Summary

 

Adding virtual nursing to a hospital unit can help reduce staffing needs, while improving patient outcomes and patient satisfaction. These remote nurses can document, observe, interact, train, and otherwise act as another set of hands, in often-understaffed hospitals. 

The U.S. is likely to continue to deal with a critical nursing shortage for the foreseeable future. Thus, health systems are now looking for ways to more efficiently ensure that patient needs are met. Many successful health systems are turning to virtual care options to supplement, and in some circumstances enhance traditional bedside care. 

Across the country, healthcare organizations are experiencing difficulty recruiting, very high labor casts, increased staff burnout, and more. The American Nurses Association noted that states were constantly challenged by unfilled positions and failure to recruit enough replacement nurses. More notably, areas and states that already experience limited access to care – such as rural southeastern areas of America – reported as many as 6,000 unfilled positions. These shortages feed on themselves, since working in a chronically understaffed setting takes its toll. 

 

Approaching the shortage: a series of stop-gaps

Some healthy systems are using travel nurses as a stop-gap to help staff more shifts. This doesn’t exactly solve the problem as added expenses limit the long-term sustainability of this approach. Other hospitals are increasing their patient-to-nurse ratios, with some facilities relying on patient care techs and nursing aides to ease the burden. Unfortunately, thousands of qualified would-be-nurses have been turned away from nursing schools due to shortage in almost every area – and even lack of financial support.

While schools implement strategies that enable them to add student capacity, health systems must find ways to do more with less, without sacrificing care quality. With declining margins due to the pandemic, it is all the more difficult to simply hire more aides, even presuming they are available.

Besides actual procedures and hands-on care, bedside nursing includes charting, consulting with team members, accessing supplies, coordinating with other departments, and speaking with family members and friends. However, given the understaffing on many floors and units, patients often interact with a variety of care team members on each shift. This fragmentation in turn makes it more difficult for patients and their visitors to decipher “who’s who,” and to bring forward important concerns.

 

Dividing to conquer

The pandemic accelerated acceptance of telehealth, along with more comfort with wearables, virtual monitoring of patients via clinicians and Bluetooth enabled devices, and healthcare systems. Incorporating virtual nursing programs within acute care facilities allows floor nurses to cover more ground. Virtual patient observation, for example, can support a number of goals, from greater patient safety to an improved patient experience.

Patients have long complained about the sleep deprivation caused by clinicians entering the room, along with the background noise from nurses’ stations and hallways. In addition to the discomfort and disorientation that interrupted rest entails, when a series of staff intrusions occur with no prior warning nor way to ask questions, the patient can easily feel like an “object,” with little control over the situation — not an ideal environment for healing.

With on-demand access to nurses and supporting care team members, patients can have their questions answered remotely, allowing floor staff to be notified and physically intervene only when needed; thus systems have seen their room entry needs, often with attendant needs for PPE or other precautions, significantly reduced.

With some basic concerns addressed by virtual nurses, the floor nurses can also cultivate an improved relationship with patients, providing more concentrated time for in-person care to focus on their needs. This is obviously a more desirable situation for a high-performing bedside nurse.

The best solutions are those that address a number of pain points, and virtual patient observation is gaining traction as a core workflow. Facilities have learned that consistent monitoring and early intervention, as is facilitated by virtual observers, can reduce wandering, falls, self-harm, and visitor security incidents. Health systems can also reduce labor expenses by leveraging virtual infrastructure. 

 

Virtual nurses: more efficient delegation and workflows

Collaboration among virtual and on-site nurses can enable floor staff to spend more time with patients at the bedside. Telenurses can address tasks such as admission and discharge planning, medication adherence and reconciliation, patient education, even monitor vitals and provide early intervention if necessary. Meanwhile, floor nurses can focus on tasks requiring hands-on and in-person skills and availability such as supervision of aidses and less experienced staff. 

Virtual nurses can even train, mentor, and otherwise support bedside nurses – coaching them when needed through unfamiliar tasks or procedures. Of course, they can also coordinate communication in urgent and emergency situations, and can instantly activate alarms on the floor or from rooms. 

Thus, telenursing does not solve the nursing shortage, but it can help to support optimal outcomes of care, staff development, retention and morale – and help to increase access to care and help close the health equity gap. 

 

If you’re interested in adding virtual nurses to your health systems team learn more about Community Wellness’s Integrated Virtual Nursing Program today!