Telehealth during COVID‐19: The perspective of alcohol and other drug nurses

Abstract

Aim This study aimed to explore the experiences of alcohol and other drug nurses transitioning to telehealth due to the COVID‐19 pandemic. Background COVID‐19 has caused immense disruption to healthcare services, and to reduce viral transmission, many services moved to off‐site care delivery modalities such as telehealth. Design We used a qualitative descriptive design for this study. Methods Secondary analysis of semistructured interviews with alcohol and other drug nurses from Australia and New Zealand (n = 19) was conducted in July and August 2020. Data were analysed using thematic analysis and reported using COREQ guidelines. Results Three were identified: ‘“All our face‐to‐face contact ceased with clients”: Changing service delivery’, ‘“How do I do my job when I can't see you?”: An anxious shift in service delivery’ and ‘“A lot of Indigenous people don't like the FaceTiming and all that”: Challenges to delivery of services through telehealth’. Conclusion Participants in our study reported challenges in transitioning to telehealth modalities. The perceived loss of therapeutic communication, difficulties in assessing risks to healthcare consumers such as domestic violence and challenges delivering telehealth care to a marginalized consumer cohort need to be overcome before telehealth is considered successful in alcohol and other drug treatment. However, telehealth was a successful adjunct to existing practices for nurses working with consumers in regional or remote areas or where consumers preferred this method of service delivery. Impact Nurses in this study described substantial issues with the delivery of alcohol and other drug treatment via telehealth, including a perception that telehealth was a barrier to addressing risks to consumers who use alcohol and other drugs, and difficulties working in a therapeutically beneficial way via telehealth. Telehealth is a means to reduce viral transmission through a reduction in face‐to‐face contact, and although it may be useful for some service functions, it may be detrimental to the clinical services nurses provide.

Impact of COVID-19 among people who use drugs: A qualitative study with harm reduction workers and people who use drugs

“…Studies also noted, however, that PWUD with limited access to internet or reliable cell phone data plans were disadvantaged and lacked the ability to access telehealth service options [ 29 , 35 , 38 ]. Some participants also noted difficulty establishing therapeutic alliance and rapport remotely [ 32 , 39 ]. The preponderance of research evidence supports the consensus that the COVID-19 pandemic negatively impacted the lives of PWUD, but also found that service providers and harm reduction workers found creative ways to support continuity of services.…”

Reflections on nursing research focusing on the COVID‐19 pandemic

“…Skill mix and staffing models were changed to build capacity as a response to the demands of the pandemic (Endicott et al, 2022), and where possible, services adopted various forms of remote working and telehealth, which was seen to be useful and effective in some ways but problematic in others (Hughes et al, 2022). Nurses identified issues with delivering alcohol and drug services through telehealth, though this modality was seen as being successful as an adjunct service to people living in regional or remote locations or with those consumers who had a preference for telehealth (Searby & Burr, 2021).…”

“…Nurse researchers were quick to scrutinize and synthesis the literature to ascertain the presenting signs and symptoms of adult hospitalized patients with COVID‐19 at a time when still little was known about the virus (Keller et al, 2020 ). There has been considerable recognition of the needs of particular populations such as older adults and those living with chronic conditions (Rodrigues et al, 2022 ; Ryan & Meskell, 2022 ; Searby & Burr, 2021 ), as well as the effects of visitor restrictions in community and health settings (Rodney et al, 2021 ), and particularly on the effects and impacts of these restrictions on minority populations (Altman et al, 2021 ). Issues such as loneliness (Rodney et al, 2021 ), attitudes and views on vaccination (Burden et al, 2021 ) and health disparity (Jackson et al, 2021 ; James et al, 2021 ) have been raised and interrogated in relation to the COVID‐19 pandemic.…”

“…Istanboulian et al ( 2022 ) recognized communication impairments in patients treated with invasive mechanical ventilation in the intensive care unit during the COVID‐19 pandemic and undertook a study to explore the barriers and facilitators for supporting optimal communication in this context. Nurses have recognized the particular needs of people with chronic and underlying health needs during the pandemic and have modified approaches to care to ensure that patients and consumers still had access to the best possible care that could be delivered during the pandemic (Ryan & Meskell, 2022 ; Searby & Burr, 2021 ). Similarly, administrators and academic nurses have revised processes and their ways of working to be optimally responsive during the pandemic, in the constraints that were faced (Ion et al, 2021 ; Riddell et al, 2022 ).…”

Telemedicine in the treatment of addictions

“…Studies published since January 2020 necessarily have to be understood in the context of a global pandemic that forced clinical settings and addiction professionals to rapidly readjust to replace nonessential face-to-face appointments by phone or video call appointments [3,7,8]. Although in some cases professionals working in addiction identified challenges in transitioning to real-time telemedicine modalities [9], patients were satisfied with receiving treatment for SUDs, and professionals perceived them as useful [10,11].…”