Abstract
Telenursing is a contemporary method of providing care services to patients in remote locations using information and communication technologies (ICT). The main advantage of telenursing is that it reduces the cost of accessing nursing services by reducing hospitalization rates. It also improves health outcomes by equipping patients with the information and skills that allow them to manage their health conditions. However, telenursing is also associated with weaknesses such as inadequate protection of patient information. Medical errors can also arise if the patient fails to describe his health condition appropriately. Errors can also occur if the nurse is unable to interpret clinical data effectively. Moreover, low-income patients might not utilize telenursing if the cost of acquiring telemonitoring equipment is prohibitive.
Introduction
The cost of providing healthcare in the US has increased significantly in the last three decades. Nearly 75% of healthcare costs are attributed to treatment and management of chronic illnesses. This has led to the adoption of alternative methods such as telenursing to deliver high quality healthcare at a low cost. Telenursing refers to the provision and coordination of care services through modern information and telecommunication technologies (Trossman, 2014). This paper will highlight the pros and cons of using telenursing. The discussion will lead to a conclusion concerning the possibility of considering a job in telenursing in future.
Advantages of Telenursing
Patients
Patients can benefit from telenursing in the following ways. First, telenursing enables care providers to minimize the cost of their services. The cost reduction is attributed to the fact that telenursing enables patients to avoid hospitalization or readmission (Monteagudo, Salvador, & Kun, 2014). As a result, patients are able to avoid the costs associated with hiring ambulances or using expensive emergency department facilities. Second, telenursing improves health outcomes, especially, among patients with chronic illnesses. Diabetes and hypertension are some of the severe health conditions that can be managed effectively via telenursing. In this case, nurses use telenursing to provide education and advice to patients. Nurses also use telenursing to monitor patients’ conditions and oversea care procedures (Trossman, 2014). As a result, patients develop the ability to engage in long-term management of their diseases, which improves their health outcomes.
Third, telenursing enhances access to healthcare services in communities where the available nurses are too few to provide services through face-to-face interactions with patients. Telenursing services are often provided through smartphones, computers, and web-based technologies, which are increasingly becoming accessible to the majority of the population due to technological advancements. Moreover, telenursing provides tools such as patient portals that facilitate sharing of information and experiences among patients, care providers, family, and friends (Monteagudo et al., 2014). This means that majority of the population can easily access healthcare even in the absence of a hospital or clinic in their neighborhood.
Nurses
First, telenursing allows nurses to provide high quality care services. Undoubtedly, observing patients’ health conditions through a digital platform requires expertise and experience in order to make the right decision concerning the choice of interventions. Therefore, telenursing often motivates nurses to improve their skills and knowledge continuously through formal and informal training programs (Monteagudo et al., 2014). Telenursing also facilitates improved surveillance by allowing nurses to track patients’ health patterns over time to detect physiological changes that may signal deterioration of health conditions (Monteagudo et al., 2014). This enables care providers and physicians to take remedial action in time to save patients’ lives.
Second, telenursing allows nurses to increase the number of patients under their care without compromising the quality of their services. For instance, a nurse can use a camera installed in patients’ homes to monitor their physical appearance and equipment safety (William, Hubbard, Daye, & Barden, 2012). This reduces the nurse’s workload. It also enhances the application of evidence-based care and treatment methods at a low cost.
Third, using telenursing is an effective way of improving patient satisfaction. Telenursing enables patients to feel more engaged with rather than isolated from nurses. This is explained by the fact that telenursing extends the nurse’s presence through online continuous monitoring (Trossman, 2014). As a result, patients are assured that someone is always watching over them and is ready to provide instant help. This reassurance increases patients’ satisfaction tremendously.
Disadvantages of Telenursing
Patients
First, telenursing can prevent access to care services among economically vulnerable groups. Poverty has led to a technological or digital divide where the low-income earners have limited access to devices such as smartphones and wearable computers. Thus, the poor might not utilize telenursing services if they cannot afford to install the required devices in their homes (Monteagudo et al., 2014). In addition, patients might not access healthcare due to their inability to use the monitoring equipment effectively. Poor communication skills among patients can also jeopardize the use of telenursing services because it limits patients’ ability to describe their conditions effectively.
Second, telenursing exposes patients to the risk of losing confidentiality or the security of their health and personal information. In the absence of effective data protection policies, patients’ information is likely to be misused by third parties (Monteagudo et al., 2014). Consequently, the patient might not be able to open up and share his or her problem with a nurse. Finally, telenursing is likely to cause overdependence on medical devices and technology to access healthcare. The risk in this case is that the devices might fail to function effectively. Moreover, sensors and telecommunication devices often expose patients to electromagnetic radiation, which can endanger their lives.
Nurses
First, using telenursing exposes nurses to ethical dilemmas that can be very difficult to address. For instance, nurses always find it stressful to balance between the principle of autonomy and beneficence due to the difficulty in determining the identity of the patient. Oftentimes, the patient’s relatives rather than the actual patient call the nurses (William et al., 2012). This causes a conflict between the autonomy of the patient and that of his relative, as well as, the nurse’s desire to serve the patient. Moreover, the nurse’s responsibility to provide information to the patient might conflict with the principle of non-maleficence. For instance, a nurse can find it very difficult to provide abrupt information on phone about a serious health condition to a patient who believes that his health problem is small. In this case, it is difficult to deliver the information without causing psychological trauma.
Second, telenursing increases the chances of medical error because of the remote interactions between the nurse and the patient. The decisions made by nurses are mainly informed by the information or data collected from the patient through telephone conversations. This perspective is based on the fact that cameras might not enable the nurse to read the patient’s body language in order to gain a comprehensive understanding of his problem. This increases the chances of making wrong diagnosis, which in turn leads to medical errors. Finally, the use of telenursing is limited by factors that are external to the nurse (Monteagudo et al., 2014). For instance, disconnection of the patient’s electricity supply is likely to prevent the nurse from delivering the desired care services using devices such as computers.
Conclusion and Recommendations
Telenursing allows nurses to utilize modern information and communication technologies to provide high quality services to patients in remote locations. Thus, it reduces the cost of providing care services and improves patients’ satisfaction. However, the adoption of telenursing is facing serious challenges such as lack of adequate health data security. Furthermore, nurses are facing ethical difficulties such as receiving information from third parties, which undermines patients’ autonomy.
Thus, telenursing can be improved by adopting the following recommendations. First, simple technologies that are available to the majority of the population should be used to avoid limiting access to healthcare due to technological barriers. Second, healthcare providers must adopt effective strategies to protect patients’ health and personal information. Finally, nurses should be trained to handle the ethical dilemmas associated with telenursing to improve the quality of their services.
Having worked as a nurse for the last five years, I believe that I can improve my career by engaging in telenursing in future. The main advantage of this decision is that I will be able to serve more patients without visiting their homes, thereby saving time and travelling expenses. Moreover, I will have to improve my knowledge and skills in nursing and communication to succeed in telenursing. The main disadvantage of the decision is that I will not be able to serve patients who will not be able to install telemonitoring equipment in their homes.
References
Monteagudo, J., Salvador, C., & Kun, L. (2014). Envisioning patient safety in telehealth: A research perspective. Health Technology, 4(1), 79–93.
Trossman, S. (2014). Back to the future? telehealth services, telenursing are on the rise. American Nurse, 46(5), 1-6.
Williams, L., Hubbard, K., Daye, O., & Barden, C. (2012). Telenursing in the intensive care unit: Transforming nursing practice. Critical Care Nurse, 32(6), 62-67.