An examination of telenursing : description of the professional role and predictors of role stress, role ambiguity and role conflict

Abstract

An examination of telenursing: Description of the professional role and predictors of role stress, role ambiguity and role conflict. Telenursing is the use of telehealth technology to deliver nursing care and conduct nursing practice (Schlachta & Sparks, 1999). In response to the rapid adoption of telemedicine technology in he'1:lthcare organizations, telenursing is emerging as a new role, prompting discussion of licensure, malpractice, and credentialing issues within nursing. Role stress associated with new nursing roles such as telenursing impacts individual patients and the larger healthcare organization, causing turnover, burnout, loss of continuity of care and loss of operational expertise. As with many emerging technologies, nurses assume increasingly complex roles and responsibilities. As telemedicine proliferates, the role of nurses in participating in and improving the telemedicine process will take on more pr.ominence. It is important to identify issues related to use and integration of telemedicine into nurses' roles to minimize role stress, encourage telenursing participation and position nursing practice to take advantage of telemedicine technologi~s. Using the portion of Role Theory, that relates to the impact of Role Set upon Role· Strain, as a framework this was a descriptive ·research study that identified a current population of 796 telenurses in the U.S., representi!lg 40 states. From this population, 196 telenurses participated in a telephonic or an online, web-based survey during Summer 2000. The purposes were to 1) Describe a) telenurses' professional role(s) and characteristics and b) U.S. strategies for nursing competence and patient safety 2) Measure telenurses' work satisfaction_ and its components, and role stress and its components 3) Predict the relationship between the components of work satisfaction, individual and professional role characteristics, and role stress, role ambiguity and role conflict. iv Findings of the Telenursing Role Study indicated that the typical Y2K telenurse is 46 years old, has worked 21 years in nursing and >6 months in her telenursing position. She has a 27% chance of being an advanced practice nurse, and has at least a baccalaureate degree, and likely a graduate degree. The typical telenurse is white, female, married, and has children .. She works full-time in teleriursing and makes just over $49,000 per year. Telenurse.s work in over 29 practice settings, including web portals, private companies and for telemedicine equipment vendors. They have a host of unique, new titles such as Bioengineering Clinical Nurse Specialist, Telehealth Project Director and Consumer Information Nurse. Telenurses experience less than average role stress, role ambiguity and role conflict. They also have the same work satisfaction as other hospital-based nurses. The most important factor contributing to telenurses' work satisfaction is autonomy. Findings of regression analysis were that education level and level of work satisfaction both predict role stress and role ambiguity in telenurses. Higher education levels of telenurses are associated with higher role stress and role ambiguity. Higher levels of work satisfaction of telenurses are associated with lower role stress and role ambiguity. Role ambiguity, level of education and work satisfaction are significant predictors of role conflict in telenurses.