Telehealth nursing

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Telehealth nursing has proven to be an important component of the health care crisis solution during the COVID-19 pandemic. With the arrival of COVID-19 and stay-at-home orders instituted across the country, nurses and nurse practitioners have relied on telemedicine as a way to remain engaged with their patients. This form of real-time, audio-video communication allows nurses and nurse practitioners and patients to connect from different locations, bringing direct patient health care into the home. Health care systems have had to adjust the way they triage, evaluate, and care for patients using methods that do not rely on in-person services. An area of concern in the implementation of telehealth is the risk of depersonalization in the clinician–patient relationship due to the lack of human contact and ability to pick up on nonverbal cues.

Discuss what you as an NP will do to maintain the clinician–patient relationship and pick up on nonverbal cues when using telehealth to see your patients. What other challenges do you anticipate?

 

Sample Solution

Maintaining the Clinician-Patient Relationship in Telehealth

As a nurse practitioner, I would prioritize maintaining a strong clinician-patient relationship, even in the virtual setting of telehealth. Here are some strategies to address the potential challenges of depersonalization and nonverbal cue interpretation:

1. Active Listening and Empathetic Communication:

  • Focused Attention: Give full attention to the patient during the telehealth visit, minimizing distractions.
  • Verbal Cues: Use verbal cues like “uh-huh,” “I see,” and “go on” to show active listening and understanding.
  • Reflective Listening: Paraphrase the patient’s concerns and feelings to demonstrate empathy and understanding.
  • Open-Ended Questions: Encourage the patient to share their experiences and concerns in detail.

2. Nonverbal Cues and Visual Cues:

  • Observe Facial Expressions: Pay close attention to the patient’s facial expressions, such as furrowed brows, tears, or smiles.
  • Body Language: Note any changes in posture or body language that may indicate discomfort or distress.
  • Eye Contact: Maintain eye contact with the patient to establish rapport and convey empathy.
  • Use of Visual Aids: Utilize visual aids, such as diagrams or images, to enhance understanding and facilitate communication.

3. Technological Considerations:

  • Reliable Technology: Ensure a stable internet connection and reliable video conferencing software to minimize technical difficulties.
  • Optimal Environment: Create a quiet and well-lit environment to facilitate clear communication.
  • Patient Education: Provide clear instructions on how to use telehealth technology and troubleshoot any issues.

Other Challenges and Strategies:

  • Limited Physical Exam: While telehealth can be effective for many conditions, it may limit the ability to perform a comprehensive physical exam. In such cases, it is essential to prioritize the most relevant assessments and consider in-person follow-up if necessary.
  • Privacy and Security Concerns: Adhere to strict privacy and security protocols to protect patient information and maintain confidentiality.
  • Digital Divide: Ensure equitable access to telehealth services by addressing technological disparities and providing support to patients who may face challenges with technology.

By implementing these strategies, nurse practitioners can effectively utilize telehealth to deliver high-quality care while maintaining strong patient relationships.

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