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