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Is virtual care appropriate?

Case study

​Note: The c​​ontent on this page is the same for LPNs, NPs, RNs, and RPNs.​​ Some of the resources are designation-specific.​​​

​​​Danny is a nurse in a community mental health unit that offers in-person and virtual (phone or video) appointments for clients. Joe has been a client at the clinic for about two years and has a well-established relationship with Danny and his mental health team. Joe has access to the technology needed to participate in a virtual health encounter.

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​​What does Danny need to consider before providing virtual care for a client?

Danny knows when he provides virtual care he must:

  • Determine that virtual care is an appropriate mode of treatment for the client at this time
  • Ensure client privacy and confidentiality by following the BCCNM Privacy and Confidentialitypractice standard
  • Obtain informed consent for the virtual care assessment and any follow-up care that is required
  • Document in the client record the care provided
  • Follow organizational policies

Danny schedules a virtual care video appointment with Joe. Joe is normally very engaging and takes pride in his appearance, but during the video appointment, Danny notices Joe is unkempt, guarded, and showing signs of paranoia. Joe claims his neighbours are watching him all the time and he is afraid to leave his house. Danny recognizes that Joe may be decompensating.

Danny determines that a virtual care visit is no longer appropriate as Joe's care needs currently exceed what can be provided virtually.

What steps does Danny take next?

  • Tells Joe that he would like to see him in person that day
  • Discusses his findings with his team and formulates a plan
  • Schedules Joe for an in-person visit at the clinic that same day for a more in-depth assessment
  • Documents his assessment findings, interventions, and plan of care in Joe's medical record

Danny makes arrangements for Joe to have an in-person visit at the unit later that day for a more in-depth assessment. At the scheduled appointment, Danny finds Joe is decompensating. Danny contacts Joe's treating psychiatrist who admits him to hospital for further investigation and treatment.

Conclusion

Virtual care may be appropriate in many circumstances. However, a client's current health status, needs, and treatment need to be considered when deciding whether virtual care is the best option for a client at a given time. As well, nurses providing virtual care services are expected to practice within their scope of practice, meet BCCNM's standards of practice, and follow workplace policies.​​

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With great respect, we acknowledge that BCCNM’s office is located on the unceded territories of the hən̓q̓əmin̓əm̓ speaking peoples – xʷməθkʷəy̓əm (Musqueam), and sel̓íl̓witulh (Tsleil-Waututh) Nations, and the Sḵwx̱wú7mesh-ulh Sníchim speaking peoples - Sḵwx̱wú7mesh Úxwumixw (Squamish Nation) whose historical relationships with the land continue to this day.​