A song once said “It doesn’t matter where you are, just as long as you are there.” As lyrics go, it may sound trite. Put those words in the context of telemedicine, however, and they are rather profound. There is a nursing shortage in the United States. Geographical location has had a lot to do with the problem. Where you live, all too often, still affects how you live. Remote regions do not have the facilities, nor the staff or technology to fill them. Thanks to telemedicine, time and distance are no longer the obstructions they once were. The prefix, ‘tele-‘, means “to or at a great distance.” Just as the telephone allows sound to travel over a distance, telemedicine allows medicine to be practiced over a distance. This doesn’t just apply to doctors. It refers to nurses as well. Telehealth nursing is defined as “the use of telehealth/telemedicine technology to deliver nursing care and conduct nursing practice.”
Like most advancements in medicine, or any field, telenursing has a specific origin point, a genesis if you will. In 1974, an RN by the name of Mary Quinn documented her care with patients at Logan Airport via telemedicine while she worked from a hospital in Boston, Massachusetts. These accounts are widely recognized as the first published work regarding telemedicine (See Telehealth, Telenursing, and Advanced Practice Nurses). By 2005, 719 Registered Nurses and Advanced Practice Nurses in 36 different countries responded to an international survey, as practitioners of telenursing. So far, it is the best indication of how expansive the practice of has become but it is by no means exhaustive. Organizations such as the American Telemedicine Association and the International Council of Nursing Telenursing Network are among the best sources of data on the subject.
To be clear, telenursing is not a separate career path or even a specialty. It is an avenue of professional improvement for all practicing nurses. Nursing telepractice can easily dovetail and co-exist with a nurse’s current workload. Since telemedicine’s very purpose is to cross borders, additional licensure for practicing across state lines may be necessary. The American Nursing Association already holds its members to a set of standards for safe, quality, and competent practice. Beyond that, the ICN published a 39 page document that details competencies expected of telenursing practitioners in over 130 countries.
Think of how overwhelming the hospital environment can be. Now, imagine that combined workload being spread over miles. It will never equate to less stress for the devoted nurse but it might give him or her room to stretch. With the aid of a simple phone or internet connection, home health aides can monitor the following:
It goes both ways. Patients can very well educate themselves at home by arranging a live video consultation with an on-call nurse. Changing a dressing or administering an insulin injection are both easily taught via such an exchange.
Call centers also exist, operated by managed care organizations comprised of RN’s who use their expertise to keep everyone from the elderly to those with special needs, educated, and as free of ER visits as possible. Such operations have co-existed with doctors and nurses for quite some time but never before have they been so readily linked and equipped to share information.
To those concerned with the nursing shortage or more importantly, those looking to fill it, the importance of computer literacy cannot be understated. If the goal is to care for patients and save lives, telemedicine is the most natural extension of those goals. Telemedicine has become so prevalent that chances are you will be a participant soon enough, knowing or not. No matter what point you are at in your career, it is never too late to expand your skills. It especially isn’t too late to expand their reach or their scope.