Let's Talk About Robotics in Nursing

Technology delivers on its promise when nurses are empowered, says this innovation leader.

While new technologies like AI and wearables are becoming more prevalent in nursing, robotics is still on the precipice.

As robotics technology enters the healthcare industry, CNOs must be prepared to help their nurses adjust as robotic assisted procedures and robotics-enhanced workflows become more common.

At Virtua Health, nurses play an instrumental role in a new robotics-assisted spinal surgery procedure, according to Jackie Wills, director of robotic services at Virtua Health. In the OR, perioperative nurses are critical to system setup, workflow coordination, sterile field management, and real time troubleshooting, Wills explained.

"[Nurses] act as the connective tissue between the technology, the surgeon, anesthesia, and ultimately the patient," Wills said.

Prepping for the future

From a treetop perspective, Virtua Health is investing in people, infrastructure, and culture to prepare and upskill nurses as robotics expand into more complex and high-volume procedures. According to Wills, this includes both structured educational pathways for nurses, and simulation-based training at the health system.

"We are very fortunate to have a dedicated simulation site at our Berlin campus that we do utilize frequently to help provide that non-consequential environment for training where our care teams can feel very comfortable with incorporating and implementing this technology without an actual patient on the table," Wills said.

The health system also implores vendor-supported certification and online training modules, as well as ongoing competencies to validate procedures as growth continues, Wills explained. Additionally, the organization is investing in clinical informatics, data analytics, and shared governance teams to help optimize workflows so the nurses can understand the 'why' behind the technology.

“Virtua Health is also investing in leadership development to ensure that nurse leaders are prepared to manage technology-enabled care models at scale, not just as individual cases or a one-off strategy," Wills said.

Nursing with precision

In terms of outcomes, robotics has had a positive influence on nursing at the bedside. Wills explained that in the case of surgery, more precise instrumentation often translates to less tissue disruption, which can mean better pain control and earlier mobility.

"We're also seeing potential reductions in complications such as infections, blood loss, and revision surgery, which directly effects nursing workload and patient experience," Wills said.

Shorter length of stay and same-day discharge for select patients require tight nursing coordination, Wills explained, but they also reflect smoother recoveries for the right patients.

"Robotic technology isn't just innovation," Wills said, "it's a powerful tool that helps our patients heal faster and reclaim their lives every single day."

Robotics can also significantly improve nurse safety during surgery by improving ergonomics and creating more predictable workflows, while also reducing physical strain in the OR. Wills explained that many robotic platforms also reduce radiation exposure by minimizing the need for repeated fluoroscopy intraoperatively.

However, robotics changes workloads, rather than eliminating them, Wills emphasized. Early on, there's a learning curve that can increase cognitive load, which is something CNOs should be aware of when implementing the technology.

"The key is really thoughtful implementation, adequate staffing during these adoption phases, as well as listening to the frontline nurses and what they are saying," Wills said. "With repetition comes efficiency and confidence, which naturally will help reduce that workload."

What CNOs need to know

CNOs who want to incorporate robotics into nursing workflows must focus on adapting care models and staffing to maintain quality and continuity. According to Wills, staffing models may shift towards stronger roles in pre-admission testing, nurse navigation, virtual check-ins, and ambulatory recovery support.

"I think CNOs need to think beyond the walls of the hospital, and this means redesigning care models that emphasize preoperative education, care coordination, and postoperative discharge follow-ups," Wills said.

Wills emphasized the importance of looking for other ways to optimize staffing, such as cross training for other areas, or looking at hybrid models to appropriately staff for at-home care.

"Continuity is maintained not by more inpatient days, but by better hands-off standardized pathways and leveraging the technology like hospital at home to keep nurses connected to the patients after discharge," Wills said.

The key to keeping frontline nurses involved and giving them a voice is governance, according to Wills. Nurses should be represented on capital planning committees, technology evaluation teams, and implementation councils. They shouldn't only be consulted after decisions are made, Wills explained.

"Creating formal feedback loops through these committees, from bedside nurses to executive leadership, ensures that insights about these workflows, safety, and patient experience are scaling these decisions," Wills said. "When nurses see their input reflected in these outcomes, adoption improves and innovation becomes sustainable long term."

Lastly, for CNOs who want to get started on the robotics journey, Wills recommended starting with a clear purpose, and then letting the technology follow.

"Be clear about the problem that you're trying to solve, whether it leads to patient outcomes, staff safety, capacity, or access to care," Wills said. "Invest early in nurse education and change management, and don't underestimate the value of pilot programs."

Wills also recommended leveraging vendor partners for support, and connecting with peers who have experience with implementing robotics.

"Treat robotics as a clinical transformation and not just a piece of equipment," Wills said. "When nurses are empowered as partners in that transformation, the technology delivers on its promise."