As information technologies alter professional routines in nursing, many professionals, including advanced practice nurses, question the effectiveness of technologies and their use in health care. For years, the use of technologies has been regarded as the gold standard of nursing care. Nurses gradually shifted their priorities towards using technological innovations as part of their professional competencies. However, human-technology interfaces in nursing can be equally advantageous and deleterious for the basic nursing practices. The privacy and security limitations of advanced technologies are widely documented. Even more problematic is nurses' resistance to using innovative technologies with the goal of improving their effectiveness in the workplace.
As a clinical nurse, I have witnessed the implementation of new technologies in our department. However, it is not until we have got a telehealth solution that I was able to reconsider the benefits and problems of the human-technology interfaces. Telenursing is a relatively new approach to delivering nursing care, which implies that telehealth technologies are used to deliver and enhance the quality of nursing care, when there is a physical distance between a nurse and a patient. In our department, the telehealth system was introduced to facilitate timely delivery of quality home care to patients, who have been discharged from the hospital, but still need constant nursing care and support. We use this telehealth application for a variety of purposes, including consultations and education. At times, patients have questions regarding their health and the information they read in magazines and the Internet regarding their health problems. We answer their questions without being torn from our primary nursing obligations within the department.
Nursing educators constantly seek new ways to facilitate effective interactions with their students. Likewise, practice nurses constantly engage in new communication activities in order to enhance the quality of nursing care delivered to their patients. The discussed telenursing initiative has greatly improved the quality of care in our department, moving us closer towards our patients while letting them spend their time in a familiar home setting. The amount of time spent with home care patients was reduced substantially, as well as the costs of home care. At the same time, the department had to invest considerable resources in nurses' training.
Certainly, numerous barriers were overcome on our way to implement the telenursing system, one of them being the issue of costs. It is no secret that the process of developing and implementing nursing technologies is impossible without considerable investments. However, even more serious are the problems of nurses' resistance to new technologies. Theoretically, actors choose to use or not to use a particular technology, based on whether or not this technology enables them to retain their power. I believe that many older nurses in our department are unwilling to give up their traditional routines, even if the new technology promises easier care delivery and better quality of care. Overcoming resistance is even more difficult than finding resources to make the system workable. These barriers could be successfully overcome by engaging nurses in training and education courses to help them understand the benefits of the new system. Education and training could also facilitate wider implementation of the discussed technology across other health care organizations. Moreover, the success stories published by various nursing departments and nurses involved could assure the professional community that telenursing is worth using in home care settings.
In conclusion, telenursing is just the beginning of the technological revolution in nursing. The benefits of telehealth solutions are obvious, but no less obvious are their drawbacks. Safety, security and resistance are just some of the many problems that should be solved before technologies become an essential component of quality nursing care.
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