Meet the telehealth nurse who saves lives from home: Q&A

From children swallowing coins to a man being crushed by his truck – a telehealth nurse's life is unlike any other.

Cora O'Brien, the clinical lead of 20 triage nurses at Medibank Health Solutions, keeps herself busy managing the day-to-day processes of helping people in need. 

A registered nurse for twenty years, Cora's worked across the world in places like Canada and the Middle East. 

"A polar bear broke into our nursing outpost in Nunavut; I've put together medical supplies for the army in Israel and cared for the Aboriginal population in Rural outback Australia," she says.

But she enjoys her current job the most.

Nursing Review asked Cora what it's like working as a telehealth nurse in Australia, what skills she's developed for the role and the phone calls that are still fresh in her memory. 

NR: Could you tell us about your experience in nursing over the years?

Cora: I received my Bachelor of Science and Nursing in Canada. I started my career up in Nunavut, a town in the remote northern part of Canada, working in a rural outpost. From there, I travelled to the Middle East, where I supplied medical equipment for the army in Israel. I found working there quite challenging and wasn't very successful in that role.

Then, after nursing in New Zealand for a while, I ended up in the rural outback of Australia. I cared for the Aboriginal population there, which was a really exciting opportunity. And then I started to work for Medibank, which I find the most enjoyable job I've had so far.

What would you say are the necessary skills for working as a nurse in telehealth?

You need to have very good communication and clinical assessment skills. Critical thinking is also important and you need to be patient. Interpersonal skills are also necessary, especially with children, as they sometimes make an appearance on phone calls.

What skills have you found harder to develop for the job?

I would say, more so than anything, being able to communicate with the caller without seeing them. As nurses, we're used to looking at our patients during an assessment, and removing that major aspect is by far the most challenging.

You must develop a way to assess your patients without seeing them and expand your questioning skills to get an accurate clinical picture.

I can imagine that showing empathy to people who might be in a challenging situation can also be hard via telephone.

It can be, but as a registered nurse, you develop these skills over time and with experience. You have to have the ability to convey empathy regardless of whether or not it's over the phone, and that does come quite naturally to nurses.

We have to show compassion because we sometimes have people calling about their mental health, such as people wanting support after a loved one has died. But, again, I find it comes naturally for nurses.

What type of phone calls do you receive on a day-to-day basis?

On a typical day, we get everything from little ones swallowing coins, car accidents, febrile children, mental health callers, maternity issues and sports accidents. It could be someone who's had an injury who wants to speak to us before going to the emergency department.

Abdominal pain and chest pains are also common, but there are many respiratory illnesses at the moment because of the season. We receive anything from neonates, maternity, aged care, emergency calls, general health inquiries and queries about provider referrals every day.

Is there a particular call that you still remember clearly to this day?

One that stands out for me was a very urgent call wherein a parent said their child was blue and not breathing. I transferred them to the emergency services and the child survived. It showed me how important we are in the community – that we provide essential service to the Australian public and that it matters, because it was a genuine emergency and the mother was quite frantic.

Another one I remember was a caller who rang saying he was crushed under his truck while working on it. I kept him calm while trying to transfer him to emergency services. It took a lot of skill to keep him focused on getting his details, assessing him and moving him through to the ambulance. He kept saying he was grateful that someone was there with him – he didn't feel alone.

How has the current flu season, in combination with COVID-19, affected telehealth?

Our calls have exponentially, I'd say dramatically even, increased due to COVID, and we had to adapt our calls to respond to the crisis. At the moment, we're having more calls concerning colds and cases of flu than before because of the season.

What does telehealth service look like for someone living in rural Australia?

Say a caller is in a rural area and has an injury or an accident; they might not have the resources you would have in an urban setting. So, they would call us and we would do two things: we first prioritise the symptoms and give them a timeframe in which to be seen by a doctor. Then, we tell them where to go and video call with that provider to inform them that the caller will come to their service.

What do you love about working as a telehealth nurse?

Nursing is both an art and a science – understanding the science of physiology and the art of how to speak to someone after their loved one has just died. Both are equally important skills to have in telehealth.

I've tried many jobs this world has to offer – the Israeli army, Nunavut outposts, and the Australian outback – but telehealth delivery stands out to me the most.

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