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  1. Falter, Elizabeth (Betty) MS, BSN, RN, NEA-BC

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Robot-Proof ... Higher Education in the Age of Artificial Intelligence. Cambridge, MA: MIT Press; 2018. Soft Cover, 187 pages, $17.95.


This book delivers good information for the academicians who are helping students prepare for careers in today's high-tech world. It is also an interesting read for nurse executives. The author had my attention at "Robot-Proof."


Why should nurse leaders read a book intended for higher education? Because nursing is already dealing with algorithms, technology, and, yes, even robots. The good news is that the author, president of Northeastern University, has written an insightful and readable book on what future professionals need to learn in order to function effectively in an increasingly technological world. Many of the competencies he identifies are already woven into the foundation of our profession. Nursing has always been able to adapt, invent work-arounds, incorporate the new, innovate on the spot, and continuously learn. We have done that while continuing to present a human face to those we care for.


The age of artificial intelligence in nursing is not science fiction. Japan has already incorporated robots in the care of its growing elderly population because of a predicted shortfall of 370 000 caregivers by 2025. Current efforts are focusing on simple robotic devices that help frail residents get out of their beds and into wheelchairs or that can ease senior citizens into bathtubs. However, more sophisticated mechanical "helpers" are on the horizon.


While today's student will still need to learn the basics of reading, writing, and mathematics, educators and leaders are challenged to add 3 more competencies to the list of essential education (p. xiv):


* Technological literacy, which provides a grounding in coding and engineering principles to understand how machines tick;


* Data literacy, which is the ability to read, analyze, and use these ever-rising tides of information; and


* Human literacy, which teaches humanities, communication, and design, allowing them to function in the human milieu.



The third competency is the one most likely to be forgotten during a time when science and technology skills are considered essential for future job seekers. However, machines simply cannot do it all. I am currently caring for my daughter who is battling pancreatic cancer. Even as a nurse, I find myself marveling at the technology in the new infusion centers, as well as the new treatments resulting from cancer research at medical centers and universities. While I am grateful for their new knowledge and expertise, I have profound appreciation and gratitude to the clinical nurses who use their critical skills to think through patient reactions to chemotherapy. No technology can replace their thoughtfulness and concern for providing the best quality care. However, I have a grave concern about the tendency of many health care organizations to use algorithms, not life, to drive patient care. While there are ways to navigate our complicated health care systems, patients and families navigating in addition to receiving and responding to care requires so much more than any machine could ever do.


It is incumbent upon senior leaders to use the knowledge shared in this book to help develop and lead nurses, particularly nurse navigators and clinical case managers. These specialists are needed now and will be even more important in the future. Their skills of navigating technology, interfacing data with plans of care, and negotiating bureaucratic systems require both education and wisdom.


I have always believed that nurses are the guardians of both quality and human kindness in hospitals and other care sites. My experiences with my own child have strengthened that viewpoint. For me, nursing remains the best profession to ensure patients get the right care, at the right time, in the right place. That charge has become much more complex than it was when I began my career decades ago. Our nurses need the skills that higher education is debating for the future... right now. While we encourage them to master new technologies and continuously change procedures based on new evidence, we must not forget that robots and technological tools can be used to extend and assist nursing care. They cannot replace the complicated coordination needed to ensure safety-nor can they replace the human touch that encourages healing.


Thomas Friedman, Opinion Columnist, recently wrote in The New York Times: "A.I. Still Needs H.I. (Human Intelligence), for now. Chatbox and other Computers are learning, but we still have skills they don't." (February 26, 2019). Nursing has those nonrobotic skills in spades ... as long as we continue to remember that neither patients nor nurses are robots.


-Elizabeth (Betty) Falter, MS, BSN, RN, NEA-BC