Contributor – Janet L. Attisha
2025 Nursology.net Intern
Statistician and nurse theorist Florence Nightingale used data and the polar area diagram to advocate for better health outcomes of British soldiers injured in the Crimea War (Bostridge, 2020). Fast forward from Nightingale to today and we are in an era of envisioning the tailored treatment of disease using technology and data. This new era has exploded with innovation and technology since 2003 when the Human Genome Project (HGP) sequenced the human genome.
This new era of tailored medical treatment to each patient was first introduced to the United States population through a presidential address by President Barack Obama who launched the Precision Medicine Initiative in 2015 (Cerrato and Halamka, 2018). This research initiative allocated funding and support for research to promote health and tailored treatments by creating a research cohort of one million volunteers. The driving force of this initiative is to optimize the health status of patients through healthcare based on patient’s genetic, genomic, or omic composition within the context of lifestyle, social, economic, cultural and environmental influences. This tailored healthcare is referred to as precision healthcare.
This era of precision healthcare has impacts on the nursing discipline, nursing research and the practice of nursing at the bedside. These impacts need to be discussed and understood by nursing educators and incorporated into the curriculum of nursing programs in the United States and worldwide. This blog post will serve to highlight the importance of technological competency to nursing practice and how Locsin’s Theory of Technological Competency as Caring in Nursing (TCCN) can ground nursing education in the era of precision healthcare.
In my role as nursing educator, I often ponder how to best serve my students, so they are prepared to adapt to the tension between nursing’s duty to care and the imperative to use technology. How can I create a foundation for their nursing practice within the era of precision medicine and precision health? I cannot teach them everything they need to know but I can provide nursing theory that grounds their practice as nurses. Providing a theory on which to guide their nursing practice empowers my students to create a nursing practice that is patient centered, caring, and holistic and creates nursing knowledge that contributes to precision healthcare.
When I first read Locsin’s theory I had the proverbial light bulb moment. Before reading the theory, I had a dualistic view of caring and technological competency in my understanding of nursing practice. Locsin’s TCCN theory (2005) is based on the tenet that the focus of nursing is the person and brings technology into the paradigm and posits that technology can be used to know persons as whole moment to moment. The wholeness of the person can be expanded by technology and this act of seeing the whole person is an act of caring by the nurse. Locsin describes the nurses’ technological competency as expressing caring in nursing (Locsin, 2005).
Viewing technological competency as caring allows the nurse to navigate innovation and their response to technology from a holistic perspective instead of reductionistic perspective. Locsin (2005) asserts technology is used to know persons more fully as whole and complete in the moment which is congruent with the goals of precision healthcare which seeks to use technology and data to see the patient more fully through science within the context of lifestyle, social, economic, cultural and environmental influences. Technology innovation allows nurses to better care for their patients because it can give a broader more expansive context of a patient and their health.
Using the theoretical basis of TCCN, technology that is being innovated to assist nurses in providing precision healthcare can be seen through a holistic and caring lens. Technology is another conduit or pathway for the nurses to better understand their patients and create tailor interventions for positive health outcomes. The patient is served better by the theoretical underpinnings of TCCN and precision healthcare. The nurse is also better served when their practice is framed by nursing theory. The work of a nurse is intellectually, physically and emotionally taxing every day, and the nurse desires to know the hard work provides care and better health outcomes for patients.
In the past, nursing has been rooted in a practice with an emphasis on intuition, experience and interactions with patients, but with the advances of healthcare innovation and technology the scope of nursing as expanded, and this expansion requires a theoretical basis for teaching students. This expansive view of technology must be embraced by nursing educators to allow for the creation of curriculum to grow future nurse scientists and thought leaders within the era of big data and precision healthcare.
References
Bostridge, M. (2020). Florence Nightingale. Penguin Books.
Cerrato, P., & Halamka, J. D. (2018). Realizing the promise of precision medicine: The role of patient data, mobile technology, and consumer engagement. Academic Press.
Locsin, R. C. (2005). Technological competency as caring in nursing: A model for practice. Sigma Theta Tau International Honor Society of Nursing.
About Janet L. Attisha
Janet Attisha teaches in the associate degree nursing program at Tulsa Community College in Tulsa, Oklahoma and is also a PhD student at the University of Kansas School of Nursing. She resides in Oklahoma, a rural state that faces significant challenges related to access to healthcare and health providers. Janet has a interest in how technology can address health disparities and lead to better health outcomes and health equity.
Janet, Thank you very much for your informative blog. A bit of a “back story” about the Human Genome Project (HGP) that sequenced the human genome. I once was at a presentation given by a faculty member at the Jackson Laboratories (located in Bar Harbor, Maine). She told us that the work that she and her colleagues as well as colleagues at other biology labs, sequenced the mouse genome within about 1 year, much quicker than those who were working on the HGP. The significance of the mouse genome is that mice have genes that are quite similar to human genes, so that knowing the location of mouse genes helped the HCP people know where to look for human genes.
Dr. Fawcett. I am honored to know you read by post and to read you comment. Thank you for your insight on the HGP and the precursor of the mouse genome.
I hope you are staying warm in Maine!
Janet
Sunday November 30 2025
Ms. Attisha, your above blog stirred up several recalls from long ago:
In the mid-1950s the visionary Dr. Martha Rogers with her Doctorate of Science from Johns Hopkins University began her life long quest to educate nursing students in the science of human caring.
In the autumn of 1963 in my senior high school year, my wise learned advanced biology teacher made arrangements for me to have a practicum at the Albert Einstein School of Medicine with a science project using electrophoresis to study proteins. Upon near high school graduation, I decided to change my future major for university study from microbiology to nursing. Seeming disappointed, my wise teacher made the comment to me that “nurses carry bedpans” but nonetheless, he supported my new choice for study. My mother was a nurse and she had paved my way toward an excellent undergraduate B.S. program.
After two employs as an RN, I began very part time study at the school division that Dr. Rogers headed and early on took the short required introductory course in the FORTRAN computer language.
Learnings from both nursology programs gratefully stay with me to this very day.
Nurses do indeed carry bedpans, more so carrying Earthlings over troubled waters when the winds of time shutter.
Dorothea Fox Jakob in Toronto