Early research from the Providence Research Network is providing valuable real-world data to inform emerging nursing models that blend bedside and virtual nursing.
What if health systems could deliver nursing care in a way that supports the nursing workforce, strengthens patient care, and addresses a growing workforce shortage?
That’s the question driving Providence researchers as we study how models that blend bedside and virtual nursing work in real-world settings.
A system-wide research effort and additional research conducted in our Alaska ministries are providing valuable data to inform the adoption of next-generation nursing models. Read on to learn about the model and early findings from this research.
A workforce under strain
The U.S. is facing a significant nursing shortage. Even before COVID-19 intensified workforce challenges, many nurses were experiencing high stress in an overburdened health care system. Retirements are outpacing the number of new nurses entering the field. And the demand for care continues to grow as the population ages and chronic conditions become more common.
According to the U.S. Bureau of Labor Statistics, nearly 190,000 registered nurse openings are projected each year through 2034. The National Center for Health Workforce Analysis (NCHWA) projects that the demand for licensed practical/vocational nurses will grow faster than supply through at least 2038, resulting in a projected shortage of 245,950 Licensed Practical Nurse (LPN) FTEs (a 30% shortage) by 2038.
A team-based approach to care
In response to these challenges, health systems have begun exploring models that blend bedside and virtual nursing. Developed by nurses for nurses, these models use telehealth technology to create a three-person care team: a bedside registered nurse, a virtual registered nurse, and a nursing assistant or patient care tech.
Virtual nurses do not replace bedside nurses. They are licensed RNs who work remotely, supporting care through video technology. They help manage tasks such as patient and family communication, documentation, symptom monitoring, and discharge planning.
The idea behind this model is that by shifting certain administrative and coordination responsibilities to a virtual partner, bedside nurses can focus more fully on direct patient care.
Studying the impact
While prior research suggests that models using virtual and bedside nurses are safe and effective, systems change in healthcare requires careful evaluation. As Providence began testing a model called Co-Caring across several hospitals, our researchers also launched studies to assess its impacts on patient safety, patient experience, the cost of care, and caregiver experience.
Findings from a Providence early implementation study published in the peer-reviewed journal Nursing Outlook found that the Co-Caring nursing model represents a viable option for addressing nursing shortages and does not adversely affect patient safety or costs.
However, the researchers identified opportunities for improvement during the transition period. Bedside RNs reported challenges around new workflows, roles, and technology, underscoring the importance of effective communication and change management support.
A related study conducted at Providence Alaska Medical Center (PAMC) found similar challenges with a partial implementation of the Co-Caring model, even with an increase in labor resources. Bedside RNs reported decreases in perceptions of areas including staffing adequacy, job satisfaction, ability to complete all activities, and manageable workload.
Based on these initial findings, the researchers recommend that health systems and leaders focus on several key areas, according to Dr. Rose Timmerman, Nurse Scientist, PAMC, and Dr. Cara Gallegos, Nurse Scientist, North Division, Providence: “The importance of managing change during the transition to Co-Caring cannot be understated. Our data reveals several areas that could help, including clearer role delineation, enhanced teamwork, and collaborating with nursing personnel to incorporate their input to optimize the model.”
Building evidence to guide innovation
These studies are preliminary, but they contribute to growing evidence around these emerging models. By measuring outcomes and listening closely to frontline feedback, health systems can refine team-based model implementations to better support nurses while maintaining high standards of safety, patient and provider experience, and cost management.
