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The new technology has offered some challenges for perioperative nurses. Although it was not difficult to learn, it took time for nurses and support staff to become comfortable with it and to trust it, Forshay said. She recalled one instance when a nurse didn’t turn on the system properly and the computer wouldn’t respond to the doctor’s voice, causing a 20-minute delay of a procedure.

Some nurses never get comfortable with the new technology. Mortenson said her department has lost a “fair number” of nurses who transferred from other areas of the hospital and became overwhelmed by the technology. “They give up and go back to floor nursing. They just can’t do it.”

She remembers feeling the same way 20 years ago, when she started working in the operating room. She was afraid of not passing the instruments fast enough and told the doctor, “I can’t do this.” Now, she said, nurses are afraid of pushing the wrong button or not knowing how to troubleshoot a machine that doesn’t work. “There is so much for them to learn,” Mortenson said.

Keeping up

Nurses, who may see as many as 10 new things a day in the operating room, should speak up if they are not comfortable using any of the new technology, said Dawn Tenney, MSN, RN, associate chief nurse of perioperative nursing services at Massachusetts General Hospital in Boston.

This can be difficult for a nurse, especially if a physician comes in excited about a new device he or she has spent a week learning about, she said. In her hospital, if the nurse can understand how a new device works and feel comfortable with it, it can be used. If not, the physician must find a nurse who is comfortable with it or else not use it.

“Whether it was 20 or 30 years ago or with all the technology in the room today, the nurse’s role is to be the safety officer,” Tenney said.

Constantly changing technology also must be constantly upgraded, which costs a lot, nurses said. Integrated operating rooms that were state of the art five years ago now seem behind the times. Tammy Woolley, MS, RN, CNOR, associate chief nursing officer at Presbyterian/St. Luke’s, estimates her older rooms will cost about $100,000 to update. Installing a new integrated operating room cost about $250,000 two years ago.

“You’ll think you have the latest and greatest thing and someone will say, ‘That’s old. This is new,’ ” Woolley said.

Not all technology is always worth the cost, nurses said. Tenney said surgeons at Mass General haven’t really taken to the surgical robots, finding them too bulky and slow. Rege said he hasn’t been able to justify the cost of buying a robot for the surgeons at his facilities, though he expects robotics to make great strides in the next five to 15 years.

Tenney expects the next revolution in OR technology to come with advances in radio frequency tracking. Her hospital is using a location device to track patients’ progress through the hospital. Eventually, she said, the tracking device and the patient’s medical history will be incorporated onto an identity bracelet that operating room computers can pick up and transmit to the surgical team.

Her hospital also is trying out a new surgical table that minimizes manual patient transfers. The patient gets into a stretcherlike holder and is wheeled into the operating room. The surgical team hooks in hosing, the wheels and trolley pull away and the device becomes an operating table.

In addition to their excitement over the new technology and the possibility of even more exciting things to come, perioperative nurses say they do not fear losing their personal touch any more than they fear machines will replace them.

“Technology will never replace the nurse’s thought process in making sure the patient is being cared for correctly,” Harres said.

Mortenson said she occasionally sees a nurse who seems more interested in the machines than in the patient, but most have gone to nursing school because they want to care for people. “They can be techno-geeks,” she said, “but they still have that personal touch. You can train anybody to run a machine. But to put the people part with it is the trick. We tell them it’s always the patient first.

“Get that down and then we can work with everything else.”

Contact Cathryn Domrose at kaguilar@well.net.