A Nurse Practitioner's Experience Using Remote Presence Technology in an Isolated Community: An Autoethnography
Date
2021-06-17
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
ORCID
0000-0001-5902-3424
Type
Thesis
Degree Level
Masters
Abstract
There are many barriers to accessing healthcare services, particularly for people living in remote communities. Embracing innovation, such as remote presence technology (RPT), is one approach to reducing barriers. Innovations for healthcare service delivery can affect the care provided at the local level.
Research Question and Methodology
I examined the effect of RPT on healthcare service delivery in a remote community. Employing analytic autoethnography, I took a three-pronged approach, considering a systems level, patient care level, and nurse practitioner (NP) practice level.
Outcomes
Systems Level
In Saskatchewan, rural and remote dwellers experience a disparity in access to primary and specialist care, allied health professionals, and diagnostic services. Contributing factors involve the centralization of services, distance decay, transportation, and unfunded costs. Social determinants of health and systemic oppression contribute to the disparity. This results in patients receiving altered standards of care and poorer health outcomes.
Patient Care Level
RPT resulted in superior care provided to patients, resulting in a decrease in morbidity and mortality. Most patients were able to remain in the community rather than being transferred out, and patients and families were actively engaged with developing the care plan.
NP Practice Level
Working directly with specialists through collaboration, mentorship, and coaching enhanced NP work confidence and competence. Professional isolation and decision fatigue decreased. Challenges included not having access to the necessary providers, provider attitudes, inflexible policies, and having to shoulder the burden of care.
Conclusion
The introduction of RPT can have a drastic effect on the healthcare system, which is felt most at the local level. Patients can receive appropriate and timely care in their home community. NPs have a unique role working in remote healthcare settings. This model of care could have a significant influence on NP practice. Initiatives should be community-driven and responsive to match needs with services.
Description
Keywords
Access to care, nurse practitioner, rural/remote nursing, remote presence technology, health service delivery, virtual care
Citation
Degree
Master of Nursing (M.N.)
Department
Nursing
Program
Nursing