Robotics in Nursing: Integrating compassionate technology into clinical practice

Augment the nursing workforce

Nurses are often regarded as the backbone of the healthcare system because they are vital in delivering high-quality, continuous, and compassionate care to patients from all walks of life–regardless of race, color, or creed. Their presence is often the most consistent and reassuring part of a patient’s healthcare journey. However, despite nurses’ unwavering dedication, their numbers in healthcare settings are increasingly inadequate to meet the growing demands of patients worldwide.^[11,12] This shortage has prompted greater interest in innovative solutions, including the development and deployment of nursing robots, which are envisioned to support the workforce by alleviating both the physical and emotional burdens placed on nurses.^[13]

Performance of repetitive tasks

Daily, nurses must carry out a wide range of fundamental but repetitive tasks such as drawing blood, administering medications, monitoring fluids, feeding patients through tubes, performing wound care, and checking vital signs. While these responsibilities are crucial, their repetitive nature can be physically exhausting and emotionally taxing, especially in an already stretched workforce. Today, robotic technologies are being developed to support nurses in performing some of these duties. For example, venipuncture robots^[14] can generate a 3D image of a patient’s arm to locate suitable veins, making blood draws quicker, easier, and less distressing for patients who fear needles.

Performance of physically demanding tasks

Furthermore, work-related musculoskeletal disorders are alarmingly common among healthcare workers, more so than in many other professions.^[15,16] Of these, low-back pain (LBP) is the most frequently reported, with studies indicating that anywhere between 28% and 96% of healthcare workers experience it each year.^[15,17] Beyond the personal suffering caused by LBP,^[18] the broader impact is significant–high rates of sick leave and reduced productivity create a substantial socioeconomic burden.^[15,19] This challenge is especially pressing given the global nursing shortage, which is projected to intensify by 2030.^[20,21] Robots designed to help with physically demanding tasks such as lifting and moving patients in and out of bed, are becoming game-changers and are being deployed in healthcare settings.

Handling of routine sanitization tasks

Nurses work in many different healthcare settings and handle various tasks, but their work often involves disinfectant use to keep patients safe and prevent infections.^[22-25] The COVID-19 pandemic increased the need for thorough sanitizing and disinfecting in healthcare, which requires dedicated staff and extensive time–two things in high demand in today’s healthcare world. However, growing research has raised concern about the health risks nurses face from repeated exposure to these cleaning agents–particularly the increased risk of developing respiratory conditions such as asthma.^[23,24,26] Studies have consistently shown that nurses, more than many other healthcare workers, are at a heightened risk for occupational asthma.^[23] This is likely due to their frequent use of bleach, ammonia, quaternary ammonium compounds (quats), and aerosolized disinfectants used for cleaning medical instruments and surfaces.^{[23,24,27,28]} Although the exact causes are still being studied, it is becoming increasingly clear that long-term exposure to certain disinfectants is linked to respiratory issues in healthcare workers.^[27]

In addressing this challenge, specialists advocate for a comprehensive infection control strategy that protects patients and promotes the overall well-being of frontline healthcare workers.^[25] As part of this evolution, healthcare systems are increasingly turning to technological solutions for assistance. Medical robots are being developed and deployed to healthcare settings to aid in cleaning and disinfection.^[29,30] For instance, ultraviolet disinfection robots are emerging as a practical option for handling routine sanitization tasks. These robots have the potential to perform repetitive, time-consuming cleaning duties, reducing exposure risks for nurses.

Valuable in physical therapy

Recovering from injuries often means patients need focused physical therapy to help them regain movement and independence, especially within the hospital environment. Simply getting out of bed and taking a few steps can make a big difference, as it has been shown to ease stress, lift spirits, and even speed up the healing process.^[31,32] New advances in humanoid robotics–specifically exoskeletons–are being explored to help healthcare professionals, especially nurses, manage repetitive and physically demanding tasks. These wearable devices are designed to ease fatigue and reduce back, neck, and shoulder pain, commonly reported by those who spend long hours on their feet or perform frequent lifting.^[33] In general, Robotic exoskeletons come in two forms. Passive exoskeletons rely on mechanical elements such as springs and dampers to capture and release energy from the wearer’s movements, making it easier to maintain good posture or perform specific actions. In contrast, active exoskeletons are equipped with powered components–such as motors or hydraulics–that actively enhance a person’s strength and mobility.^[34]

These supportive suits can be tailored for different parts of the body – upper, lower, or even full-body versions exist, as well as models that target just a single joint.^[35] For nurses, back-support exoskeletons are especially promising, as they can help prevent work-related injuries caused by repetitive lifting and moving of patients.^[34,36,37] Furthermore, robotic exoskeletons have been demonstrated to be valuable in assisting patients to regain their mobility, as they act like an external set of muscles and bones, thus retraining their body to move correctly and even helping those with disabilities walk again. For many patients, this renewed sense of autonomy and movement is vital to their recovery and general well-being.^[38]

Assist in providing emotional support

Emotional support is vital to every patient’s healing process, but nurses sometimes face challenges from staff shortages and demanding workloads. Nurses provide emotional care by empathizing sincerely and compassionately, listening actively, educating appropriately, using emotional presence, empowering the patient to cope, and providing reassurance, respect, and dignity, which helps reduce anxiety and foster trust. However, because they spend so much time managing clinical tasks and caring for many patients, they may not always have enough time or energy to meet every individual’s emotional needs fully. This can lead to exhaustion and make it harder for nurses to consistently provide the compassionate support that greatly benefits patients’ recovery and well-being.

Robots are being built to accomplish this task and are surprisingly effective at providing emotional support to patients. An example of a robotic application in eldercare is “Stevie,” a social robot developed at Trinity College Dublin. Tested in a care facility in 2019, Stevie engaged residents in conversation and games while simultaneously monitoring for medical distress. The robot was also capable of recognizing emergency voice commands and alerting healthcare staff, demonstrating its potential to enhance both companionship and safety in long-term care settings.^[39]

Financial constraints and limited access to AI education

The robot revolution could have profound negative implications for healthcare service equality due to financial constraints. As robotic technologies become more common in healthcare, people with limited financial resources may not be able to afford or access them, while wealthier individuals can. This is particularly true in most of the developing countries, where the healthcare delivery system is unorganized, with a tiny proportion of the population possessing health insurance.^[40] As robot-assisted care is becoming more common, many people with limited economic means may find it harder to access these services, unlike their privileged counterparts. This deepening divide may put the principle of equal care for all at risk and may lead to even greater differences in health outcomes across communities. From an ethical standpoint, the principle of the common good demands that technological advancements, including healthcare robots, be inclusive and accessible to all, especially vulnerable and marginalized populations who are most at risk of being excluded in today’s data-driven, intelligent society, and make conventional, human-delivered nursing care a more realistic and compassionate option for them.^[41]

Task delegation issues

To delegate in nursing practice means to transfer one’s responsibility for completing a task from one nurse to another, while the original nurse retains accountability for the outcome.^[42] However, it can be argued that AI robots do not qualify as “individuals” because they lack personhood, a key aspect of delegation. The American Nurses Association framework for safe and effective delegation is built around five rights, the first being the “right task.” This principle requires that the task be matched to the appropriate person based on their scope of practice, competencies, and skill level.^[43] When a nurse delegates, he/she must ensure the task is assigned to someone who has been evaluated and deemed qualified, reflecting the “right situation” and “right person,” which are the second and third rights. The “right situation” involves assessing factors such as timing and urgency to minimize risks. While robots/AI can effectively support certain aspects of care during appropriate situations, they cannot be entirely entrusted with delegation responsibilities. The “right person” requires the nurse delegating the task to have confidence in the delegatee’s knowledge, skills, and education level. It is worth noting that delegation also encompasses mutual trust among healthcare team members and the capacity for open communication, which is vital for providing safe and adequate patient-centered care. However, despite the advancements in robotics/AI, they cannot still engage in truly open communication, particularly in comprehending contextual nuances and nonverbal cues. Therefore, robotics/AI may support nursing but cannot replace the human-to-human trust and accountability required in the delegation process.

Lacks creative and critical thinking skills

The creative capacity of robots is fundamentally limited to the data they receive and the algorithms that govern their operation. When confronted with new areas of work or unforeseen circumstances that fall outside their programmed data sets, robots become ineffective. Unlike nurses, who can brainstorm innovative concepts and develop better ways to accomplish tasks, robots lack this human ability. As established, robots operate solely within the confines of the data input into them and predefined templates or programs. Consequently, they cannot engage in critical thinking or formulate novel methods or individualized plans of care.

Critical and creative thinking are indispensable components of clinical practice. Creativity in nursing encompasses the ability to transition from one thought to another seamlessly and the invention and approval of novel ideas that enhance patient care, thereby ensuring these innovations are simple, valuable, efficient, affordable, and safe.^[44] This process demands inventive vision, sensitivity, and critical thinking beyond conventional boundaries.

Importantly, creative thinking allows nurses to “think outside the box.” By design, robots think within the box, and because of this, they are restricted and only function strictly according to the data and rules programmed into them. Nurses, however, draw from diverse sources of information and generate innovative solutions to complex patient problems, often in the absence of complete data. Since robots lack the capacity for out-of-the-box thinking and genuine creativity, they cannot fully replace nurses in the clinical workspace.

Lack of emotional intelligence (EI)

EI involves the ability of an individual to understand emotions accurately and use emotional knowledge to enhance thought and decision-making.^[45] It is this distinctive ability that makes nurses perpetually relevant in the healthcare setting. Caring is a fundamental element of nursing that is deeply a human act built on compassion, sensitivity, and honest communication. The act of caring enables the nurse to offer support and guidance that helps individuals, families, and communities enhance their health and general well-being.^[41] Caring in nursing extends far beyond providing physical assistance to encompass forming genuine human connections that nurture the whole person. Nursing embraces not only the patient’s physical needs but also their mental, spiritual, and social dimensions of life. This whole-person approach enables nurses to interpret subtle expressions, recognize alexithymia (difficulty experiencing, identifying, and expressing emotions), and identify unspoken concerns or hidden intentions in patients.

Despite their hi-tech design and sophistication, robots still lack the consciousness necessary for subjective human experience, as they do not possess unique human qualities such as emotions, ethical reasoning, or the capacity for moral judgment and responsibility essential to nursing. These attributes not found in robots are what make nursing a profession grounded in genuine human interaction and care. While they may appear to exhibit a degree of consciousness externally, they lack the internal, subjective experience (qualia) that defines human consciousness and thus only simulate consciousness rather than truly possessing it.^[46]

Although AI can be trained to recognize specific human emotions through technologies such as neural networks, natural language processing, and sentiment analysis, its ability to predict and respond appropriately to the complex and dynamic emotional and physical states of patients remains limited.^[47] Social robots designed for companionship can detect emotional cues and adapt interactions, improving mood and engagement, especially among older adults.^[48,49] Even if emotions were codified, it does not mean machines can imitate all human behavior. Behavior is emotions and actions. However, these robots operate within programmed responses and lack actual emotional experience or moral responsibility.^[50] Therefore, the concept of human dignity and genuine emotional connection in the nurse–patient relationship remains intrinsically human, maintaining the irreplaceable role of nurses in delivering compassionate nursing care.

Poor interpersonal relationship

Building a strong relationship can be more challenging when communication between patients and healthcare providers relies heavily on digital methods. Digital touchpoints often lack the personal interaction and non-verbal cues of face-to-face appointments. As a result, patients may feel less connected and less understood by their providers, which can ultimately lead to lower satisfaction with their care.

As social animals, humans have an inherent longing for emotional connection, achieved through biological and chemical exchanges such as hormones and emotions. Personal and human connection is essential in clinical nursing practice to create trust, make patients feel understood, and support a lasting therapeutic bond. Robots, composed of software and chips rather than biological cells, do not have this capacity for genuine emotional connection or empathy.

Lack of soft skills

Robots may be helpful in many ways, but they fall short regarding soft skills–vital qualities in healthcare. These include thinking critically and creatively, working well in a team, paying close attention to detail, communicating effectively, building strong relationships, and managing conflicts.^[51] Nurses are trained to develop and apply essential soft skills daily as human caregivers, which distinctly sets them apart from robots. Unlike robots, nurses bring EI and deep reasoning to patient care–qualities that robots cannot replicate. This human capacity enables nurses to provide compassionate, nuanced care that machines are inherently unable to deliver.

Embrace change as a nurse

Change can feel overwhelming, but as a nurse, staying informed about the latest healthcare technologies empowers one to incorporate new tools into practice confidently. Embracing change means using technology to complement the nurse’s skills and improve patient outcomes, not to replace the human touch they provide every day.

Educate patients clearly

Nurses are trusted educators. When introducing new technology, take the time to explain its purpose and benefits in simple, clear language. Helping patients understand how technology supports their health encourages their engagement and strengthens the nurse’s therapeutic relationship.

Personalize technology for each patient

Nurses know their patients best, as they are the only healthcare professionals who stay with patients 24/7. Therefore, customizing technological tools–whether it is monitoring devices or communication platforms–to fit their individual needs and preferences are essential. This personal approach shows patients that nurses care about their comfort and will help them to feel more at ease with new technology.

Maintain empathy in every interaction

Even with advanced technology, nurses’ empathy remains irreplaceable. Nurses should use technology to reduce time spent on administrative tasks so that they can focus more on listening, comforting, and responding to patients’ concerns. Nurses ought to remember that their compassionate presence is often the most healing part of care.

Commit to continuous learning

Because healthcare technology evolves rapidly, engaging in training and continuous professional development to stay current with new tools and best practices is a pivotal task for every nurse. This keeps the nurse’s technical skills sharp while reinforcing the importance of compassionate, patient-centred care.

Foster open feedback with patients and colleagues

Nurses need to encourage patients and fellow healthcare professionals to share their views and concerns about new technologies. By actively listening and adapting based on this feedback, the nurse can help ensure technology supports–not hinders–the caring relationships they build.

Human-centered design

Involving nurses and patients in the design process of the technologies/robots will help to ensure that technology addresses real needs and supports compassionate care.

Interdisciplinary collaboration

Ongoing research and collaboration among engineers, ethicists, and clinicians are essential to creating systems that uphold ethical standards.