When all other doors are closed: Telenurses' experiences of encountering care seekers with mental illnesses

Abstract

The aim of the study was to describe the telephone nurses' experiences of encountering callers with mental illnesses. Telenursing services are solely staffed with telenurses, who with the support of a decision support system (CDSS) independently triage callers based on the severity of the main symptoms presented by the care seeker. The system focuses on somatic symptoms, while information regarding mental health and mental illnesses is limited. Information about telenurses' experiences of encountering care seekers with mental illnesses is scarce, despite the increase in mental illnesses in the population. The study used a descriptive design with a qualitative approach. Twenty telenurses were interviewed, and the data were then analysed using inductive qualitative content analysis. The results are elaborated in the following three categories: (i) Experiences of encountering care seekers with mental illnesses; (ii) Experiences of facing difficulties and challenges; and (iii) Experiences of facing dissatisfaction and threats. Encountering care seekers with mental illnesses is metaphorically addressed as 'when all other doors are closed'. Encountering care seekers with mental illnesses was perceived as time-consuming and did not adequately correspond to the resources given by the service. Even though telenurses strive to achieve agreement, there is a collision between human needs and organizational structures. The study pinpoints the lack of resources for and education about mental illnesses and the limitations of the decision system, which needs to be updated in order to provide all care seekers care on equal terms.

Clinical Decision Support and Implications for the Clinician Burnout Crisis

“…The 75 non-review, non-opinion articles used a variety of metrics to evaluate the usability and acceptability of their CDS tools, with many using more than one metric. The most common evaluation was via interviews (n=29) 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 , followed by surveys or questionnaires (n=16) 27 29 50 53 55 56 57 58 59 60 61 62 63 64 65 66 . Other qualitative feedback responses were obtained by focus groups or workshops (n=5) 43 57 61 67 68 .…”

Psikiyatri Hemşireliğinde İnovasyon ve Evde Hasta Takibi

“…Tele-psikiyatri uygulamalarında aktif rol alan psikiyatri hemşireleri etkili iletişim kurma yetilerini kullanarak, sağlık bakımının niteliğine yön vermektedir (17,18). Bu amaçla, tele-psikiyatri alanında hizmet sunumu gerçekleştirecek sağlık profesyonellerine teknik eğitim verilmesi ve uygulama ile ilgili tele-hemşirelik rehberlerinin oluşturulması gelişen bakım anlayışıyla paralellik gösterecektir (19).…”

“…Ruhsal bozukluğu olan bireylerin kendi sosyal ortamlarından koparılmadan, toplum temelli tedavi ilkeleri çerçevesinde hizmet almalarını desteklemek amacıyla son yıllarda elektronik temelli tedavi ve bakım modelleri geliştirilmiş ve psikiyatri alanına yansımaları olmuştur (17). Tele-psikiyatri, tele-tıp hizmetlerinin ruh sağlığı hizmetlerine uyarlanmış biçimidir (18).…”

Giving advice to callers with mental illness: adaptation among telenurses at Swedish Healthcare Direct

“…As well as being expected to answer many calls per hour, the performance of these telenurses is monitored and evaluated by the management. This call centre culture is problematic, since care-seekers with mental illness often require more time from the telenurses and need to be listened to (Bjorkman & Salzmann-Erikson, 2018). Telenurses also perceive the ethical dilemma of careseekers potentially being lost in the healthcare system (Holmström & Dall'Alba, 2002;Holmström & Höglund, 2007).…”