Many registered nurses choose to work as on-site nurses for organisations. These on-site nurses focus on the well-being of an organisation’s employees. In addition, they empower and support employees in leading healthier lives, and aid in overall workplace health improvement.
However, the current on-site nurse model leaves much room for improvement. Firstly, staff not working at head office are unable to access the nurse on-site; this differential access leads to inequitable service outcomes for most of an organisation’s employees.
Secondly, the nurse is somewhat limited in the extent of the services they can provide to patients. Most saliently, the majority of nurses do not have prescribing rights and so cannot provide patients with prescriptions in the way a general practitioner can.
After having assessed a patient needing urgent care, the on-site nurse will still have to send the patient to a general practitioner or to an accident and medical centre for further assessment or treatment. One of the inconveniences in this model is borne out in the fact that sometimes all the patient requires is a repeat prescription of their medication or an antibiotic for an infection.
Thirdly, patients needing help with mental health issues like stress and anxiety have to be sent elsewhere for advice and management of these conditions. Physical illnesses can be caused or aggravated by mental factors like workplace conflict and stress. Staff finding their jobs particularly stressful could benefit from a more holistic health service model that integrates mental health. Those dealing with difficult clients in retail, call centres, and other customer-oriented settings may need debriefing in particularly difficult situations.
Shared resources are shared amongst several users so operating costs are divided amongst users making it cheaper. Dedicated resources, on the other hand, are dedicated solely to one user and are therefore more expensive. The nurse on-site model is an example of a dedicated service. Employers pay for resources whether or not they are being utilised.
Employees who book appointments with the on-site nurse may fail to attend due to work conflict, thus the service goes unused and cost incurs when organisations are looking for ways to add value to a service while reducing cost. The online delivery model such as Doctor2go offers greater flexibility. Sharing existent resources delivered online reduces cost.
The nurses who work on-site triage patients with no access to services that integrate mental health or general practitioner services, which limits the services they can provide to patients. Telemedicine models such as Doctor2Go, however, can dramatically improve access to such services, thereby improving patient outcomes.
Telemedicine addresses the shortcomings of on-site nursing and is the perfect solution for both employers and employees. Doctor2Go uses technology to improve patients’ overall experience. The use of technology in healthcare is not just about computers instead of diaries, or electronic records instead of paper ones: it is about new ways of organising services, and new approaches to handling, sharing and managing medical information and knowledge. The Doctor2Go team includes doctors, nurses and mental health professionals who are able to share and manage information while still respecting patient privacy.
Workplace Telehealth has the ability to provide care for low acuity visits, providing effective care in a convenient location and at a convenient time. Most of the information that is required for a diagnosis is in taking a comprehensive patient history. This does not need a physical visit and can quite easily be achieved over the phone or via video call.
Ultimately, investing in the health and well-being of employees can save employers millions of dollars. Employees are more productive if their health and well-being are taken care off, while employers will find that rates of absenteeism are lowered. Although the on-site nurse makes a very specific contribution to the overall management of patients with whom they come into contact, they are limited by their scope of practice. Is the current on-site nurse model outdated?
References
Cook R (2012) Exploring the benefits and challenges of telehealth. Nursing Times 108 (24), pp. 16-17.
Maddison D, Kellehear KJ (1982) Psychiatric Nursing, 5e. Churchill Livingstone: Edinburgh.
“Registered Nurse Scope of Practice.” Nursing Council of New Zealand.