FUTURE OF NURSING CARE IN NIGERIA: CONSIDERING TELENURSING

Caring is an integral part of nursing. The nursing client or recipient of care is central to nursing practice. Individuals – sick or well – require care and it is why nursing services will know no downward progression, instead, an unabating growth and development.

In current times, where virtually everything is digitalized, it becomes a necessity for nurses in all practice areas and establishments to embrace technology – fully employing it in the art and science of caring – the basis of Nursing. Florence Nightingale – the founder of modern Nursing , in her theory, environmental theory stated that “the environment refers to all the external conditions and influences that affect the life and development of an organism, that are able to prevent, suppress or contribute to health and death.” With this, she emphasized the importance of utilizing the patient’s environment to assist him in his recovery.

In the 21st century therefore, technology has become an indispensable component of the environment; thus, the need to employ this in providing a suitable avenue for nurses and their clients to connect is not out of place. Besides, technology as part of the environment directly and indirectly affects health of individuals, families and communities; necessitating the need to employ it for the betterment of health outcomes.

Telenursing originates from the Greek word “Telos” meaning “distance” and can be said to have evolved from the more general Nursing Informatics, defined as the application of information, and communication technologies (ICT) to nursing scopes and activities. Telenursing can be defined as “the use of telecommunications and information technology in the provision of nursing services whenever a large physical distance exists between patient and nurse and between any number of nurses”. It is part of other technology-driven care approaches such as Telehealth, Telemedicine and Telediagnosis. While it is still an evolving field of Nursing, advanced nations such as America are recording considerable success in its implementation.

Telenursing seeks to improve and broaden the scope of nursing practice yet improving Nurse-Patient contact through the use of devices and facilities such as the internet, telephones, computers, electronic assessment tools (digital monitors) to plan, implement and evaluate nursing activities – particularly client care – but also extends to nursing education and administration. In addition, it has been successfully applicable in areas such as: triage, counselling, nursing consultation (pre and post-admission), home care support, community care, school health care, monitoring high risk pregnancies, physically-challenged and other special clients, follow-up care, emergency nursing services (such as poisoning management), intensive care nursing (E-ICU), rehabilitation, nursing tele-education and training as well as research advancement. Furthermore, with appropriate and efficient use of resource, telenursing will substantially promote health outcomes.

Britton and his colleagues in 1999, while describing the benefits its development and adoption, stated that, ”Telenursing is effective in reducing the requirements for; or the length of, hospital stays; in increasing access to services to widely dispersed populations; and in expanding high-quality home services…The result is a decrease in total health care cost and increased access to health care with more appropriate use of resources”. Moreover, this has been affirmed as telenursing has driven-down the cost of health care without compromising quality of care, increasing the number of aging and chronically ill population and increasing coverage to distant, rural, small or sparsely populated regions. In addition to its far-reaching benefits is the potential to provide care to desolate regions, during climatic catastrophes and disasters. In addition to these identified benefits, the hands-free approach provided by telenursing has been proven to be a tool for the reduction of job-related stress among nurses, increased job satisfaction with significant reduction in brain drain. In the same vein, there is also the reduction in the length of hospital stay and cost as well as significant reduction in on-site waiting.

Despite these numerous advantages however, there are shortcomings – typical of every phenomenon. Telenursing will not be effective when direct nurse-patient contact cannot be replaced such as in the case of physical examination. Also, problems related to the malfunction of devices and poor internet connection are other limiting factors. There could also be the problem of limited privacy at certain times in which connection is efficient only in an open area – where other people are. Nonetheless, with effective technological management and care approach, these potential obstacles could be significantly evaded.

Although, only sparse information about telenursing exists in the country at the moment, cooperation and readiness on the part of nurses to utilize technology as well as partnership between and among nursing bodies, government at all levels, non-governmental organisations, technological agencies and institutions as well as individual care centres will facilitate the understanding and implementation of this cost-effective, yet efficient mode of nursing care. Therefore, with careful research, planning, and identification of areas of application based on available resources and facilities, the future of nursing care promises to be brighter than ever.

In the meantime, it is essential to instill a strong base of technological knowledge into nursing students in all Nigerian institutions as well as training of nursing man-power by individual institutions, organisations, government at all levels, nursing bodies and other concerned agencies is highly required to specifically move nursing care and generally Nigerian health care to suit international best practice.

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