Nurses’ Guide to Telenursing

Telenursing over the phone has been accepted since the 1970s, but the COVID-19 pandemic caused a large increase in telehealth visits. The New York University Langone Health System saw a 683% increase in telehealth visits between March 2, 2020 and April 14, 2020.

This increase in telehealth visits made nursing programs start to consider how to add telehealth to their curriculum and better prepare nursing students to provide telenursing. Discover how nursing programs educate students about telehealth, what telenursing is and how it began, and the differences in telehealth and in-person care.

What Is Telenursing?

Telenursing, telehealth, and telemedicine are sometimes used interchangeably. All three terms refer to the use of information technology and telecommunications to provide healthcare, medical care, and health education services virtually. Yet, the definitions of each term hold slight differences.

Telehealth services started in the 1800s when the telephone was invented. By the 1950s, the National Aeronautics and Space Administration used remote patient monitoring to evaluate the health of astronauts in space.

Twenty years later, nurses providing nursing care over the phone became a widely accepted practice. As new technology, such as video conferencing, remote monitoring, and electronic health records, were invented, the types of technology used in telehealth expanded.

The pandemic increased the use of telehealth. Telehealth visits at the New York University Langone Health System increased from 102.4 to 801.6 between March 2, 2020 and April 14, 2020.

Telehealth can be more effective for the provision of some healthcare services but not all of them. It works well to provide home healthcare, medicine and treatment compliance, and chronic disease monitoring because patients are more likely to attend virtual visits.

Telehealth is not recommended for initial consults because it is hard to build a relationship between providers and patients through a screen. Healthcare providers cannot use their sense of touch or smell remotely. Pictures, poor video quality, and a bad connection also make examining and treating skin, bone, and muscle conditions difficult. Providers can more easily look at and treat wounds, burns, or rashes in person.

Types of Telehealth Nursing

Healthcare professionals provide four types of telehealth services: live video conferencing, asynchronous or store-and-forward technology, remote patient monitoring, and mHealth.

Telehealth in Nursing Education

The COVID-19 pandemic forced the widespread adoption of telehealth in nursing practice and distance learning in nursing education. While healthcare professionals changed their method of care from in person to remote, nursing programs used telehealth to fulfill clinical hours.

Before the pandemic, most nurses received telehealth training through their job, nurse residency, or companies hosting the technology. Nurses found themselves poorly trained for adapting their methods of care to telehealth. Nursing programs realized nursing students needed more training to uphold the standard of care while navigating the unique environment of telehealth.

Some aspects of care that are different for telehealth include:

• Patient care management (including evaluating patients)
• Telehealth etiquette
• Legal considerations such as patient privacy and multistate licenses or nursing license compact (NLC) states
• Comforting patients and family members
• Financial considerations like insurance reimbursement
• Technology skills including how to troubleshoot issues of connectivity
• Cultural competence

The American Nurses Association identifies four phases for effective telenursing: planning, preparing, providing, and performance evaluation. The planning and preparing phases involve setting up and implementing the telehealth program.

Nursing education focuses on the providing and performance evaluation phases. The providing phase involves conducting telenursing through coordinating care, triage, patient education, and patient monitoring. Performance evaluation assesses telehealth factors such as data, patient outcomes, and tools for data collection.

Telehealth clinicials and simulations use the same three stages used on clinical sites: preparing, telenursing visit, and debriefing.

The preparation stage allows students to research patient conditions, review key nursing skills, and come up with a plan for what they need to address during the call. Students confirm patient consent, ask questions, and record data during the visit. The debriefing process evaluates the assessment process, the patient’s condition, communication, and outcomes.

In-person Visits vs. Telehealth Visits

Telehealth can provide many healthcare services with the same quality of care that in-person visits provide, but in-person visits do hold some advantages for patients and providers.

Telehealth visits should not replace in-person visits. Instead patients and providers should look at the advantages of telehealth visits and in-person visits before they decide which method of care is best for the patient.

Frequently Asked Questions About Telenursing

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Is telenursing part of telehealth?

Yes, telenursing refers to providing nursing care through telecommunications and information technology. Telehealth refers to medical, healthcare, and health education services provided virtually by all healthcare professions.

What are the three types of telemedicine?

Three types of telemedicine are remote patient monitoring, live video conferencing, and asynchronous store-and-forward monitoring. Mobile health, or mHealth, combines all three.

What is an example of telenursing?

The example of telenursing that people are likely most familiar with is when a nurse provides health education or advice over the phone.

Can telenurses work from home?

Yes, an increasing number of telehealth nurses work from home.

Sources

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• Frey MB, et al. (2021). Considerations when using telemedicine as the advanced practice registered nurse. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7835535/
• Guenther J, et al. (2021). Five steps to integrating telehealth into APRN curricula.
• https://www.sciencedirect.com/science/article/pii/S1555415520306462
• Hargreaves, L, et al. (2021). COVID-19 pandemic impact on nursing student education: Telenursing with virtual clinical experiences. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8529906/
• Reierson I, et al. (2015). Nursing students’ perspectives on telenursing in patient care after simulation.
• https://www.sciencedirect.com/science/article/pii/S1876139915000146#:~:text=The%20students%20reported%20that%20telenursing,trained%20for%20such%20nursing%20care
• Rutledge C, et al. (2021). Preparing nurses for roles in telehealth: Now is the time!
• https://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-26-2021/No1-Jan-2021/Preparing-Nurses-for-Roles-in-Telehealth-Now-is-the-Time.html#Mataxen
• Telehealth, telemedicine, and telecare: What’s what? (n.d.). https://www.fcc.gov/general/telehealth-telemedicine-and-telecare-whats-what

Page last reviewed September 12, 2022