Can Digital Nursing Save the Workforce?

Can Digital Nursing Save the Workforce?

After a grueling few years responding to the COVID-19 pandemic, turnover, burnout, and hospital emptiness charges have all elevated amongst nurses. With hospitals drowning below a sea of sufferers due partly to an sooner than ordinary surge in respiratory sicknesses, an issue compounded by staffing challenges, some specialists argue a change is required. Can digital nursing assist?

Digital nursing has been round because the early 2000s, and MedPage Right now spoke with a handful of specialists within the subject who argued that now greater than ever, integrating digital nurses in hospitals might help hold new nurses training safely and forestall extra skilled nurses from leaving the sector solely.

Turnover for registered nurses (RNs) rose by about 8% in 2021 and now stands at roughly 27%, in accordance with a survey from NSI Nursing Options. That very same survey reported RN emptiness charges of 17.1%. What’s extra, two-thirds of nurses say they plan to depart the occupation within the subsequent 3 years, in accordance with a latest survey within the journal Crucial Care Nurse.

One of many largest impacts of the elevated turnover in nursing and present vacancies is the lack of skilled nurses, as a result of it creates a information hole, stated Teresa Rincon, RN, PhD, a senior telehealth marketing consultant for Blue Cirrus Consulting. The Crucial Care Nurse survey discovered that of the roughly 9,000 respondents, solely 24% stated their models had the best variety of nurses with the best degree of expertise and information greater than 75% of the time.

The information hole “is the place digital nursing is available in,” Rincon stated. There is a subset of nurses who could not have the ability to work 12-hour shifts on their ft. They might have a foul again or a foul knee, or they could be immunocompromised and fear about being uncovered to an infection in a hospital setting, stated Wendy Deibert, MBA, BSN, senior vp of scientific options for Caregility, a digital care platform firm in Eatontown, New Jersey. These nurses, a lot of them with years — even many years — of expertise, characterize an untapped useful resource, and below the best circumstances they may not go away the occupation, she defined.

Three core advantages of integrating digital nurses into care, specialists say, embody teaching or precepting nurses; relieving bedside nurses of time-consuming duties; and surveillance. As well as, “it is an effective way to deliver extra nurses again into the sector,” stated Ashley VonNida, DNP, MSN, chief nursing officer for Equum Medical, an acute care telehealth staffing agency in Nashville, Tennessee. Numerous the digital nurses presently working for Equum Medical retired from healthcare however miss the interplay with the sufferers and nonetheless wish to present care, she stated. As for the features digital nurses can serve, “something {that a} bedside nurse does that does not require palms on a affected person, we offer that utilizing AV [audio-visual] expertise.”

VonNida harassed that she would not see digital nursing changing bedside nurses; as an alternative, she views the digital nursing as a “hybrid” strategy and a “redistribution” of the workforce. “So as an alternative of getting six bedside nurses on a unit, you’ve got 5 bedside nurses on a unit and a digital nurse,” she stated.

Teaching, Precepting New Nurses

New nurses coming onto the ground of a hospital for the primary time are “scared to demise” of creating a mistake, stated Deibert. “They’re thrown right into a world … with not lots of expertise behind them,” she stated. “So having a button on the wall the place you’ll be able to push … at a second’s discover and get a nurse in that room to help” nearly is a large assist.

For instance, she will information a nurse by means of placing in a chest tube or one other process that could be routine, however requires observe. “I can zoom in to [see] precisely what they’re doing and provides path and help, in order that they do not really feel like they’re on the market on a limb by themselves,” she stated. “Not solely does that increase their confidence, but it surely additionally actually stops that turnover, as a result of in the event that they get too scared and don’t really feel supported, they don’t seem to be going to remain there.”

And the system she works in has two-way audio-video functionality in addition to the power to zoom in to both 20× or 30×, Deibert informed MedPage Right now. “I can learn an IV pump. I can see [a patient’s] pupil. I can see their wound — how deep that wound is … I can zoom up, zoom out, go left, proper, up, down … look throughout the room,” she stated. Earlier in her profession, Deibert wasn’t capable of assess coronary heart sounds and lung sounds, however now with Bluetooth stethoscopes, that hole is closing too, she famous. The nurse and the affected person may also see her on a monitor, except she “goes in quietly,” which she stated she makes it a behavior to do when a affected person is sleeping.

Relieving the Burden on the Bedside

One other core good thing about this “hybrid mannequin” is that the digital nurse can take among the weight off the bedside nurses by managing duties that do not require a nurse’s bodily presence. Digital nurses can handle admissions and assist educate sufferers about their plan of care, Rincon defined. Digital nurses may also assist with affected person training, documentation, household conferences, and discharging sufferers.

“I am unable to begin an IV. I am unable to put a tube in … or do these dressing modifications that may be fairly elaborate,” Deibert stated. However any time a bedside nurse is giving one affected person a shower, for instance, that is when that nurse can faucet the digital nurse, and she will then “spherical” on the bedside nurses’ different sufferers, and guarantee their wants are met.

“Numerous occasions the digital nurses can doc issues to save lots of the nurse on the bedside time… So it would not tie their palms up… after they could possibly be doing one thing that is bodily serving to the affected person” equivalent to administering a drugs, stated Fiona Winterbottom, CNS, a scientific nurse specialist who has been working in digital nursing for the final decade.

Surveillance, Screening

One other space the place digital nurses can help these on the bedside is thru monitoring and surveillance. Whereas bedside nurses try to juggle seeing 5 or 6 sufferers, a digital nurse could be doing distant screening, defined Winterbottom.

Digital nurses see developments in another way than nurses on the bedside as a result of they’ve fewer distractions, Winterbottom stated. Digital nurses are gathering information — watching affected person’s very important indicators, physiological lab information, being attuned to algorithms and scientific resolution help alerts, whereas additionally actively rounding on sufferers, Rincon stated. As they do all this, they’re deciding whether or not a affected person is starting to stabilize or shifting towards deterioration.

This sort of fixed screening and leveraging of scientific resolution help programs permits for digital nurses to zero in on sufferers throughout the flooring they’re nearly liable for, and assist keep away from a code or a fast response staff from being referred to as, added Deibert.

“When you’ve got small teams of individuals taking good care of massive quantities of sufferers inside a quiet, non-distracting atmosphere, they’ll actually do protocolized care very effectively,” stated Corey Scurlock, MD, MBA, founder and CEO of Equum Medical.

Selecting Digital Nursing

Digital nurses, relying on their specialty want not less than 1 to three years’ expertise, stated Deibert, and to work in crucial care at Equum requires 10 years.

For many who select to principle or coach nurses new to the sector, they should be each affected person and skilled, Winterbottom stated. “It’s miles simpler … to do one thing myself than speak anyone by means of one thing, as a result of it takes me 3 times as lengthy. So, if you do not have the endurance, the teaching skills … [and] you’ll be able to’t do it on the bedside, you are most likely not going to have the ability to do it by means of a digital camera.”

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    Shannon Firth has been reporting on well being coverage as MedPage Right now’s Washington correspondent since 2014. She can be a member of the location’s Enterprise & Investigative Reporting staff. Follow