Navigation Links
Telenurses face conflict between what is best for patients and what services are available
Date:2/17/2010

Nurses who provide telephone advice services have to balance the conflicting demands of providing appropriate medical advice and acting as a gatekeeper to limited healthcare services, according to a review in the March issue of the Journal of Advanced Nursing.

Canadian researchers reviewed 16 studies carried out over the last two decades, covering more than 700 nurses in the UK, Canada, the USA and Sweden. The studies included interviews, videotaped consultations, simulated calls and stimulated recall.

"Telenurses who took part in half of the studies expressed a conflict between what they thought was best for the caller and what healthcare services could provide" says lead author Dr Rebecca J Purc-Stephenson from the University of Alberta, Canada.

"They believed patients had a right to accurate handling of their problems, but were also conscious of the fact that doctors had a limited number of appointments available and that these needed to be kept free for urgent patients.

"Sometime telenurses advised callers who needed primary care to go to the emergency department because there was nowhere else to refer them to."

Dr Purc-Stephenson and co-author Dr Christine Thrasher, from the Faculty of Nursing at the University of Windsor in Ontario, maintain that telephone triage and advice services have substantially changed nursing practice.

"The first is that the nurses work in call-centre environments, rather than clinical settings, and the second is that they no longer have the opportunity to physically examine patients" explains Dr Purc-Stephenson.

Other key findings of the study include:

  • The degree to which the telenurses used protocols varied across the studies, with some being restrained by decision-making software and others having more flexibility to use their clinical judgement.

  • Telenurses often felt they had developed new communication skills including listening to verbal and non-verbal clues, like tone of voice, breathing, words and expressions used and general conversational tone.

  • While some nurses felt that their clinical knowledge had been enhanced by working with colleagues, some raised concerns about retaining clinical skills. Although training was encouraged, heavy workloads and retention issues created barriers to ongoing training.

  • Other nurses said that workloads left little time to interact with other telenurses and that the lack of feedback from the advice they gave was frustrating and had a negative impact on their job satisfaction.

  • Some nurses felt stressed and exhausted by their heavy workloads and others were concerned that rushing calls could compromise quality of care. They also said that callers could become aggressive if they were kept waiting.

  • In some cases telenurses felt uncomfortable making decisions over the telephone and considered worst-case scenarios in an attempt to reduce legal or professional consequences.

  • One of the greatest challenges was to work out whether patients were exaggerating or playing down symptoms.

"Our review has revealed that telenurses face complex decision-making processes when they are dealing with calls, as they need to consider a range of factors" says Dr Purc-Stephenson. "Addressing some of these can help to remove barriers, but others can actually create barriers that prevent telenurses from adequately addressing their callers' needs.

"For example, the conflict between doing what is best for the patient and not overwhelming limited healthcare resources poses a real dilemma and in many cases there is no easy solution.

"There are a number of other implications for clinical practice and policy that need to be addressed.

"It is clear that the assessment skills used in face-to-face consultation are not directly transferable to the telephone and telenurses need specific training in telephone consultation, assessment and decision-making skills.

"Managers also need to address job demands, such as heavy workload, autonomy in decision-making, isolation and stress as these can have an impact on job satisfaction."


'/>"/>

Contact: Annette Whibley
wizard.media@virgin.net
Wiley-Blackwell
Source:Eurekalert

Related medicine news :

1. Couples who say we do better at resolving conflicts
2. From Conflict to Consensus: Interaction Associates Outlines How Leaders Can Achieve Successful Alignment and Implementation
3. Veterans From Iraq, Afghanistan & Other Conflicts Partner With Service Dogs in Americas VetDogs Graduation Ceremony
4. Conflict-affected countries receive less aid dedicated to reproductive health
5. Conflicts of Interest Still Exist in Cancer Research
6. Review finds conflicts of interest in many cancer studies
7. How to turn conflict into collaboration when patients and physicians disagree
8. Statement by Christine K. Cassel, MD, President and CEO of the ABIM Foundation on the Institute of Medicine Report: Conflict of Interest in Medical Research, Education, and Practice
9. Lutheran World Relief Responds to Escalating Conflict in Sri Lanka
10. Argus Honored by Flaspohler Research Group as Highest-Rated PBM for No Conflicts of Interest
11. Conflicts of interest in clinical research
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/26/2016)... ... June 26, 2016 , ... Many women are confused ... endometriosis. These women need a treatment plan to not only alleviate symptoms and ... help for preservation of fertility and ultimately achieving a pregnancy. The specialists at ...
(Date:6/25/2016)... ... 2016 , ... "With 30 hand-drawn hand gesture animations, FCPX users can easily ... of Pixel Film Studios. , ProHand Cartoon’s package transforms over 1,300 hand-drawn pictures ... . Simply select a ProHand generator and drag it above media or text in ...
(Date:6/25/2016)... ... June 25, 2016 , ... On Friday, June 10, Van Mitchell, Secretary of ... award to iHire in recognition of their exemplary accomplishments in worksite health promotion. , ... Workplace Health & Wellness Symposium at the BWI Marriott in Linthicum Heights. iHire was ...
(Date:6/24/2016)... ... , ... June 19, 2016 is World Sickle Cell Observance Day. In an ... of holistic treatments, Serenity Recovery Center of Marne, Michigan, has issued a ... Cell Disease (SCD) is a disorder of the red blood cells, which can cause ...
(Date:6/24/2016)... CA (PRWEB) , ... June 24, 2016 , ... ... is now offering micro-osteoperforation for accelerated orthodontic treatment. Dr. Cheng has extensive experience ... Damon brackets , AcceleDent, and accelerated osteogenic orthodontics. , Micro-osteoperforation is ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... -- Guerbet announced today that it has been named a ... One of 12 suppliers to receive the ... of Premier members through exceptional local customer service and ... lower costs. "We ... customer service from Premier," says Massimo Carrara , ...
(Date:6/23/2016)... June 23, 2016 Research and ... Procedure Volumes: Global Analysis (United States, China, Japan, Brazil, ... report to their offering. ... for healthcare business planners, provides surgical procedure volume data ... trends with an in-depth analysis of growth drivers and ...
(Date:6/23/2016)... The Biotechnology industry might still ... great opportunities to investors. Stock-Callers.com assesses the recent performances ... XON ), Vertex Pharmaceuticals Inc. (NASDAQ: ... ARNA ), and Regeneron Pharmaceuticals Inc. (NASDAQ: ... your complimentary trade alerts at: http://stock-callers.com/registration ...
Breaking Medicine Technology: