Virtual Nurse
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Nursing has evolved over the past few decades. The commonly perceived view of the nurse at the bedside, monitoring a patient’s vital signs or assisting physicians during rounds, has changed. With the advent of new digital technologies in health care, such as telehealth and remote monitoring tools, today’s nurse can be practically virtual. As we celebrate International Nurses Day today, I want to shed some light on what it takes to be a virtual nurse.
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As a critical care nurse at Banner Health, a health system serving seven states in the Western United States, I’ve spent the last eight years working in telehealth, as a “virtual nurse.” On average, I monitor 40 to 45 patients every day, across three to six facilities in the region – a far shot from the five or six patients I could monitor as a bedside nurse in the past. My job is to provide care to patients and support to nurses when they need it most, especially at remote community hospitals that don’t have specialized ICUs. When these hospitals admit high acuity patients, our virtual telehealth command center allows me to monitor patients remotely, so these local care teams can keep the patient in their community hospital, rather than having to transport them four or five hours away to access higher acuity care.
The eICU environment at Banner Health is designed to bring care to the patient. My work station has three large monitors, with six split screens connected with patients’ monitors. My two computers are linked to the Philips eICU software called eCareManager, as well as the patients’ electronic medical records, capturing detailed notes about the patients’ conditions. The cameras we use have extremely high definition, allowing us to even read the numbers on an IV bag. With the eICU technology in place, it feels as though I’m in the same room with the patient, even though I’m monitoring from hundreds of miles away.
Undoubtedly, there is a steep learning curve in this new virtual command center. But nurses have traditionally been the earliest adopters of new technologies, and access to these tools has not only enhanced patient care, but is also changing the playing field for nurses. Here are some ways the “virtual” environment is transforming nursing:
The concept of virtual nurses is still new and will require both patients and staff to adjust. As more and more patients become aware of the benefits of telehealth, hospitals around the country are starting to adopt these programs, requiring more skilled nurses to manage them. Telehealth is growing and will be a market driver for health systems. But for nurses like me, it boils down to the fact that thousands of patients received the care they needed, and are alive today, thanks to telehealth. I’m sure even Florence Nightingale would be proud of that.
Alice Larsen Sneed RN BSN CCRN FCCS is a critical care nurse at Banner Health. She has more than two decades of experience as a critical care nurse, before transitioning to her current role in Banner’s Telehealth program since. Alice is a graduate of the Oregon Health Sciences University, and received her CCRN, critical care certification from the AACN in 2003.
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Modern nursing looks little like it did even a few decades ago. Today’s registered nurses hold greater authority than ever before. They’re charged with everything from performing diagnostic tests to administering treatments. The pace of change, although already swift, is about to pick up again as telehealth takes over the medical profession.
As health care providers seek new solutions to handle the unique needs of today’s vulnerable patients, many look to virtual nurses to bridge the gap. Their goal: to address a variety of patient concerns without requiring them to visit clinics in person. This can alleviate numerous issues, including limited access in remote settings, the potential spread of disease within clinics or hospitals, and the sheer cost of meeting all patients in person regardless of the scope or urgency of their concerns.
Virtual nursing is increasingly common, and yet, many aspiring nurses still wonder: What is telehealth nursing—and what role will digital services play in the future of nursing? A greater understanding of the latest telehealth opportunities can ensure that nurses enter the profession fully equipped to take on a variety of challenges, both in person and on a virtual basis.
As its name implies, virtual nursing involves health care from afar. While some clinics offer phone-based services, digital options such as videoconferencing are increasingly preferred. Regardless of the technology relied upon, however, this approach allows nurses to provide key services without meeting patients in person.
From checking vitals to making specialist referrals, telehealth nurses serve nearly as many functions as their in-person counterparts. Meanwhile, they assist both patients and fellow health care professionals in navigating cutting-edge technology, all with the interest of making virtual appointments as streamlined and personable as possible.
A variety of factors can be credited with the recent rise of telehealth nursing. While coronavirus and the need for social distancing have played a key role in this niche’s explosive growth, virtual options were already on the rise long before COVID-19 took over. This option has long been regarded as a viable solution for vulnerable patients at risk of suffering influenza or hospital-acquired infections.
Telehealth also presents a wonderful opportunity for serving rural communities that lack reliable access to health care. Patients who need to travel extensively for routine checkups are less likely to seek preventative care. If telehealth services are available, however, these otherwise reluctant patients may seek the proactive assistance needed to solve future health problems. Telehealth may also be of value when ICU beds are unavailable.
Another key area of opportunity in telehealth? Treating patients with mental health concerns. While these patients often benefit greatly from in-person interactions, they may struggle to leave the house in pursuit of traditional care. In some situations, patients diagnosed with depression or anxiety may find it easier and more comfortable to interact with nurses over the phone or via videoconferencing. In such situations, every effort must be made to encourage patients to pursue the treatment they require.
As with conventional nursing, telehealth can look considerably different from one day to the next. Still, this setup tends to be more structured than many nursing roles, as the very technology required for telehealth necessitates strict scheduling. Some flexibility may be required, however, as many telehealth nurses are placed on call to handle patient concerns as they arise.
The unique life of a telehealth nurse is accurately conveyed in an article published in the journal Home Healthcare Now . In this insightful piece, registered nurses Colleen Zahs and Mary Hagen explain the ins and outs of working for dedicated telehealth programs, through which they monitor as many as 200 patients per month. As this article highlights, a ‘typical’ day in telehealth nursing could include:
While most virtual nursing functions take place online or over the phone, some elements of care may occur in person. Likewise, although many virtual nurses are able to spend some of their time working from home, they may also frequent specialized facilities or traditional clinics to follow up on patient results or handle necessary equipment.
Banner Health clinical care nurse Alice Sneed tells Philips that she primarily operates within an eICU unit equipped with several split screens that attach to patient monitors. This allows her to serve patients staying at remote hospitals that lack ICU capacity. As monitoring equipment improves, such solutions may become more common for handling urgent care needs.
Although telehealth offers a variety of exciting possibilities, these are accompanied by several notable challenges. Communication, in particular, can be difficult, as many patients struggle to build trusting relationships when they exclusively interact online. Likewise, the higher volume of patients associated with virtual nursing can make it tough for RNs to connect with patients.
While some telehealth nurses thrive on new technology, this represents a huge area of struggle for others. The pace of change is dizzying, with new equipment and applications constantly unveiled. These developments make it possible to better serve patients in need, but they can be difficult to master, even for nurses who think of themselves a technologically savvy.
While telehealth presents considerable challenges, these are far from impossible to mitigate. Many of the field’s chief difficulties can be addressed through quality training that takes both clinical and technological considerations into account. Ideally, academic programs will highlight the very real possibility that students will ultimately serve patients in a digital capacity—and prepare them accordingly.
Virtual nurses must meet all the academic and training requirements set in place for registered nurses in general. This includes passing the National Council Licensure Examination (NCLEX) at the RN level. Depending on the facility or the state in which a given nurse practices, a Bachelor of Science in Nursing may also be advisable. Some telehealth programs require nurses to undergo specialized training prior to serving in a digital capacity.
Given the tech-oriented nature of virtual nursing, the knowledge and skills needed to excel in this niche clearly go beyond those required for conventional practice. Virtual nurses must be comfortable with operating videoconferencing platforms, eICU equipment, and a variety of other advanced programs or apparatus. Because security represents a growing concern, they must be capable of handling medical applications without compromising patient privacy. All this can be a lot to take on, but targeted coursework within RN-BSN programs can set the stage for success, regardless of future changes to health care technology.
If you’re passionate about the latest technological opportunities in the health care industry, you may be a good fit for the rapidly expanding field of telehealth nursing. This is your chance to make your mark on the medical field of tomorrow.
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