Introduction
Technology and the computers are becoming more dispensable than ever in our daily lives. Because of this fact, the health care provision through technology is not an exception. The population is growing so rapidly causing the people to spread all over up to the remote areas. The technology has to be hence changed progressively in line with the population changed. Telehealth referred to the vast range of services that are rendered and managed through telecommunication techniques. Telehealth is continuously enhancing patient care in the most effective and efficient way possible by involving the use of the technology. Telehealth uses computers, monitoring equipment, videophones, and telephones to reach the patients at their residential areas. More so, telehealth is applied in many different means such as in hospital, doctor’s office and within the privacy of one home. Telehealth not only offers medical treatment, but it also offers health maintenance, education, and prevention of the diseases. Prevention of the diseases is the most important area in this service to the population composed of patients of old age and is prone to chronic obstructive pulmonary disease and congestive heart failure. It is shown according to a survey that was conducted by the American Association for Retired Persons in 1996 more than 90% of the seniors over the age of 65 wanted to remain independent at home and age in a familiar place. Telenursing on the other hand refers to use of information and telecommunication technology in dispensing of nursing services to patients who are in physical away from a nurse. Under this field of telenursing, there are many points of contacts between nurses and patients on medical and non-medical backgrounds like teleconsultation, telediagnosis, and telemonitoring. Telenursing is growing at a high rate in many countries because of reducing the cost of health care, there is increasing number of chronically and aging population, and increasing health care coverage area to rural, remote areas, and sparsely populated regions. Telenursing has benefits and disadvantages from nurses or patients perspective as highlighted below. The merits of telenursing greatly surpass the demerits and hence have to be embrace in our day-to-day lives.
Advantages of telenursing from a patient perspective
Enhance patient’s voice in decision making: according to several studies it shows that patients using the telenursing system have a good understanding of their own disease processes and are comfortable in managing their own care with improved quality of life. Therefore, by allowing the elderly patients to take responsibilities and control of the care through telenursing will enable them to lengthen their lives.
Decrease patient visit: through telenursing home care to the patients, the patients will be able to drastically reduced visits to the doctor’s office and hospitalizations that should have been made in monthly or weekly basis.
Transcending miles and borders: the inconvenience that it could be caused by travel and transport to elderly patients is eliminated through telenursing equipments. Additionally, the patients will become worse than initial emergency by the time they will reach the hospital through travel and transportation. However, through telenursing facilities this unnecessary trauma and stress on the elderly patients will be prevented.
Provide remote care: patients find it easy to get familiarized to telenursing, and they are assured of health care services quickly as possible. In the case of any problems with the health status of the patient, he/she is sure of immediate response by the health care professionals.
Disadvantages of telenursing from a patient perspective
The above same advantages can be also seen as disadvantages to some patients.
Inability of the patient to use the facility: for the telenursing to be implemented, it has to be accessed first to check if the individuals will be capable of caring for themselves. Some individuals are then not comfortable in providing their own care and instead prefer to have where they can be treated.
Dehumanizing effects: the physical presence of the health care professional rather than monitoring through telenursing facilities is required to give the patient with specific directions which pertinent and acceptable by the patients.
Knowledge based of the nurse: face-to-face interaction amongst doctors, nurses, and patients is eliminated through telenursing, but some patients highly value this. Some patients can only cooperate and develop trust to the nurses when they felt a personal connection. If the trust is not there, it may be so difficult to convince the patients to adhere to medical recommendations and treatment. Because of this, telenursing will only be suitable if the patients felt they are satisfied with it and if imposed on them or the situations forced patients to be attended through telenursing then it may not work very well with them.
Equipment malfunction: in case an equipment breakdown it will result into severe impacts to the patient. At times, it may break down at odd hours, and it will become so difficult for the patient to fight for life at that particular emergency period.
Cost of the telehealth equipment: the will have to meet the extra cost of installation, maintenance, and running the telehealth equipments on top the service charges.
Technology and interoperability
Telenursing as we have seen above incorporates the technological aspects of health services that the world is revolving and evolving to do. The research that I have carried out about the topic is a positive approach to the way nurses should relate with patients around the world regardless of their distance from the service. Telenursing can be viewed as therapeutic nurse-client relationship where the nurse is entitled to ensure there is a proper relationship formed between the client and the nurse. On top of that, it brings out a clear and comprehensive understanding on the field of study to bring out safety, effectiveness, and ethical dimensions on the manner in which the patients are treated.
Technology is a driver that has led to the evolution around the world. The technological approach to this topic is that the nurses have been brought close to their clients despite their distances. Technology has enabled a lot of effective time saving; resources are also saved, and the output is maximized. Technology also comes about with a lot of changes that should be also emulated and adhered to. Telenursing also brings out the issue of privacy of rights or confidentiality of the client information. The registered nurses have an ethical responsibility to maintain the confidentiality of information of a patient. It should again go hand in hand with the level of their integrity, respect, and honesty. In this field of study confidentiality and privacy are of utmost importance. This is for both nurses interaction with their clients and the information of their patients. Technology here is applicable in that they should ensure information of a client remains private and not hacked. The process being an online thing may require the use of emails; twitter, Facebook, MySpace and web based sites information should be encrypted. When using says teleconferencing or Skype, the information should only be between the professional nurse and the client. The manner to protect privacy should come along with the use of passwords.
Ethical issues
It is well established that telenursing in health care brings advantages for both the client and the nurse. The main factor to consider when handling this is ethical observation. Ethics is all about how we should conduct our lives as professionals and how to relate to and behave towards other people. Telenursing involves patients communicating with their nurses via phone. Therefore, the nurse should develop good communication skills and ensure they give out the right information. The issues on moral philosophy should also apply where we judge actions are basing on our consequences. The norms and virtues plus values should be upheld. The nurses should also keep the integrity and their documentation on their clients. They should also give responsible information to their clients and not information that may be wrong or unjustified. However ethical dilemmas may occur but the issue of ethical competence in telenursing is urgent. The whole issue of ethics should be perceived in an individual perspective and organizational level. This should be kept straight and upheld with high moral standards.
Consumer education
The patient should always ensure that they are given enough information basing on the topic they may wish to find clarifications. The information given should be true and that which will help the patient. This will lead to patient satisfaction. Patient education is also very essential. This where the professionals undertake a program where they train their clients on how they will be relating and how they will be fetching information on various topics i.e., the sites they should visit and how to do that. The medication and how they should get their prescriptions.
Employers also should ensure the competence and integrity of their telenursing employees are observed. They should follow the content of information like, relevant communication media, a review of selected telenursing interactions e.g. videos or documented notes. There is also a demonstration on hands on practice of computer software and applications. There is also a criterion of policy development where there is accountability, client choice, liability protection, informed consent, and documentation.
Recommendations
Combining the traditional health with evolved telenursing will enhances provision of the health to all people requiring the health services. According to findings in this web page (http://www.ncbi.nlm.nih.gov/pubmed/15378102), the patients getting services through telenursing are many and are satisfied with telenursing. Therefore, because of these new findings I will recommend Manuel to join this field of profession if he gets a chance as it is seen as a field that is new and saves time, resources and one can get time to do other things.
Conclusion
Through the conclusion part of the topic, models of care delivery continue to change, and new technologies emerge. The field of telenursing will continue to evolve, because it is field where the rest of the world is heading. As the scope of nursing practice expands, the nurses getting to the field should acquire necessary technical and clinical competence. This is in order for them to practice telenursing with ease, safely, competently, ethically, compassionately and efficiently. By doing so, it will reduce readmission of patients to the hospital and the hospitals will be able to avoid penalties. The readmission rate will be considerately reduced if telenursing will be implemented and it will save the individual and the government a lot of money. Readmission into hospitals and avoiding of penalties is shown on the web site page http://health.usnews.com/health-news/hospital-of-tomorrow/articles/2013/08/09/hospitals-focus-on-maximizing-medicare.
References
Milholland, D. K., & International Council of Nurses (2000). Telehealth & telenursing: Nursing and technology advance together. Geneva: ICN.
Schlachta-Fairchild, L., & International Council of Nurses (2007). International competencies for telenursing. Geneva: ICN, International Council of Nurses.
Bohnenkamp, S.K., McDonald, P., Lopez, A.M., & Krupinski, E. (2007). Traditional Versus Tele-nursing Outpatient Management of Patients With Cancer With New Ostomies.Fairchild, L.S., Elfrink, V., & Deickman, A. (2010). Patient Safety, Tele-nursing, and Tele-Health. Telemedicine Journal of Health, Vol. 12 (1), pp. 34-56. (CINAHL)
