Carol Boston-Fleischhauer, JD, MS, BSN, RN

Carol Boston-Fleischhauer, JD, MS, BSN, RN

SVP/Chief Clinical Officer

Several years ago, pre-pandemic, I penned a column in the Journal of Nursing Administration (JONA) that highlighted the emergence of ‘virtual nursing’ as an intriguing care model innovation for nurse leaders to consider; for reasons including fiscal and workforce challenges as well as an increasingly co-morbid patient population in need of significant care support1.  At that time, a handful of healthcare organizations and systems were ‘piloting’ various virtual nursing models and technology platforms with varying degrees of success. In that column, I posed several questions for nurse leaders to consider:


    1.  What are the core functions of a virtual nurse?

    2. What skills and competencies are needed?

    3. How does the virtual nurse interact with the onsite care team?

    4. Does the virtual nurse interact with patients and families?

    5. Will patients and families accept virtual care?

    6. Will RNs derive professional satisfaction from a virtual nurse role?

    7. How will we measure the impact of virtual nursing?

    Fast forward to August 2023, where ‘virtual nursing’ appears to be THE number one workforce strategy leading healthcare organizations and systems are considering to address unresolved RN turnover and burnout, ensure quality, support novice nurses, and control labor costs, including the over-reliance on premium labor.  Indeed, the trade press is full of case study examples; all SORTS of models and technology platforms are being tried, with varying results.  Notably, the questions I raised in my 2017 JONA article have not been answered, and more questions are now being introduced, including whether national policies and regulations are needed.  

    I believe the fundamental question is this. What IS virtual nursing?  Is it a technology tool that could be periodically used to support some monitoring of care and lighten up some of the work of direct care RNs?  Or is virtual nursing a 24/7 staffing model innovation optimized through a comprehensive technology platform, with virtual nurses becoming core care team members?  How you define virtual nursing will be pivotal to the outcomes you achieve. 

    As Banyan’s Sr. Vice President and Chief Clinical Officer, I view virtual nursing as way more than a part-time technology strategy; instead, a compelling staffing innovation that, if implemented effectively, can yield substantial results.  However, this model is challenging to implement, with myriad professional, organizational, and cultural challenges to status quo nursing practice.

    Therefore, my upcoming blogs will address the core questions I and others have raised and provide executive insights intended to assist nurse leaders and executives in examining the power and the potential of virtual nursing as a strategic solution to sustainable staffing and overall workforce stabilization. Your comments are always welcome

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    1. Boston-Fleischhauer, C.  The explosion of virtual nursing care.   JONA, 2017; 47(2):  85-87.