By Angel Bozard, RN, Chief Nursing Officer, VirtuAlly
LinkedIn: Angel Bozard, MSN , RN , CENP, CAVRN
LinkedIn: VirtuAlly
Hospitals are under growing pressure to strengthen care delivery while supporting nurses who manage heavier workloads, more complex patients, and persistent staffing challenges.
The National Center for Health Workforce Analysis projects that the national RN shortage will persist through 2038. In 2028, the shortfall is expected to reach 8% nationwide, with nonmetro areas facing a much greater gap than metro areas — 24% versus 5%. By 2038, the national shortage is projected to be nearly 109,000 full-time-equivalent RNs.
In this environment, virtual nursing has become an increasingly important part of modern care models. However, virtual nursing’s value to providers depends on how it is designed, introduced, and sustained.
When virtual nursing is treated primarily as a staffing workaround or a way to shift tasks away from the bedside, organizations may see operational relief but often miss the larger opportunity. The strongest programs are built as clinical partnerships that connect experienced remote nurses with bedside teams through clear workflows, shared expectations, and consistent communication.
This distinction matters. Bedside nurses need to understand who their virtual colleagues are, what responsibilities they own, when they should be engaged, and how their work supports the plan of care.
Without that clarity, virtual nursing can create confusion, duplicated effort, or skepticism. In contrast, with thoughtful integration, virtual nursing can reduce cognitive burden, improve patient education, and give bedside nurses more uninterrupted time for hands-on care.
Virtual nurses as integrated members of the care team
A strong virtual nursing model starts with role definition. Remote nurses should function as licensed clinical professionals who extend the team’s capacity, contribute to patient monitoring and education, and help coordinate key transitions throughout the inpatient stay.
In practice, this can include admission support, discharge preparation, medication history review, patient and family teaching, documentation assistance, safety surveillance, and escalation when subtle changes in patient status require attention. These responsibilities are most effective when they are assigned intentionally and aligned with bedside workflows.
That alignment requires more than installing cameras or adding a virtual platform. Hospitals need to map existing processes, identify pain points, determine which tasks are suitable for virtual support, and establish reliable communication channels between remote and bedside clinicians. Nurses should have opportunities to practice the model, ask questions, refine handoffs, and build trust.
When this structure is in place, bedside nurses can remain focused on high-touch care, urgent patient needs, and relationship-building. Virtual nurses can take on work that benefits from focused time, clinical experience, and fewer interruptions. Patients and families can receive more consistent education during admissions and discharges, when information volume is high and comprehension is critical.
Evidence from MUSC’s virtual nursing experience
A recent study from the Medical University of South Carolina shows how virtual nursing can support care delivery at scale. MUSC operates across a large statewide footprint that includes 16 hospitals, roughly 2,700 beds, nearly 750 care locations, and additional hospital sites in development.
The organization is also working in a state facing significant workforce pressure, including one of the nation’s highest projected registered nurse shortages by 2030 and rapid population growth over the past decade.
MUSC launched virtual nursing in 2023 in five units at three hospitals and rapidly implemented its virtual nursing model in 32 units systemwide in 2024. Costing analysis of 2024 data found that 23,516 virtual nursing visits, with a mean visit length of 36.8 minutes, delivered care equivalent to approximately 10.2 full-time nursing positions.
Their work was concentrated on admissions, which accounted for 65% of activity, along with quality-of-care surveillance at 18% and discharge support at 17%. The data also showed that virtual nurses often provided more than one type of support during a single patient interaction. The staffing implications were notable, especially in the areas of admissions support, discharge teaching, and documentation compliance.
Bedside nurse feedback also pointed to meaningful benefits including a more team-based approach to care, time saved on admission documentation, and more time available for rounding. Nearly two-thirds reported being very satisfied with the model, and 87% said virtual nursing slightly or significantly decreased their workload.
Building for long-term success
Timing plays an important role in adoption. Programs launched only after a staffing crisis has intensified may face more resistance because teams are exhausted and immediate needs can crowd out thoughtful planning. Earlier implementation gives organizations more room to design workflows, train staff, and build confidence before pressures become more acute.
Leadership also needs to define success broadly. Labor efficiency is important, but a mature virtual nursing strategy should also evaluate nurse satisfaction, patient education completion, discharge readiness, documentation timeliness, escalation patterns, safety events, and patient experience.
Bedside nurses should also have a meaningful voice in program design. Their input can identify which processes create the most friction, where virtual support would add the greatest value, and how communication should work in real clinical situations. Co-design helps build trust by showing nurses that their expertise is respected and that the model reflects the realities of their daily work. That trust, in turn, is essential to adoption and sustained engagement.
Virtual nursing has moved from an emerging experiment to a practical care delivery strategy with growing evidence behind it. When hospitals treat virtual nurses as clinical partners, define roles clearly, and integrate the model before crisis conditions take over, they can strengthen the nursing workforce, improve patient support, and create more resilient care teams for the future.
