Telenursing: Creating More Problems Than it Solves in Nursing

On the surface, the ease and convenience of telenursing is tempting as a cost-effective solution to healthcare, and also as a way of dealing with the nursing shortage. Nurses can give low-cost advice to a large number of patients, in a short period of time over the phone, and effectively 'triage' important and unimportant cases. However, the practice presents a number of troubling issues. "The encounter over the phone is 'faceless' which makes it difficult for the nurse to 'read' the patient through body language and face expressions" (Hoglund & Holmstrom 2009). This runs counter to the nursing principle of treating the patient holistically. The nurse cannot respond to subtle nonverbal cues that might give additional, vital insight into the patient's condition. Furthermore, the nurse may not even speak to the patient, if a caregiver is calling the nurse and giving information as a proxy. The nurse has few means of assurance that the information he or she is receiving is correct. The telenurse only can make a diagnosis based upon the information he or she receives verbally, without any visual empirical evidence. The nurse cannot gain a sense of the patient's relationship with others and his or her environment. The ability of the patient to follow through upon the orders given by the nurse may be unclear, given the nurses' lack of knowledge about the patient's situation.

While some aspects of medicine may make good use of new technology and distance communication, like x-rays or laboratory results that are 'read' by a physician, nursing is a discipline that demands emotional and psychological understanding on the part of the nurse. The nurse's ways of assessing the patient cannot be easily outsourced. In addition, there are legal questions as to liability regarding advice dispensed over the phone, particularly across state lines by nurses licensed in other states (Watchter 2002).

Works Cited

Hoglund, Anna & Inger Holmstrom. (2009). Ethical issues in telenursing. International Hospital equipment and solutions. Retrieved July 2, 2009 at http://www.ihe-online.com/index.php?id=2695

Wachter, Glenn. (2002, May). Interstate licensure for telenursing. Telemedicine information exchange. Retrieved July 2, 2009 at http://tie.telemed.org/articles/article.asp?path=articles&article=telenursingLicensure_gw_tie02.xml