The impact of digital technology use on nurses' professional identity and relations of power: a literature review
Open accessAbstract
Aim: This study seeks to review how the use of digital technologies in clinical nursing affects nurses' professional identity and the relations of power within clinical environments. Design: Literature review. Data Sources: PubMed and CINAHL databases were searched in April 2023. Methods: We screened 874 studies in English and German, of which 15 were included in our final synthesis reflecting the scientific discourse from 1992 until 2023. Results: Our review revealed relevant effects of digital technologies on nurses' professional identity and power relations. Few studies cover outcomes relating to identity, such as moral agency or nurses' autonomy. Most studies describe negative impacts of technology on professional identity, for example, creating a barrier between nurses and patients leading to decreased empathetic interaction. Regarding power relations, technologically skilled nurses can yield power over colleagues and patients, while depending on technology. The investigation of these effects is underrepresented. Conclusion: Our review presents insights into the relation between technology and nurses' professional identity and prevalent power relations. For future studies, dedicated and critical investigations of digital technologies' impact on the formation of professional identity in nursing are required. Implications for the Profession: Nurses' professional identity may be altered by digital technologies used in clinical care. Nurses, who are aware of the potential effects of digitized work environments, can reflect on the relationship of technology and the nursing profession. Impact: The use of digital technology might lead to a decrease in nurses' moral agency and competence to shape patient‐centred care. Digital technologies seem to become an essential measure for nurses to wield power over patients and colleagues, whilst being a control mechanism. Our work encourages nurses to actively shape digital care. Reporting Method: We adhere to the JBI Manual for Evidence Synthesis where applicable. EQUATOR reporting guidelines were not applicable for this type of review. Patient or Public Contribution: No patient or public contribution.
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Bisschop, A., Risling, T., & Nowell, L. S. (2026) · Advances in Nursing Science · doi:10.1097/ans.0000000000000675 · Cited by 1 · see citing works
From Concept to Conditions of Practice: Digital Empathy Must be Designed, Taught, and Protected
Huang, F., & Wei, L. (2026) · Nursing Inquiry · doi:10.1111/nin.70132 · Cited by 1 · see citing works
“Knop et al. (2024) add another important layer by suggesting that digital technologies can alter professional identity, reshape workplace power relations, and constrain nurses' sense of agency.”
Forde‐Johnston, C., Butcher, D., Mounce, G., & Aveyard, H. (2026) · Journal of Advanced Nursing · doi:10.1111/jan.70668 · Cited by 1 · see citing works
Rethinking violence prevention in elderly and special needs care: requirements for digital solutions
Kappe, M., & Schobel, J. (2026) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2026.1843725 · Cited by 1 · see citing works
Virtual Care Centers and the Evolving Role of Nurses
Sonneveld, H., Tan, A. J. Q., Leenen, J. P. L., & van Houwelingen, T. (2025) · Bled eConference · doi:10.18690/um.fov.4.2025.24
Virtanen, L., Kainiemi, E., Kaihlanen, A., Vehko, T., & Heponiemi, T. (2025) · BMC Health Services Research · doi:10.1186/s12913-025-13333-0
Olive, M. V., Gastaldi, L., & Radaelli, G. (2025) · Social Science & Medicine · doi:10.1016/j.socscimed.2025.118746
Supporting the development of professional identity in nursing students
Hill, B., Machin, A. I., Derbyshire, J., & Wade, J. (2025) · Nursing Standard · doi:10.7748/ns.2025.e12605
Abdullahi, F. I., Nesengani, T. V., & Maree, C. (2026) · International Journal of Africa Nursing Sciences · doi:10.1016/j.ijans.2026.101027
Digital health capability and confidence among mental health and general healthcare nurses
Chee, G., Gallagher, O., & Loe, S. (2026) · Archives of Psychiatric Nursing · doi:10.1016/j.apnu.2026.152140
Feeling Heard Flips the Switch: Defining the Power of Professional Nurses
Dawes, J. (2026) · Advances in Nursing Science · doi:10.1097/ans.0000000000000644
Unkart, A., Decker, E., Lahmann, N., & Strube‐Lahmann, S. (2026) · BMC Medical Education · doi:10.1186/s12909-026-09465-4
“Nurses in particular have been shown to experience higher barriers to digital engagement, often due to limited autonomy, insufficient IT support, and lack of structured digital training pathways [3, 4, 11].”
When Care Becomes Digital: Shared Experiences in Psychiatric Nursing—A Phenomenological Study
Şahin, F., & Ulaşoğlu, Ö. (2026) · Journal of Psychiatric and Mental Health Nursing · doi:10.1111/jpm.70162
“The integration of digital systems into clinical practice increasingly positions nurses as participants in algorithmic decision-making processes (Knop et al. 2024).”
InfluentialLi, X. J., Jing, C., Gong, Z., Zhang, J., & Zhang, S. (2026) · Frontiers in Digital Health · doi:10.3389/fdgth.2026.1842497
Beyond Bullying: Digital Platforms, Power and the New Landscape of Violence Against Nurses
Kornhaber, R. A., Cleary, M. L., & Jackson, D. W. (2026) · Issues in Mental Health Nursing · doi:10.1080/01612840.2026.2676205
“Digital aggression reshapes professional identity, erodes personal wellbeing, and constrains the ability of nurses to engage safely in the online professional spaces that are now central to nursing practice, education, and collegial communication (Knop et al., 2024).”
Smart, S., Booth, L., & Miller, P. K. (2026) · Radiography · doi:10.1016/j.radi.2026.103485
Peršolja, M., & Svetlin, A. G. (2026) · Annals of Nursing · doi:10.5937/annnur4-67047
Liu, Y., Huang, Y., Huang, A., Chen, X., Chen, Y., & Li, L. (2026) · Frontiers in Medicine · doi:10.3389/fmed.2026.1929882
Portincasa, P., Khalil, M., Novielli, P., & Tangaro, S. (2026) · European Journal of Clinical Investigation · doi:10.1111/eci.70254
AI-powered autonomous support robots in healthcare: task inventory and nursing staff priorities
Castonguay, A., & Hegg-Deloye, S. (2026) · Health Policy and Technology · doi:10.1016/j.hlpt.2026.101316
Hashish, E. A. A. (2026) · Frontiers in Psychology · doi:10.3389/fpsyg.2026.1959352
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Russow, F., Cap, C. H., & Põder, J.-C. (2026) · BMC Medical Ethics · doi:10.1186/s12910-026-01621-1
Wang, X., Sun, Z., Lee, G., Dykes, P. C., Hu, Y., Mu, W., Zhang, C., Zou, Z., & Xu, L. (2026) · Journal of Medical Internet Research · doi:10.2196/90982
“Such work can advance the understanding of how nursing practice, professional roles, and professional boundaries are being reshaped as digital technologies become increasingly embedded in clinical research and health care delivery [26,27].”
Tarhan, M., Doğan, P., & Yaman, R. (2026) · Journal of Nursing Management · doi:10.1155/jonm/6857380
“Under heavy workload, nurses’ attention shifts from the patient’s subjective experience toward measurable indicators such as vital signs and device data, creating distance between nurse and patient in technology-ICU settings [3].”
Beyond Technification: Ontological and Hermeneutic Foundations of Nursing Care
Sellán, A. V., Sellán-Soto, M. C., & Mateo-Martínez, G. (2026) · Nursing Inquiry · doi:10.1111/nin.70170
“…professional identity, task‐ oriented models of care, managerial pressures, and the challenge of preserving relational and interpretive dimensions of practice within increasingly complex healthcare systems (Caza and Creary 2016; Ewertsson et al. 2017; Knop et al 2024; Melo and Augusto 2025).”
Occupational Distress Among Nurses Through Social Media Narratives: A Scoping Review
Gioiello, G., Ivziku, D., Renghea, A., Daza, A. I. R., Monaco, M. L., Anastasi, G., Tusconi, M., Curcio, F., Lommi, M., & González, C. I. A. (2026) · Healthcare · doi:10.3390/healthcare14193146
“Within nursing specifically, digital technologies may interact with professional identity, autonomy, and relations of power [60].”
Wanli, L. I. U., Jing, Z. H. O. U., Xuefang, A. N., Deng, Y., Yanhong, S. U., & Jianhui, Z. H. O. U. (2026) · Research Square · doi:10.21203/rs.3.rs-10743142/v1
Beer, N. J. E. D., Wiersma, N., de Winter, P., & van Os‐Medendorp, H. (2026) · Journal of Advanced Nursing · doi:10.1111/jan.70782
- Authors
- Knop, M., Mueller, M., Kaiser, S., & Rester, C.
- Affiliations
- Deggendorf Institute of Technology (DE)
- VDI/VDE Innovation + Technik (DE)
- Research Center, Mauthausen Memorial Vienna Austria
- Corresponding author
- Knop, Michael
- Venue
- Journal of Advanced Nursing
- Publisher
- Wiley
- Published
- 2024-04-01
- Volume
- 80
- Issue
- 11
- Pages
- 4346-4360
- ISSN
- 0309-2402 (ISSN-L)
- 1365-2648
- OpenAlex
- W4393386770
- Cited by
- 47
- References
- 86
- Citations by year
- 2026: 34 · 2025: 11 · 2024: 1 · 2023: 1
- FWCI
- 3.70
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Journal of Advanced Nursing (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Opus4 THD (Technische Hochschule Deggendorf (THD)) (submittedVersion, cc-by-nc)
- OPUS THD
- Topics
- Health Sciences › Nursing › Research and Theory › Nursing education and management
- Health Sciences › Health Professions › General Health Professions › Ethics in medical practice
- Health Sciences › Health Professions › General Health Professions › Social Policies and Healthcare Reform
- Keywords
- power relations, moral agency, nursing autonomy, nurse-patient relationship, empathetic interaction, technology dependence, clinical nursing practice, patient-centered care, digital care
- MeSH terms
- Digital Technology, Adult, Attitude of Health Personnel, Female, Humans, Male, Nursing Staff, Hospital, Power, Psychological, Social Identification
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