In a growing number of hospitals, a camera and screen sit in every patient room. Behind the screen, often miles away, an experienced nurse completes admission questionnaires, delivers discharge teaching, double-checks high-risk medicines and supports new graduates, while the bedside nurse focuses on hands-on care. This is virtual nursing.
Supporters say it eases workloads, keeps experienced nurses in the profession and improves quality. Critics fear it will be used to justify fewer nurses at the bedside. This guide explains the models, the evidence so far, and the questions nurses should ask.
Imagine you are a new graduate with six patients, two admissions and a discharge before lunch. Instead of drowning, you call the virtual nurse. She completes the admission history by video, reviews the discharge medicines with the patient and his daughter, and then talks you through your first blood transfusion checks. She has 25 years of experience and a bad back that ended her bedside career. Today, both of you are still nursing. That is the best version of virtual nursing.
What is virtual nursing?
Virtual nursing is a care model in which registered nurses work remotely, using video, audio and access to the electronic health record, to perform tasks that do not require physical presence. It is different from telemetry monitoring or tele-ICU (which focus on monitoring data), although some organisations combine them.
What virtual nurses do
- Admissions: health history, medication reconciliation, risk assessments, orientation to the unit.
- Discharge: teaching, medication review, follow-up arrangements, answering family questions.
- Documentation support: care plans, education records.
- Second checks: verifying high-alert medicines or blood products where policy allows.
- Mentoring: supporting new graduates and nurses in unfamiliar areas.
- Patient surveillance: rounding by video, checking on high-risk patients.
- Family communication: updates and video calls.
Common models
| Model | How it works |
|---|---|
| Hub model | A central team of virtual nurses supports several units |
| Unit-based | Each unit has its own virtual nurse during busy hours |
| Admission/discharge focused | Virtual nurses only manage admissions and discharges |
| Team nursing | Bedside RN, support staff and virtual RN share a patient group |
| Virtual sitters | Trained staff observe patients at risk of falls by video |
Potential benefits
- Reduced documentation and admission/discharge workload for bedside nurses.
- Better discharge teaching and fewer gaps in medication reconciliation.
- Support and safety for new graduates.
- Retention of experienced nurses who can no longer work physically demanding shifts.
- Improved patient and family communication.
Early evaluations from hospitals have reported improvements in nurse satisfaction, discharge times and patient experience, but research is still limited and results vary by model.
The concerns
- Replacement, not support: unions and nurse groups worry that virtual nurses will be counted in staffing ratios or used to increase bedside patient loads.
- Privacy: cameras in patient rooms raise questions about consent and dignity.
- Fragmented care: patients may not know who their nurse is.
- Technology failures: connectivity issues and poor audio.
- Communication gaps between virtual and bedside nurses.
- Licensure: virtual nurses working across state or national borders need the right registration.
Questions nurses should ask
- Will bedside staffing levels stay the same or improve?
- Who is accountable for each task?
- How will patients consent, and can cameras be turned off for privacy?
- How will virtual and bedside nurses communicate?
- Were frontline nurses involved in designing the model?
- How will outcomes be measured and shared?
Careers in virtual nursing
Virtual nursing roles usually require several years of acute care experience, excellent communication, strong documentation skills and comfort with technology. They can suit experienced nurses seeking less physically demanding work. Related roles include telehealth nursing and remote patient monitoring.
Frequently asked questions
What is virtual nursing?
A model where nurses work remotely by video to support bedside teams with admissions, discharges, documentation and mentoring.
Does virtual nursing replace bedside nurses?
It should not. Its purpose is to support bedside nurses, but staffing decisions depend on each organisation.
Do virtual nurses need to be registered?
Yes, and they must be registered where the patient is located, according to local rules.
Who can become a virtual nurse?
Usually experienced registered nurses with strong acute care, communication and digital skills.
But is virtual nursing good for patients?
It can be, when it adds support rather than replacing hands-on care. A screen cannot reposition a patient, hold a hand or notice the subtle change in a patient’s colour. Virtual nursing works best as an extra pair of experienced eyes, not a substitute for enough nurses.
Your next step: If your organisation is considering virtual nursing, ask to join the planning group, and bring the six questions above to the first meeting.
Related: Remote patient monitoring · Telehealth nursing jobs · AI in nursing
Sources: Published hospital evaluations of virtual nursing models; American Nurses Association and nurse union statements on virtual nursing and staffing; national guidance on remote clinical practice. Practice models vary by organisation.
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