CANOE Network

The Toronto Sun CareerConnection


Nurses on call

By David Chilton
Special to the Toronto Sun

Giving advice over the phone has been common practice for banks, bookies and bureaucrats for years. Now health care is getting into the act with a comprehensive lineup of services accessible via a toll-free number.
Telenurse Kristen Desouza converses with John Langworthy (inset, on the screen), a patient who remains comfortably at home while Desouza checks his vital signs using telehomecare technology. Centennial College's pilot project linked 200 East York homes with telenurses.

In this province it's Telehealth Ontario that's making its presence felt as it logs up to 130,000 calls a month from the public, and more than 155,000 calls a month during a health scare such as the recent SARS outbreak.

Laurie Poole, professional and quality services director for Clinidata, the service provider for Telehealth Ontario, says its lines are staffed 24 hours a day seven days a week all year by registered nurses with at least three years of recent clinical experience behind them.

In all, says Poole, Telehealth Ontario employs between 225 and 250 full- and part-time nurses in four centres in Toronto, North Bay, London and Sudbury.

Most callers speak to a nurse for 10 minutes, on average, says Poole, with 90% of them -- or their children -- already symptomatic. Thus the nurses' main job is primary care triage and symptom management. The other 10% of callers want information on such illnesses as chicken pox and so on, Poole adds.

About three per cent of Telehealth Ontario's calls are in French, but Poole says the service can provide translators in 110 languages who can be in on a three-way call within 60 seconds of the nurse determining the caller's native tongue. CanTalk Canada in Winnipeg provides the translators. The most in-demand languages are Mandarin, Cantonese, Farsi (Persian), Italian and Portuguese.

Clinidata doesn't hire new nursing graduates, and anyone applying for a job with Telehealth Ontario faces rigorous vetting. There's "a very comprehensive clinical interview," says Poole, and three weeks of orientation. There's also a fourth week the would-be employee spends with a supervisor on the floor of the call centre. Telehealth Ontario nurses' pay is the same as they would earn in hospitals and clinics.

Fees are reimbursed

One of the best ways for an RN to get hired at Telehealth Ontario is to have Centennial College's certificate program in nursing telepractice under her belt. It lasts a year and Clinidata reimburses the tuition fees -- about $2,900 -- for the nurses who take and pass the program. The 12-month course has been in place for two years and is delivered entirely on-line, says Robert Luke, manager of applied research and e-learning, at Centennial's School of Applied Arts and Health Sciences.
  • Telehealth Ontario is a free service from the Ministry of Health and Long Term Care.
  • All staff are experienced registered nurses.
  • Calls can be answered in English or French or in 110 other languages with the help of a translator.
  • Centennial's program in nursing telepractice is unique in Canada and the U.S.
  • The 12-month program is delivered entirely online.

  • "(Telehealth) certainly is a growing area, and with the expertise we have in developing this certificate program we also have the ability to offer some tailored education in all aspects of telehealth," Luke says. "We also recently did some funded research in telehomecare and developed a course for telehomecare which we're presently marketing."

    Doris McLean, the nursing telehealth program manager at Centennial, says about 75 nurses are enrolled in different stages of the program. Twenty five nurses have already graduated and McLean expects another 15 graduates this year from the program, the only one of its kind in Canada or the U.S.

    Millicent Pitterson, a Telehealth Ontario nurse since 2001, says she's worked in cardiac and other hospital departments and was looking for something different when the Clinidata opportunity came up. She says the main difference between working as a nurse on a hospital ward and at Telehealth Ontario is the hands-on approach of the former and the hands-off method of the latter.

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