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As of 2015, 36 countries around the world utilize telenursing for a wide variety of outpatient procedures (Johnson, Wilhelmsson, Börjeson & Lindberg, 2015). Whether its a telephone call, a video conference or through data sent via medical equipment from a patient, a doctor or nurse is no longer limited by distance or even proximity when it comes to checking on the current condition of a person that has just been discharged from the hospital.
Telenursing is a part of the new wave of technologically inclined outpatient procedures that focus on streamlining the provision of care to patients utilizing technology based replacements for age-old practices (Williams, Hubbard, Daye & Barden, 2012). However, telenursing should not be considered as a panacea since there are limitations to its applicability and there have been numerous cases where people have accused it of a violation of privacy. What this paper will attempt to show is that despite its limitations, telenursing is one of the most convenient and effective ways of provisioning care to patients who are too ill or infirm to visit the hospital for their checkups.
Benefits of Telenursing
One of the first and most obvious benefits of telenursing is its ability to allow nurses to perform outpatient checkups without the patient having to be physically in the same room. The elderly or patients with physical debilitations often find themselves in situations where they cannot go to the hospital on a regular basis. This is both due to their limited physical abilities as well as the distances involved (Röing, Rosenqvist & Holmström, 2013).
Through the use of telenursing, medical practitioners can examine a patients overall condition and determine if they are progressing positively when it comes to whatever form of treatment they are under. Nurses could also talk to the patient and ask if there are any physical issues they are experiencing and can determine whether such issues would require the patient to go to the hospital for a more detailed examination (Snooks, Williams, Griffiths, Peconi, Rance, Snelgrove & Wai-Yee, 2008).
Another benefit of telenursing is the cost-benefit it would have for patients that require semi-regular observation due to their medical condition. Hospital stays are incredibly expensive and there are limitations on the amount of money that insurance companies would be willing to pay. As such, in cases where semi-constant observation is required for non-critical cases, telenursing presents itself as an affordable alternative.
Aside from this, it is also more convenient for nurses who regularly perform outpatient home examinations. The amount of time travelling to and from a patients home could be better spent on other activities. Through the use of telenursing, a nurse would be able to examine multiple patients at the same time, thus limiting the amount of personnel that a hospital would need to hire.
Limitations on the Applicability of Telenursing
While this paper has so far delved into the advantages of telenursing from an economic and medical practitioner perspective, it is also important to delve into its limitations. While it can be agreed that telenursing makes it easier for nurses to implement outpatient examinations, there are still limitations when it comes to certain medical procedures.
For example, the practice of dialysis often involves the use of specialized equipment that a vast majority of outpatients simply cannot afford to purchase for use at home. In fact, many medical maladies such as issues with respiration, proper drug use, and other similar processes often require the intervention of a nurse to properly implement. Yes, medical technology and medicine, in general, has advanced to a point that many treatments can be done from home; however, for the elderly and the infirm who have difficulty simply getting up in the morning, implementing such procedures may be difficult if not impossible.
Aside from procedural and physical issues, there are also limitations imposed on telenursing when it comes to the willingness of patients to undergo the medical checkups via live video feeds to their nurse. The analysis of Höglund & Holmström (2008) which delved into patient cooperation with nurse practitioners revealed a high rate of recidivism when it came to independent action and behavior that compromised medical checkups.
Telenursing does make it easier for patients to have checkups, but it is also just as easy for these patients to abstain from the checkups entirely by simply not turning on their telenursing devices and sending a message to the hospital that they are fine (Höglund & Holmström, 2008).
Höglund & Holmström (2008) explained that while patients are initially eager for checkups during the first few sessions of the telenursing process, they begin to feel that such procedures are no longer as necessary as they proceed through their treatments. As a result, many patients who utilize telenursing start to have fewer sessions as they believe that treatment has done its job. Unfortunately, it is at this juncture that the lack of proper monitoring can take its toll resulting in relapses.
Issues Regarding Privacy
There have been some accusations that the process of telenursing could be considered as a violation of the private lives of patients in their homes. The problem with this argument is that the alternative would consist of either the patient being confined in the hospital and thus having even less privacy or having no monitoring taking place which could result in the patient getting worse in the long term.
Conclusion
Based on everything that has been presented so far, this paper can state that telenursing is one of the most convenient and effective ways of provisioning care to patients who are too old or infirm to visit the hospital for their checkups. Do note though that its limitations show that its use should be limited strictly to patients that do not require extensive monitoring or immediate intervention due to their medical condition.
Recommendation
The literature that was used stated that there were medical standards adhered to when it came to the examinations conducted during telenursing sessions; however, what was missing from the literature was how the examinations of the nurses were evaluated from the patients perspective. For example, when someone calls a customer service hotline from a company, they are often asked by an automated message to help in evaluating the client service representative that evaluated them. This practice enables companies to track employee performance and determine whether an employee is performing poorly.
A similar system is apparently not in place when it comes to evaluating the telenursing procedures which is a serious gap in the process. Nurses who perform teleconferences should not only be assessed on how close they adhere to proper medical procedures; rather, they should also be evaluated based on their level of interaction with the patient. Without such a process in place, some patients may begin to feel a lack of sufficient care and attention resulting in a negative outlook towards the telenursing experience.
Reference List
Höglund, A. T., & Holmström, I. (2008). Its easier to talk to a woman. Aspects of gender in Swedish telenursing. Journal Of Clinical Nursing, 17(22), 2979-2986.
Johnson, C., Wilhelmsson, S., Börjeson, S., & Lindberg, M. (2015). Improvement of communication and interpersonal competence in telenursing development of a self-assessment tool. Journal Of Clinical Nursing, 24(11/12), 1489-1501.
Röing, M., Rosenqvist, U., & Holmström, I. (2013). Threats to patient safety in telenursing as revealed in Swedish telenurses reflections on their dialogues. Scandinavian Journal Of Caring Sciences, 27(4), 969-976.
Snooks, H. A., Williams, A. M., Griffiths, L. J., Peconi, J., Rance, J., Snelgrove, S., & Wai-Yee, C. (2008). Real nursing? The development of telenursing. Journal Of Advanced Nursing, 61(6), 631-640.
Williams, L., Hubbard, K. E., Daye, O., & Barden, C. (2012). Tele-ICU Enhancements. Telenursing in the Intensive Care Unit: Transforming Nursing Practice. Critical Care Nurse, 32(6), 62-69.
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