In a recent article published in Medscape Nurse, Dr. Gregory A. Hood described an interesting event that occurred during a “telehealth” visit. The patient’s wife was setting up the visit in the backyard of their rural, mountainous home when she encountered a Copperhead snake and was subsequently bitten. The story had a happy ending, however, it did make me pause to stop and think. What are we doing with telehealth, how are we managing expectations and outcomes, and more importantly are we doing things safely? Here are a few suggestions if a virtual visit is being conducted outdoors:

• Check the surroundings thoroughly. There may be distractions such as bees, airplanes flying overhead, barking dogs and other factors that make it hard to hear or communicate during the visit.
• Be mindful of what is in the background of the video display. We need to be aware of privacy issues, unnecessary distractions, etc.
• Be alert to the fact that others may be within hearing/visual range, remind the resident of this risk as personal information may be heard by someone else.
• Check the weather report, is it going to start raining in the middle of the virtual visit? Might want to move indoors?
• If in a warm climate, provide a shaded area to assist in preventing overheating/sunburn issues.
• If in a colder climate, ensure the resident is provided with appropriate outerwear including gloves if needed.
• Always helpful to have water available as when we talk we often need to drink some water.
• Sunglasses are a great option to keep the resident from squinting however if doing a telehealth visit the physician/provider may need to see the resident’s eyes.
• If the resident requires assistance getting to and from the location, be sure staff are available when the visit ends to assist the resident back to their room.
• During this time of pandemic, be sure to provide face coverings for the resident during transport and avoid moving through units dedicated to COVID care.
• Residents with positive COVID, in transmission-based precautions or with signs/symptoms of infection should remain in their room for virtual visits.

Remember, each resident has unique needs, expectations, and safety risks. Be sure to ask them, are they comfortable with virtual visits, are they satisfied with the level of care they are being provided with, and of course, be sure you are following the CDC, CMS, and local health department recommendations regarding virtual visits and telehealth! Stay well, stay safe, and stay tuned!