Telenursing; The Future Is Now Paper
The purpose of this assignment is to explore the specialty of telenursing as one example of the
use of technology in various practice settings. Advantages and disadvantages for the patient and
legal and ethical principles for the nurse of this technology will be explored.


The use of technology in healthcare has been of great impact in healthcare. This is
particularly in relation to telenursing. However, there are challenges that should be solved early
so as to avoid risks (Schlachta-Fairchild, Elfrink & Deickman, 2008). Although a nurse is
required to communicate with her patients with the use of the internet or telephone, she is also
supposed to assess, plan, evaluate, and intervene. In addition to this, there might be a need to use
audio feeds, videos, telemonitoring tools, and digital assessment equipment. However, the key
thing to note is that nursing care remains the same where the guidelines and the expected
outcomes should be met.
In the global healthcare environment, the use of telenursing is increasing at an alarming
rate (Snooks et al., 2008). However, it is worth noting that the work involved in telenursing is
knowledge-intensive and complex. Nurses are required to be able to operate independently, make
decisions regarding the patient’s need for more care, offer self-care advice, and refer patients to
proper help sources. As telenurses triage the conditions their patients are suffering from, their
assessments are normally founded on verbal communication (Snooks et al., 2008). As such, there
is a high need for high communication skills’ level as well as the ability of listening. Telenurses
face a major limitation in that they are unable to see their patients. Nurses feel that they possess

considerable responsibility towards the patients and fear making improper decisions. In addition,
telenurses may think of the relationship with their patients in telenursing as a conflict between
acting as a gatekeeper and care provider.

Safeguards and decision-making support tools

When engaging in telenursing, there is likely to be the emergence of constant and new
challenges such as potential liability issues. Regardless of the fact that the absence of legal
precedents brings about uncertainty regarding telenursing liability, vividly defined
accountabilities can go a long way in addressing various recognized liability categories. This is
more so in cases dealing with the health professionals involved, particular applications or
technologies, the involved organizations, and training and human resources. Telenurses should
be key participants in the documentation and development of the risk management plans as well
as the related policies (Snooks et al., 2008). There is a great need for telenurses to discuss
liability issues with the legal counsel and employers (Schlachta-Fairchild, Elfrink & Deickman,
Telenurses possess the primary accountability of ensuring that their technical and clinical
competencies are current. This is closely related to the need of telenurses to evaluate and identify
their learning needs regularly; come up with as well as implement the learning plans, in addition
to evaluating the learning impact on their practice. It is advisable for telenurses to utilize the
‘Building Your Profile’ as well as other performance management and professional development
systems in their practice so as to promote the delivery of competent, safe, ethical, and
compassionate telenursing practice.
Consumer education, patient satisfaction, interoperability, ethical issues, privacy rights,

and technology

There is a great need for telenurses to network and collaborate with other professionals
readily. This goes a long way in ensuring that ethical issues on record keeping, patient care, and
confidentiality are worked out as needed. Clinical safety is extremely vital when practicing
telenursing. Considering the limitations of technology, higher chances for incomplete and
inaccurate information, and the fact that no face-to-face interaction is involved, providing
telenursing services may be accompanied by immense risks. Although the patient-nurse
encounter during telenursing is a bit different from the traditional setups, the nurse still remains
responsible of promoting the delivery of safe, ethical, and appropriate care and services.
Promoting and maintaining security, privacy, and confidentiality in telenursing settings is
basically extremely challenging as opposed to ordinary health-care environment. Principally, this
is because of factors like electronic information transfer (client data as well as video imaging)
between the sites. This is in addition to the increasing number of people participating in the care.
In this regard, nurses as well as employers have the responsibility of developing, implementing,
as well as adhering to telenursing policies. This goes a long way in promoting privacy, security,
and security in all interactions. Nurses should also obey all relevant legislation. It is also very
important for nurses to participate in measures that are aimed at improving quality including
audits (Snooks et al., 2008).

The professional role of nurses in telehealth

In the present technological era, nurses are also acknowledged to be knowledge workers.
As such, they possess an increased role in coming up with telehealth solutions that is very
essential in increasing client benefit. Telenurses are also participants in data collection that
includes outcome data as well as system utilization. In addition, telenurses are required to
support the evidence-based practice by leading as well as participating in research. This goes a

long way in evaluating and informing telehealth practice. This is particularly in areas such as
accessibility, the clinical impacts of the clients, and cost-effectiveness of services.

Advantages and disadvantages to patients

Telenursing is beneficial to patients as well as the physicians (Snooks et al., 2008).
Patients benefit from quick and immediate care access in addition to information. The second
benefit is that patients get education chances, and this enables them to know more regarding the
conditions they are suffering from. Through telenursing, nurses are involved more in making
decisions about their care. Patients are also empowered since as they are getting healed from
operations and managing chronic diseases such as asthma and diabetes, they take up dedication
to self-care more enthusiastically (Snooks et al., 2008). The patients become increasingly
knowledgeable and can care for themselves even better. This is based on the assurance that
assistance is only a call away. Patients also save time and money considering that no travelling is
On the other hand, patients may have the attitude telenursing brings about dehumanizing
impacts. This is based on the fact that regardless of the fact that care of different conditions goes
on, physical interaction is absent (Snooks et al., 2008). As a result, some may opt not to use the
telenursing services. With the use of telenursing, patients are forced to remain lonely and there is
no chance to connect with as well as share experiences with patients ailing from similar
conditions. This may greatly contribute to delayed healing or even depression from the
loneliness, which may complicate the condition.
Additional costs come in the form of the extra payments for the communication forms in
use. There may also be challenges as the patient tries to utilize the care equipments. This is
usually very technical as it indicates delayed care. There are high chances of the equipment

malfunctioning and as such, care is also delayed (Schlachta-Fairchild, Elfrink & Deickman,

Ethical and legal principles

When practicing telenursing, telenurses should obey the registered nurses’ code of ethics,
relevant legislation, relevant practice guidelines, as well as the professional practice standards
(Williams et al., 2012). When the patient begins offering telenursing services to a patient, she
should introduce her name, provincial and territorial regulatory body, place of work, and
professional designation. This is usually the starting point towards creation of rapport and a
lasting relationship that is based on trust and confidentiality. The healthcare professional should
also be keen on knowing the details about the patient (medical and personal history). This gives
the patient an insight that the professional is really concerned and cares about him. When a
positive relationship exists between the patient and provider, this permits the provision of high
quality care (Schlachta-Fairchild, Elfrink & Deickman, 2008). On the same note, if the patient is
aware about his provider’s details, he can follow up in case of clarifications and when seeking
more information. The same case applies when filing for a complaint. Similar to the telenursing
setup, the normal settings are also required to offer high quality care. As such, nurses are
required to promote nonmaleficence, confidentiality, and autonomy. In telenursing, the most
ethically troubling areas are autonomy, integrity, documentation, information prioritizing,
confidentiality, security, and privacy (Schlachta-Fairchild, Elfrink & Deickman, 2008).
Telenurses experience an ethical dilemma involving the conflict between the relative’s
and patient’s autonomy, in addition to the ambition of the nurse to assist the patient. In this
regard, the beneficence and autonomy principles are in conflict (Jerant et al., 2003). There is an

ethical question regarding the manner of ensuring the identity of the caller within telenursing
(Kuriakose, 2011).

Conclusions and recommendations

It is highly advisable and recommendable that Manuel should seek extensive and high-
quality training. This will be essential in making telenursing productive, preparing him for the
role, and preventing the risks involved with it. There is also a great need for him to network with
more experienced as well as the new telenurses for more learning.


Jerant, A. F., Azari, R., Martinez, C., & Nesbitt, T. S. (2003). A randomized trial of telenursing
to reduce hospitalization for heart failure: patient-centered outcomes and nursing
indicators. Home health care services quarterly, 22(1), 1-20. (Googlescholar)
Kuriakose, J. R. (2011). Telenursing an emerging field. International Journal of Nursing.