Virtual Nursing for the Care of Hospitalized Patients

Importance It is unknown if virtual nursing (VN) enhances care quality or improves the workload of bedside nurses in hospitals. Objective To describe what services VNs provide to patients and nurses in hospitals; to evaluate whether the presence of VNs improves nurse workload and patient care quality; and to examine bedside nurses’ experiences with VNs. Design, Setting, and Participants This cross-sectional study using mixed methods included results from the 2024 Nurses4All survey conducted between December 2023 and March 2024. Eligible respondents were hospital-employed registered nurses in 10 states. Exposure Experience providing VN-assisted bedside care. Main Outcomes and Measures Bedside nurses reported the services provided by VNs and answered questions about VNs’ impact on workload and quality of care. Nurses also answered the open-text response, “Please share any positive or negative experiences you have had working with virtual nurses.” Results The registered nurse sample included 880 respondents with a mean (SD) age of 44.2 (12.3) years and 13.3 (11.3) years of experience (92 Asian 10.5%, 87 Black 9.9%, 514 White 58.4%; 84 9.5% with Hispanic ethnicity). The top uses of VNs reported by nurses were patient observation (434 nurses 53%), admission and discharge activities (381 nurses 45%), and patient education (306 nurses 37%). The majority of nurses (483 nurses 57%) reported that VNs did not reduce their workload, and among these, 81 nurses (10%) said VNs increased their workload. Of the 366 nurses (43%) who said VNs reduced their workloads, only 70 (8%) reported that workloads were reduced “by a lot.” Slightly over half of nurses (452 53%) said VNs improved quality of care, but only 96 (11%) reported that quality was improved “by a lot.” VNs had no impact on care quality according to 391 nurses (47%), with 34 (4%) stating that VNs reduced care quality. Nurses described the strengths of VNs for monitoring and documentation, and limitations related to staffing, patient distrust, and workflow inefficiencies. Conclusions and Relevance In this cross-sectional study, there were mixed findings on VNs, suggesting such models should be introduced cautiously.