Tag Archives: patient care

Nurses In Telehealth and Why It is Important

Our technology through the years has been advancing to provide patients with nurses that can manage their care through the telephone and through field visits in their homes.  With the recent pandemic that has spread throughout the globe, more than ever the field of nursing doing telehealth has become important.

Through my job as an independent nurse consultant, I am able to provide much needed and sought after medical information to my patients and their family caregivers via telephone and telehealth.  In order for me to do this, I must be able to have good communication skills and if I am providing telemedicine a good eye for what may be concerning my patient.  In the past few years, telehealth has grown.  According to the American Academy of Ambulatory Care Nusring (AACN).  “Telehealth practice originally began when registered nurses (RNs) were available to patients by telephone to ensure they had access to health care. The RNs triaged patients to appropriate levels of care. ”

Many people lately since the pandemic occurred ask me what do you do for work?  My answer is, as a nurse consultant, I educate and assess my patients about their medications, symptoms, and chronic disease processes.  I ensure that they are making follow up appointments with their primary care doctors or their specialist.  Together we develop a plan of care that will best suit their current situation.  Now I also have injured workers that are seeing their doctors and anxious to get back to work.  They sometimes have chronic conditions that through my assessment they may or may not know about.  These are the moments when as a nurse consultant, I can educate them, provide best practices, and refer them to their primary care doctor to get the help that they need.  As for their injuries, I help them to get the right treatment ordered and coordinate their visits to another specialist that can help them when a referral is needed.  My job does not end there though, coordinating light duty work for the,m with their employing agency is another aspect of what I do.

Having a telehealth nurse allows doctors the ability to follow up with patients that are not able to come to the office as frequently by carefully monitoring the medications that they are on after they are reconciled with their pharmacist.  It also allows for a team approach in managing their healthcare with their caregiver and the patient to provide autonomy, a willingness to participate, and be involved in their own healthcare.

One important time that my patients benefit from is pre and post-surgery.  These are scary times for patients and knowing that they have a nurse to contact them and review their instructions before surgery, plan for their needs after surgery, and contact them afterward, assures them that they can manage their needs while waiting for the follow up with their doctor.

This year with Hurricane Dorian almost hitting Florida, there was preparation to plan ahead for patients especially those that were in need of a special needs shelter due to compromised health.  It takes preparation at the beginning of the hurricane season to assess all your patient’s needs and plans for disaster.  I usually start this around June 1st right when hurricane season starts so that if one should happen, we are prepared with the patient’s plan of care.  Once the warning is issued that we need to prepare, then I contact each one of my patients and put their emergency plan into place.  I visit each patient and make certain that they are prepared.  Once the danger is over, I follow up with each patient by phone and when it is safe to go out, I will visit them in their homes to ensure that they are safe.

Most all my patients receive an in-person visit from me at their home or doctor’s office but they also receive phone calls to maintain the communication lines open about their care.  Usually, I have flexibility in my schedule to take time off to spend it with my husband and my son or catch up on housework to free up my weekends.  However, during this pandemic of COVID-19, my short days have turned into 16 plus hour days almost 6 days a week and somedays 7 ( although I try to not let that 7th day happen).  Many ask what happened to your comfortable hours?  Well COVID-19 changed that !!  My patients are scared, they have more questions, I have more telehealth visits at doctor’s offices with patients because I am not able to go per my contracted client accounts; it is for their protection and mine.  So although tiring, I am grateful that I can still provide the care that they need through telehealth.

So today someone dropped off a sign at my door that says they are praying for healthcare heroes and first responders.  I am honored to be among the professions that help support our patients at home to keep them safe during this pandemic.  Every telehealth visit that I make with each patient has a COVID-19 question and answer session and they know that if they have a question, they can contact me.

So today, find a healthcare worker and honor them with a kind word of encouragement.  We are here working for the health of our country.

This is the sign that was left on our front yard today( Pardon the garden we were going to start planting flowers in it until COVID-19…times are too busy for gardening)

Rosie Moore, DNP, RN

Follow Rosie’s Nurse Corner

Website:  Windermere Baby and Family

 

 

 

 

Are Healthcare Workers Forgetting Good Patient Care

I remember most recently having a bad reaction to zinc when I took it on an empty stomach (yes learned that lesson) and passing out with blood pressure and blood sugar bottoming out.  I felt better on the ambulance ride to the hospital after some IV fluids.  The paramedics stayed with me until they had a room to take me to for an exam.  But the nurse then said since I was feeling better, I can get up off the stretcher and wait in the regular waiting room.  They sent an orderly to walk me to the waiting room.  I had my purse, winter coat, boots in one hand and my work bag in the other hand.  The orderly did not offer to get a wheelchair to help me considering I had just passed out an hour ago.  I thought to myself at that moment boy he is rude as he walked 20 feet ahead never looking back to see if I was okay and two, never offered to help carry anything.  My husband arrived minutes later and was appalled at the treatment of a patient this way.

Now at this moment, I still have not been seen for any lab work or by a doctor.  When I finally got into a room two hours later, the doctor did not come in for another hour and a half.  When he came in, he was there a whole 2 minutes and said we are going to send you for some chest x-rays, lab work, EKG and put you on a heart monitor and watch you for 23 hours.  I said wait, I had a bad reaction to a medication how do you derive at all this in a 2 minutes checkup? The best part is where they make you wait for 23 hours is an open room with many other patients looking at you from across the hall.   This triage area does not have curtains, it is a holding area.  I grabbed my things and said I will see my regular doctor thank you very much.

I cannot understand legally or ethically how patients can be treated this way.  Is there not a policy in hospitals that they must follow to give better patient-centered care? As in the Colorado model, it states there should be a management leader looking out for the rest of the team to be sure that patients are being informed of things and being involved in their care as opposed to left alone for hours at a time and not a single explanation of care and why it is being ordered (Goode, Fink, Krugman, Oman, & Traditi, 2010).

References

Goode, C. J., Fink, R. M., Krugman, M., Oman, K. S., & Traditi, L. K. (2010, August 10). The Colorado patient-centered interprofessional evidence-based practice model: A framework for transformation. Worldviews on Evidence-Based Nursing, 96-105.