Start/Search | Browse by Day | Author Index

Rural nurse practitioners fill a desperate need for obstetrical and gynecologic health care in remote areas of Arkansas.  They often provide care for many counties and travel from clinic to clinic daily. The rural nurse practitioner is often on their own and do not have the option to call a colleague into the patient’s room for a consultation. This sometimes creates a situation where the rural nurse practitioner feels isolated and alone in their practice. The Arkansas Health Department and the University of Arkansas for Medical Sciences began a new collaboration in July 2009 to improve resources and support for the rural nurse practitioner.

The first program implemented was a consult line for rural nurse practitioners. The tertiary care nurse practitioner provides coverage for the phone consultation. Often the questions or needs can be answered without consulting a physician or specialist. If further consultation is required, the tertiary care NP facilitates the call to the maternal fetal specialist or OB/GYN generalist.

The next component is a monthly teleconference, which provides a venue for continuing education and dialogue of various clinical topics. The conference is coordinated by the tertiary care NPs and the teleconference can be viewed via the web by the NPs who were not able to attend.

Rural high risk pregnant patients often have to travel for specialty care visits. This places a burden on the patient and her family. Through collaboration with the rural nurse practitioner and telehealth, the nurse practitioner or physician co-manages and consults with the high risk patient using telehealth. The rural nurse practitioner attends the visit, so they are able to remain current on the latest changes in care. An example is a pregnant woman with insulin dependent diabetes. The physician or NP at the academic health science center manages the insulin changes while the remote NP provides the pregnancy care.

As the demand for high risk services increases, it is essential for health care providers in women’s health and obstetrics to partner in new and innovative ways. Collaboration between the academic health science center and the rural nurse practitioner to co-manage patients via telehealth is a wonderful solution for the rural high risk patient.