Healthcare systems today face a myriad of challenges, from staffing shortages, provider burnout, and rising costs to ever-present patient safety concerns.
Amidst these pressures, innovation has exploded and is being earnestly considered for the potential to solve each of these complex challenges.
Solutions that support virtual nursing have emerged as one of the most promising innovations from this period of rapid adaptation, and all signs point to virtual care becoming a permanent fixture in modern healthcare. Today, hospitals across the country are implementing virtual nursing programs, each tailored to their unique needs, resources, and patient populations. We're witnessing a period of exploration and discovery, where healthcare systems are learning in real time what works—and perhaps more important, what doesn't.
During the pandemic, health systems experimented with hybrid workforce arrangements out of necessity. While those initial solutions weren’t perfect, they opened the door to reimagining traditional staffing models, sparking the creativity and flexibility that drive evolving virtual nursing strategies.
Clearly, no one-size-fits-all approach to virtual nursing integration exists. The most successful implementations recognize that each organization has different needs, cultures, and capabilities. As virtual nursing continues to expand nationwide, several innovative hybrid workforce models have emerged, each offering distinct advantages and applications.
The Rise of Hybrid Nursing Models
Hybrid nursing models develop positions that strategically combine traditional bedside care with virtual nursing capabilities to maximize both human connection and technological efficiency. These models are gaining traction not just for their potential cost savings, but for their ability to address multiple pain points simultaneously: nurse retention, workload management, care efficiency and quality.
One of the most compelling benefits is the ability to retain experienced senior nurses who might otherwise leave the profession entirely. By offering virtual or hybrid roles, hospitals can preserve invaluable clinical expertise while accommodating changing physical capabilities or lifestyle preferences of veteran nurses. The cost savings from reduced turnover alone make these programs worth considering, but the preservation of institutional knowledge and mentoring capacity adds immeasurable value.
Leading Hybrid Workforce Models in Virtual Nursing
The following models represent the most promising approaches emerging in healthcare systems today:
Hub-and-Spoke Model
This centralized approach creates virtual nursing "hubs" that support multiple units or facilities simultaneously. Experienced nurses staff these command centers, providing remote support, documentation assistance, and clinical expertise to numerous bedside nurses. This model efficiently leverages scarce nursing resources across wider areas, making it particularly valuable for healthcare systems with multiple locations or in under-resourced rural facilities.
ADT (Admission, Discharge, and Transfer) Model
Perhaps the most widely implemented virtual nursing application, the ADT model focuses on optimizing the critical patient flow processes of admission, discharge, and transfer. Virtual ADT nurses specialize in managing these transition points, handling the documentation-intensive aspects of patient movement through the healthcare system. This division of responsibilities allows bedside nurses to focus on direct clinical care while reducing unit bottlenecks and
addressing administrative burden—a significant contributor to nurse burnout. For hospitals just beginning their virtual nursing journey, this model serves as an ideal starting point with clearly defined responsibilities and immediate workflow benefits.
Virtual Nurse Specialist Model
This approach deploys specialized nursing expertise (wound care specialists, diabetes educators, etc.) virtually across multiple units or facilities. Bedside generalist nurses can consult with these remote specialists as needed, bringing specialized knowledge to the point of care without requiring physical presence. This model is particularly valuable for facilities without the patient volume to justify full-time specialists in every area.
Follow-the-Sun Staffing Model
This model uses time zone differences to ease the burden of overnight staffing by distributing virtual nursing coverage across locations. While in-person staff are still required, certain tasks—like patient monitoring, documentation, medication reconciliation, or discharge planning—can be handled virtually by nurses working daytime hours in other regions. For example, a virtual nurse in California or Hawaii can support a hospital on the East Coast during its night shift, while still working reasonable hours in their own time zone. This helps reduce the need for local overnight virtual staff and supports in-person teams during one of the hardest shifts to fill: nights.
Cross-Unit Virtual Team Support Model
In this flexible arrangement, experienced nurses remotely support multiple units during high-demand periods, providing supervision, documentation assistance, or virtual clinical care based on real-time needs. The virtual nurse is an active member of the team, playing an established role, like charge nurse, mentor, or staff nurse colleague where they share patient care responsibilities for a group of patients with their bedside colleagues. This model creates a dynamic staffing resource that can be deployed where and when it's most needed, addressing the variable nature of healthcare demand.
Customizing for the Future
The most successful virtual nursing implementations recognize that organization-specific factors heavily influence which model will work best. Facility size, technological infrastructure, patient demographics, and staff capabilities all play crucial roles in determining the optimal approach. Many hospitals find that combining elements from different models yields the best results, for example, implementing ADT support across all units while maintaining specialized virtual resources for complex care areas.
As virtual nursing evolves, we can expect further refinement of these models and improved supporting technologies. What remains constant is the need for thoughtful implementation that prioritizes both patient care quality and nurse resilience. The most successful programs involve bedside nurses in planning from the earliest stages, ensuring the resulting systems support, rather than complicate, their workflow. Virtual nursing isn't replacing traditional bedside care. Rather, virtual nursing is enhancing care by removing barriers, streamlining processes, and enabling nurses to practice at the top of their license while preserving invaluable clinical expertise that might otherwise be lost to the profession.
Christine Gall, DrPH, MS, BSN, RN, Chief Nursing Officer, Collette Health