Can AI help us in the hospital?

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In mid-2023, the author of the Palate and Pabulum blog began implementing recommendations from technology experts regarding the functionality of AI platforms. The usability and accessibility of AI language learning apps are increasingly gaining traction. As a healthcare provider, the author became aware of these applications through a website called Recomendo, created by the original editors of the well-known magazine Wired. Recomendo distills technology-related information and shares it for free.

Now more than ever, the AI revolution is upon us, leading to a distinction between early and late adopters. The academic community actively explores artificial intelligence applications across various disciplines, and the healthcare service industry is no exception. The following essay and dialogues aim to draw on academic literature as source material for the following blog post. A keyword search in CINAHL using "AI" and "nurse*" was conducted to surface relevant articles. The selected articles were chosen randomly based on titles that included "AI," "artificial intelligence," and "nurse."

Scholars have identified that advances in computer technologies, such as artificial intelligence modalities, can affect patient care by enhancing services and offering best practices (Wangpitipanit et al., 2024). One of the diverse ways that AI has been able to differentiate itself, for example, from a general online Google search, is that some of the platforms' methods do not just offer up random facts of knowledge; instead, these applications can first and foremost analyze questions when submitted, integrate, and organize prototypal insights for the user.

Additionally, others have reported that AI can be used as an adjunct to trusted research databases. For example, Epstein (2024), a healthcare informationist, has discussed that nurses often need information from trusted academic sources such as CINAHL, a standard library index of evidence-based literature for allied healthcare professionals and registered nurses, and the upcoming surge of significant language computational programs can assist those seeking knowledge to help them distill queries when searching for evidence-based literature to inform best practices when delivering care to patients.

Without question, more scholars have added to the knowledge available for artificial intelligence capabilities in healthcare. Ronquillo et al. (2021) have noted that the applications for AI's reach will address tasks and activities requiring little to no reasoning or contemplation, such as resupplying medications when electronic dispensers need refilling or using robot-assisted notifications when rooms need cleaning after a patient has been discharged automatically freeing up time for nurses. What is more, the scholars pointedly acknowledge, as to be expected, that the use of AI platforms can help nurses strategically gather information regarding their patients and that education on these technologies is paramount to continuing education as they evolve and become visible in healthcare delivery (Ronquillo et al., 2021).

References:

Epstein, Helen-Ann B. (2024). Suggestions from experience and AI tools to teach evidence-based practice to nurses. Medical Reference Services Quarterly, 43(1), 59-71. https://doi.org/10.1080/02763869.2024.2289335

Ronquillo, C. E., Peltonen, L., Pruinelli, L., Chu, C. H., Bakken, S., Beduschi, A., Cato, K., Hardiker, N., Junger, A., Michalowski, M., Nyrup, R., Rahimi, S., Reed, D. N., Salakoski, T., Salanterä, S., Walton, N., Weber, P., Wiegand, T., & Topaz, M. (2021). Artificial Intelligence in Nursing: Priorities and Opportunities from an international invitational think‐tank of the Nursing and Artificial Intelligence Leadership Collaborative. Journal of Advanced Nursing, 77(9), 3707–3717. https://doi.org/10.1111/jan.14855

Wangpitipanit, S., Lininger, J., & Anderson, N. (2024). Exploring the deep learning of Artificial Intelligence in nursing: A concept analysis with Walker and Avant's approach. BMC Nursing, 23(1). https://doi.org/10.1186/s12912-024-02170-x

Followers 1st, Organization 2nd & Leader last?

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Scholars, particularly Robert Cialdini, have highlighted the effects of influence on others in his book Influence: The Psychology of Persuasion. One key concept he discusses is the idea of reciprocity, which suggests that we should strive to give back what has been given to us (Cialdini, 2021). In organizational leadership, a leader can embody this principle by actively giving back to their team and fostering a culture of responding in kind. The hypothesis is that any leader who influences others to achieve a common organizational goal frequently faces challenges related to their personality and those around them. By choice, training, or preference, leaders often pivot to a leadership style they commit to affecting the organization's mission, vision, and goals.

Many viewpoints or philosophies on leadership styles exist. This blog post will focus on servant leadership, which resonates deeply with the author in his current role as a middle manager in a healthcare organization. According to the Center for Servant Leadership, this leadership style is characterized by a desire to prioritize the needs and wants of others above one's own (Greenleaf Center for Servant Leadership, n.d.). In other words, servant leaders are oriented toward serving others rather than being motivated by self-interest or personal gain.

It is essential to clarify that prioritizing service over self should not be misconstrued as overly accommodating or submissive. Instead, as explored by other scholars in the field of leadership, the servant leader functions as a regulatory force within the larger organization, promoting its overall health and well-being. Let us review what other scholars have uncovered.

According to Friedman et al. (2017), the playbook for the leader emerges by maintaining the health and integrity of the entire unit. Like how the human body reacts to invasive organisms—such as viruses, allergens, or bacteria—with an immune response, a leader protects the organization from potential threats. In Aristotle's notes in Nicomachean Ethics (Hutchins, 1978), we can learn from the wisdom of past sages. Aristotle argues that credit is given to those who possess knowledge. This wisdom influences individuals to act according to their values, determining what is good or bad for others. As discussed further, an individual's philosophy directly informs their leadership style, benefiting their fellow man. These concepts of interpersonal reciprocation, immune-response qualities, application of wisdom, discernment, and experience influence leaders and their followers. Can these themes be tied to a servant leadership strategy? The following dialogue will investigate what is known in the literature regarding servant leadership.

To wedge a definition from known research, an academic journal titled The Leadership Quarterly will serve as source material for the following. A servant leader symbolizes people connection, virtuosity, soul-stirring, and the belief in a higher power motif to nurture, stimulate growth, and entrust followers (Eva et al., 2019) while not absconding from the responsibility and accountability of holding others to performance expectations. Eva et al. (2019) highlight the promising potential of servant leadership based on their research for more context. They begin their systematic literature review by discussing the tribalism associated with this leadership style. In earlier times, particularly before the current few hundred century, communities that relied on hunting and gathering for sustenance had a clear, social sense of their tribal leaders' roles. This connection to the life of the tribal leader was evident, transparent, and familiar (Eva et al., 2019). In today's capitalist economy, an organization leader needs to be experienced by their direct reports as one who is transparent, as in the old days when an Indigenous chieftain lit the way for the community. The blueprint of servant leadership constitutes the following that Nathan Eva and the co-authors of the article "Servant Leadership: A Systematic Review and Call for Further Research" have outlined three motifs in a servant leader: incentive, method, and mentality (Eva et al., 2019, p. 114).

Incentive

The concept of a servant leader's incentive is imagined as what motivates one to act as a servant leader. The open question is if one is unwilling to be a helper of others, should that individual seek leadership roles? Addressing the incentive for one who seeks to serve, scholars point out that the servant leader is incentivized not through personal ambition or goals; on the contrary, a sense of purpose steered outward to help others is the internal stimulus for the servant leader (Eva et al., 2019).

Method

Next, and arguably most challenging to clinch for anyone aiming to illustrate and represent the archetype of a servant leader, are the techniques and strategies involved in the interpersonal interactions of leaders and their followers. Servant leaders influence followers by arranging their needs, desires, and aspirations in order of importance that are predominately worthier than the leaders (Eva et al., 2019). In simple terms, the servant leader puts the direct report needs first before themselves and, to a greater extent, that of the organization, which debatably is open for conjecture.

Mindset

Lastly, the way a servant leader thinks is meaningful. It is often understood that how a person thinks impacts the actions a person carries out. Servant leaders' firsthand thought processes are focused on something other than the betterment of themselves. Instead, self-interests are set aside again; the idea and focus are on empowering followers, building up others, and instilling a sense of trust, which, in turn, at least theoretically, direct reports themselves will bring the image of servant leadership style to the more excellent organization or community (Eva et al., 2019).

Finally, Nathan Eva and associates highlight areas such as business, management, selling, education, the healthcare industry, and hotel services, where leadership is addressed in the literature (Eva et al., 2019). A thought to consider or contrast is what applications, if any, where the servant leadership motif would be less valuable or relative, for instance, in government, military, or law enforcement? More analysis and inquiry are needed in these settings where leadership is undeniably present via rank, classification, and pay grade.

To summarize the blog, it is understood that logically, scores of duties for a leader abound, to the infinite sum innumerable but not limited to the least that involves coaching. Any aspiring leader needs to unblock interpersonal boundaries through coaching; however, leaders should recognize instances when coaching becomes therapy and refer direct reports to counseling professionals with empathy and care. How do we differentiate our leadership style from those divergent to servant leadership? Questions such as this kind and more are undoubtedly precarious and puzzling and garner more attention given the multidimensional nature where leadership manifests. As covered above, setting an example and reciprocating attitudes and behaviors will follow when done altruistically. Secondly, leaders are the immune system and set point for their units or organization, and by applying core experiences and personal and professional acumen, followers become empowered to imitate, as evidenced by improved organization culture.

References:

Cialdini, R. B. (2021). Influence: The psychology of persuasion. Harper Business.

Eva, N., Robin, M., Sendjaya, S., van Dierendonck, D., & Liden, R. C. (2019). Servant leadership: A systematic review and call for future research. The Leadership Quarterly, 30(1), 111–132. https://doi.org/10.1016/j.leaqua.2018.07.004

Friedman, E. H., Treadwell, M. M., & Beal, E. W. (2017). A failure of nerve: Leadership in the age of the quick fix. Church Publishing.

Greenleaf Center for Servant Leadership. (n.d.) What is servant leadership? (n.d.). www.greenleaf.org

Hutchins, R. M. (1978). Aristotle II. In Great Books of the Western World (Vol. 9, pp. 389). Encyclopedia Britannica.

A Salute to Everett Worthington

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One benefit of being a healthcare professional is that access to academic literature is available and critical in guiding evidence-based practice. It is speculated that only some adult learners, readers, or lay people have access to the databases that universities, colleges, or healthcare institutions possess; moreover, reading journal articles is a pastime that the author of Palate and Pabulum enjoys. For this blog post, such an article is highlighted as a review that was stumbled upon during a database keyword search on forgiveness.

Interestingly, areas of study that pique the interest of this aspiring writer are the social sciences, particularly the study of human behavior or psychology and spirituality. As background for connection, recently, while trying to wrestle with Pauline literature, specifically the Epistle to the Roman Christians in the seventh chapter, the apostle describes himself in a state of duality, precisely describing himself as wanting to do good but not able to perform it (The Holy Bible, New International Version, 1999, Romans 7: 14-25).

To better understand the biblical text of this nature and difficulty, a commentary from scholars on Paul's letter to the Romans provided insight. According to Plumer (1979, p. 358), an eighteenth-century biblical teacher and theologian comments on verse twenty-five of the Epistle that Paul was in a condition of a mended, spiritually repaired state but acknowledges his person has still lodged and stained in his character a corruptedness telling of this dual nature that Christians can attest to and experience.

In other words, the great apostle of the Christian faith describes the conflict and internal struggle against what the natural self desires and what God's spirit desires; in another reference, Plumer (1979, p. 359) describes what Paul purports to be in a constant battle or struggle against his depraved nature that will never cease.  

As such, the scientific literature surrounding spirituality and religiosity is flourishing. When searching for journals discussing the idea of forgiveness, the journal Spirituality in Clinical Practice surfaced. The student can locate the journal through a library search of Ovid, a database of hundreds of academic journals.

The article's title in the June issue of the online publication stood out like a beacon: "How to grow experts in the study of virtue and religion/spirituality." The columnist of the article, a student of the teacher to which the column refers, conveys his insights from the man Everett Worthington. Mr. Worthington was and is an academic mentor to many, has recently retired, and has made great strides in studying forgiveness (Davis, 2024).

Be a Mentor and a Student

According to Davis (2024), it is essential to remember the power of mentorship. His article describes what Everette Worthington encompasses in his experiences working alongside him. For more on Everette Worthington's work, click here. Mentors have one job: to give valuable instruction and opinions to newcomers or recruits to help them fabricate new abilities and techniques in their field or career, which could be both professional and personal. On the other hand, the newcomer, essential to remember, commits effort, energy, and time to become gradually more proficient at a craft.

Davis (2024) further summarizes a few of Mr. Worthington's sayings that impacted him and others in his sphere of influence. His aphorisms strike the reader and are shared for others' benefit. The students with firsthand experience of the man are the sole inheritors of his impact, but the reach of Mr. Worthington's reputation through the article is far-reaching.

Shoot for Heterogeneity

Based on Davis (2024), Mr. Worthington was known for telling students to avoid performing something for a specific goal. Although others may not have a working knowledge of doctoral study under scholarly research and publication, the expressions that Mr. Worthington was known for saying need to be more evident. The interpretation of this expression could be that if something is performed or done, it is better if the outcome of that action could be applied and used at some point for interconnection, transferability, and integration on other projects. For example, learning how to perform self-care as a registered nurse can and should be applied to helping patients perform self-care as a superficial understanding.

Be Mindful of Critiques

Next, Mr. Worthington was experienced by others through his expressions of academic writing and research in the context of authors rereading and reviewing drafts of articles for publication. Davis (2024) writes that Mr. Worthington has a good rule of thumb: to avoid leaving remarks on another's work. In academic writing, according to Davis (2024), science can only occur in a group or thrive in the presence of teamwork. This is true in academic writing, where many authors participate in a study or publish research in conjunction with the primary author. Through proofreading and peer-reviewing, the article often needs revising. To eliminate the practice of marking up the work, the rule that Mr. Worthington was noted for saying was not to leave comments; instead, to communicate within the team to collaborate and refine the work together, for instance, a phone call or a brief email to discuss rough drafts of articles. As often is known, according to Davis (2024), in academia, sometimes senior academics are known for marking up preliminary drafts and then sending the comments back to the primary author, who sometimes is a budding scholar, making for additional hundreds of hours of work for the primary author. The apothegm from Mr. Worthington is self-explanatory.

Build Others Up

In sequence, Davis (2024) points out that Mr. Worthington expressed the need for people to decline and avoid the temptation to discredit others. This insight is difficult to apply to any industry, not just academic writing, and even more challenging in interpersonal relationships. Davis (2024) points out that Mr. Worthington firmly grasped the family systems theory, which became a part of his interpersonal relationships. An elementary definition of the family systems theory is available in the healthcare literature. It is based on the concept that systems operate with other elements within themselves in a shared manner, such as a family unit (Wright and Leahey, 2013, p. 26). When family system theory is applied to the health of organizations, for example, and the interpersonal relationship within, seeing the challenges in the units instead of the challenges with individuals themselves, attention to the whole is the focus for solving problems instead of isolating the part. Davis (2024) reiterates what he learned from his mentor, which can be applied to all: to avoid power manipulation, triangulating conversations, blaming, accusing, rumor milling, and suspicion.

Stability Requires Effort

Finally, Davis (2024) wraps up the article with a catchphrase that is apparent to most but goes without saying that Mr. Worthington had a background in nuclear physics before becoming a counselor in psychology, and that is: if organization is to be implemented, it will require effort.

In summary, the concepts of Mr. Worthington are penetrating and discerning but require practice and repetition and are rudimentary truths. If taken to heart, the article generously provided in the scholarly archives can be applied to any area in life, whether professional or personal. The take-home is first as a recap from Davis (2024), perform those things that will contribute to your pursuits in a compounding fashion; next, if you need to leave comments, be mindful of the hearer and address them directly and collaboratively to benefit the whole, next, make an effort to build others up and never tear them down, and finally if anything should resemble structure and assembly, it will require relentless effort.

References:

Davis, D. (2024). How to grow experts in the study of virtue and religion/spirituality. Spirituality in Clinical Practice, 11(2), 133–142. https://doi.org/10.1037/scp0000318

https://www.evworthington-forgiveness.com/

Plumer, W. S. (1979). Commentary on Romans. Kregel Publications.

The Holy Bible: New International Version. (1999). Cornerstone Bible Publishers. (original work published 1973)

Wright, L., & Leahey, M. (2013). Nurses and Families: A Guide to Family Assessment and Intervention (6th ed.). F.A. Davis. 

Two Types of Burden

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We can carry two types of burdens; regardless of our choice, both require effort. Ultimately, work is involved, and after work is performed, the rest follows. One kind of burden leads to sweet rest, while the other results in insomnia.

According to Peloubet (1901), the world imposes one burden on us. His scholastic commentary on Jesus' words recorded by Matthew describes this burden as selfishness, bad habits, worries, anxieties, regrets, depression, and a desire for wealth and pleasure. These burdens weigh heavily on us, leading to weariness and distress.

In contrast, if we give attention to the words of Jesus that great commentators such as Peloubet (1901) offer in his understanding of the gospel of Matthew, there is an alternative burden. Highlighting the invitation from Jesus to all of us who choose to follow Him to take on His burden (The Holy Bible, New International Version, 1999, Matthew 11:28-30), which consists of the responsibility to care for others, the commitment to prayer, the act of loving others, the endurance of long-suffering, the development of character, and the hard work required to become more like Him and His Father. 

Jesus' burden is lighter and more manageable than the world's burdens. The real challenge lies in choosing which burden to carry; ultimately, we will all have some burden to bear.

References:

Peloubet, F. N. (1901). The teachers' commentary on the gospel, according to St. Matthew. Oxford University Press.

The Holy Bible: New International Version. (1999). Cornerstone Bible Publishers. (original work published 1973)