Telenursing is a new technology used to deliver nursing services to patients where the patient and the nurse communicate directly through audios or videos. It was developed in the 1970’s to curb the professional nurse shortage. Telenursing seeks to monitor a patient while at home, therefore preventing admission and readmission of a patient in a health facility. The telehealth equipment used to monitor the patient give out the patient health progress thus determining the status of their health. Telenursing has helped patients get the love and care they require from their family members, curbing the boredom that is experienced in a hospital setting. This program has experienced some drawbacks and potential advantages to its users. A lot of concerns have been raised regarding the ethical issues that arise from telenursing. This paper focuses on the advantages and disadvantages of telenursing, discusses the ethical issues and legal requirements related to patient’s privacy and confidentiality.
Patients suffering from chronic diseases and congestive heart failure have been using the program due to its benefits. They acknowledge that telenursing technology has continuously sought to improve the lifestyle of the people. Telenursing has been able to address the issue of the shortage of nurses. Nurses who are registered are not enough to serve everyone, therefore, making telenursing a good alternative. Through telenursing a nurse can provide monitoring, education, follow-up, remote data collection, remote interventions, pain management, family support, and multidisciplinary care in an innovative fashion (Peck, 2005).
The nurses through the use of telephones, audios and videos assess the progress of their patient from time to time. This has led to the provision of health services to patients regardless of the distance; leading to a reduction in the death numbers annually. The nurse has been given the advantage of attending to their duties since they can monitor the sick from home. This has reduced the long working hours associated with the medical field. Telehealth allows people to remain in their own homes, monitoring their chronic diseases in real time while supported by healthcare professionals who review the results and contact patients when necessary (Scullion, 2014).
Telenursing has also eased the burden of financial strain. Most patients who suffer from chronic diseases tend to be hospitalized for long periods of time amounting to high medical expenses. People that lack medical insurance cannot afford to pay, end up dying in their homes. The use of telenursing will check on the medical expenses leading to people getting better healthcare services that are much-needed.
The travelling expenses incurred during doctor’s appointments and checkups will also be curbed. The patients using the technology showed some level of satisfaction. The patients who have at one time used telenursing seem not to mind using it again. They state that though the nurse is not physically there, they can communicate their fears and how they are feeling; leading to treatment and encouragement where possible. Using telenursing is also convenient both for the patient and the nurse. The nurse while in the office can communicate to the patient at any time enhancing the satisfaction.
The disadvantages that come with telenursing could lead to complaints among the patients due to lack of face to face communication with the nurses. The program enables a patient to talk to their nurse through videos, leading to some patient’s feeling alone. Most patients would miss the personal care that a professional nurse has to offer. Just seeing the nurse around and talking to them makes the patient feel appreciated and well taken care of. Patients using telenursing miss the contact. Patients agree to have been taken care of in the best manner possible, but the physical touch was not felt. Therefore, the technology has a lot of advantages, but absence of the physical contact is highly missed by patients.
Another disadvantage that patients experience is the breakdown of the machine. The machine at some point could fail leading to unplugging then plugging afterwards. This could delay an issue that need to be addressed. It could also lead to timewasting since the nurse has to sit back and wait. The machine can also show images that are not clear leading to the misinterpretation of the nurse’s judgment on the patient. Telenursing also requires the use of internet connection that could not be available to the rural areas minimizing the use of the services to these places. Also, disasters like war could cause disruption on the internet services leading to lack of communication between the patient and the nurses. A workable internet service provider and intact telecommunication services are required at both ends. Telecommunications fail when there is any significant disruption on services, power, or trained people to initiate a telemedicine request (Merrell, Cone & Rafiq, 2008).
The machine could also at some point give false positive alerts since it is not a hundred percent efficient. If such occurs, a nurse could conclude that their patient is getting better. The nurse’s conclusion could lead to misdiagnosis of patient’s condition. There could also be an increased workload on the part of the nurse. Collection and analyzing of the patient’s data could take a long time leading to accumulation. The patient can also be given extra doses that are not necessary. Physical absence of the nurse can lead overtreatment. The patient could be back on their feet but since the nurse is not physically there, the nurse can miss noticing the improvements.
Telenursing could have some ethical issues that need to be addressed at an early stage. The nurse should be able to use the machine so that communication with the patient and treatment would be easy. The nurse should also master the skills of a good listener, communicator and observer because she solemnly depends on these skills in judging the health status of the patient. The nurse should also show caring and concern to boost the self-worth of the patient. She should also be courageous and patient with the sick to ensure that the best services are delivered. The nurses could experience some dilemmas in deciding the best advice to give leading to stress. During such moments, the nurse should relax and give the best advice they can think of.
Some of the negative ethical issues are privacy and security of the patient is not guaranteed due to the displaying of the machine. The nurse is not allowed to give the patient a lot of information so that assessment will run smoothly. However, that denies a patient’s right to information compromising the nurse’s integrity. Information about the patient should be communicated directly to them to ensure integrity and privacy. The nurse should also ask questions concerning the last talk with the patient to ensure the identity of the patient.
The nurse should communicate to the patient about his or her real condition to ensure that they take the necessary measures to escalate their health. Installation of the machine that monitors the health of the patient has proved to be easily operated, ensuring comfort of the patient. Good documentation of the patient’s medical reports should be ensured while the security issues that concern the use of technology should be communicated to the patient. The patient should also be informed on the possibility of loss of their medical documents due to the undependable nature of the internet.
Telehealth can help save money and improve care through efficient and accurate patient tracking and effective coordinated patient care, and by retaining experienced and dedicated nurses (Peck, 2005). Telenursing is a good health-technology that can be able to cut cost on both the patient and the nurse. Timewasting and travelling costs are avoided in telenursing. A nurse is able to examine their patient through video calls or audios, enhancing socialization. Once the machine has been installed, the patient finds it easy to operate since it is not complicated. Nurses get the extra time to spend with their families which enhances bonding. Telenursing, however, can give a wrong conclusion about the patient’s health since the nurse will judge the patient according to the voice. Also, identifying small wounds on the patient’s body might not be possible especially when the pictures displayed are not clear.
The patient also lacks the physical touch that comes with a face to face interaction. The patient could feel that the nurse is doing nothing if their health is deteriorating. Physical contact brings about assurance and moral support. When overtreatment occurs the medicines prescribed could harm the patient leading to a possible death or disability. The nurse therefore while dealing with the patient should be extremely cautious and observant. Telenursing has ensured that patients suffering from chronic diseases are not continuously admitted and discharged giving them the peace of mind. The aged also have benefitted by minimizing the troubles of visiting hospitals frequently.
Therefore, Manuel should take the job if he manages to secure it. The benefits that he is going to enjoy are numerous. The core business of the task will be ensuring the patient satisfaction with his services. Manuel will also be able to equip himself with the technological knowledge that comes with understanding of telenursing. Telenursing will also enable him to give his services to a larger group of people compared to face to face nursing. He will also be able to spare time to bond with his friends and family leading to his satisfaction.
Merrell, R. C., Cone, S. W., & Rafiq, A. (2008). Telemedicine in extreme conditions: disasters, war, remote sites. Studies in health technology and informatics, 131, 99-116. Peck, A. (2005). Changing the face of standard nursing practice through telehealth and telenursing. Nursing administration quarterly, 29(4), 339-343. Scullion, J. (2014). Placing a value on telehealth. Primary Health Care, 24(3), 12.
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