Introduction
Tracy Breece is a nurse and a leader in merging the fields of technology and healthcare. While talking to her, I learned about the advancements that nurses have seen using artificial intelligence. This interview was an opportunity for me to see how curiosity and innovation can lead to a stronger workforce and more connection between providers and patients. I hope the highlights shared below serve as a reminder of the endless possibilities and potential that await each and every one of us.
Oftentimes, the information available about AI is very negatively focused, and the potential it has for good goes unseen. How does your work use this technology to improve workspaces in healthcare?
I am a registered nurse by background and I’m always curious about technology and how it enables us to do our job better and to take care of the patients the way we want to. In an environment where we’ve been really just layering on technology in a nurse's daily work, I knew we wanted to do that differently with artificial intelligence. When the pandemic hit, the emotional toll and burden created an environment where nurses were just crumbling. It also allowed us to step back and say, well, as professionals and as administrators, what accountability do we have for that technology? So artificial intelligence for me just came about in the last three or four years. So that was the state of it: overburdened, not really helping, a ton of workarounds. And then we had generative AI. And we had industry partners, global companies that took an interest in us being curious. What problems were we trying to solve for nurses? How were we going to do it with purpose and intentionality? How are we going to solve effective handoffs at the bedside between, say, the ED nurse and the inpatient nurse? Generative AI was our solution.
Originally, people never realized how simple AI could be to us, but I think because of that simplicity, people have now forgotten how much it can actually do. People always write it off as a simple answer generator, and they forget that it can do so many other things.
Exactly. You can create rules. You don't have to see it. It can draft replies. But perhaps the average everyday user doesn't understand all that it can do. And that's where we see that sense of empowerment and ownership. Someone might be in my role to advocate for the nurses. When it comes to workflow engineering, I'm the first one to say, well, let's go out to the floor and talk to the nurses. I'm not the bedside nurse using the tool I help create.
How do you define your role? What does a typical day at work look like for you?
I work with a multistate health system involving more than 4 states and more than 70 hospitals. My days involve understanding the technology in front of the nurses. My number one priority and role is to organize a cohesive structure around applied artificial intelligence. I sit in AI governance meetings, I sit in meetings to talk about our partnerships, and I understand our shared work and our common goals so we can continue to be in alignment. Our number one priority is to make sure nurses can do what they do best every single day and take care of patients who want to be well. I find my role really exciting. I get to do the fun stuff, and that’s looked different over the course of my career.
I started as a bedside nurse, documenting everything on paper. I had zero technology. Before I left every day, I would have to find another nurse and we would have to count the narcotics I had left. This way, we could track what we used and didn't use. My very first project around technology integration was automatic dispense cabinets of medications that controlled inventory and replenished supplies automatically. We created a system of barcode medication administration that would scan a patient's wristband and give us the details of their health and dosage. At the time, I didn't know that I had this natural ability to translate nursing science to technical science. That was my first project and I loved it. But first and foremost, I'm always a nurse and I love being a nurse.
What does your work focus on primarily - managing previous projects or brainstorming new solutions for situations that arise?
I spend about 80% of my time in new and 20% of my time in old. I'll give you a very specific example. Super users were folks that were specially trained to answer questions. I was developing a concept around retiring the super user terminology and beginning to think about influencers. While super users have served us well, that practice doesn't fully capture what we need for artificial intelligence in an emerging technology era. When you hear the word influencer, it makes you feel a certain way. It’s almost like you're a mentor or a peer versus a super user. It conjures a different feeling ,which goes back to psychology. I mentioned in our earlier conversations that I've been studying the human brain for the last year, specifically neuroscience and habit formation. I'm reading anything and everything about what it means to develop habits and how those habits influence us. In this era, there is a fear of artificial intelligence and how it could take over society. My job is to build confidence and create excitement around what these machines can do. Artificial intelligence is allowing us to be present with our patients. It allows us to maintain that special touch, that human side of caring that perhaps we drifted away from.
When you have the little things taken care of, that would free up more time for patient-provider connection, right?
Yes. The brain is the most powerful organ in our body, and if we can alleviate any bit of cognitive burden to promote critical thinking, we can really allow a nurse to really continue to learn. I consider myself a lifelong learner. I like new concepts, and I’m an agent of change. As we continue to learn, our brains continue to develop. There’s no better way to invest in this particularly in the profession of nursing. When we need ourselves to show up in hard times, artificial intelligence offloads a lot of that cognitive burden, saving us time that can then be repurposed. As a society, when we hear skepticism, it's because we don't know. We haven't felt it ourselves. We haven't seen what it can do. I think this is where we see a need for adaptive leadership. I'm an adaptive leader because I lead with curiosity. Not defensiveness. Fear is often just a defensive mechanism. If we simply just reframe and ask questions, society as a whole could squash that fear.
When you talk about being a leader, what does that mean to you? What does it look like in your field?
First and foremost, it's seeking to understand and actively listening. Different perspectives and diversity mean more when we're trying to accomplish a shared goal. Leadership means mentoring others to grow and develop. It's alleviating barriers for someone who is trying to do their best. Sometimes, it's proactively anticipating failure points, and even allowing that failure to happen. It’s hard when someone needs to grow and develop. You really want to do the work for them, but it’s important to let go and allow whatever happens to happen. Afterwards, you help that person by lifting them up and finding a way to pivot. That experiential understanding is monumental for growth and development.
Leadership for me is also emotional intelligence. A leader should have self-awareness to know when they can and can’t help someone. If I don’t have an answer, I connect people with someone who can help them. For example, I'm not a lawyer. If you have legal questions, I will instead connect you with a lawyer who can answer those questions while hanging back to offer support.
Do you prefer work that involves more interaction with other people or work that is more solo and research-focused? Which one do you find to be more fulfilling to you?
People. I work on the people side of things because I can always see the art of possibility. What I do is I ask the people that are on the project to come with me to the hospital. Come watch a nurse work when you don't need nursing care when you're well. I want the team to experience nursing when they're well so they get an objective view of how their work influences what a nurse does every single day. I still have to understand research. I have to understand statistics if I'm going to be leading an AI portfolio at an enterprise level. I seek out those certifications that allow me to say that I have not only my experience, but learning in academic settings.
What other roles did you occupy in healthcare before moving to focus on artificial intelligence?
My career has been in and out of technology, in and out of operations. In my 29 years as a nurse, I have had more than 12 different jobs ranging from nurse manager to IT professional. In between, I’ve gone back to school to get my master's degree as well as multiple certifications in leadership and technology. Artificial intelligence has been the most transformative and the most inspiring. The ability to actually alleviate pressure for the nurse encourages me to keep going. My current role is the one that’s truly fulfilled me, but without all of my past experience, I wouldn’t be here today.
When people think of AI in healthcare, they are often scared that doctors will get completely replaced. Do you think that the roles of nurses and doctors can ever be taken over by technology completely?
No, I don't. Even today, we have robots that fill medications in the hospital and move supplies across floors. That didn't lead to anybody being replaced. The workforce is actually much lower than we want it to be. The National Council for State Boards of Nursing indicates that we're going to be short millions of nurses in the years to come. Artificial intelligence is giving us the opening to change our care delivery model when we’re short of humans to do the more important work. For example, if we can have a robot fill a medication bin instead of having the pharmacy tech do that, then that pharmacy tech can work with the pharmacist to do things that involve critical thinking. Humans are only strengthened by the support of artificial intelligence; they are not replaced.
In addition to having artificial intelligence supplement the smaller tasks, there's a level of importance to seeing another human when being cared for. Do you think it’s necessary to have a real person caring for you?
Yes, and we can see how the psychology of the brain comes in. Jean Watson is a nursing theorist, and she talks about the human side of caring, right? Her theory humanizes the touch that a nurse provides every single day in our care environment. When we have artificial intelligence offloading administrative tasks and the friction of everyday life, a nurse can be physically present with someone and hold their hand. Empathy, compassion, touch. It goes far beyond starting IVs and giving meds. I would argue that what I have seen with emerging technology and documentation for nursing is exposing all of the invisible work that nurses have never taken credit for. We're just scratching the surface of understanding the art and science of nursing.
What are some skills that have helped you be successful in your position?
I'm going to tell you a story from when I was a kid. I didn't know what it meant until I became an adult. I was riding in the backseat of a car and I was asking a lot of questions about street signs. Now I was probably 7-8 and I was in the car with whoever was driving me. I was asking questions about the cycles of the lights around our neighborhood and I was stating the neighbor who was driving me said “Tracy, you're really observant.” I didn't know what that meant at the time, but my parents always allowed me to stay curious. What that means for me today is that I have a natural desire to ask a lot of questions. I find myself seeking out new relationships and new interactions. I raise my hand when I don’t know anything, and I will tell you that is the scariest thing ever. I'm around people that allow me to say yes and that give me opportunities to do things. That diversity and the constant change allows me to see things like a mosaic and understand all the pieces that come together to form beautiful things.
What is one piece of advice you would give to people who are looking to go into professional fields?
Find ways to shadow and observe the environment you’re interested in. When you tour universities, you can often gauge a lot just by how you feel being in the space. Look at all the different kinds of careers and find people who are willing to have you in their space and show you what their life looks like. There's a lot right now in the industry about academia and degrees. I'm a firm believer that the academic side of learning and an environment/workspace are what really create a person. It’s not one or the other.
It’s also important to have a circle of people who you trust that can help you get through bad days. Life is really hard and it can get really messy at times. Having people is the most important thing. Everything comes down to the people around us.