บทถอดความฉบับเต็มของ A World Without Nurses

00:04:56,810 --> 00:05:00,920 that. She formalized the basics, requiring hand washing and 73 00:05:00,920 --> 00:05:05,180 changing bedding. She defined the nurse's role as patient 74 00:05:05,180 --> 00:05:09,500 monitor and advocate. She even established the first modern 75 00:05:09,500 --> 00:05:10,730 nursing curriculum. 76 00:05:10,755 --> 00:05:13,965 Archive: Aided by the medical staff who contribute by lectures 77 00:05:13,965 --> 00:05:15,345 and demonstrations. 78 00:05:15,345 --> 00:05:22,185 Narrator: And as this burgeoning field grew and grew and grew the 79 00:05:22,185 --> 00:05:27,195 demand for specialized nursing skills grew with it. 80 00:05:27,195 --> 00:05:30,540 Cynda Rushton: Because you got to realize that alongside 81 00:05:30,540 --> 00:05:31,080 this... 82 00:05:31,170 --> 00:05:33,750 Archive: It is now possible to make x-ray pictures. 83 00:05:33,870 --> 00:05:37,350 Cynda Rushton: ...there were advances in surgery, advances in 84 00:05:37,390 --> 00:05:40,240 Archive: the electrocardiogram, respirators, blood transfusion 85 00:05:40,240 --> 00:05:40,810 service, 86 00:05:40,810 --> 00:05:43,900 Cynda Rushton: advances in treatment of all kinds of 87 00:05:43,900 --> 00:05:45,190 infectious diseases. 88 00:05:45,190 --> 00:05:47,500 Archive: The healing power of penicillin, enables the 89 00:05:47,500 --> 00:05:47,770 patient... 90 00:05:47,770 --> 00:05:51,130 Cynda Rushton: So nursing practice had to keep pace with 91 00:05:51,130 --> 00:05:52,690 the technology. 92 00:05:52,690 --> 00:05:54,970 Narrator: Nurses developed a revolutionary treatment for 93 00:05:54,970 --> 00:05:59,950 polio, discovered a life-saving fix for jaundice. In fact, by 94 00:05:59,950 --> 00:06:01,540 the 1950s... 95 00:06:01,540 --> 00:06:03,715 Nurse: Thank you for your patience, Miss Johnston. 96 00:06:03,715 --> 00:06:05,965 Narrator: ...around the time Miss Johnston showed up with her 97 00:06:05,965 --> 00:06:07,255 family at the hospital... 98 00:06:07,255 --> 00:06:09,535 Nurse: No problem, no rush at all. 99 00:06:09,535 --> 00:06:12,505 Narrator: ...there were as many types of nurses as there were 100 00:06:12,505 --> 00:06:15,055 flavors at the soda fountain. 101 00:06:15,055 --> 00:06:18,625 Archive: Staff nurses guard and care for the sick on the wards. 102 00:06:18,625 --> 00:06:22,375 Nurses in the operating rooms give emergency nursing service, 103 00:06:22,375 --> 00:06:25,540 and the private duty nurse goes ready to fit in wherever the 104 00:06:25,540 --> 00:06:27,040 patient may be. 105 00:06:27,040 --> 00:06:30,460 Narrator: Yes, in a mere century the field had gone from an 106 00:06:30,460 --> 00:06:35,740 afterthought to a systematized scientific and structured field, 107 00:06:35,740 --> 00:06:41,500 improving outcomes for everyone involved, but while on the 108 00:06:41,500 --> 00:06:46,390 surface things looked wonderful, just below the crisis at the 109 00:06:46,390 --> 00:06:50,275 heart of our story was brewing, gaining strength like a 110 00:06:50,305 --> 00:06:52,045 hurricane cresting the horizon. 111 00:06:54,445 --> 00:06:59,845 Archive: The lights on the hospital call board flash faster 112 00:06:59,845 --> 00:07:05,035 today than they can be answered. Each one is a distress signal 113 00:07:05,035 --> 00:07:13,120 sent to thousands of nurses who aren't there, who don't exist. 114 00:07:13,120 --> 00:07:15,340 Narrator: There simply weren't enough nurses. 115 00:07:15,340 --> 00:07:18,790 Cynda: We had a shortage, yes, because there weren't enough 116 00:07:18,790 --> 00:07:23,020 schools of nursing to meet the demand, and so there was, there 117 00:07:23,020 --> 00:07:28,060 was a push for many, many years to increase the number of 118 00:07:28,060 --> 00:07:32,995 training programs, but focusing on the supply problem alone is 119 00:07:32,995 --> 00:07:38,425 insufficient, because we were also just not providing that 120 00:07:38,425 --> 00:07:42,985 kind of environment that enabled nurses to do what they were 121 00:07:42,985 --> 00:07:49,555 trained to do. There was a lack of support. 122 00:07:49,660 --> 00:07:53,440 Narrator: This was the root of our crisis, and yet we left it 123 00:07:53,590 --> 00:07:59,080 untreated. And so, like a wound covered only with gauze, it 124 00:07:59,140 --> 00:08:05,520 spread, it festered quietly under the bandage until the 125 00:08:05,760 --> 00:08:09,420 early 21st century, when the crisis could no longer be 126 00:08:09,540 --> 00:08:10,020 denied. 127 00:08:11,870 --> 00:08:14,450 Reporters: Hospitals across the country are facing a nursing 128 00:08:14,450 --> 00:08:17,960 shortage. Florida is feeling the impacts of a nursing shortage, 129 00:08:17,960 --> 00:08:21,050 with... The number of nurses not keeping up with the demand. 130 00:08:21,050 --> 00:08:25,010 60,000 positions will be left empty. Burnout and fatigue are 131 00:08:25,010 --> 00:08:31,370 pervasive. The largest nurses' strike in the city's history. If 132 00:08:31,370 --> 00:08:34,970 something isn't done to stem the tide, this could plunge us into 133 00:08:35,015 --> 00:08:38,315 a health care crisis of huge proportions. 134 00:08:41,600 --> 00:08:44,800 Narrator: To meet the moment, hospital administrators did what 135 00:08:44,830 --> 00:08:56,200 they could. They unveiled a series of primitive automated 136 00:08:56,290 --> 00:08:56,830 systems. 137 00:09:00,370 --> 00:09:02,220 Automated Speaker: Thank you for calling True Life Hospital, 138 00:09:02,670 --> 00:09:06,150 where customer service is our number one priority. We're 139 00:09:06,210 --> 00:09:08,970 excited to provide you with our automated over the phone 140 00:09:09,030 --> 00:09:12,870 diagnostic service. Are you calling on behalf of yourself or 141 00:09:12,960 --> 00:09:17,910 someone else? Press one for yourself, press two for someone 142 00:09:18,000 --> 00:09:21,020 else. Thank you.

Please hold. 143 00:09:26,960 --> 00:09:31,340 Narrator: Yes, gone were human nurses picking up the phone, but 144 00:09:31,340 --> 00:09:35,600 the price of their replacement was right and proved almost as 145 00:09:35,780 --> 00:09:37,070 caring and capable. 146 00:09:37,480 --> 00:09:39,130 Automated Speaker: Is the issue you're calling about above the 147 00:09:39,130 --> 00:09:44,680 torso or below the torso? Press one for above or two for below. 148 00:09:44,680 --> 00:09:48,340 You've selected above the torso. Is the issue you're calling 149 00:09:48,340 --> 00:09:52,750 about today pain related? If so, rate the pain by entering the 150 00:09:52,750 --> 00:09:57,310 number corresponding with the pain, nine being the highest. If 151 00:09:57,310 --> 00:10:00,970 you are not in pain, press pound. You have entered an 152 00:10:01,000 --> 00:10:02,680 unrecognized response. 153 00:10:02,890 --> 00:10:05,635 Narrator: Getting a diagnosis could take a bit longer over the 154 00:10:05,635 --> 00:10:12,265 phone, sure, and the experience lacked that human touch... 155 00:10:12,265 --> 00:10:12,445 Automated Speaker: Goodbye. 156 00:10:12,445 --> 00:10:17,845 Narrator: ...but the higher ups were happy. This was the new way 157 00:10:17,845 --> 00:10:21,415 of the world, they declared proudly. More automation, more 158 00:10:21,415 --> 00:10:25,600 intelligent systems, fewer humans in the loop. It was 159 00:10:25,600 --> 00:10:31,930 imperfect, they'd admit, but you can't fight the future. There 160 00:10:31,930 --> 00:10:35,080 was, however, a problem. 161 00:10:35,120 --> 00:10:36,650 Sterling A. Wilmer: You love this field, and you love your 162 00:10:36,650 --> 00:10:46,070 patients, and so just being able to be in this space and just 163 00:10:46,565 --> 00:10:49,865 show them kindness and care and compassion and continue to have 164 00:10:49,865 --> 00:10:52,205 the privilege to care for them and their families. 165 00:10:52,165 --> 00:10:53,875 Narrator: The nurses that remained. 166 00:10:54,240 --> 00:10:56,580 Diane Couchman: There's a reason nursing is the most trusted 167 00:10:56,580 --> 00:11:00,900 profession. People who are drawn to it really do care, they're 168 00:11:00,900 --> 00:11:03,870 committed to both the science and the understanding and the 169 00:11:03,870 --> 00:11:06,960 lifelong learning, but they're also committed to the 170 00:11:06,960 --> 00:11:09,090 compassion. 171 00:11:09,000 --> 00:11:12,510 Narrator: Brought up in an old world way of doing things, they 172 00:11:12,510 --> 00:11:15,900 believe there was something about being human themselves 173 00:11:15,900 --> 00:11:23,550 that helped them do their job. 174 00:11:23,550 --> 00:11:25,320 Sharon A. Adamski: I've been at the beginning of life, and I've 175 00:11:25,320 --> 00:11:30,360 been at the end of life, and, you know, there's there's times 176 00:11:30,360 --> 00:11:32,685 when sometimes we're the only person there. 177 00:11:38,085 --> 00:11:42,525 Narrator: And empathy, in particular, many said, was 178 00:11:42,525 --> 00:11:45,765 vital. 179 00:11:43,280 --> 00:11:47,459 Tamara Hill: Wow, so this is very personal for me. I was a 180 00:11:45,000 --> 00:12:23,355 Tyler Silvey: I'll 181 00:11:47,552 --> 00:11:53,495 new nurse here in the PICU, and my daughter was two, and I was a 182 00:11:53,588 --> 00:11:59,068 single mom, and she was helping out in the kitchen, and she 183 00:11:59,161 --> 00:12:04,919 tilted a pot of water. She loved macaroni. And, a pot of water 184 00:12:05,012 --> 00:12:10,770 fell on her arm, and I grabbed her and put her on the bathtub, 185 00:12:10,863 --> 00:12:16,435 and ran cold water, and I called 911, and she recovered, but 186 00:12:16,528 --> 00:12:21,822 there's still a significant scar. So, having to live with 187 00:12:21,915 --> 00:12:27,208 that blame and the shame of it... And when I came back to 188 00:12:23,000 --> 00:13:09,530 Caitlin McGeehan: had talk to 189 00:12:27,301 --> 00:12:32,873 work, I always avoided burn patients, because I just thought 190 00:12:32,966 --> 00:12:38,632 I wasn't going to be able to do that. And one night, we had a 191 00:12:38,724 --> 00:12:42,904 patient come in, a three-year-old burn and my 192 00:12:42,997 --> 00:12:48,476 church nurse said, I know what you've been through, but the 193 00:12:48,569 --> 00:12:54,141 best way for you to get through is you're gonna have to take 194 00:12:54,234 --> 00:12:59,714 this assignment. And, I said, give me five minutes before I 195 00:12:55,235 --> 00:13:57,260 Lauren Geiling: I like to describe my shift as 196 00:12:59,807 --> 00:13:05,286 can take this assignment. And I went to the bathroom, and I 197 00:13:05,379 --> 00:13:10,394 prayed, and I took the assignment, and it was probably 198 00:13:09,530 --> 00:13:12,890 Cynda Rushton: and they were frustrated about having to be 199 00:13:10,487 --> 00:13:16,152 the most challenging, but best experience to be able to share 200 00:13:12,890 --> 00:13:19,250 sheltered at home, where they had to have masks and all these 201 00:13:16,245 --> 00:13:22,096 with the family my experience, and let them know everything was 202 00:13:19,250 --> 00:13:26,810 constraints on their own decision making, and they come 203 00:13:22,189 --> 00:13:27,018 going to be okay... to be on that journey with them, 204 00:13:26,840 --> 00:18:07,970 into a hospital, and who gets the brunt of that is the nurse. 205 00:13:27,111 --> 00:13:32,033 something that I had to experience personally and was 206 00:13:32,126 --> 00:13:34,820 having to still deal with it. 207 00:18:08,020 --> 00:18:10,870 Reporters: Tonight, a nurse is fighting for her life after she 208 00:18:10,870 --> 00:18:14,170 was brutally attacked by a patient at Palms West Hospital 209 00:18:14,170 --> 00:18:15,310 in Loxahatchee. Yeah, she was... 210 00:18:15,970 --> 00:18:20,680 Cynda Rushton: Violence against nurses

escalated to really 211 00:18:20,680 --> 00:18:29,470 alarming levels, and what I began to hear from nurses was, 212 00:18:29,470 --> 00:18:35,125 you know, the reason I'm here is my patients. When our patients 213 00:18:35,125 --> 00:18:44,185 turn against us, what is left? 214 00:18:44,185 --> 00:18:48,295 Narrator: It was bad news for all. Longtime nurses retired 215 00:18:48,295 --> 00:18:51,265 from the field. Up and coming nurses left jobs or the 216 00:18:51,265 --> 00:18:55,690 profession entirely. Patients became more frustrated, and 217 00:18:55,690 --> 00:19:02,770 hospital administrators had no easy answers, but then... 218 00:19:02,920 --> 00:19:07,690 Tech Announcer: Hello Silicon Valley, make some noise. 219 00:19:07,810 --> 00:19:10,090 Narrator: ...a technological solution was found. 220 00:19:10,000 --> 00:19:12,340 Tech Announcer: Thank you, everyone, for being here on this 221 00:19:12,340 --> 00:19:16,150 exciting, historic day. After years of development and 222 00:19:16,150 --> 00:19:19,540 research, we here at Med Robotics are finally ready to 223 00:19:19,540 --> 00:19:26,140 unveil to the world our hospital-ready Mark 3 Nurse Bot. 224 00:19:26,140 --> 00:19:30,340 With its humanoid design, the Mark 3 Nurse Bot does everything 225 00:19:30,340 --> 00:19:34,405 you could ask for. It delivers medication, cleans up messes. 226 00:19:34,405 --> 00:19:37,825 Best of all, it doesn't need to sleep or eat or receive a 227 00:19:37,825 --> 00:19:41,155 paycheck. Say hello to your adoring fans, Mark. 228 00:19:41,155 --> 00:19:44,635 Mark 3 Nurse Bot: Hello, I am here, excited and ready to help 229 00:19:44,635 --> 00:19:46,285 you. 230 00:19:46,285 --> 00:19:52,885 Tech Announcer: Alright! 231 00:19:52,885 --> 00:19:56,530 Narrator: Yes, not long after the pandemic subsided, Med 232 00:19:56,530 --> 00:20:00,610 Robotics released its miraculous nurse bot. It looked like a 233 00:20:00,610 --> 00:20:04,510 human, sounded like one too, and while the medical industry could 234 00:20:04,510 --> 00:20:08,200 finally breathe a sigh of relief, some, like Cynda 235 00:20:08,200 --> 00:20:10,090 Rushton, remain skeptical. 236 00:20:10,000 --> 00:20:14,080 Cynda Rushton: If we were able to use technology in its right 237 00:20:14,080 --> 00:20:20,590 relationship to nursing practice, what we could see is 238 00:20:20,590 --> 00:20:27,040 nurses being able to spend the time with their patients: being 239 00:20:27,040 --> 00:20:32,890 able to educate them, guide them, advocate for them, the 240 00:20:32,890 --> 00:20:39,265 parts that really nurses are the best at. That would be my most 241 00:20:39,265 --> 00:20:47,635 hopeful view. What I worry might happen is that organizations 242 00:20:47,635 --> 00:20:52,855 take a replacement view. They say, okay, we can get rid of 243 00:20:52,855 --> 00:21:10,660 half of these nurses, and we can get robots in their place. I 244 00:21:10,660 --> 00:21:25,540 want nurses to be able to do what they do. You know, when 245 00:21:25,585 --> 00:21:33,655 you see the difference you make, you know, with people when 246 00:21:33,655 --> 00:21:40,375 they're at their most vulnerable... I don't think a 247 00:21:40,375 --> 00:21:42,055 robot could do that. 248 00:21:46,980 --> 00:21:52,410 Caitlin McGeehan: At some point, you know, our bodies betray us, 249 00:21:52,410 --> 00:22:01,590 and we are vulnerable to death. Nurses have that distinct 250 00:22:01,590 --> 00:22:08,175 privilege to help people become more comfortable with what it is 251 00:22:08,175 --> 00:22:10,005 to be a human being. 252 00:22:12,705 --> 00:22:21,015 Cynda Rushton: And, if we didn't have that, that kind of care, 253 00:22:21,015 --> 00:22:28,185 that kind of competence, that kind of compassion... I'm not 254 00:22:28,185 --> 00:22:30,270 sure what kind of world we'd have. 255 00:22:37,710 --> 00:22:40,950 Archive: The lights on the hospital call board flash faster 256 00:22:40,950 --> 00:22:43,350 today than they can be answered. People will depend on you. 257 00:22:43,710 --> 00:22:47,370 People will confide in you. An attack on nurses at St. John's 258 00:22:47,370 --> 00:22:50,400 Hospital. If something isn't done, this could plunge us into 259 00:22:50,400 --> 00:22:53,685 a health care crisis of huge proportions. 260 00:23:04,280 --> 00:23:06,620 Narrator: As we now know, the world of today is one of 261 00:23:06,620 --> 00:23:11,390 efficiency and precision. It's a world of automated excellence. 262 00:23:11,390 --> 00:23:15,980 It's a world without nurses. And while we owe a debt of gratitude 263 00:23:16,025 --> 00:23:19,865 to Florence Nightingale, Mary Seacole, Cynda Rushton, and all 264 00:23:19,865 --> 00:23:27,005 the nurses that worked alongside them, a word of caution: don't 265 00:23:27,005 --> 00:23:31,805 romanticize the past. Don't pine nostalgic for the way things 266 00:23:31,805 --> 00:23:37,175 were. Time is a train locked to its tracks. You've got to get on 267 00:23:37,175 --> 00:23:41,180 board, and you'd best keep all your limbs safely inside the 268 00:23:41,450 --> 00:23:47,150 vehicle, because while today is wonderful, tomorrow will be even 269 00:23:47,150 --> 00:23:57,170 better. That is, if you help make it so. Thank you, and good 270 00:23:57,170 --> 00:24:05,285 night. A World Without Nurses is an iDeas Lab original 271 00:24:05,285 --> 00:24:09,215 production. It was written and produced by Simon Adler. The 272 00:24:09,215 --> 00:24:12,665 executive producers were Lauren Aurora Hutchinson and Tony 273 00:24:12,665 --> 00:24:17,195 Phillips. It was mixed by Alex Overington. A World Without 274 00:24:17,195 --> 00:24:21,065 Nurses was produced in association with Maryland's R3 275 00:24:21,065 --> 00:24:25,205 Resilient Nurses Initiative led by Dr. Cynda Rushton and 276 00:24:25,205 --> 00:24:28,760 supported by the Nurse Support Program Two grant administered 277 00:24:28,760 --> 00:24:32,120 by the Maryland Higher Education Commission and funded through 278 00:24:32,120 --> 00:24:36,230 the Health Services Cost Review Commission. Our nurses were 279 00:24:36,230 --> 00:24:40,250 Nurses: Sterling Wilmer, Diane Couchman, Sharon Adamski, Tamara 280 00:24:40,250 --> 00:24:44,930 Hill, Rachel Robinson, Tyler Sylvie, Lauren Geiling, Caitlin 281 00:24:44,930 --> 00:24:47,390 McGann, Daniel McCamey. 282 00:24:47,390 --> 00:24:50,075 Narrator: The producers for the iDeas Lab at the Berman 283 00:24:50,075 --> 00:24:54,635 Institute of Bioethics at Johns Hopkins University include Lyric 284 00:24:54,635 --> 00:24:59,135 Bowdich, Kim Buikema, and Axel Kacoutié. Our production 285 00:24:59,135 --> 00:25:02,735 assistant is Brian Ricker, and our production administrator is 286 00:25:02,735 --> 00:25:11,105 Leah Lord.