment.

This is a major issue as, according to Cancer Research UK, there are 20,000 more cancer cases a year in deprived areas.

People in these areas, sadly, are more likely to get cancer, get diagnosed late and be more likely to lose their lives.

At The Christie, we treat a patient population from all over the North of England, so we see the stark reality of this health inequality first hand.

The importance of digital nurses

Digital nurses provide an important link between the clinicians who use technology every day, and the digital team who build, adapt, and introduce new technologies.

Sometimes, for example, the digital team will have a great idea, but the digital nurse can use their clinical background to advise them how to improve it to make it work better in practice.

The other side of my role is engaging clinical staff in new digital projects.

For example, I’ve taken over the trust’s Digital Champions Group to get clinicians involved, canvasing them for ideas, and inviting them to test and shape new systems as well.

I also provide training for staff on new digital technologies, including the hospital’s new bleep system.

Recently, I’ve put together a digital education bundle for new nurses containing apps I’d like them to use and share, as I know they will help make their clinical work more streamlined.

Advocating for digital

Really, most of my role is advocating for digital.

As I’ve worked as a nurse in many different roles at The Christie, starting as a healthcare assistant, I have a huge network within the hospital compared to, for example, the digital team who often work separately from clinicians, except during major go lives.

I’m also a chatty and empathetic person (some might argue it’s part of the job description!), so it’s easy for me to approach a clinician during a tea break or at a desk to talk to them about digital solutions, especially those that can help tackle healthcare inequality.

One example is CardMedic, which is a mobile- and web-based app for communicating with patients experiencing communication barriers.

The app uses flash cards to provide simple, multi-format and multi-language scripts for common healthcare interactions, which can help improve care for patients who – for example – don’t speak English.

As a nurse, it’s easier for me to demonstrate the value of digital solutions. I can use my clinical experience to decide which elements to show them that are most relevant.

This then helps encourage uptake as they can understand straight away how using it will benefit them by seeing it in their clinical context.

That doesn’t mean encouraging engagement is always an easy process. Often, I need to be quite persuasive because clinicians are busy and overstretched.

Having spent years in a clinical role, I know there are thousands of things that clinical teams could be doing while listening to me, but I also need to be persistent.

If I can encourage a clinician to spend thirty seconds watching an app being demonstrated, their face will often light up as they realise how helpful it can be in their clinical practice.

Sharing good practice

Among the activities I do regularly is talking to digital nurses across the country.

I belong to the North-West CNIO (Chief Nurse Information Officer) network, which is a wonderful place to share ideas, celebrate successes and get support.

They have a Digital Minute where you can talk about a success in your role.

The Digital Minute is about celebrating success whereas the wider network is also interested in problem-solving and sharing best practice.

As The Christie is a tertiary trust that focuses solely on cancer care, I’m especially proud of how I’ve been able to develop digital solutions specific to cancer patients.

This is something I wouldn’t have had the opportunity to do in a non-dedicated digital nursing role.

I’d have been too busy and tired alongside my nursing duties.

One of the things I’ve done, for example, is work with CardMedic to co-develop scripts specific to cancer care for the library.

Working as a team, the company’s founders and I have been able to develop both extensive and shorter scripts for communicating with cancer patients who may, for example, be deaf or have learning difficulties.

I simply wouldn’t have had the time to do this as a non-digital nurse, but the benefits for patients are huge.

Each time we communicate better with a vulnerable patient, we help tackle healthcare inequality by improving the standard of their care.

Advocating for vulnerable patients

Whether you’re a digital nurse or not, the patient is always kept in mind.

The five minutes I spend persuading a registrar to use a helpful technology is a win for my patients.

Another way I advocate for patients is through the fortnightly meetings where senior leadership discuss incidents, such as falls and pressure ulcers.

I attend in case there’s a digital solution to a problem.

In one case, for example, we had a vulnerable patient who’d fallen and didn’t speak much English.

I suggested using CardMedic to help communicate with the patient afterwards, to make them feel more comfortable, and to improve the likelihood of a good health outcome.

I always hope that the thirty or forty people in the room will remember the digital solution I suggested and adopt it afterwards, in similar situations, without me having to be there to remind them.

I think this is why it’s so important to establish as many digital nurse roles as possible at every trust, so we can maintain more and more digital conversations.

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