Rethinking Staffing Models with Virtual Nursing: Flexible Solutions for Improved Efficiency
The rise of virtual nursing presents hospitals with opportunities to address long-standing staffing shortages while also rethinking traditional shift structures. Historically, nurses have worked standard shifts—eight, ten, or twelve hours—to provide 24/7 care. However, virtual nursing offers the chance to move beyond these rigid schedules, creating flexible, hybrid models that better match staffing with patient needs.
For instance, certain units may only need virtual nursing support for tasks like admissions and discharges during peak hours, such as Monday through Thursday, 8 AM to 1 PM. This flexibility allows hospitals to adjust staffing dynamically, depending on workload patterns. Emergency departments, for example, experience predictable busy periods, making hybrid staffing—where virtual and core in-person staff work together—a practical solution.
In adopting these models, it’s crucial for nursing leaders to involve frontline staff in decision-making. By getting input from experienced nurses and influential unit leaders, hospitals can ensure smoother adoption and better alignment with real-world needs.
The future of virtual nursing isn’t one-size-fits-all. Success lies in building tailored hybrid models that suit each unit’s unique workflow, ultimately improving efficiency and patient care without overburdening staff.
Listen to Holly Lorenz, Narinder Singh, and Tiffany Wyatt explore virtual nursing roles.
Video Transcript
Narinder Singh:
Let me move us on for a second because you brought up something around kind of the nature of work and I wanted Tiffany to chime in on how we’ve looked at that and some questions we have for you on that.
Tiffany Wyatt:
Yeah, so we touched briefly on staff shortages and where that’s a really big impact for hospitals right now and has been honestly for a long time since I’ve been a nurse. And historically we’ve had shifts for nurses pretty standards, eights, twelves, tens, and to cover most of the hospital 24 7. And we’d see travelers and some outside nurses. And with virtual nursing we do have the opportunity to give different types of staff, the nurses a different type of employment option, but we also can have the opportunity to have more hybrid approaches. And with that, it looks like possibly only Monday through Thursday eight to one, that unit needs help with admits and discharges. And then in virtual nursing in general, we’re seeing some people going a hundred percent with their own staff. And we’re also seeing people having external staff where they’re not able to manage the program themselves or hire their own nurses. And we’re starting to also see this hybrid approach where maybe you start with some external staff and bring in your staff, et cetera. So when Holly, does it make sense to kind of bring this model and where can you see the need for outside help outsourcing that resource? And what do you think about the opportunity for these hybrid models?
Holly Lorenz:
Well, I was a chief nursing officer and I was putting in virtual nursing. The first thing I would do is really get a core advisory team, a frontline staff together to ask them that question for people who would be interested, get some influential leaders on units or people who have maybe had experienced this and allow the staff to make that decision. Think of how much easier adoption’s going to be if you allow the nurses to say, Hey, or I experienced in one hospital that I worked with that actually the more senior nurses were who everyone preferred to be their virtual nurse, the nurses that were part of already the unit team or the hospital team because then there was already this level of confidence and easy ability to not say, well, they’re getting to do this and I’m not, but make that experience nurses that are interested in this, but make the decision, make sure that you’ve included the frontline staff and the decision for your model without deploying something that they haven’t had any say in.
Tiffany Wyatt:
And what do you think about the opportunity for the hybrid models with virtual nursing with just care when you need it? Do you see that as something in the future or for virtual nursing specifically?
Holly Lorenz:
Well, I think let’s use an emergency department as a great example. The flow, it has historical patterns of the busiest times a day. It does make sense to me that there is a version of hybrid nursing in which maybe there’s core staff, but then you add to that incrementally and staff that based on where your volume of workload and activity are, because it is going to be different in a surgical unit than it is going to be in an ICU or on a medicine unit. And so it doesn’t have to be a cookie cutter model. In fact, it shouldn’t be a cookie cutter model, but allow that hybrid option to use the workflow on the unit to determine when the hybrid nurse is in the virtual nursing. Don’t let the product or the terminology influence how you build the hybrid model. Use the population of the unit that you’re trying to use virtually virtual nursing with help inform you and discern what that hybrid model looks like. And to me, it could probably end up being the most successful one.
Narinder Singh:
I some great insights, Holly, on different parts of where care redesign has happened in hospitals, we have the great debates between open and closed ICUs. We have the rise of the hospitalists as an area. Those are examples of large scale care transformations in the nursing side. See, is there an analogy that you think about in your career that, oh, this is like when we shifted from A to B or do you think this is a new muscle that’s going to require nursing leaders to have these kind of on the ground conversations and really build bottoms up because there’s no template for this? How do you look at what this change will look like for care design from the nursing perspective?
Holly Lorenz:
Well, I’m going to look back a very long time ago maybe when we moved from eight hour as a very traditional shift to a 12 hour traditional shift. And now we’re really looking at flexible scheduling, which has really just changed the industry and being able to figure out how to do that because no one’s really figured it out or we would be not having turnover anywhere. So to me it’s an example of things are changing so fast that sometimes we can’t implement a solution quick enough to really see the impact in time. And I would use that virtual nursing as the same. We’re probably, it’s a shame that we hadn’t figured this out before covid instead of building and learning at the same minute where we could have really built the foundation and then learned much more methodically than really building and learning at the same time.