Hospitals Launch Virtual Nursing Programs to Address Workforce Issues
- Virtual nursing models are a unique approach to staffing shortages that can improve patient care.
- Without a universal approach, hospital systems can tailor their programs to meet system-wide needs.
- Virtual nursing models may help lower labor costs and help some rural hospitals remain open.
The COVID-19 pandemic, the retirement of baby boomer nurses, a rising aging population, and a lack of nurse educators drove nursing shortages to a tipping point across the country. Experts believe one answer to the staffing shortage may be implementing virtual nursing programs within hospitals.
Virtual nursing programs impact patients, clinicians, and healthcare systems. However, the programs are so new that nursing schools do not yet prepare nurses for this unique opportunity. Let's explore virtual nursing, including how it might change patient care and how nursing educators can prepare students.
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What Is Virtual Nursing?
The virtual nursing model is a unique approach to addressing staff shortages and reining labor costs that ballooned during the pandemic. The model was developed pre-pandemic but has expanded in the past two years, with five hospital systems announcing new programs in June 2023 and more in the planning stages.
The issues perpetuating the nursing shortage are not likely to be solved quickly. Yet, the need for clinical nurses continues to grow as the population ages and the number of people with chronic diseases grows. Using a virtual nursing team may change nursing care delivery, but experts believe it will maintain a high level of care and protect patient outcomes.
How It Works
Virtual nursing programs use technology to enable nurses to perform tasks without being physically present. Because the model is in its infancy and there is no universal approach, hospital systems can tailor virtual nursing programs to their specific needs.
For example, some programs are campus-based, where a virtual nurse is located in a room with a computer and camera set up. Other systems may choose a command center where a remote nursing staff manages operations across several campuses.
Additionally, hospitals can hire staff or a third-party clinical service to manage the technology. How the organization uses a virtual nurse depends on healthcare system needs.
- Physical assessments with the assistance of sensors or a technician assistant
- Admission history
- Discharge education
- 24/7 patient surveillance
- Remote observer
- Patient and family resources
- Staff trainer for new graduates
Effective virtual nursing programs allow an on-site team to spend more time in patient care and less in administrative tasks. Although there is no universal approach, it's also likely that a single set of tasks will not work across various facilities.
How Hospitals Are Using Virtual Nursing
The ingenuity that goes into implementing a virtual nursing model is part of what makes the model successful, including the flexibility institutions have to mix the skill sets of a bedside team with a virtual nursing team.
Sarah Bell, RN, MSN, MHA is the nurse administrator of virtual nursing, remote patient monitoring, and home hospital at Mayo Clinic, Rochester, MN. "Virtual nursing is a critical strategy for staff satisfaction and retention. Building the infrastructure to support virtual care is the first step and an important investment in the future of healthcare," Bell mentions in a LinkedIn post.
Today, two virtual nursing models are being used in separate hospital systems. The first employs oversight telenurses to focus on higher acuity patients and monitor for physiological signs that indicate deterioration.
UCHealth in Colorado claims to have cut the number of codes by 70% after implementing telehealth technology to monitor patient status. The second option employed by facilities focuses on using virtual clinicians to support patient and family communication using two-way audio and video technology.
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How Will Virtual Nursing Impact Patients, Clinicians, and Health Systems?
One of the primary clinical benefits of a virtual nursing model is the ability of the virtual staff to handle time-consuming administrative tasks, such as documenting admissions and discharges or closely monitoring patients at risk for deterioration. The process enhances bedside efficiency at a time in history when nursing shortages across the country have placed patient care in danger.
According to the 2022 National Nursing Workforce Study, roughly 100,000 RNs have left the profession since 2021, and another 800,000 have reported the intent to leave by 2027. The survey found roughly 20% of all working RNs plan to leave healthcare.
Should these nurses leave the profession before nursing schools have had the opportunity to increase the number of new graduates in the pipeline, experts hope that the virtual nursing model may be enough to fill the gap.
Staffing issues, labor costs, and overhead have led to one-third of rural hospitals at risk of closure. Hospitals like St. Margaret's Hospital in Spring Valley, Illinois, have closed, leaving residents without local emergency care, needing to drive at least 30 minutes to the next hospital or up to 60 miles for some emergency calls in nearby Putnam County.
While the virtual nursing model changes how nurses administer care, hospitals that institute this model and lower their labor costs may be able to stay open and serve their community.
Patients and nurses are benefiting from virtual nursing models. In addition to answering the need for patient care, many hospitals are engaging nursing staff in developing the program to ensure it meets the needs of the nurses and the patients.
Additionally, hospitals that have successfully implemented virtual models use a daily debrief with bedside and virtual nurses to troubleshoot areas of concern, make necessary changes, and help bedside staff communicate with virtual staff to form a cohesive team and dispel any concerns.
Preparing Students for Virtual Nursing Education
Telehealth nursing and virtual nursing models are relatively new to the profession. While some nursing programs are beginning to integrate coursework to help nurses deliver healthcare remotely, especially in a telehealth nursing model, others are not.
Online environments are fraught with challenges for nurses and patients, which must be overcome to increase the viability of these models. One of the challenges is preparing student nurses for the differences between implementing patient care at the bedside and virtually.
During the pandemic, telehealth grew in popularity and importance. While it is an important way to deliver healthcare to rural areas, implementation occurred using nurses with little — if any — training in technological healthcare delivery.
The lack of experience with virtual care lengthens the time it takes nurses to accept and fully utilize this model. We spoke briefly with Bell about how nursing programs could prepare students to deliver care in a digital environment.
Bell recommends a clinical rotation that includes a virtual care team observation. "At Mayo, we have a summer intern program, and one of the rotation assignments is within our eICU [electronic intensive care unit]. This allows students to understand what virtual care teams can do to support them if they encounter this model once they are out of school."
She also notes the importance of developing coursework that provides students with an understanding of virtual care models. "It’s important for nurses to understand the benefits of virtual care and how the roles integrate into the greater care team."
According to an article in the Online Journal of Issues in Nursing, nurses are ill-prepared in their educational programs to deliver care using digital technology. While educational programs for primary care providers, such as nurse practitioners, include training on using telehealth to provide care, entry-level nursing programs are lacking.
Meet Our Contributor
Sarah Bell, RN, MSN, MHA
Sarah Bell, RN, MSN, MHA works as a nurse administrator for virtual nursing, remote patient monitoring, and home hospital at Mayo Clinic in Rochester, Minnesota. She began her career in critical care nursing before advancing the development of telehealth program options to manage clinical situations. She is an experienced nursing leader with a strong telehealth background and more than 16 years of experience developing, managing, leading, and deploying teams. Bell is skilled in using data to drive technological solutions in healthcare.
Bell S. 2023. Personal Interview
National Nursing Workforce Study. (2022). NCSBN
Rutledge, C et al. (2021). Preparing Nurses for Roles in Telehealth: Now is the Time! OJIN
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