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The virtual nurse is here!



Alice Sneed

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.

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:


  • Expanding nurses’ specialization – Telehealth nurses need to be tech savvy, with the majority of their role being behind a computer screen and heavily based on digital analytics. But the new virtual nurse also has deeper knowledge and understanding of a variety of clinical specialties from neurology, cardiology, oncology, etc. Telehealth nurses are seen as a resource for clinicians, which means they can get all kinds of medical questions that need quick research and answers. It’s not surprising that all telehealth nurses begin with at least five years of experience in intensive care. But a virtual nurse’s learning continues for a longer time.
  • Serving as a critical resource for all clinicians – A nurse may be responsible for several patients, but when working on a single patient, he/she must be – and can only be – focused only on that patient. With a telehealth program, nurses can feel confident that if they’re wheeling one patient down for a test and another patient needs help, a remote nurse can attend to them immediately or call in another nurse on the floor to help provide care. Bedside nurses now also have access to a physician at the push of a button.
  • Increasing length of career – Nursing is a physically demanding job. Imagine moving a 200 pound patient, on a 350 pound bed, with a couple of hundred pounds of additional monitoring equipment needed for transport. Over time, these physical demands become more difficult. Telehealth provides nurses with the opportunity to extend their career. It certainly had its own demands – for example, nurses are accustomed to focusing on a few patients, rather than managing larger populations of patients. However, nurses now have the option for extending their skills into the later years of life.


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.

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Alice Sneed

Alice Sneed

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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