Nursing Situation in Need of Change

Nursing professions are front-line workers who play a critical role in ensuring better health outcomes. Since the onset of Covid-19, the need for nurses in the US escalated (Krupnick, 2020). The increased demand for nurses to attend Covid-19 patients has brought some significant semi-direct and indirect nursing situations. One of the direct nursing situations concerns changes in the working model for most nurses, shifting to telehealth and remote work-from-home positions.

Telehealth concerns delivering nursing services from a remote location using telecommunication technologies. For instance, a nurse may talk with a patient through a phone call or a video call to guide them or assist them with nursing services. Telehealth service has been there since the 1970s, but it has become a large-scale working model for nurses in the US since the onset of Covid-19 (Monaghesh & Hajizadeh, 2020). It is a direct current situation because it has affected how nurses viewed their professional work schedules and have disrupted many traditional nursing programs, including working shifts. There are many benefits of telehealth nursing, which include covering the shortage of nurses (Monaghesh & Hajizadeh, 2020). Notably, there has not been a high demand for nurses in decades, as witnessed since the beginning of the covid-19 era, and nursing schools are not producing enough workforce (Krupnick, 2020). As such, telehealth in nursing helped deliver nursing services to as many patients as possible without the inconveniences of on-site appointments.

However, telehealth comes with its underlying challenges, which affect the effectiveness of nursing professionals. Such include the adoption and appropriate use of the telehealth facility. For instance, telehealth had yet to be widely accepted until the demand for nurses escalated in 2010. There were nursing professionals who did not have an interest in telehealth, and as such, they do not understand how the infrastructure works (Mohammadi et al., 2017). Therefore, telehealth in nursing poses challenges which concern inadequate assessment, resistance to change, and privacy.

Luckily, these issues are viable to approach and overcome through a nursing change theory, such as Rogers’ Change Theory. Roger developed this theory from Lewin’s Change Theory by changing it from three steps to five steps. Hence, Roger believed that change, such as diffusion of innovation, begins with awareness, then proceeds to interest, evaluation, implementation, and ends with adoption (Mohammadi et al., 2017). The change theory is ideal for the current situation because reduced social contact with people has become a new normal. That is, Rogers’ Change Theory is feasible for long projects such as the adoption of technology.

Given that nurses will have to adapt to the current situation for an unknown period of time, it is prudent to develop an implementation plan to adopt effective telehealth in nursing using Rogers’ Change Theory. It is worthy to note that Rogers’ Change Theory – which applies in contexts such as nursing, is similar to the popular and more general Diffusion of Innovations Theory. Theorists of Diffusion of Innovations Theory believe that an effective change process undergoes stages called knowledge, persuasion, decision, implementation, and conformation (Wagner, 2018). The five stages represent the steps of nursing change which begin with awareness, then proceed to interest, evaluation, implementation, and end with adoption.

The implementation plan may begin with nurses’ exposure to the impacts of the Covid-19 on nursing demand and the role of telehealth in the situation. The creation of awareness will lead to the next step – persuasion, where nurses will gain interest in learning the work model. That may include expositing its pros and cons and related factors such as HIPAA laws which concern privacy. Some nurses may decide to take a short course that may be accompanied by EHR, making sure to weigh the viability of telehealth in their setting. For instance, older adult nurses who are ideally at a higher risk of succumbing to Covid-19 may serve through telehealth to reduce their health risks (Banerjee, D’Cruz & Sathyanarayana Rao, 2020). That way, nurses who decide to adopt the technology will reduce their resistance to change and implement the remote working model. The implementation will entail optimizing the assessment of patients, which will reduce incidences of inadequate assessment and privacy breaches. Lastly, as many nursing professionals learn and use the technology, it will become a widely acceptable working model in nursing.

The effectiveness of adopting telehealth in nursing will be evaluated continuously since new professionals keep joining the workforce. Nursing professionals who get into the second stage may enroll for short courses or benchmarks within one month of awareness. The decision to work remotely or on-site should be made during the short course or the benchmark since one evaluates the pros and cons of the technology. Once learned, nurses will change into effectively using telehealth within a month since the demand for remote nurses is very high. Fully-fledged adoption may take up to five years.

The change into telehealth and remote working in nursing will increase accessibility to nursing services. Removing the inconveniences of in-site nursing, such as transport logistics, enables one nurse to serve a more significant number of clients. Besides, it will improve flexibility in the nursing profession, such that nurses can work in many healthcare facilities and manage their schedules – which may reduce burnouts. That will also improve the safety of nurses by partly removing them from direct contact with patients. Overall, telehealth in nursing will make the profession more effective and exciting.

References

Banerjee, D., D’Cruz, M., & Sathyanarayana Rao, T. (2020). Coronavirus disease 2019 and the elderly: Focus on psychosocial well-being, agism, and abuse prevention – An advocacy review. Journal Of Geriatric Mental Health, 7(1), 4. doi: 10.4103/jgmh.jgmh_16_20

Krupnick, M. (2020). NPR Cookie Consent and Choices. Retrieved 7 March 2021, from https://www.npr.org/2020/12/21/947496118/despite-high-demand-for-nurses-colleges-arent-keeping-up

Mohammadi, M., Poursaberi, R., & Salahshoor, M. (2017). Evaluating the adoption of evidence-based practice using Rogers’s diffusion of innovation theory: a model testing study. Health Promotion Perspectives, 8(1), 25-32. doi: 10.15171/hpp.2018.03

Monaghesh, E., & Hajizadeh, A. (2020). The role of telehealth during COVID-19 outbreak: a systematic review based on current evidence. BMC Public Health, 20(1). doi: 10.1186/s12889-020-09301-4

Wagner, J. (2018). Leadership and influencing change in nursing. Regina: University of Regina Press.