In September 2024, the American Academy of Nursing (Academy) hosted a policy dialogue titled “Addressing the Challenges and Policy Implications of Virtual Nursing.” The Academy’s Expert Panels on Building Health Care System Excellence and Informatics & Technology convened this dialogue to discuss the implementation of virtual nursing models of care and technology-assisted nursing into current health care practices. Participants in this dialogue were able to hear from leading experts about critical questions surrounding virtual nursing’s impact on established competencies, licensure, standards of practice, regulation, evaluation, payment, and the implications for policy. 

• Virtual Nursing Can Meaningfully Expand Access to Care and Improve Nurse Well-Being
  In the wake of the COVID-19 pandemic, ongoing nursing shortages, and a rapidly evolving care environment, virtual nursing can achieve dual aims of improving access to care as well as bolstering workforce well-being through shifted team care. The option of serving as a virtual nurse can also extend the careers of experienced RNs who may otherwise exit the workforce.
• Intentional Design of Safe, User-Centered Systems Must Account for Common Challenges and Risks
  The digital divide, mis- and disinformation about technology, and disparate internet access across regions must be considered when designing and implementing virtual care models. Furthermore, clinical governance of virtual nursing must account for the risks of internet and power outages, cybersecurity breaches, and virtual platform breakdowns. Nurses have a key role to play in assuring safety in all aspects of virtual platforms and promoting safety in the emerging regulatory landscape. 
• Virtual Nursing Strengthens Patient Engagement and Empowerment in Care 
  Virtual nursing empowers patients beyond being health care consumers to being meaningful partners in their care. With essentially on-demand access to a virtual nurse, the patient feels more seen, heard, and included. This powerful shift ultimately leads to better quality and safer outcomes.
• Policies Guiding Standards, Competencies, Licensure, and Payment Must Evolve with Virtual Care
  Barriers that impede the implementation and success of virtual nursing models must be addressed, such as reliance on waivers for implementation and licensing requirements that limit nurses’ ability to practice across state lines virtually. For long-term sustainability and success, updated standards and competencies for nurses must also be developed.
• Quality and Safety Measures Must Be Reimagined for the Virtual Care Environment
  Traditional quality measures such as hospital-acquired infections and falls continue to underpin assessments of virtual nursing models. As the virtual care environment continues to evolve, quality and balancing measures, including patient reported outcome measures, must evolve to evaluate quality not only within but across health systems and ensure that novel models are not resulting in adverse or unintended consequences in other areas of care.

Guest Panelists

• Jeanette Ives Erickson, DNP, RN, NEA-BC, FAAN, Chief Nurse Emerita and Paul M. Erickson Chair in Nursing, Massachusetts General Hospital
• Cynthia Salisbury, MSN, RN, NEA-BC, CPHQ, CPPS, Executive Director of Nursing Operations, Providence
• Murielle Beene, DNP, MBA, MPH, MS, RN, NI-BC, PMP, FAMIA, FAAN, Senior Vice President and Chief Health Informatics Officer, Trinity Health
• Patricia McGaffigan, MS, RN, CPPS, Senior Advisor of Patient and Workforce Safety and President of Certification Board for Professionals in Patient Safety, Institute for Healthcare Improvement 

Planning Committee

• Chair, Planning Committee: Susan Grant, DNP, RN, NEA-BC, FAAN 
• Jane Carrington, PhD, RN, FAAN
• David Marshall, JD, DNP, RN, CENP, NEA-BC, NHDP-BC, FAONL, FAAN 
• Beth Taylor, DHA, RN, NEA-BC, FAAN
• Mattia Gilmartin, PhD, RN, FAAN
• Eric Staples, ND, FAAN
• Deb Zimmerman, DNP, RN, NEA-BC, FAAN
• Lindell Joseph, PhD, RN, FAONL, FAAN
• Cynda Rushton, PhD, RN, FAAN
• Debbie Gregory, DNP, RN, FAAN
• Lesly Kelly, PhD, RN, FAAN
• Sylvain Trepanier, DNP, RN, CENP, FAAN