Telehealth in Rural Nursing: Embracing Change for Better Patient Outcomes

rural road Photo by Bradyn Shock on Unsplash

When I first heard of telehealth services coming to our rural hospital, no one was a bigger skeptic than I was.

Perhaps the main reason was the way I was educated as a nurse and how I learned to practice as an APRN. Honestly, I am “old school” in every way possible. My first thought was, “This is not good practice; how could it be? Won’t there be shortcuts? How about the lack of a physical exam? How can you properly physically evaluate someone over telehealth? How can you take safe care of patients and avoid missing something that’s potentially life-threatening if you can’t touch them? How could someone a thousand miles away help me way up in the mountains of the Eastern Panhandle? What could they know about the community here and their needs?”

These were just a few of the questions and concerns I had regarding telehealth coming to our rural community access hospital. When we assess our patients, we not only to listen to their heart and lungs, look into their eyes, hear their voice, feel the temperature of their skin, but we connect. We are building trust and ensuring support with looking, listening, and […]

2023-10-03T10:04:41-04:00August 25th, 2023|digital health, Nursing, nursing roles, patient experience, Patients|5 Comments
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40-years of Forensic Nursing and Current Opportunities in Remote Sexual Assault Care

Remembering an influential article.

Patricia Speck

Timing is everything. Forensic nursing service through telehealth is possible today, as reported in a recent Kaiser Health News story, but it wasn’t always that way. Fifty years ago, Ann W. Burgess, a psychiatric–mental health nurse working in the emergency room, wrote a paper with a sociologist colleague about what she was seeing in patients who complained of being raped. “The Rape Victim in the Emergency Ward” (pdf), published in AJN, was reported nationally and informed 1970s kitchen table conversations about what rape is, is not, and when “no means no.”

Naming the trauma and its effects.

The ideas in this article were new at the time. Burgess wrote that sexual assault causes acute emotional trauma, requiring time for recovery, and she named phases of what she eventually called “rape trauma syndrome.” Prior to the article, victims of sexual assault often did not report the assault, and when they did they waited hours for a newly minted physician intern who had been punished with “rape-duty.” These physicians had no knowledge about what to do.

In accordance with societal views at the time, victims were often blamed for their rape—the way you dress, how you act, […]

2023-02-17T10:40:20-05:00February 17th, 2023|digital health, nursing roles, patient experience, Public health|2 Comments
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A COVID-Era Telehealth Appointment Drives Home the Fragility and Strength of the Therapeutic Relationship

The Reflections essay in this month’s AJN is by LaRae Huyck, a psychiatric mental health NP. In this one-page story with a dramatic COVID-era twist, she explores her years accompanying a young counseling patient from suicidal depression during adolescence to joyful engagement with life as she heads out into the world on her own. Writes Huyck:

The time I spent with her seems so short, but in actuality it made up nearly a fourth of her life. We had traveled though the awkward adolescent years, the landmine of her parents’ divorce, the loss of a beloved grandmother, and a failed relationship that ended her dreams of a prom date.”

The healing power of a therapeutic relationship.

“The Importance of Time” adroitly summarizes this journey, revealing the author’s compassion for this young woman and her hopes for her as well. It’s a story of healing and growth that reveals the good that therapeutic relationships coupled with medication can do for some patients. […]

2021-01-11T13:47:05-05:00January 11th, 2021|mental illness, narratives, Nursing, Patients|0 Comments
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Hospital Closings Hit Rural Communities Hard, But Aren’t Inevitable

Photo by Taylor Sisk/North Carolina Health News

Community hospitals across the country have been closing in recent years. Reasons given include system consolidations, rising costs of care, Medicare reimbursement issues, and changing models of health care delivery. Few hospital closures are welcomed by patients or employees, but those that take place in rural areas, where there may not be another hospital for many miles, often affect the local community with particular severity.

A double hit for local economies.

Not only do hospital closings in rural areas make access to health care a challenge, sometimes forcing local residents to drive many miles for care. But—as this month’s AJN Reports points out (“Will Rural Community Hospitals Survive?“)—rural hospital closings also have a ripple effect on a local economy, meaning lost jobs as well as lost revenue for ancillary businesses in the area.

Hospital that innovate may survive.

Despite current pressures, some rural hospitals are finding new ways to thrive. As the article describes in greater detail, hospital “survival strategies” include partnerships and “becoming increasingly creative with providing services,” including expanding the use of telehealth. […]

2017-09-26T09:45:27-04:00September 26th, 2017|Nursing|0 Comments
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AJN in September: Predicting Injurious Falls, Military Sexual Trauma, Recognizing MI, More

AJN0916.Cover.OnlineThe September issue of AJN is now live. Here are some articles we’d like to bring to your attention.

CE Feature: “Original Research: Predicting Injurious Falls in the Hospital Setting: Implications for Practice”

Despite years of research and increasingly evidence-based practice, falls continue to be the most commonly reported adverse events experienced by hospitalized adults. Yet most of the relevant research has focused on predicting and preventing falls in general; there has been little focus on injurious falls. In an attempt to identify which patient factors are associated with injurious falls in hospitalized adults, the authors of this retrospective study analyzed 10 variables. Their findings may help hospital clinicians to identify at-risk patients and create better fall-related injury prevention interventions.

CE Feature: “Military Sexual Trauma in Male Service Members”

The experience of military sexual trauma (MST), which can result from assault, battery, or harassment of a sexual nature, may jeopardize the mental health of service members. This article discusses the unique ways in which men may experience MST and examines how social stereotypes of masculinity, myths surrounding sexual assault, and military culture and structure often influence a man’s interpretation of an attack and his likelihood of reporting the incident or seeking treatment. It also describes current treatments for MST-related mental health conditions and addresses implications for nurses and other health care […]

2016-11-21T13:00:58-05:00August 26th, 2016|Nursing, nursing perspective|0 Comments
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Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
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