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Health Care Analysis
Published in: Health Care Analysis 4/2010

Open Access 01-12-2010 | Original Article

The Heart of the Matter. About Good Nursing and Telecare

Author: Jeannette Pols

Published in: Health Care Analysis | Issue 4/2010

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Abstract

Nurses and ethicists worry that the implementation of care at a distance or telecare will impoverish patient care by taking out ‘the heart’ of the clinical work. This means that telecare is feared to induce the neglect of patients, and to possibly hinder the development of a personal relation between nurse and patient. This study aims to analyse whether these worries are warranted by analysing Dutch care practices using telemonitoring in care for chronic patients in the Netherlands. How do clinical practices of nursing change when telecare devices are introduced and what this means for notions and norms of good nursing? The paper concludes that at this point the practices studied do not warrant the fear of negligence and compromised relations. Quite the contrary; in the practices studied, telecare lead to more frequent and more specialised contacts between nurses and patients. The paper concludes by reflecting on the ethical implications of these changes.
Footnotes
1
Telecare is a term that loosely refers to many different carepractices using many different devices. Telecare is s ‘direct patient care, in which the recipient is at home and spatially remote from the clinician, nurse or informal carer, and in which communication media are used’. This definition is an adaptation from a recent Cochrane definition of telemedicine [4]. Telecare is discerned from ‘telemedicine’, which involves the communication with patients at home. In our project, we studied three classes of telecare in the Netherlands: monitoring devices, educational devices and webcam projects.
 
2
The conference was called ‘Telecare: Dialogue and Debate—The emergence of new technologies and responsibilities for healthcare at home in Europe’ and took place in Utrecht, Netherlands, 20 & 21 September 2007. It is documented well: see http://​www.​csi.​ensmp.​fr/​WebCSI/​MEDUSE/​, last accessed: 28 July 2008.
 
3
‘Speaking the truth’is not the only way of answering. Other patients negotiated their answers with expected responses for the nurse, and their own care for the nurse.
 
4
This reflects a difference between the tradition of ‘clinical knowledge’ and the tradition of ‘laboratory knowledge’ [26]. The clinical tradition refers to the treatment of individual patients, callibrating different variables to match their situation [13]. The laborator tradition refers to the scientific tradition that in these days would be called ‘evidence based nursing’, finding statistical support for the effectivity of cerntain treatments. In this article, however, we will be adressing both as clinical, because laboratory evidence comes to matter only when put to use in clinical care.
 
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Metadata
Title
The Heart of the Matter. About Good Nursing and Telecare
Author
Jeannette Pols
Publication date
01-12-2010
Publisher
Springer US
Published in
Health Care Analysis / Issue 4/2010
Print ISSN: 1065-3058
Electronic ISSN: 1573-3394
DOI
https://doi.org/10.1007/s10728-009-0140-1

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