There have been various advances in the medical and nursing sectors. Technology has undoubtedly played a crucial role in these advancements. Telenursing refers to virtual nursing conducted from a distance. It involves the professional not mingling with the patients as a norm. The whole process is mediated by electronic means. Telehealth nursing is also the delivery and coordination of care of nursing services by electronic means. These electronic means include telephones, radio, television, and other electronic networks such as internet. Nursing as a field of healthcare has utilized the telephone to advance its profession (Jones & Andrea, 2014). The phone guided communication between peers, nurses to patients, and students to their educators. The other form of communication that has been embraced by the nursing fraternity is the use of pagers and voicemail. Other technological advancements in the field of nursing are through the use of telephone triage, teleconferencing, telecollaboration, and pager mobility in rural and community health. Such technology improved accessibility of nursing services in the remote and inaccessible areas (Varghese, Deickman, Castelli, & Fairchild, 2010).
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The field of nursing education has utilized various technological models to advance the practice. These include radio, television, and wireless transmission. These models are also essential in the administrative and research fields. For instance, in the University of Washington, these technologies were utilized to facilitate distant nursing education. Wireless communication has contributed immensely in the fields of military nursing and aeronautics nursing. Patient teaching and professional development utilize interactive video and other electromagnetic spectra. There are various diverse clinical care functions of telenursing. These include monitoring chronic and terminally ill patients, aiding patients in the management of their symptoms and coordination of patient care under various nursing professionals (Varghese,, 2010).

Nurses in the medical practice are constantly shifting careers for professional development and improvement of their quality of lives. At my work place, Manuel whom we have worked with for 12 years is considering shifting to Telenurse Specialist at a nurse-owned home health agency. Manuel is seeking advice regarding the new field. He needs to understand the concept of telenursing. He also needs to comprehend the advantages and disadvantages. There are various advantages of telehealth nursing. In a professional sense the merits include specialty consultations in home healthcare, ambulatory care, stroke care, prison and mental care settings, monitoring in the intensive care units, new-born unit, health promotion, research and development. Telenursing ensures that the health practitioner mages their time effectively. The working hours are flexible, and dedicated to the service of various patients. It allows the nurse to undertake other activities if the patients are few. Other undertakings include research and professional development. Telenursing also involves less commuting. These are particularly advantageous in a remote setup. In turn, telenursing improves patient contact and consultations. Travel time and resources are reduced immensely. Telenursing is convenient to triage nurses. Telenursing provides job satisfaction to various specialist nurses. It provides for an opportunity to research and consult peers. It also provides an opportunity to care for the patients (Jones & Andrea, 2014).

There are numerous advantages of telehealth nursing from a patient’s perspective too. Telenursing has been used to improve population health. It ensures that various patients are involved in the decision making process regarding their healthcare. It is achieved by face-to-face consultations with the patients with the right access to internet services. Telenursing is an integral tool in the management and consultation of diseases. Telehealth nursing has been utilized in the diagnosis of debilitating conditions such as myocardial infarctions. Acute leukemia cases have been diagnosed using telehealth (Roberts, Tayler, MacComark, & Barwich, 2007).

Telenursing is essential in fostering patient satisfaction. Telehealth service offer channels of education for the nursing care providers and patients. The chance for patient education is an essential part in the improvement of healthcare service delivery and patient outcome. Telehealth has been successful in initiation and provision of patient-counseling and education. Various patients with chronic illness have been educated and counseled on various modalities involved in the management of these conditions. These patients include those with Chronic Obstructive Pulmonary Disease (COPD) and Congestive Heart Failure. Asthmatic patients receive information and management of their cases over video conferencing or telephone calls. Home health nurse have also utilized these equipments to consult regarding the management of a particular patient. In the end, it fosters patient satisfaction (Marca, Joyce, & Vicki, 2012).

Patient safety is a vital concept in healthcare practice. This concept is undermined by poor patient-compliance and adherence to medical services. Many patients falter in their treatment plans once they leave the consultation office. This is attributed to miscommunication and misunderstanding of instruction from the physicians. Inaccessibility of the healthcare facilities also facilitates poor adherence. Telehealth nursing is crucial in fostering adherence and surveillance of patients on treatment. It is attributed to the accessibility of services. Telehealth nursing is crucial in facilitating management to complex regimens hence improving compliance and adherence. Telehealth nursing is effective in the monitoring patients beyond acute care and inpatients services. Telenursing improves access to specialized care. Various specialists care nurses can care of home-patients, rural and medical underserved areas. This helps to reduce issues such as compliance (Jones & Andrea, 2014).

Telenursing is a successful in improving clinical outcomes of chronic conditions. Various studies have demonstrated the role of telenursing in reducing these conditions. It is supported by efficient communication channels in telenursing that foster intercommunication and healthcare interoperability. It ensures that various specialists deal with patients. Telehealth intervention played a crucial role in the management of diabetes mellitus. It is achieved through monitoring of the patients HbA1c levels (Jones & Andrea, 2014).

There are various demerits of telenursing. Inaccessibility to technology has affected its use in various remote centers. It also influences patient choices and decisions regarding healthcare services. Various individuals prefer face-to-face consultations with the physicians. It is facilitated by the culture that the population has adhered to for a long while. The geriatric population is notorious for this culture. There is technological knowledge in this population to implement telehealth home care. Furthermore, such patients cannot take care of themselves as directed by the telenurse. As such, it requires the physical presence of the nurse to care for these patients effectively. Telehealth communication eliminates one-on-one interactions with the patients. It goes against the principles of medicine that give the patient the right to determine the treatment. Some patients prefer personal interaction with the healthcare provider. Such services are eliminated by the use of technology. It proves a major hindrance in the achievement of patient satisfaction (Jones & Andrea, 2014).
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Telehealth equipment eliminates the natural alert systems that nurses are trained to elicit using their senses. For instance, diagnosis diabetic ketoacidosis requires the identification of a particular scent. This is largely eliminated in technological interaction with the patient via a videophone or radiophone. This would reduce the population healthcare service delivery. It must also be noted that telenursing is expensive. The cost of installing the technology and training in the use of the technology is very expensive. It must be noted that advancements in technology bring about efficiency but the cost of installation and use of the technology is very expensive. It explains the reason behind very few healthcare institutions adopting technology in their practice. Reimbursements offer challenges to the use and adoption of telenursing. Many healthcare providers lack reimbursement services (Marca,, 2012).

Patient data security and privacy guarding are a challenge in telenursing. The recent increases in espionage reports suggest that various hackers may interfere with the patient health data. It requires regular system maintenance, and changes that are costly. The risk of losing patient data and privacy comes with litigation that healthcare nurses cannot afford. Such problems hinder the adoption of telenursing in the healthcare sector. Sometimes the security may be breached leading to equipment malfunction. It hinders the delivery of services to various patients by the nursing staff. These patients may be experiencing an acute episode. These technological difficulties may lead to violations of the law and regulations regarding healthcare service provision (Roberts,, 2007).

With the advancement in medical technology, various ethical and legal issues should be determined to ensure that healthcare service provision benefits the patients. These issues include privacy, patient data security, autonomy, and confidentiality. Telenurses also encounter various ethical dilemmas in their practice. Integrity and prioritizing information access contribute to the ethical dilemma faced by these nurses. Patient autonomy is usually compromised since most technological communication occurs between a relative of the patient and the nurse. This leads to a conflict in the principles of beneficence and autonomy. The nurse is unable to access and communicate with the patient in emergency cases. Cross cultures also contribute to this dilemma. Some cultures prohibit a wife from contacting a health practitioner without the consent of the husband. It may also prohibit patient data privacy and confidentiality (Tahereh, Fariba, Sakineh, & Abbas, 2014).

Integrity is another ethical dilemma faced by these telenurse. This is attributed to the elimination of personal communication with the patient. Sometimes the caller may fail to identify themselves to the nurses. Therefore, ensuring callers’ integrity in telenursing proves a dilemma to these nurses. Telenurses are also supposed to be caution of sensitive health information documentation. This information may be hacked into and expose the patients. Telenursing interferes with patient data security and privacy. Such information relates to psychiatric illness, and venereal diseases. The right to privacy may be infringed upon with the requirement of interoperability in health technology (Varghese,, 2010).

The regulation demand that nurses should be honest to the patients without providing information that may overwhelm the patient. This leads to a dilemma of integrity and non-maleficence. Such a scenario occurs when a patient calls with a small problem while the information relates to serious diseases. The nurse may fail to inform the patient adequately. In the event of death or cost of healthcare, the nurse faces legal claims from the patients for misinformation (Tahereh,, 2014).

Conclusion and recommendations

There are various advancement in the nursing field. Technological advancement has spearheaded most of this campaign to make healthcare accessible and efficient to the population. As such, many healthcare professionals have embraced technology to improve their efficiency and develop their career. The field of telenursing is developing, and absorbing many professionals in the field. Many nursing services can be offered via the use of various electronic mean of communication. Various evidence-based reports indicate that telenursing has improved service delivery. The home-owned agencies have benefited from introduction of telemedicine in the practice. These nurses can also aid in the monitoring and surveillance of chronic conditions. Telenursing contributed to accessibility of specialized care to various chronically ill patients. Telenursing is an important tool for research and professional development. Services offered in telenursing are flexible to suit the professionals and the patients. The cost of installation and maintenance of the system is a major hindrance in telemedicine. Lack of knowledge and interest regarding technology in the geriatric population also hinders telemedicine. Cultural obstacles also play a role in hindering telenursing. The nursing profession should also be wary of various ethical and legal conflicts regarding telenursing. This includes interference with patient privacy, confidentiality, and non-maleficence.

In conclusion, I recommend that Manuel accepts the role of Specialist Telenurse in the home agency. This will offer a challenge that is vital for professional development. Besides, the flexible working hours and comparable pay ensures that he/she can research and develop in the profession.
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Jones, J., & Andrea, C. (2014). Hospital admission avoidance through the introduction of virtual ward. British Journal of Community Nursing, 19(7), 330-34.

Marca, J., Joyce, H., & Vicki, C. (2012). Towaard an understanding of caring in the context of telenursing. International Journal for Human Caring, 16(1), 7-15.

Roberts, D., Tayler, C., MacComark, C., & Barwich, D. (2007). Telenurisng in hospice palliative care. Canadian Nurse, 103(5), 24-27.

Tahereh, L., Fariba, B., Sakineh, S., & Abbas, A. (2014). effect of telenursing on glycemic control and body mass index of type 2 diabetes patients. Iranian Journal of Nursing & Midwifery Research, 451-456.

Varghese, S., Deickman, A., Castelli, D., & Fairchild, L. (2010). telehealth and telenursing are alive: APN policy and practise implications. Journal for Nurse Practitioners, 6(2), 98-106.


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