As hospitals and healthcare providers face increasing pressures to do more with less, nurses are feeling burnt out. A more novice nurse workforce, in addition to inadequate education and training, higher patient acuity, and rising nurse-to-patient ratios are amplifying this, ultimately leading to nurse staffing shortages. These problems not only affect the well-being of nurses but also impact the quality of patient care.
To address these ongoing issues, hospital systems are reevaluating their workflows and looking at technology solutions to help support their staff. For example, many hospitals are adopting virtual care platforms and AI-enabled tools to help relieve administrative burden. However, before making decisions on solutions, it’s important to really understand the root causes of nurse staffing issues.
Top Reasons for Nursing Shortages:
Nurse Burnout
Nurse burnout is a common consequence of the overwhelming responsibility and pressure placed on nursing staff in hospital systems. Reduced resources and support lead to some nurses deciding to leave the healthcare industry all together. Nurses play a vital role in ensuring that patients’ well-being remains a priority. RNs aren’t the only ones affected; when it comes to Patient Care Technicians (PCTs) and Certified Nursing Assistants (CNAs), health systems are seeing turnover rates in excess of 30%. So, what happens when nurses experience burnout and leave the profession? The remaining nurses within the hospital are stretched too thin with the number of patients they must care for. Job satisfaction begins to decrease, and turnover rates rise, leading to more resources and funds spent to replace and train new staff. As a result, trust in the hospital system starts to fade.
Higher Patient Acuity and Reduced Resources
Another key contributor to the nurse shortage is higher patient acuity and limited training and resources. Patient acuity refers to the level of care or monitoring a patient requires from hospital staff, particularly nurses. The higher the patient’s acuity, the more attention the patient needs. As the patient-to-nurse ratio increases, less attention is given to patients with less demanding issues and health concerns. This leads to diminished patient care, as nurses are unable to provide the attention each patient deserves. Inadequate resources and training leave nurses feeling overwhelmed, making it challenging to provide proper care for all their patients. More experienced nurses are retiring early, leaving junior nurses with a larger workload and less mentorship. This results in stressful situations and higher risk of incidents under the care of the hospital.
Solutions to the Nurse Staffing Shortage
One solution to this issue is to hire additional staff and nurses at the bedside. However, the high cost of hiring travel nurses makes it challenging for hospitals to support their existing nursing staff while meeting the demand for additional help. This is where virtual care can play a key role in providing support, helping optimize the staffing they have. It is crucial for hospital systems to address nurse staffing problems. By providing a better work environment for nurses and offering education and support to nurses’ journeys, hospitals can help the 52% of the nursing workforce who have considered leaving the bedside.
Virtual Care: a Solution to Help the Staffing Crisis
Virtual care is a resource used by healthcare providers and hospital systems to connect patients with doctors, nurses, specialists, and virtual sitting staff remotely. This includes use-cases such as virtual sitting, virtual nursing, and virtual visits. This approach increases efficiency in managing workloads and can help patients receive care more quickly. Virtual care is becoming a prominent resource to help solve staffing issues. It allows nurses to return to the bedside and focus on direct patient care, working at the top of their license. Studies have proven that virtual care, specifically virtual sitting, reduces burnout and improves nurse well-being. A recent survey of 74 nurses from Renton, Washington-based Providence found virtual sitting improved their “emotional labor” and “emotional exhaustion” over in-person sitting. The survey illustrated that virtual sitting improves the well-being of nurses and helps maintain patient safety. Emily Anderson, MSN, RN, PCCN-K, nurse manager at Providence Medical Center in Anchorage, AK said, “Having insightful research into virtual sitting helps us alleviate burnout among our nursing staff and optimize the usage of all our resources to get the right care to the right patient at the right time.” As healthcare systems are evaluating ways to reduce nursing shortages, aid their teams, and deliver the best care possible, solutions like virtual sitting, virtual nursing, and AI need to be considered to support staff and ease the workload and pressure that has been causing the drop in workforce.
What is Virtual Sitting?
Virtual sitting, also referred to as virtual monitoring, is a resource for nurses at the bedside, reducing the need for one-to-one in-person sitting and helping to prevent adverse events for patients. Virtual sitting equips trained safety attendants to use video and audio connections to watch over multiple patients and improve overall safety. Virtual sitting has been used for preventing a variety of adverse events, such as falls, elopement, possible self-harm, suicide ideation, and staff abuse. By using this technology, events that once required 1:1 sitting can now be monitored by a virtual safety attendant, who can safely observe up to 36 patients at a time. This helps reduce the workload of nurses, allowing them to work at the top of their license and focus on higher-acuity patients.
One hospital that successfully implemented virtual sitting amid nurse staffing shortages is St. Luke’s Duluth, a Minnesota-based health system. Like many health systems, St. Luke’s faced challenges such as a tightening labor market, increasing competition for experienced healthcare workers, and rising costs. To provide additional resources and support to their current patient care staff, St. Luke’s implemented a virtual sitting program. They utilize a two-person model: one staff member provides rounding services for patients and staff, while the other staff member observes patients via video monitors. Nursing leaders have found that this approach enhances patient and staff safety and helps support monitoring staff by providing adequate breaks to avoid monitor fatigue.
Read more about St. Luke’s virtual sitting program.
What is Virtual Nursing?
Another way virtual care has emerged as a solution to nurse staffing problems is through virtual nursing. The American Nursing Association describes virtual nursing as a resource that “support(s) the team at the bedside to alleviate the workload and provide greater satisfaction for both the patients and the nursing staff.”1 Through virtual platforms, nurses and care managers can support teams at the bedside to educate patients, complete admissions and discharge paperwork, automate documentation, and mentor more novice nurses. This allows virtual nurses to have direct, uninterrupted time with patients, leading to less errors or gaps in documentation and freeing up floor nurses to care for their patients at the bedside. It enables a care model where RNs, CNAs, and VRNs (virtual nurses) perform the most appropriate patient care activities based on their skills and experience.
Virtual nursing tools also connect hospital staff with external care providers in real time, ensuring smooth transitions and avoiding delays in securing post-discharge services. Holzer Health System is a recent example of this use case. Using the AvaSure virtual care platform, scarce specialists in neurology, nephrology, diabetes education, and wound care were able to serve patients in two facilities, located 30 miles apart. Natalie Gardner, BSN, RN, CWON, CFCS, describes the benefits: “This has provided a way for me to do video consults with the Jackson facility which saves precious time as well as mileage. The staff take the device to the patient’s room, remove their dressings, and position the patient so that I can see the wound. This leaves me more time to spend with all patients by eliminating the time it would take to drive to Jackson and back.”
Additionally, virtual nurses can provide real-time mentorship, feedback, and confidence to recent graduates and novice bedside nurses, nurturing a nursing workforce for the future.
What is Computer Vision and AI?
While AI is advancing and gaining attention in the healthcare industry, hospital leaders must remember to use applications that can be easily used by their staff, enhance patient safety, and improve the overall hospital experience, all while ensuring that workflow is not disrupted.
There are multiple types of AI currently being used in healthcare settings. Computer vision is a subset of AI that can vastly improve the way hospitals provide care without requiring care providers to compromise on safety and control. One application of computer vision is to help to prevent falls, elopement, and workplace violence by being able to detect factors that are potential warning signs. Following the detection, computer vision alerts a worker to address the issue that may be at hand. The technology is used to augment virtual sitting, helping care team members monitor patients more efficiently, identify patients in need, and make fast, informed decisions that keep them safe.
To know you are using computer vision and AI correctly, keep an eye out for three positive indicators:
- Data is used both to prevent immediate incidents and to drive proactive interventions based on insights over time
- Real-time alerts are targeted enough to inform the right staff of risk without contributing to alarm fatigue
- The program is scalable; AI isn’t just another expense but a way to reduce operational costs and drive savings that fund additional technology investments.
AI in healthcare systems can be a tool but be sure to use the correct collaborative platforms, and track ROI from the start of the AI journey.
A new example of AI in the healthcare space is AvaSure’s virtual care assistant, designed to bridge gaps in communication, prioritize urgent patient needs, and support healthcare teams in delivering timely, high-quality care. The Virtual Care Assistant appears as an avatar, helping triage requests, questions, or needs and assist within the nursing workflow. Requests are categorized into clinical and operational groups, and the assistant, named Vicky, ensures they are directed to the appropriate human personnel or team, helping healthcare systems integrate a reliable, trustworthy, and supportive system for healthcare workers.
Implementing Virtual Care
While there are many virtual care tools and technologies to help reduce the burden on nurses, what does implementation look like in practice? There are multiple phases of the virtual care journey; while it may feel like other hospitals are ahead of the curve, 29% of healthcare leaders established that they have no virtual care solutions, and 39% of hospitals are still in early exploration with virtual nursing. The 5-stage maturity model, developed with the input of 1,100 hospitals and 15+ clinical and hospital IT executives, represents a blueprint for care model redesign led by change-management oriented, outcome-focused leaders. By making virtual care workflows a standard part of care delivery, facilities can meet the evolving needs of both patients and healthcare providers. It can help by expanding access to care, improving patient experience, reducing caregiver workload, and increasing the efficiency and scalability of staffing.
Nurse staffing shortages are a real challenge in hospitals and create a chain reaction that impacts everything, from quality of patient care to the health and well-being of nurses. This issue contributes to burnout and stress, ultimately affecting the care that patients receive. It’s crucial that hospitals find solutions that support nurses and improve the entire healthcare system.
AvaSure’s virtual care platform deploys AI-powered virtual sitting and virtual nursing solutions, meets the highest enterprise IT standards, and drives measurable outcomes with support from care experts. By offering our virtual care platform to monitor and support staff and patients, AvaSure can help reduce the burden on nurses, improve patient outcomes, and assist healthcare systems to better improve staff workflow and patient care.
Resources
1Ball, J. (2022, July 1). Virtual nursing: What is it?. Innovation Site. https://www.nursingworld.org/practice-policy/innovation/blog/virtual-nursing-what-is-it/
