budget 2017

Tele-Nursing, Shifting Paradigm in Healthcare

Increased number of patients, hospitals running out of bed during seasonal diseases, difficult admissions, long distance travel, out of pocket expenditure, and limited access to healthcare has suddenly created a need among the patients to get all basic facilities through healthcare at home services. Now, they don’t want to stand in queue, wait for their number to come and having regular visits for routine check-ups. Busy lifestyle and hectic schedule, has bring the demand of receiving all the healthcare needs in their hands, anytime, anywhere. To meet this need of the hour an innovative cost effective health care modality came into existence which is known as Tele-Nursingtelemedicine.

Tele comes from the Greek origin meaning “at a distance,” and commonly used as prefix, such as telescope, telemetry. And the word when attached with the healthcare, gives health a new dimension as tele-health, tele-nursing and tele-radiology.

Technology to deliver nursing care and perform nursing practices is Tele-nursing. However, the technology once used will change the delivery method of nursing care, but the nursing process and scope of practice does not differ with telenursing. Nurses engaged in telenursing practice continue to assess, plan, intervene, and evaluate the outcomes of nursing care, but they do so using technologies such as the Internet, computers, telephones, digital assessment tools, and telemonitoring equipment. The American Nurses Association has defined telenursing as a subset of telehealth in which the focus is on the specific profession’s practice (i.e., nursing).

Opportunity in the field of Telenursing

Healthcare at home, to the community and people not only who are living in rural areas but also for the patients who are living in the metro cities but could not afford to walk weekly to the hospitals for their routine check-ups and dialysis.  Nurses, if trained, skilled and well informed about their role as Tele-nurses with full technology facility, decision support software and ready access to management they can deliver services safely. Easy to use cable tv-based video system, regular follow up calls and are being used to deliver such services at home. Advises provided by tele-nurses are based on the superior consultation, proper diagnosis and management protocols.

Tele-nursing in ICU has emerged as one of the major breakthrough. The nurses working in ICU can get instruction for the care of patient through interactive videoconferencing and manipulating sensors.

Further to this, Pallative care has become more hand held at anytime. Help lines with expert nurses for specialized community based palliative care services has been designated to confront the patient’s emotional and informational support.

Secondly, there has been seen that patients in India hid their problems from the nurses and doctors during face to face consultation but they become more open in knowing about their issues over the phone.  Major disease like diabetes, heart failure, stoke, chronic diseases and depressions, tendency to suicide, HIV/AIDS, can be easily handled by Tele-nursing. Even women problems like menopausal, ostomy and wounds can also be addressed through tele-nursing.

Few Initiatives:

Proper training and knowledge about the know-how for th evidenced based nursing care is carried out by videoconferencing. The technology is also being used to train nursing students. Nurses have also used telenursing to get ICU care guidelines. Few initiatives in the face of Tele-nursing in the country:

  • WHO developed webinars and mobile apps for critical new born care center at AIIMS
  • Indian Nursing council is using it for training and research protocol presentations of Ph.D nursing students.
  • Mysore based Vishwabharati School, has their own Tele-nursing center.
  • PGIMER telemedicine center, Chandigarh is educating nurses from Nepal and Afghanistan.

Benefits of Telenursing to nursing practitioners:

  • Better Time management: Now, time will not be any constraint for nurses. Through Telenursing, one can opt for hours suitable for them; look for other Pending tasks while there is low patient load and earn more by providing services to many patients at a same time with in short span of time.
  • Less travel. Being a nurse in rural areas means, you have to travel a lot and spend a lot. While with the introduction of telenursing, you can have face to face consultation even from your home. This will curtail the expenses and travel time to zero.
  • Improved remote patient services: Needless to say, this technology brings ease even to patient who travel hundreds of kms to get the best healthcare. Now, your patient will be a call away from you.
  • Improved Job satisfaction. Telenursing has increased the job satisfaction among the nurses today. Nurses, now even have the opportunity not only to help patients immediately but to consult with their seniors and other medical specialties when needed. Earlier, they have long working hours and hectic schedule, but with the technology advancement they become more productive, they find their work more rewarding with lower attrition rate, and increase in knowledge and skills.
  • Good use of resources. Today, major corporate hospitals including government one are overloaded with the patients, so need for the home based care has increased. In such instances, Telenursing has emerged as best option where one can use all resources in best possible manner, sitting anywhere.
  • Rapid response time: And the major benefit of the Telenursing is the rapid response time, where nurses can respond within a minute for the patients who need immediate attention

Benefits to patients

Healthcare at home: The foremost benefits that patients receive from the telenursing are quick and immediate access to information and care. Further, people living in rural and under developed areas, where getting basic healthcare is a tough task can access finest consultation through telenursing, even at their homes.

Minimize cost: Whilst, no travel and no accommodation at other lands , saves lot of money for the people, who before travel long distance with their relatives and family members to access the medical facility in metro cities. No waiting in ques, and no paying for the mid brokers are the added advantage of telenursing.

Mandatory know-how

Its not a rocket science, you just need to have a optimistic approach, patience, open-mindedness and a nerve to break the stereotype of nursing care. An urge to learn the new technology and its limitations can make you the best Tele-nurse. Here, the foremost skill is how immediately you can able to evaluate the need for the hospitalization of the patient and need of change in the care plan.

For any delivery, the basic and most important skill is language, or communication competence. So, for the Tele-nurses to triage the patient you must have an proper video/telephone behavior. As the telecommunication requires a frequent use of technology, nurses must be technology friendly and as Tele-health works with evidence based information, they should be updated regularly.

Tele-nurses must have an ability to deliver proficient nursing services through the technology. The Interstate Licensure is must because the services can’t be restricted to one state only.

Loopholes in telenursing

Lack of proper knowledge, education, competency in handling computers and internet is one of the major loopholes both for nurses and patients, in bringing out the best of Tele-nursing care. This is not just failure of technology but also a threat to the the patient safety and malpractice. Mishandling of the conversation, leaking of the confidentiality and informed consent among patient and nurses brings a big ethical issue. Even, there have been also cases of disrespect among the opposite genders; there are nurses who found it difficult while talking to male person.  With the cameras fitted at home, for an much better cause can be used to invade the privacy of the person and nobody can ensure that these services would not be used by disadvantaged groups.

The way forward

Many experts and majority of the studies that has reviewed the benefits of Tele-nursing has showed that this technology has been brought to provide the best facility to the patients and nurses around the world, including students of medicine. Though, still Indian medical practitioners prefer traditional practices over technology based facilities. Major use of the technology in the country has been during webinars and for the nursing care students of Indian Nursing Council for the Ph.D program. There is a huge need for establishing collaboration with international medical practitioners and nurses with the Indian nurses for skill development.


A cost-effective, time saving and easy to access, Tele-nursing is an innovative technology in healthcare spectrum. Expanded at a very fast pace, over few decades, it has emerge as one of the excellent opportunity for career building in healthcare for the nurses. Especially, for those who are ready to learn and earn more, by breaking the barriers of old method and want to live in more technology friendly atmosphere, ensuring their patient’s safety and cure.


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