Developing a virtual nursing program begins with incorporating cross-functional teams, says this CNE.

Virtual nursing is rapidly becoming a standard of care in the healthcare industry.

Right now, while many programs are still in their infancy, CNOs have a great opportunity to learn from each other's strategies and outcomes.

Here are three tips from Patty Donley, senior vice president and CNE at WellSpan Health, on how to build a virtual nursing program. 

Click here to read the accompanying article.

Addressing the nursing shortage requires a careful, multipronged strategy and a mindful approach.

The national nursing shortage is an ongoing pain point for CNOs and for healthcare organizations across the country.

It's critical for CNOs to understand why the nursing shortage is happening and the full extent of its impact, so they can develop robust strategies for combatting it.

According to Dr. Brad Goettl, chief nursing officer at the American Nurses Enterprise, the nursing shortage impacts a health system's financial situation and care delivery for patients. 

Economic impact

CNOs need to know that the nursing shortage has more of an impact on some areas than others, and there are still many people who are interested in becoming nurses, Goettl explained. However, there is a shortage in faculty and training capacity in educational settings.

"I like to point that out because it really is part of the solution to the workforce, making sure that we have enough training capacity at our universities to be able to get people that are interested and qualified through training programs so they can get out there and take care of our patients," Goettl said.

From an economic perspective, it's expensive to operate under workforce shortages. Labor costs are higher across the country in every aspect of healthcare, Goettl explained, but having to fill the gaps with agency nurses and overtime pay is also costly. Average turnover can cost a typical hospital anywhere between $4 million to $6 million a year.

"That can turn into this cyclical process where people are working too much, they get burnt out, and then they call out and then we're short," Goettl said. "We know that the average cost of turnover of a nurse can be upwards of $40,000 to $60,000, and it's only going up as labor costs are going up."

According to Goettl, there are significant financial returns from investing in turnover.

"Hospitals that invest in this, for each percent change that they decrease their turnover, they can save almost $300,000 a year," Goettl said, "so that investment in retaining your staff and keeping your staff and investing in your staff really comes full circle."

Patient care delivery

The impact on care delivery is largely straightforward: If there are not enough nurses to take care of patients, or if nurses are spread too thin, patient outcomes suffer.

"We have a healthcare capacity issue," Goettl said. "It's not just happening in the acute care hospital environment, but really all clinical environments, and patients are often being held all over the hospital while they're waiting for rooms, or there are delays in getting outpatient treatment [and] elective or semi-urgent procedures."

This causes barriers to healthcare access, and in turn that negatively impacts public health, Goettl explained.

"We know that there are poor outcomes to patients that are being treated at facilities that have nursing shortages or are understaffed," Goettl said. "That can translate to increases in pressure ulcers or outcomes, falls, increased mortality rates, and even nurse injury because you're not able to have your nurse colleagues help you with lifting, boosting, or needle safety."

Filling coverage gaps

For CNOs who are working towards addressing these shortages, Goettl recommends caution when developing staffing strategies.

"Don't spread your staff so thin and then make that the new normal," Goettl said. "[You] still have to invest in appropriate and safe nurse staffing, but the big investment is in professional development, providing opportunities for non-nurses like techs and LPNs to go back to school so they can stay in the health system."

Goettl emphasized the role of virtual nursing as well, as an opportunity to augment staffing. Virtual nursing can help with teaching, peer-to-peer mentorship, and retaining seasoned nurses who can work as preceptors or as clinical mentors.

"It doesn't replace a nurse, but it can definitely help in scenarios where you need to spend more time with patients," Goettl said.

Work-life balance is critical for nurse retention, Goettl said. Solutions such as self-scheduling and flexible scheduling can give some autonomy back to the nurse and simultaneously help fill up the schedule while empowering nurses to do what's best for them. Investment in transition to practice programs is also key.

“Investing in your nursing staff so that they have the tools [that prepare them] to do their job will help with retention all the way around," Goettl said.

As cost of living continues to rise, nurses, like many other professionals, are feeling the strain.

Financial insecurity has a significant impact on every aspect of a person's life, and inadequate compensation can be a major driving factor in employee turnover at an organization.

Nurses are overworked and feeling burnt out, and that plus high cost of living pressures is a recipe for increased turnover rates. CNOs must do what they can to advocate for their nurses and define the value of their work to build more sustainable workforces that benefit the nurse, the patient, and the organization.

Here's what CNOs need to know about nurse compensation in 2025, according to a report by Vivian.

Click here to read the accompanying article.

A robust virtual nursing program should be created with long-term goals in mind, says this CNE.

Virtual nursing is rapidly becoming a standard of care in the healthcare industry.

Right now, while many programs are still in their infancy, CNOs have a great opportunity to learn from each other's strategies and outcomes.

For Patty Donley, senior vice president and CNE at WellSpan Health, the original goal of WellSpan's virtual nursing program was twofold. First and foremost, Donley emphasized the workforce shortage and planning for when the baby boomer generation retires.

"We'll likely need more care at the same time that our baby boomer nursing and healthcare professionals are retiring," Donley said.

Donley explained that as nurses retire, the rate at which they will retire is predicted to be greater than the rate of those entering the profession.

"That combined with that increase in the number of aging adults will likely create a supply and demand issue," Donley said. "We're really trying to look ahead and determine how [to] plan for what likely will become an even greater shortage moving forward."

Additionally, WellSpan is considering how to support nurses with their current workload and how to do that in an innovative way that provides greater satisfaction for bedside nurses, Donley said. The health system is also interested in leveraging the knowledge of experienced nurses to help support newer generations of nurses.

Developing the strategy

According to Donley, developing the virtual nursing program, which has been in place since 2023, began by looking at it from a cross-functional perspective.

"We knew what we were looking to accomplish, but doing it in such a way that we pulled in our IT colleagues," Donley said.

WellSpan’s innovation and design teams also got involved with the project. According to Donley, the next step was to create a governance structure that leveraged executive leadership who had the vision, a budget, and a timeline, and a committee of clinical leaders and team members who provided insights on the program’s impact. The technical team also was present to look at all the technical components that needed to be considered.

"I think that's what made us successful and particularly engaging frontline nurses from the beginning was integral to our ability to be where we are today," Donley said. "I think that listening and gaining their insights and input into how we did it initially helped us to build a platform and to create a virtual care model that worked for our nurses."

Donley also emphasized the importance of messaging when starting a virtual nursing program.

"The other thing we started at the very beginning was to message that the virtual care nurse was not meant to replace nurses, but to support them," Donley said.

Looking to the next generation

In terms of looking to the future, while there are no new grads currently working in WellSpan's virtual nursing program, Donley says they have taken Gen Z nurses into consideration for their strategy.

"We're looking to partner with…our colleges and universities to introduce the technology while the nurses are in nursing school so that they can be prepared if potentially that's an area that they're interested in," Donley said.

The goal would be to get new graduate nurses familiar with the technology to equip them for the future of their careers.

"Introducing that technology and the platform and how it's done early on in a person's career might help to eventually move in that direction," Donley said.  

In the future, WellSpan plans to continue reducing administrative tasks and unnecessary burdens at the bedside. Donley says they are looking into ambient listening and how to leverage their virtual nursing platform for documentation. The health system is also looking at different efficiencies in sites of care like the operating room and where the virtual care platform and their chosen vendor platform, Artisight, can help capture different documentation pieces.

"That's exactly the position we want to be in as we continue to talk to our frontline nurses and team members, to say, 'how else can we support you?'" Donley said.

Donley recommends having a long-term mindset when strategizing for virtual nursing. Engaging the frontline teams and celebrating milestones and successes are also key for CNOs and other leadership.

"You might start small, you might start with doing admissions or something like that, but think about a platform that's going to take you to the next level and that might be able to solve some future challenges.”