Many organizations are turning to virtual nursing to address staffing and wellbeing, and with the current trajectory virtual care will be an integral part of the future of healthcare.
So, while your rooms won’t be completely devoid of in-person nurses, soon an entire department of onsite clinical staff will be a thing of the past.
Here’s how to adapt and advance.
Virtual nursing is here.
The use of telemedicine following the COVID-19 pandemic kick started the virtual nursing movement. And while some systems are just getting started, many have been utilizing virtual nursing for years and continue to expand.
In fact, according to Steve Klahn, system clinical director for virtual medicine at Houston Methodist, virtual nursing roles are about to expand exponentially. Klahn predicted that within the next five to 10 years, 60% to 70% of nursing positions across the industry will become virtual or have a virtual component.
TAKEAWAYS
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Within the next five to 10 years, more than half of all nursing positions could be entirely virtual or have some kind of virtual component, which will only expand thereafter.
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Care delivery models will have virtual nursing fully integrated and will involve support from remote nurses and new ways of collecting patient information.
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Virtual nursing has the potential to impact staffing by eliminating contract labor and serving as a flexible scheduling and education tool for both new nurses and tenured nurses.
TAKEAWAYS
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Within the next five to 10 years, more than half of all nursing positions could be entirely virtual or have some kind of virtual component, which will only expand thereafter.
-
Care delivery models will have virtual nursing fully integrated and will involve support from remote nurses and new ways of collecting patient information.
-
Virtual nursing has the potential to impact staffing by eliminating contract labor and serving as a flexible scheduling and education tool for both new nurses and tenured nurses.
Steve Klahn
System Clinical Director for Virtual Medicine, Houston Methodist
"I'd say well over half," Klahn said, "just with [the] massive growth and expansion over the last two years."
Klahn explained that this is largely due to the response to virtual nursing programs.
"This is going to stick with us for a while," Klahn said, "understandably so, because there's such positive response to programs that are engaging a virtual component or fully virtual."
Dr. Shakira Henderson, dean and chief administrative officer and associate vice president for nursing education, practice, and research at the University of Florida College of Nursing, and the system CNE of UF Health, said this strategy will transform the landscape of nursing by enhancing care and improving efficiency.
"One of the facts that struck me was that we are going to produce now the first generation of nurses who could potentially never touch a patient," Henderson said.
60% to 70%
The amount of nursing positions across the industry that will become virtual or have a virtual component within the next 10 years, according to Steve Klahn, system clinical director for virtual medicine at Houston Methodist.
60% to 70%
The amount of nursing positions across the industry that will become virtual or have a virtual component within the next 10 years, according to Steve Klahn, system clinical director for virtual medicine at Houston Methodist.
60% to 70%
The amount of nursing positions across the industry that will become virtual or have a virtual component within the next 10 years, according to Steve Klahn, system clinical director for virtual medicine at Houston Methodist.
A care model for the future
Leaders must keep in mind that with every new wave of technology, there will be an adjustment period as the technology is integrated with workflows. That won’t be any different with virtual nursing.
Klahn said the standard care model for nursing will be highly comprehensive, due to the integration of virtual nursing. It will include both task-driven support from remote nurses and a new way of collecting biometric data.
Nurses will soon be able to monitor a wide variety of healthcare data including blood pressure, heart rate, and respiratory rates through remote patient monitoring, according to Klahn. The collected data can be automated and synthesized through a software system and delivered to the experienced clinical personnel that are remotely supporting bedside teams.
This new model also enables non-traditional nursing ratios in the form of paired nursing teams, where the bedside nurse can take on more patients while moving a portion of their workload to the virtual nurse.
"Now you can actually have one or two nurses supporting a much larger group of patient populations," Klahn said, "and truly load balancing and taking those calls as they come in and reducing the wait times for that process."
Benefits for everyone?
Virtual care platforms have many benefits for nurses, patients, and their families.
"There are various ways that you can define it, but it is what it is," Henderson said. "It's virtual nursing and the ability to be able to augment our nursing services at the bedside or even in the community using a virtual nurse component."
Dr. Shakira Henderson
Dean and Chief Administrative Officer and Associate Vice President for Nursing Education, Practice, and Research, University of Florida College of Nursing, and the system CNE of UF Health
According to Jesus Cepero, CNO at Stanford Medicine Children's Health, virtual nursing should be leveraged to best suit patient and family needs, as well as what the nurses can do for them virtually.
"There are ways that we could actually have a virtual nurse that comes on into the room via technology," Cepero said, "via a TV and a speaker, and be able to deliver care, education, and information to the patient virtually."
“We are going to produce the first generation of nurses who could potentially never touch a patient.”
—Dr. Shakira Henderson, dean and chief administrative officer and associate vice president for nursing education, practice, and research at the University of Florida College of Nursing, and the system CNE of UF Health.
This new care model frees up time at the bedside for nurses to spend with their patients, while the virtual nurse can take on documentation. It will also Enable nurses to take needed breaks to reduce stress and burnout.
"We will have a virtual nursing job duty be on rotation to all experienced staff," Cepero said, "so everybody can actually do that role and have a little a break from the direct care nurse role between delivering patient care."
According to Klahn, patients are seeing the benefits of increased throughput with timely discharges, which positively impacts the patient experience.
"They’re really enjoying dedicated one-on-one time with a live, experienced, empathetic nurse that's interacting with them and taking their time through either their admission or discharge," Klahn said. "Administration is loving it obviously too, with the fact that turnover rates seem to be really softening."
The nurses also love the virtual nursing platform, Klahn said.
"They enjoy being able to have that kind of helpful hand that takes a little bit of the load off their very busy shoulders," Klahn said, "and allows them to do those equally important or more important physical touch and empathy with the patient, and all those hands-on types of procedures."
U.S. Virtual Care Market (Size, by consultation mode, 2020-2030 (USD Billion)
SOURCE: https://www.grandviewresearch.com/industry-analysis/us-virtual-care-market-report.
Impact on staffing
Virtual nursing will likely have the biggest impact on staffing. At Houston Methodist, turnover rates are down, according to Klahn, and contract labor has been reduced or eliminated entirely.
"At our flagship location, Houston Methodist Hospital, here in the Texas Medical Center, we were able to eliminate contract labor in all inpatient environments pretty quickly," Klahn said. "We don't know that there's a complete direct correlation with our virtual nursing program, but it happened to coincide with the timing of us installing it."
The virtual care platform can help administrators schedule flexible bedside teams as well as support activities for patients. Klahn explained that Houston Methodist is approaching ratios and shifts differently, using a hybrid workforce. For instance, some nurses will work a 12-hour shift late at night from home instead of in person, so that they don't have to drive home when it is unsafe.
Jesus Cepero
CNO, Stanford Medicine Children's Health
"I think [we need to make] sure that we're not building a model that's so rigid in nature and focused around the team that's providing that service," Klahn said, "but more around the needs of that patient and the frontline teams."
Flexible scheduling addresses not only staffing issues, but also wellness concerns. Sometimes nurses become burned out and a need a break, while others have physical limitations, so being able to rotate nursing into a virtual setting can be extremely helpful.
“This is going to stick with us for a while, and understandably so, because there's such positive response to programs that are engaging a virtual component or fully virtual.”
— Steve Klahn, system clinical director for virtual medicine at Houston Methodist.
"Think about the opportunity for a nurse being able to have six months [at] the bedside and then six months in virtual nursing," Henderson said. "[Nurses] would have the ability to recover and then come back to the bedside."
Virtual nursing also provides tenured nurses with an alternative to working at the bedside.
"The world of virtual care is just beginning," Cepero said. "It is going to be a huge benefit for the more senior nurses that are having difficulties working three-and-a-half-hour shifts on their feet."
Henderson explained how virtual nursing can also help with nursing education and training and supporting new nurses at the bedside.
"I think we also have to expand our lens when it comes to virtual nursing and think of [it] as an advocate in terms of nursing education and training," Henderson said. "I love what virtual nursing will potentially do in the future because I think we will have great opportunity in that space."
Advice for leaders
Ultimately, the key to adapting to virtual nursing is just to jump in and try it, according to Klahn.
"There's enough people that have taken that deep dive and shown the positive outcomes," Klahn said, "but sometimes the biggest hurdle is making the decision to say, ‘You know what, we're committed to this.’"
CNOs must make sure they engage with the frontline leaders and nurses as soon as possible, and strategically build a program that can address the top prioritized services that can be offered virtually.
86%
The percentage of CNOs that believe the most important metrics for measuring the success of virtual nursing programs are improving nurse satisfaction and retention (86%)
"Build the simplistic workflows behind that," Klahn said, "and make sure that you don't have excessively long, lengthy handoffs and processes that would prevent or preclude people from utilizing the service."
Leaders must also not be afraid of the technology.
"You can try something that you already have, whether that be an iPad or if you have some existing parts from some other technology that you're using for some other type of telemedicine service," Klahn said. "But don't feel like you have to hardwire everything."
"Keep things as simple as possible," Klahn said, "and it could work really well for you."
G Hatfield, Editor, HealthLeaders