March 2024 | Certifications / Informatics / Innovation

MARCH 2024

Focus: Certifications / Informatics / Innovation

Editor’s Notebook

Are you ready to dive into the world of healthcare innovation? It can be exciting and daunting, especially in an industry that values patient safety above all else. But what if I told you that embracing emerging technologies can help us provide better patient care, minimize errors, and relieve the burden on nurses and caregivers?

The rapid development of technology is driving significant improvements in healthcare, enabling better dashboards, more meaningful patient engagement, and virtual capabilities for clinical services. And the best part? Nurses can play a vital role in this new culture of innovation.

By sharing your expertise and experience, you can help inform the evolution of this exciting field.

This month, Minority Nurse takes a deep dive into the intersection of nursing informatics and certifications with nursing innovation. Discover how they contribute to a nursing culture that embraces innovation and inspires nurses to embark on their innovation journey. Get ready to explore the future of healthcare, and let’s innovate together! “Innovation is the great equalizer in nursing. Innovation is not dependent on the degree one holds as long as you have the passion to drive ideas forward and improve the world. Nurse innovation is transforming and uniting nurses across all levels.”

– Rebecca Love, RN, MSN, FIEL, an experienced nurse executive and first nurse featured on TED Talks (TED.com) and one of the co-authors of the book The Rebel Nurse Handbook: Inspirational Stories by Shift Disruptors

—Reneé

Advancing Your Nursing Career Through Certifications

By Keith Carlson

When you earn a nursing degree— an ADN, BSN, MSN, or beyond— you signal to the world that you’re a professional who values education and advancing your career. Consistently reaching for increased expertise is a goal for individuals working in almost any discipline, and nurses are no exception.

Beyond your formal education, you have other opportunities to expand your knowledge, and certifications are one such avenue for demonstrating dedication to having the most up-to-date, evidence-based information possible in your area of nursing practice.

Why Get Certified?

If you haven’t yet pursued nursing certifications, now may be the time to consider the possibility. Certification can serve many purposes, each of which holds value for you and your career.

Validated commitment to mastery: Your potential capacity to grasp the subtleties of your chosen nursing specialty is limitless. There’s no end to how much you can learn by digging deeper and deeper into the nuances of a particular branch of nursing and the clinical judgment that comes with it. Many certification processes are no walk in the park, and if you want validation of being the best you can be, certification can accomplish that goal.

Enrich your marketability and earning potential: In the job market, you need every advantage to stand out from the crowd. Certification shows a potential employer that you’re serious about your career and have gone above and beyond. Being certified could be the thing that gets your resume noticed. You may also enjoy increased earning potential.

Augment your sense of pride and empowerment: Some nurses rest on their laurels, others keep learning, and your accomplishments say a lot about your

ambition to be the best you can be. As you gain knowledge, skill, and expertise, you can be proud of who you’ve become, and having those extra letters after your name is something you earned by going the extra mile.

Other benefits of certification include the respect of your colleagues and the benefits experienced by patients in the care they receive.

Popular Certifications

There’s an enormous and growing list of certifications available to nurses. Remember that to sit for certification exams, you’ll need to have logged a certain amount of clinical experience in that specialty, so research is essential.

Here are a few popular certifications for your consideration:

Pediatric Advanced Life Support (PALS) can be attained through the American Heart Association, the Red Cross, and several other organizations.

Certified Emergency Nurse (CEN)  is available through

the Board of Certification for Emergency Nursing (BCEN). Two years of emergency experience is recommended but not required.

Critical Care (CCRN) from the American Association of Critical-Care Nurses (AACN) is geared toward those working as intensive care and critical care nurses. There are specific clinical hour requirements in direct critical patient care before sitting for the exam: 1,750 hours during the previous 2 years, with 875 of those hours in the most recent year, or 2,000 hours in the last 5 years, with 144 of those hours in the most recent year.

Oncology Certified Nurse (OCN)  requires a minimum of 2,000 hours of adult oncology nursing practice (clinical, administration, education, research, or consultation) in the previous 4 years, 2 years of experience as an RN, and 10 hours of continuing education in oncology in the last 3 years.

The Psychiatric-Mental Health Nursing Certification (PMH-BC) offers specialized expertise and knowledge.

Applicants must be an RN with at least 2 years of experience, 2,000 hours of psychiatricmental health experience in the last 3 years, and 30 hours

of specialized continuing education in the previous three years.

Certified Diabetes Care and Education Specialist (CDCES) is a specialization that gives the successful applicant the tools to work with patients facing the challenges

of life with diabetes. Applicants must have 2 years of RN experience, at least 1,000 hours providing diabetes care and education in the previous 5 years, with 20% of those hours in the most recent year.

It’s also prudent for nurses to note that newer nursing certifications are periodically introduced.  Board Certified Nurse Coach: NC-BC and Board Certified Holistic Nurse: HN-BC are relatively recent additions.

The Certification Train

Since many certifications require significant experience in the designated specialty to sit for the exam, some employers will support and pay their nurses to become certified once they have sufficient experience. Certain employers may

At this point, it’s important to note that all areas of advanced nursing practice (family nurse practitioner, pediatric nurse practitioner, adult-gerontological nurse practitioner) are considered specialty certifications, and NPs trained in one area of practice can take an exam and receive post-graduate certification in another advanced practice discipline at their discretion.

even make pursuing certification within a set period a part of your contract.

Of course, paying for your certification and recertification is a significant benefit, although paying for the process yourself wouldn’t be the end of the world. Nothing stops you from getting the certification if you want to

demonstrate your commitment and sharpen your expertise. Train yourself in the interest of your professional development and career.

The nursing certifications list is long, and you can decide what makes sense for you. The validation of your expertise that certification confers is real, as is the increased

marketability. Certification is a powerful avenue to accomplishing that goal if you take pride in your nursing specialty and want to take your knowledge and skill as far as you can.

Keith Carlson, BSN, RN, NC-BC, has been a nurse since 1996. As a holistic career coach, nurse podcaster, writer, blogger, and

well-known motivational speaker, Keith empowers nurses regarding personal branding; professional networking; entrepreneurship; resume, job search, and interview strategies; emotional and relational intelligence; personal wellness; and the building of a dynamic nursing career.

Nursing Informatics: Connecting Tech With Care

By Louis Pilla

Are you the tech-savvy nurse on the unit? Do your colleagues seek you out with questions about the quirks of your electronic health record (EHR)? If so, consider turning that know-how into a career in nursing informatics.

Leveraging Bedside Experience

The definition of nursing informatics from the ANA’s Nursing Informatics: Scope and Standards of Practice, 3rd Edition, “is the specialty that transforms data into needed information and leverages technologies to improve health and healthcare equity, safety, quality, and outcomes.”

A background at the bedside is critical for a successful nursing informatics role. “There’s typically some kind of clinical experience involved before jumping into an informatics role,” said Christy St. John, MSN, RN, NI-BC, CPHQ, president of the  American Nursing

Informatics Association (ANIA), in an interview. “To come straight from your studies into informatics is fairly rare.”

Christy St. John, MSN, RN, NI-BC, CPHQ, is the president of the American Nursing Informatics Association (ANIA).

A combination of clinical nursing experience and education in informatics is essential, according to Melinda L. Jenkins, PhD, FNP, associate professor and director, nursing informatics specialty, Rutgers School of Nursing. Lori

Martone-Roberts, DNP, RN, CHSE, director of simulation and professor of the practice of nursing, Wheaton College, agrees, saying experience with patient care in the clinical setting is essential to the nursing informatics role because this role is the connection between the clinical setting and the technology piece of healthcare.

Melinda L. Jenkins, PhD, FNP, is an associate professor and director of nursing informatics specialty at Rutgers School of Nursing.

Although training and handson experience with technology are important, Michael Mickan, chief nursing informatics officer

at Memorial Hermann Health System, looks for experience using the tools on hand and a natural curiosity that leads to self-teaching. He feels that a nurse with that kind of informal experience is usually more successful as a nurse informaticist than those who wait to be formally trained before exploring a new technology.

Range of Skills

You’ll need to bring many skills to a nursing informatics role. Mickan outlines a variety of abilities:

Communications:  Nurse informaticists must be able to “translate” patientcare and clinician needs to technology partners as well as technology concepts and requirements to clinical users and communicate with various disciplines.

Problem-solving: Informaticists must be able to identify the real problem with astute observation and critical thinking encompassing people, processes, and technology.

Change management:  Nurse informaticists must understand change management strategies and be comfortable facilitating, guiding, and managing change.

Project management: Often, a nurse informaticist facilitates collaboration between clinical and technology partners to solve problems and support the optimal use of technology. To do this effectively, proficiency in project management is a must.

Data analytics: Nurse informaticists must have a solid grasp of the data that validate the problems to be solved and provide the baseline for measuring progress.

Day-to-Day Projects

What kind of work will you do on a daily basis? An example, notes Martone-Roberts, could be to evaluate workflows or improve usability and streamline processes, leading to improved functioning and efficient data capture.

She notes that nurses in the nursing informatics role will work with EHRs in various

ways, including managing information and troubleshooting issues when healthcare professionals use the system. Other projects involve training, validating, and reporting data and ensuring the collected data are useful.

She suggests that one example of a project could involve using chatbots to keep a patient engaged and decrease rehospitalization. Similarly, Mickan outlines workflow analysis and optimization projects, working with clinical decision support systems and EHR implementation and optimization.

Growing Field

When it comes to future demand for nursing informaticists, “I see it as a growing sector,” says St. John.

“I think sometimes it’s a matter of being a little bit more broad in the way we think about nursing informatics,” she notes. Instead of simply searching for the term on a job site, a job search can be more about “opening my eyes to things that might include AI, analyst, or health informatics

roles. I think nurse informatics roles will be more in demand in the bigger picture of health technology.”

Education and Certification

According to Martone-Roberts, you’ll need an RN and BSN to serve in a nursing informatics role. Also, she says, a nurse with a master’s degree in healthcare informatics, nursing informatics, or data management will be better positioned to succeed.

As in most nursing roles, certification can enhance your standing. The ANCC’s  Informatics Nursing Certification (NI-BC) is

Michael Mickan is the chief nursing informatics officer at Memorial Hermann Health System

Suzan Ahmad, PhD, MSN, RN, is an assistant professor of nursing informatics at the Rutgers School of Nursing,

Lori Martone-Roberts, DNP, RN, CHSE, is the director of simulation and professor of the practice of nursing at Wheaton College.

one of the foremost certifications specifically focused on the characteristics of the nurse informaticist’s role, says Mickan. While not specifically focused on nursing, he says the HIMSS’s  Certified Professional in Healthcare Information and Management Systems (CPHIMS) certification demonstrates knowledge of informatics.

Serving the Patient

Although one of the more technical roles in nursing, nursing informatics still has patient care as the end goal. “At the end of the day, what

we’re after is better outcomes for the populations that we’re serving, whether that’s in the inpatient setting, whether that’s in an ambulatory setting, whether that’s in our communities,” says St. John.

AI and Informatics

Undoubtedly, if you pursue a career in nursing informatics, you’ll need to understand and work with artificial intelligence (AI). AI already is having – and will continue to have – a significant impact on nursing informatics, says Michael Mickan. The immediate potential of AI in nursing informatics may

be for data analytics and predictive modeling, clinical decision-making, and population health management, according to Suzan Ahmad, PhD, MSN, RN, assistant professor, nursing informatics, Rutgers School of Nursing. AI, she says, aids in pattern identification, predicting patient outcomes as well as population trends.

According to Ahmad, nursing informaticists may implement AI to reduce manual data entry, support natural language processing to interpret unstructured data, enhance remote patient monitoring, create personalized care plans, offer

real-time recommendations and alerts, and automate routine tasks.

AI, says Mickan, will provide a level of predictive analytics and advanced clinical decision support that will alert clinicians to developing conditions and potential risks in timeframes clinicians haven’t experienced before.

Louis Pilla is a seasoned publishing expert with over 20 years of experience providing content and digital products to healthcare audiences.

How Data Lead to Better Nursing: Improving Workflows and Patient Care

By Julia Quinn-Szcesuil

Whether or not nurses think their job includes data informatics, it does in one way or another. For almost any nurse, data is a touch point in their day, whether they work at the bedside, in an independent office, or a boardroom.

“Data is critical,” says Andrew Awoniyi, ND, RN, NI-BC, education director and board member of the American Nursing Informatics Association (ANIA) . “It underlies everything we do.” When a fellowship experience revealed the way technology could have a positive and significant impact on healthcare, Awoniyi says he developed a new understanding of how nurses can use it. “It opened my eyes to how you deliver the best healthcare,” he says.

Many nurses hear informatics and think it does not apply to their jobs, but the opposite is true, says Awoniyi. “There’s a school of thought that all nurses are nurse informaticists,” he says. “Everyone is

using data whether they fully understand it or not.”

Often, a nurse’s day includes responsibilities unrelated to numbers or patterns in data. Still, those responsibilities and the equipment or directions they rely on are a direct result of information that has been collected and analyzed.

It’s All About Data

“When a new initiative comes out, or there is a new process or new product, that is all because of data,” says Kathleen Ulanday, MBA, MHA, BSN, RN,

NI-BC, CPHIMS, and a senior clinical informatics specialist at  Texas Children’s Hospital

For example, a new process that aims to solve an identified workflow issue is often found because measurements indicate needed improvement. Once implemented, the new process will be measured as well. All the data produced during those assessments reveals patterns or other information that can influence everything from how

nurses dispense medication to shift adjustments.

The most basic nursing process of identifying a problem, assessing what is being done, intervening, and evaluating all relies on some collection of information, Awoniyi says. Assessing a patient uses the data produced through

vitals, lab results, and tests, so everyone from a bedside nurse to a chief nursing officer knows how to check those results to help direct patient needs. “Nursing is holistic, and everything we do around that involves data,” he says. “It is not foreign to us.”

Ideally, nurses work more efficiently when any change is implemented to improve an outcome because they gain fact-based information that can be applied broadly, says Ulanday. If a new process has a more significant positive impact on a cardiovascular patient population than a gastro one, there’s an opportunity to learn why. “Nurses might notice those patients go home quicker and ask why is that,”

Andrew Awoniyi, ND, RN, NI-BC, is the education director and board member of the American Nursing Informatics Association (ANIA).

Kathleen Ulanday, MBA, MHA, BSN, RN, NI-BC, CPHIMS, is a senior clinical informatics specialist at Texas Children’s Hospital.

she says. That discrepancy can trigger a deeper investigation into new areas needing attention.

Informatics Isn’t Just Computers

Nurses who are especially drawn to the idea of working as a nurse informaticist might be happy to know that gathering data doesn’t mean sitting in front of a computer all day. Data, Awoniyi says, has a way of helping nurses when the results are interpreted and applied. And with artificial intelligence leading to advances in medical robotics and more targeted

applications, nursing informatics is advancing rapidly. It can be a significant factor in closing gaps in healthcare access. The recent expansion of telehealth shows how technology expands potential. As the population shifts and more people are living longer and with more complex conditions, data, says Awoniyi, can help close the gap in health care because it can offer healthcare in settings that are located far from high-tech hospitals.

While data is something that nurses can point to as proof of something working (or not), there’s another unexpected benefit to using data to help

guide how nurses perform their jobs and care for patients in any setting. Compliance with a new process can improve a workflow, says Ulanday. When nurses see that improvement, their motivation and morale increase.

An In-demand Career Path

As data output grows, the industry needs nurses who use data efficiently and know how to interpret and apply the data to different nursing scenarios. “There’s a lot of data that is generated,” Awoniyi says, “and we must understand that.” Whether they want to switch careers or not, Awoniyi

recommends that nurses understand how and why technology is incorporated into healthcare processes and settings. “Be willing to contribute,” he says. Partner with other nurses, look at how new systems impact nursing workflows and offer feedback on what might improve the process or quality.

Informatics opens up nursing jobs for everything from a nursing informatics specialist or clinical informatics specialist to that of a professor or educator. According to the Healthcare Information and Management Systems Society (HIMSS) 2022 Nursing Informatics Workforce

Survey, 60 percent of the 1,118 respondents reported annual salaries of at least $100,000. The survey also showed how nursing informatics roles are positioned in organizations, with 34% of respondents reporting to information systems/technology, 33% to informatics, and 30% to nursing. Reflecting on this kind of role’s medical and technical aspects, most respondents said they report to two departments more often than just one.

How Data and Healthcare Work Together

Even as informatics helps nurses and patients, it does

require time and investment, so backing from leadership is critical, say Awoniyi and Ulanday. At Texas Children’s Hospital, Ulanday says the Magnet® status of the hospital requires that the perspective and experiences of bedside nurses, who give hands-on patient care and know how a workflow is helping or not, are included in leadership’s decision-making.

Nurses who are interested in learning more can start by reaching out to their organization’s technical team to ask questions and gain insight into how technology impacts healthcare, says Ulanday. She

says to join a professional organization like ANIA to hear about the latest developments and bring those back to leadership.

Ulanday says nurses know it takes time to learn and adapt to new technology, but they also find it will save them time in the long run. It also has a significant safety impact, as data can improve how something is done. Implementing a new workflow based on those findings can eliminate outdated processes and improve patient safety and outcomes.

“As we look to the future, data needs to be a critical part of that,” says Awoniyi.

“Understand how data is collected, analyzed, and interpreted. It’s then about how to leverage that data to bring about change.”

Julia Quinn-Szcesuil is a freelance writer based in Bolton, Massachusetts.

How Health Systems Are Using Technology to Combat Burnout and Improve Nurse Retention

By Julie Lambert

Nurse burnout continues to hinder the healthcare system across care settings.  Hospital margins  are thinning, and allocating resources to nurse retention and engagement is imperative to offset the cost of losing nurses. The average cost of turnover for one bedside RN is $52,350, which can add up to expenses between $6.6 million and $10.5 million , according to a recent retention and staffing report stating “each percent change in RN turnover will cost/ save the average hospital an additional $380,600/year.” In skilled nursing facilities, regulated staffing levels will likely impact quality care scores and reimbursements in the future. Staffing and reducing turnover are top of mind for healthcare leaders everywhere, even more so as they continue to look ahead to 2025.

Overcoming Nurse Burnout

While the industry challenge of nurse burnout is clear, the right approach to ease nurses’ burden is harder to decipher. Staffing leaders must balance competing priorities, such as investing in expensive agency labor versus racking up internal hours and offering nurses more flexibility to choose the best shifts while ensuring every shift is filled.

Three themes are among the top strategies to address nurse burnout: improving communication, increasing flexibility, and supplementing staff.

1. Improving Communication Between Nurses and Managers

Many organizations need help in traditional staffing workflows, tediously tracking multiple spreadsheets or using one-by-one phone calls or text messages to make scheduling adjustments and fill last-minute openings. This approach is not just time-consuming; it’s disruptive, siloed, and

does not take advantage of widely accepted and expected technology.

With healthcare workforce software to deploy one-tomany communications, nurse leaders can post shifts, set rules for shift selection, and relay scheduling needs quickly – for example, by implementing a first-come, first-served open shift approach or shift bidding based on seniority or other factors. This respects nurses’ time and frees up time for nurse leaders to focus on their team’s growth and development, supporting operations, and improving patient care.

2. Giving Nurses More Flexibility

More shifts are not the answer to nurse burnout – but more scheduling options could be. With real-time scheduling available at their fingertips, nurses have the necessary flexibility. More choice empowers them to select schedule changes that best fit their

work–life balance. It gives nurses the freedom to trade shifts or take on open shifts and makes them feel like they have control over their schedule, motivating them to do their best work.

Greater scheduling flexibility can reduce the likelihood of no-shows or call-outs and reengage nurses in their work, preventing turnover. Meanwhile, nurse leaders can ensure these individual choices are made with commitment rules in mind by defining scheduling rules that make their staffing software work with their team’s unique needs.

3. Supplementing Staff With Agency Nurses

For some healthcare leaders, agency staff can be an expensive response to reducing burnout and attrition. However, it could be the more affordable option in the long run. Compared to the cost of losing a nurse and the time it

takes to hire a new nurse, the investment in supplemental agency staff could greatly outweigh the costs of staff turnover. If managed well, agency staff becomes an extension of the team – used as needed, but not the immediate response to every open shift.

At the core of all these decisions is data and using available technology. Schedulers must have confidence in who is doing what, when it’s

happening, and where it’s taking place. Clear, at-a-glance staffing data differentiates between taking a one-sizefits-all approach and making appropriate staffing adjustments based on an organization’s most significant contributors to burnout and resignations.

Accessible staffing data revenue objectives and organizational goals empower healthcare leaders to take

a holistic approach. They can weigh their options and resources from a united front and choose investments to target specific challenges while understanding the impact this may have on another aspect of the organization.

Smarter Planning Leads to Reduced Stress, Higher Satisfaction

While there are many options to address nurse burnout, one

thing is clear: better staffing management is necessary. In fact,  57% of nurses planning to leave the workforce would reconsider returning to their position if their workplace implemented a more flexible approach to scheduling and shift management.

With data and a smart workforce management solution, staffing leaders can make thoughtful, more informed choices that fluctuate

seamlessly with day-to-day, real-time scheduling needs.

Nurses can impact their schedule and sign up for shifts that give them the best work–life balance through technology customized for their practice. Managers can refocus their time to make strategic staffing decisions. And ultimately, patients get high-quality, uninterrupted care.

As President and General Manager of Inovalon’s Provider business unit, Julie Lambert leads the organization that delivers cloud-based SaaS solutions to tens of thousands of provider organizations nationwide, empowering them to achieve better outcomes and economics for their organizations and the millions of patients they serve. Ms. Lambert holds a Bachelor of Science in Business Administration from the University

of Wisconsin-La Crosse and numerous certifications.

Behind the Screen But Not Behind the Scenes: Virtual Nurses Provide Clinical Support and Additional Expertise

By Kristie Aylett

Virtual nurses may work from behind computer screens, but their impact is felt throughout healthcare as their expertise is increasingly integrated into patient care and nursing workflows.

Since the invention of the telephone in the modern digital age, healthcare providers have used telecommunication tools to bring clinical expertise and care to wherever patients need them. Regardless of the technology, nurses play essential roles throughout telemedicine, usually conveying or using insights or information.

Simply put, virtual nursing is the practice of nursing using telecommunication and telehealth tools and technologies.  Initially focused on increasing access to care in rural and remote areas and responding to the aftermath of natural disasters, telehealth and virtual nurses have become part of the care provided to thousands of patients across the globe every

day. They now support clinical teams throughout the patient care continuum to help ease the overwhelming demands and address serious healthcare issues.

During the COVID-19 pandemic, many care providers considered how telehealth tools could be used in innovative ways in the care of patients. The U.S. Government Accountability Office reported a 15-fold increase over the prepandemic level in telehealth use among Medicaid beneficiaries. Numbers skyrocketed from 2.1 million in the year before the pandemic to 32.5 million from March 2020 to February 2021.

Teresa Rincon, PhD, RN, FCCM, is a pioneer in virtual nursing. In 2003, she was one of the first nurses to practice from behind a camera as part of a teleICU. Today, she is an assistant professor at UMass Chan Medical School and its Tan Chingfen Graduate School of Nursing in Worcester, Massachusetts, and a senior telehealth consultant with Blue

Cirrus Consulting, Greenville, South Carolina. She recently served as editor for a symposium of articles on virtual nursing for W, a journal published by the American Association of Critical-Care Nurses (AACN).

Teresa Rincon, PhD, RN, FCCM, is an assistant professor at UMass Chan Medical School and its Tan Chingfen Graduate School of Nursing in Worcester, Massachusetts, and a senior telehealth consultant with Blue Cirrus Consulting, Greenville, South Carolina.

When Rincon became a virtual nurse, there were fewer than 1,000 teleICU beds

in the United States. Over 20 years, that number has grown 20-fold, with an estimated one in eight ICU patients now monitored remotely.

“The level of technology acceptance has created opportunities to apply the virtual nursing model to ‘virtually’ anywhere,” she said. “The ability to leverage clinical expertise across and despite geographical boundaries is an efficient and

Fiona Winterbottom, DNP, MSN, APRN, ACNS-BC, ACHPN, CCRN, is a clinical nurse specialist at Ochsner Health in New Orlean, Louisiana.

cost-effective way to ensure safe, timely, and effective care in critical situations and routine care delivery.”

Immediate Access to Clinical Support

Virtual nurses regularly assist with tasks that do not require physical proximity to the patient, such as patient–family education, completing admission and discharge tasks, and participating in two-person verification processes.

During a patient assessment, a remote nurse and an on-site nurse can efficiently work in tandem, with one managing tasks that require physical proximity to the patient and the other completing tasks

such as clinical documentation, patient–family education, and expert nurse surveillance.

Virtual nurses provide an additional layer of clinical support to nurses at the bedside. At the push of a button, bedside clinicians have immediate access to additional nursing support.

This ease of access gives bedside nurses peace of mind, knowing that an experienced fellow nurse is not only assisting in monitoring for changes in a patient’s status but is available to collaborate and assist with care at a moment’s notice.

Virtual nurses serve as valuable mentors to novice nurses as they develop into competent and confident clinicians.

They also may support travel or agency nurses to help bridge knowledge gaps caused by a lack of familiarity with specific facilities and policies. In addition, peer-to-peer collaboration can help on-site colleagues feel more supported.

Lisa-Mae Williams, PhD, RN, CCRN, is the chief nursing officer at Intercept Telehealth, Weston, Florida.

“In addition to caring for patients, virtual nurses are helping to address the experience gap by providing an extra layer of support and expertise to the on-site team,” Williams said. “Knowledge and expertise are precious commodities, especially when caring for critically ill patients.”

Beyond the ICU

Virtual nurses and tele-critical care (TCC) programs have become more pervasive, thanks to technological advances, modalities expansions, and the number of patients served.

Lisa-Mae Williams, PhD, RN, CCRN, is the chief nursing officer at Intercept Telehealth, Weston, Florida.

“We’ve seen significant growth in the number of telecritical care services, as they expand beyond traditional critical care areas, including to emergency departments, medical-surgical units, and even home-care settings,” said Fiona Winterbottom, DNP, MSN, APRN, ACNS-BC, ACHPN, CCRN, clinical nurse specialist, at Ochsner Health in New Orleans, Louisiana.

Advances in technology have led to increased use of mobile carts, which bring the expertise of intensivists and TCC nurses wherever they may be needed. In the emergency department, they can proactively manage patients waiting for hospital admission, providing earlier access to interventions and improving outcomes.

Remote clinicians can also support rapid response teams to help stabilize a patient with a deteriorating condition. The patient can often remain in their current unit and avoid transfer to an ICU. An added

benefit is that the mobile cart can stay in the patient’s room, allowing the virtual nurse to continue monitoring them for a defined period.

There are also opportunities to create an observation space in the emergency department where patients who need short-term care for diabetic ketoacidosis, drug/alcohol overdose, allergic reactions, and other issues can get the expert care they need without being admitted to another unit.

Beyond the hospital, wearable devices and monitoring kits that link to an on-call automated system and a mobile app can help patients self-manage at home with a medical support system.

Unlimited Options

Ryan Morcrette, BSN, RN, CEN, is the director of virtual care and clinical communications at St. Luke’s University Health Network in Pennsylvania and New Jersey.

Ryan Morcrette, BSN, RN, CEN, is the director of virtual care and clinical communications at St. Luke’s University Health Network in Pennsylvania and New Jersey.

“The concept of virtual nursing will continue to mature along with the technology to support it, and we’re going to look back and wonder how we ever provided healthcare without this asset,” Morcrette said. “It will become second nature for patients, bedside nurses, and other clinicians.”

“As we look to the future, we have to think about how to harness the knowledge and skills we need to improve the care we provide to patients.

We need innovative solutions to manage the impacts of the global nurse staffing shortages successfully,” Rincon said. “Thanks to telehealth technologies, an expert can be located anywhere in the world and connect with someone who needs their assistance.”

Kristie Aylett is an accredited public relations practitioner who provides strategic counsel and senior-level communication expertise to clients throughout the United States. During her more than 30-year career, she has worked with multiple healthcare organizations, including medical schools, hospitals, nonprofit organizations, public health agencies, and professional associations such as the American Association of Critical-Care Nurses. She also teaches PR courses at Tulane University. Connect with her on LinkedIn

Are the Robots Coming for My Nursing Job?

By Keith Carlson

Throughout history, new technologies have always sparked legitimate fears that some jobs will be radically changed or eliminated due to innovation. The telegraph, the telephone, the tractor, the steam engine, the internet, robotics, artificial intelligence—each of these developments has brought some form of change in the job market, the viability of particular professions and skills, and how things get done.

When it comes to nurses and the nursing profession, innovative technologies might give us pause to consider what nurses do, how they perform specific tasks, and if the profession might stand to lose something.

While medication-dispensing robots, telemetry, electronic fetal monitoring, artificial intelligence, and other technological advances have altered our work as nurses, fears that robots will replace us and send nurses into the historical career dustbin are

likely unfounded. New opportunities are being created as nurses embrace emerging technologies and become educated and trained in valuable 21stcentury skills.

The Human Touch Nurses are the most trusted profession in the United States because they touch patients literally and figuratively daily. The trust between nurses and their patients is born mainly from the human-to-human interactions that make nursing a compelling combination of an art and a science.   No matter how efficient a robot may be in doling out medications and how powerful artificial intelligence and machine learning may become, the absolute humanity of nursing care would be impossible to replace entirely with a machine.

The physical  assessment of a newborn, the expression of empathy, and the practice of hospice nursing are just three areas that come to mind where

the human side of nursing care is so utterly crucial. While an immersive virtual or mixed reality application could be utilized to educate a patient about dialysis or provide basic diabetic teaching, no application can take the place of a nurse sitting on the edge of a patient’s bed, holding their hand, and providing emotionally intelligent supportive counseling as the patient mentally prepares for surgery.

The human side of nursing is the art that maintains the sacredness of the nurse–patient bond. Nursing may be partially driven by plans of care developed within the parameters of the nursing process, but where the rubber hits the road is where personto-person interaction informs the patient experience and the nurse’s calling.

Nursing Embracing Technology

Rather than considering how technological advances might

cause nurses to be replaced by machines, the more likely new reality is that of nurses embracing technology in the interest of their careers.

Nursing informatics  has opened new career paths for nurses interested in computers, data management, and analytics. Nurses who master their facilities’ electronic medical records (EMRs) can make themselves invaluable as super users capable of training other nurses and staff in using an EMR.

Nurses pursuing master’s and doctoral degrees in informatics can pursue previously closed opportunities, including positions such as Chief Nursing Informatics Officer (CNIO). For nurses who can find such opportunities, companies creating new bedside technologies and digital interfaces will need skilled clinicians who can act as consultants on testing devices and applications that have yet to be ready for prime time.

The Robots Won’t Be Replacing You

Although science fiction could tell an entirely different story, the reality is that we won’t be seeing autonomous robot nurses speeding from room to room, providing hands-on patient care without ever needing a break for dinner or the bathroom, at least not anytime soon.

Rather than considering how the robots may be coming for your nursing job, perhaps it’s best to focus on how you can embrace them and leverage these new developments to the advantage of your nursing career.

Are you a nurse fascinated by data? Do you have strong computer skills? Would you like to earn a higher degree and be

involved in deciding how new technologies will be used in a clinical setting you care about?  Don’t worry—the robots won’t be rolling into town next week to staff the ICU. But if you’re a nurse wondering how the tech revolution could revolutionize your nursing career, there’s much to learn and new opportunities just around the corner.

Keith Carlson, BSN, RN, NC-BC, has been a nurse since 1996. As a holistic career coach, nurse podcaster, writer, blogger, and well-known motivational speaker, Keith empowers nurses regarding personal branding; professional networking; entrepreneurship; resume, job search, and interview strategies; emotional and relational intelligence; personal wellness; and the building of a dynamic nursing career.