title: Telenurses' understanding of work: detective or educator?
abstract: OBJECTIVE
  This paper is a report of a study to describe the different ways of understanding work among a group of Swedish telenurses.
  
  
  BACKGROUND
  Telenursing is an expanding service in many western countries and telenursing work is likely to be understood in a variety of ways. The way in which a person understands work influences how work is performed. Telenursing demands high levels of competence.
  
  
  METHODS
  A qualitative interview study was conducted during 2004-2005. Twelve of the 20 telenurses working at a call centre in Sweden were interviewed, five of them twice because of organizational changes. The 17 interviews were analysed using a phenomenographic approach.
  
  
  RESULTS
  Five different categories were identified in the data: (1) Assess, refer and give advice to the caller (2) Support the caller (3) Strengthen the caller (4) Teach the caller and (5) Facilitate the caller's learning. The first category can be seen as a base for telenursing work and was the only category used by some telenurses. The second category has components of traditional caring and the third is a coaching function. The fourth category contains a teaching component, but the fifth is the only category where the caller's learning is in focus. Telenurses who reported the fifth way also included all other ways of understanding work. Hence, this seems to be the most comprehensive way of understanding work.
  
  
  CONCLUSIONS
  The categories together constitute a telenursing 'workmap'. This 'workmap' can be used for reflection to expand telenurses' current understanding of work, and hence promote competence development. Telenurses need to be aware of their role in public health education.
authors.affiliation: Department of Public Health and Caring Sciences, Health Services Research, University of Uppsala, Sweden. elenor.kaminsky@pubcare.uu.se
authors.forename: Elenor
authors.initials: E
authors.lastname: Kaminsky
authors.forename: Urban
authors.initials: U
authors.lastname: Rosenqvist
authors.forename: Inger
authors.initials: I
authors.lastname: Holmström
mesh_terms: D000328:Adult; D002983:Clinical Competence; D003142:Communication; D032882:Comprehension; D003657:Decision Making; D005260:Female; D006801:Humans; D008875:Middle Aged; D024802:Nurse's Role / Q000523:psychology; D009723:Nurse-Patient Relations; D010353:Patient Education as Topic; D036301:Qualitative Research; D013548:Sweden; D017216:Telemedicine; D055817:Telenursing