AdventHealth hospitals add ‘virtual nurses’ to reduce work intensity for bedside RNs

AdventHealth has made recruiting and retaining talented nurses one of its top priorities, and as part of that commitment has added “virtual nurses” to help reduce the workload on care teams at three of its area hospitals.

The health system has been piloting the program in the inpatient units in Daytona Beach and DeLand, as well as the emergency department in Orange City, and there are plans to expand it to other campuses.

Here’s how it works: After getting the patient’s OK, the virtual nurse — a registered nurse working offsite — talks to patients via a webcam in the patient’s room. The virtual nurses are a second set of eyes for bedside nurses and help with admissions and discharges, so the onsite care teams can work closer with high acuity patients.

“Our patients tell us it feels like having a second nurse taking care of them,” said Michele Goeb-Burkett, chief nursing officer of AdventHealth’s hospitals in Volusia, Flagler and north Lake counties. “And this program is just one of many initiatives we’ve put in place to better support our teams and improve work intensity. We’ve also added licensed practical nurses and patient care technicians to many of our care teams, so our bedside nurses have the support they need.”

Amid a nationwide shortage of nurses, AdventHealth has also invested $100 million in market pay and bonus initiatives and begun doing more frequent reviews to ensure pay rates are competitive. The health care system offers all team members tuition assistance, loan repayment programs and 24/7 access to mental health professionals and provides mentorship programs and on-the-job training.

Led by Chief Nursing Executive Julie Vincent, the AdventHealth Central Florida Division has also been focused on creating a pipeline from local nursing schools into the hospitals. Three dedicated education units have opened across the system: in Orlando with AdventHealth University, in Tavares with Lake-Sumter State College and in Winter Park with Seminole State College, with more on the horizon. Vincent has also formed a Nursing Advisory panel, made up of nine frontline, bedside nurses from all different specialties and campuses, to consult about issues within the profession and possible solutions.

Five months into the virtual nursing pilot at AdventHealth Fish Memorial in Orange City, RN turnover has dropped to 15.8%; it was 46% in January 2022 during the Omicron variant surge. John Lazarus, emergency department director at Fish Memorial, told Florida Trend magazine that virtual nursing is a “major reason” for the decrease.

“Our leaders had the foresight to really think outside the box and think of innovative ways to support bedside nursing. We really needed to stabilize that workforce because at the end of the day, we need qualified, competent and compassionate caregivers to care for our community,” Lazarus said.

Fish Memorial is the first in the hospital system to bring virtual nursing to the emergency department and is working closely with AdventHealth’s Research Institute to see how it impacts burnout among nurses. Early results are promising — nurses are spending more quality time with their patients and reviewing patient history, helping ensure the best care possible.

“My colleagues and I were excited when we heard about the program. ‘We’re getting someone to help us?’” said Melinda Leach, an ED nurse at Fish Memorial and member of AdventHealth’s Nursing Advisory Panel. “It made a lot of us feel like we’re heard and that management understood how stressed we are. It’s been a relief in a way.”

By giving nurses a remote work option, AdventHealth leaders also expect the program to help retain experienced, veteran nurses in the profession longer. If they’re not able to work on their feet for the traditional 12-hour bedside shift, those nurses could work remotely as a virtual nurse.

In an interview with the Orlando Sentinel, Jun Baniqued, a nurse at AdventHealth DeLand, said the pandemic accelerated the shift to telehealth — for the primary care setting, mental health visits, the emergency department and now nursing.

“I think this is the evolution of what nursing’s future is,” Baniqued said. “Bedside nursing will not go away, but it will be improved by technology — virtual nursing, robotics, everything. These are the things that we should look forward to.”