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Telenursing is a form of distance health care wherein nurses communicate with patients through the phone, Internet, or other means of telecommunication. Most of the time, nurses make use of distance health care in order to provide routine services to infirm patients and people in remote, rural areas. These sorts of remote consultations never replace in-person primary care, but they can significantly reduce unnecessary doctor and hospital visits, and in so doing save both patients and insurance plans money.
The practice of telenursing has expanded dramatically with the growing ubiquity of the Internet, but is by no means a new practice. So long as there has been basic telephone service, there has been remote nursing in some form or another. People who live far from clinics or care centers often look for quick ways to connect with specialists without having to travel, particularly for minor issues.
Some of the earliest examples of telenursing involved call centers of registered nurses, usually employed by hospitals or primary care clinics. Patients could call certain designated hotlines in order to speak to a nurse about any range of health concerns. These sorts of call centers were never designed for emergency care, but general questions about rashes, fevers in children, or other non-pressing concerns were commonly fielded.
Telephone triage scenarios like this still exist, but in many places are augmented by new technological capabilities. Live online chats, video conferencing capabilities, and real-time provision of information in the form of Internet hyperlinks or e-mailed documents are all possible. Modern telemedicine also enables nurses to build individual relationships with specific patients, which is not always possible in a call center.
Most of the time, nurses who work in telehealth do so only on a part-time basis. They usually are based more permanently in a practice or hospital, then use the Internet to keep in touch with patients who either cannot make it into the office or who live too far away to make regular office visits. The patients who most often make use of regular telenursing are those with chronic conditions or those with long-term ailments that require regular maintenance and preventative care.
Nurses involved in telenursing operations will often “check in” with patients over the Internet during predetermined intervals. They will ask pointed questions about known conditions and will look out for symptoms and medical warning signs. Telenurses can often also evaluate worrisome conditions like rashes and skin conditions through videoconferencing technology. Serious cases are usually referred to physicians or emergency hospital care. Otherwise, nurses are usually able to remotely advise patients of over-the-counter remedies or care tactics.
Telediagnosis is one of the most controversial parts of telenursing. Medical experts largely acknowledge the benefit of having nursing specialists connected to remote patients through whatever means available where general questions are concerned. Actually diagnosing and prescribing treatment for conditions over the Internet usually raises more concerns.
In most jurisdictions, nurses and other medical professionals must have first established an in-person relationship with a person before they can make diagnoses or substantive treatment decisions over the Internet. Even then, the rules about how diagnoses can be issued varies widely. In some places, nurses must be licensed in the patient’s jurisdiction before they can even interact on a more than information-only level. Other times, nurses must be specially trained in telemedicine before they can so much as speak to patients.