Virtual nursing models use remote communication and related technology to deliver nursing care in coordination with an in-person team. ANA's principles describe a virtual nurse as a licensed nurse in a different physical location who supports the nurse providing in-person care, with both collaborating in patient care and monitoring the care environment.
A virtual model is a way to organize nursing work. Its safety depends on clearly defined roles, reliable communication, and an appropriate relationship between remote activity and care that requires someone physically present.
Specify the work before choosing equipment
An organization might consider remote support for admission information, discharge education, consultation, or observation. These are possible uses, not a universal task list or evidence that every activity is suitable for every patient.
For each proposed function, define what the virtual nurse does, what remains with the bedside team, and how responsibility transfers. Describe the limits of the technology and the response when the patient needs immediate in-person attention. Avoid leaving a task between two nurses who each believe the other is completing it.
ANA's principles call for clear role delineation, person-centered care, competence, collaboration, and appropriate transitions. They also emphasize privacy, secure communication, and documentation consistent with institutional standards.
Include patients in the design
Patients need to understand who is communicating with them, how the remote nurse participates in their care, and how to request assistance. Explain when technology is in use and follow the organization's privacy and consent processes.
The model should accommodate differences in communication, cognition, language, and ability to use equipment. A camera and speaker do not by themselves create an accessible interaction. Determine how interpreters, support people, and in-person assistance will be involved when needed.
Illustrative division of work
In an illustrative model, a virtual nurse begins discharge teaching while the bedside nurse manages a separate immediate care need. During teaching, the patient raises a concern that requires an in-person assessment. The virtual nurse uses the agreed escalation route, and the team documents who accepted responsibility and what remains unfinished.
The example illustrates coordination, not a recommended staffing ratio. It does not show that remote support permits fewer bedside staff or produces a particular outcome. Those questions require evaluation of the actual model and patient needs.
Evaluate the model as a care service
ANA calls for research and ongoing improvement to establish the effects of virtual care. A local evaluation should consider patient understanding, response to concerns, duplicated work, missed handoffs, staff experience, and accessibility. Include the time spent connecting, troubleshooting, and communicating between nurses.
Define comparison periods and patient groups before attributing a change to the virtual model. A shorter discharge process, for example, may reflect several simultaneous changes.
The remote and bedside teams need shared governance and a way to revise assignments.
For the practical steps before, during and after a remote encounter, see telehealth nursing workflows.
Related
Nursing Informatics Project Governance
Sources
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ANA: Principles of Virtual Nursing (accessed 2026-09-17).
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SAFER: Clinician Communication (accessed 2026-09-17).
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AHRQ: Health IT Evaluation Toolkit (accessed 2026-09-17).