Dep. of Public Health and Caring Sciences, Uppsala University, Sweden
Title: Telephone Nursing Stakeholder views and understandings from a paediatric and a gender perspective
Elenor Kaminsky, PhD, RN-BC (pediatrics, district nursing and medical science), has clinical experience from most areas of Swedish pediatric inpatient childcare, school nursing and telephone nursing. The latter a Pediatric Emergency Department, the Swedish National Pharmacy Line and The Swedish National Helpline for Women subjected to threats and violence. She completed her thesis on Telephone Nursing within Swedish healthcare direct in 2013, including four publications, and has held several international conference presentations during her PhD studies. She co-authored, with Inger Holmström and Urban Rosenqvist, a chapter, Telephone nurses can understand their work in different ways, in Telephone advice within healthcare (2008 in Swedish). At the moment, Elenor Kaminsky works in a research project focusing on increased awareness of equity in health, in an intervention study designed for telephone nurses. She also teaches communication and telephone nursing at the Nursing Program at Uppsala University, Sweden.
Objective: To describe telephone nursing in from telenurse, parent caller and operation manager viewpoints.
Methods: Four empirical data collections, where of three qualitative interview studies, were conducted. Data were analysed with phenomenographic approach, content analysis and statistical analysis.
Results: Telenursing work can by telenurses be understood in a variety of ways. Authentic pediatric calls between parents and telenurses revealed 73% mother callers concerning newborn to teenage children. Ear, skin problems, and fever were common complaints and call median 4.4 minutes. Call outcome for referral/self-care was 48/52%, with a likelihood of receiving a referral almost twice as high for fathers compared with mothers. Parent's degree of worry and trust influenced whether to contact SHD or not. Calls were carefully prepared and the caller often depended upon family routine. Most parents followed recommendations, some to such extent that they, despite a continuously strong worry, reported not to seek healthcare without a telenurse recommendation. Operation managers mainly reported organizational goals as goals of telenursing work. Equitable healthcare was regarded important, while health promotion was not.
Conclusions: The studied viewpoints of telephone nursing calls for clarification regarding goals of telephone nursing work and the goals related to healthcare obligations. The studied viewpoints can all contribute to a telenurse work description. Lack of time as a barrier to health promotion should be looked upon critically since it might be counterproductive to the goal of saving healthcare resources elsewhere. Telenurses need to be aware of their valuable role and increase parents’ consciousness of holding the ultimate responsibility for their child’s condition.