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Telenurses' understanding of work: detective or educator?
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research. (Health Services Research)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research. (Health Services Research)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research. (Health Services Research)
2009 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 65, no 2, 382-390 p.Article in journal (Refereed) Published
Abstract [en]

AIM

This paper is a report of a study to describe the different ways of understanding work among a group of Swedish telenurses.

BACKGROUND

Telenursing is an expanding service in many western countries and telenursing work is likely to be understood in a variety of ways. The way in which a person understands work influences how work is performed. Telenursing demands high levels of competence.

METHOD

A qualitative interview study was conducted during 2004-2005. Twelve of the 20 telenurses working at a call centre in Sweden were interviewed, five of them twice because of organizational changes. The 17 interviews were analysed using a phenomenographic approach.

FINDINGS

Five different categories were identified in the data: (1) Assess, refer and give advice to the caller (2) Support the caller (3) Strengthen the caller (4) Teach the caller and (5) Facilitate the caller's learning. The first category can be seen as a base for telenursing work and was the only category used by some telenurses. The second category has components of traditional caring and the third is a coaching function. The fourth category contains a teaching component, but the fifth is the only category where the caller's learning is in focus. Telenurses who reported the fifth way also included all other ways of understanding work. Hence, this seems to be the most comprehensive way of understanding work.

CONCLUSION

The categories together constitute a telenursing 'workmap'. This 'workmap' can be used for reflection to expand telenurses' current understanding of work, and hence promote competence development. Telenurses need to be aware of their role in public health education.

Place, publisher, year, edition, pages
2009. Vol. 65, no 2, 382-390 p.
Keyword [en]
Communication, competence, health education, learning, phenomenography, support, telenursing, workmap
National Category
Medical and Health Sciences
Research subject
Health Care Research
Identifiers
URN: urn:nbn:se:uu:diva-102283DOI: 10.1111/j.1365-2648.2008.04877.xISI: 000262511300014PubMedID: 19040692OAI: oai:DiVA.org:uu-102283DiVA: diva2:214573
Funder
Swedish Research Council
Available from: 2009-05-06 Created: 2009-05-06 Last updated: 2014-01-23Bibliographically approved
In thesis
1. Telephone Nursing: Stakeholder views and understandings from a paediatric and a gender perspective
Open this publication in new window or tab >>Telephone Nursing: Stakeholder views and understandings from a paediatric and a gender perspective
2013 (English)Doctoral thesis, comprehensive summary (Other academic)
Alternative title[sv]
Omvårdnad per telefon : Intressenters syn och förståelsefrån ett pediatrik- och ett genusperspektiv
Abstract [en]

‘First line healthcare’ is offered via telephone in many Western countries. The overall aim of this thesis is to describe Telephone Nursing (TN) from three viewpoints: telenurses, parents calling for their children, and operation managers. Four empirical studies were conducted. Telenurses described their work in five different ways: ‘Assess, refer and give advice to the caller’, ‘Support the caller’, ‘Strengthen the caller’, ‘Teach the caller’ and ‘Facilitate the caller’s learning’, which all constitute a TN ‘work map’. Authentic paediatric calls between parents and telenurses revealed that 73% of callers were mothers and children were aged between 5 days and 14.5 years. The top three contact reasons were ear and skin problems, and fever, with a median call length of 4.4 minutes. More than half of the calls resulted in referrals and 48% received self-care advice. The likelihood of fathers being given referrals as a result of their call was almost twice as high as that for mothers, while mothers were almost twice as likely to receive self-care advice as fathers. Parents described their degree of worry and trust that influenced their decisions whether to contact SHD or not. Their calls were carefully prepared, and the parent calling often depended on family routine. Parents reported to follow recommendations. Most relied upon their own intuition if further worried, but some indicated they would never seek healthcare unless it was recommended. Operation managers described four main goals of TN work: ‘create feelings of trust’, ‘achieve patient safety’, ‘assess, refer and give advice’, and ‘teach the caller’. Equitable healthcare was regarded as important, whereas health promotion was not considered as part of the goals.

Conclusion: The studied TN viewpoints present concordance and discrepancies. Paediatric health calls appear mostly to be a woman-to-woman activity. Telenurses’ increased gender competence might increase TN safety. For that matter, telenurses’ collaboration with parents and making parents aware of holding the ultimate responsibility for their child’s condition is important. Goals of TN work and their relationship with healthcare obligations such as equitable healthcare and health promotion need further clarification. The viewpoints described in this thesis may contribute to the development of TN.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2013. 75 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 933
Keyword
Children; Equitable Healthcare; Gender; Health Promotion; Managers; Paediatric; Paediatric Health Calls; Parents; Registered Nurses; Telenurse; Telephone Nursing; Qualitative Research
National Category
Medical and Health Sciences
Research subject
Health Care Research
Identifiers
urn:nbn:se:uu:diva-200204 (URN)978-91-554-8746-1 (ISBN)
Public defence
2013-10-25, Auditorium Minus, Gustavianum, Uppsala Universitet, Akademigatan 3, Uppsala, 09:15 (Swedish)
Opponent
Supervisors
Funder
Swedish Research Council, 522-2005-7461
Available from: 2013-10-02 Created: 2013-05-22 Last updated: 2017-03-13Bibliographically approved

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Publisher's full textPubMedhttp://onlinelibrary.wiley.com/doi/10.1111/j.1365-2648.2008.04877.x/pdf

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Kaminsky, ElenorRosenqvist, UrbanHolmström, Inger

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