Episode 11: Virtual Nursing

This transcript was generated automatically. Its accuracy may vary.

Cara Lunsford

Oh, hey, nurses. Welcome to the Nurse Doc podcast. Giving nurses validation resources and hope. One episode at a time. So today on Nurse Dot podcast.

Bonnie Clipper

Technology is going to bail us out on a lot of fronts. Yet it also has to become much more intuitive and workable for us so that we don't have to disrupt what we know and what we do in order to bring technology into it.

Cara Lunsford

I'm your host, Kara Lunsford, registered nurse and VP of community at NASSCOM Body Clipper. First of all, you are Dr. Bonnie Clipper. I will start with that. You have your DNP right?

Bonnie Clipper

That I do. I probably have the receipts to prove it, but. Yeah. Yes.

Cara Lunsford

You're a podcast host, bestselling author, advisor, innovator, LinkedIn Top voice, which is also very cool. Your podcast is Health Care Soothsayer. I was on your podcast, which was a huge honor. Thank you for having me. And the founder of Innovation Advantage.

Bonnie Clipper

Yeah, I have a lot of spare time. I guess I need to find a few more things.

Cara Lunsford

Yeah. I mean, really, Why are you so lazy?

Bonnie Clipper

I know, right? It's this motivation issue. I have.

Cara Lunsford

Oh, like how we really need to work on that. Let's start off with in general. Tell me a little bit about innovation advantage. How did that come to be your passion around innovation and this next health care reimagined? You know, in the future of health care, what that looks like and how innovation feeds that.

Bonnie Clipper

Ooh. Okay. That's a great question. So I have created this consulting company back in 2019, and certainly there was a timing issue that didn't work out quite right and that happened to be the pandemic. What it allowed me to do was really to think about and to refine to a very, very sharp point exactly what I wanted to do and what I wanted to offer.

That would make me very differentiated in a crowded marketplace of health care consulting. So I am the CEO and founder of Innovation Advantage. We are a boutique healthcare innovation consultancy. We focus on two things. One of them is coming in to organizations to help them learn to think differently and collaborate in sometimes uncomfortable ways around problems so that they truly solve them in a different manner than they've tried in the past.

The other part of what I do is I help hospitals and health systems integrate technology into the workflows in the processes for nursing so that really when they spend hundreds of thousands, millions, hundreds of millions of dollars on tech, it doesn't just get installed and used as really fancy fall monitoring equipment. Right. But rather, let's integrate the technology into nursing workflows to truly leverage what they have invested their time and money on and really create a new care delivery model.

Cara Lunsford

Well, Mike, drop to that. First of all, as somebody who actually decided to jump into the world of technology and try to use it to bring nurses together. I was never a very tech savvy person. I wasn't really somebody that was on social media all the time. I really hated learning like new electronic health records. The minute somebody started talking about technology, it was just like that shut down.

And I think a lot of that is because sometimes to what you were just saying is that they implement technology and they don't really think about how they're implementing it. They're using technology to fix this and then fix this other little thing and then fix this. And then you almost end up with this Frankenstein technology that you've tried to, like, patch together.

And the systems are not talking to each other.

Bonnie Clipper

And that happens all the time. Right. I mean, organizations will buy this amazing platform or that amazing platform. Things don't integrate. They don't show up in one place. So you have to rely on how well-organized your desktop is to find things. It's sort of an odd time because technology is going to bail us out on a lot of fronts.

Yet it also has to become much more intuitive and workable for us so that we don't have to disrupt what we know and what we do in order to bring technology into it. So I think that part of it is going to settle down over the next couple of years as we get to be more demanding and particular about how we like things to work together and will understand what things should look and feel like and the intuitive nature of them.

This is where I see a fundamental shift happening in nursing instead of technology happening to us. Nurses are getting much more demanding and much more savvy about what technology should do for us. So I feel like the tail isn't going to wag the dog for much longer.

Cara Lunsford

I always appreciate a little bit of hope in this podcast because, you know, oftentimes when you when you talk to nurses, we have a lot of issues. There's a lot of problems and really trying to encourage nurses to bring those solutions to the table. You know, some of them are really great about bringing solutions. Other people like have them they keep them all in their brain, but they don't like share them with anybody.

I feel like part of like this podcast is the one we're doing today is really like, get those ideas like out of your head. Bring them to places like innovation Advantage. Bring them to places like Bonnie Clipper where you can potentially make real change in this environment because nurses are holistic thinkers. We're just naturally holistic thinkers. When we look at a patient, we don't just see the disease.

We see socioeconomic challenges, we see disparities, we see all kinds of things that are very holistic in nature. And it is that holistic thinking that I think allows us to bring these really great ideas and this technology to the table because we can identify a lot of problems and potentially put forward a solution for several problems, not just one problem.

Bonnie Clipper

And I think you're exactly right. And there's two ways to do this. You can do it from the outside in, which is where you can actually create something or develop build something that is a solution to a problem that you see. Or we can do it from the inside out. And the inside out, in my opinion, is actually trickier.

I think there are plenty examples from the outside in where we see all kinds of technology companies coming up with solutions. They don't always meet a problem that we have. So I think there is clearly a very, very precipitous down side for being a solution in search of a problem. If we do this from the inside out, that means that we as nurses have a front row seat to health care, to patient care, to family dynamics, to population health, to community wellness, to any of these things.

Yet we don't always use our influence or advocacy, our leverage to really amplify that work. So from the inside out, we should absolutely be involved in the design and the development of existing systems in our own organizations to make them functional and make them better. And we should be involved with all of the thousands and tens of thousands and probably hundreds of thousands of tech companies that have solutions.

Whenever tech companies come to me for advisory work, I will say, Do you have a nurse on your advisory board? And nine and a half times, maybe 9.9 times out of ten, they're like, Well, no, if you're in health care, there is no excuse for not having a nurse on your advisory board because we bring such a wealth of knowledge.

We have such a different vantage point. So if we approach this from the inside out, the nurses spend more time with their patient. There are four times as many of us as there are physicians. It's so important that we're the ones that are really driving the processes, the workflows, the outcomes, the safety, the quality around patient care. It's a really solid ecosystem that we should play a huge part in.

We don't for a variety of reasons. It isn't always because of nurses either. It's sometimes because the opportunities and what's going on around us. And you know, you're not going to be invited into this space. You know this. People don't knock on your door and go, Hey, you're awesome. We would love you to be involved. This is where you push your way in and you get invited.

You get to the table and you sit there and you talk and you share. But this is the stuff that we have to do.

Cara Lunsford

Yeah. And it's going to these tech meetups, show up to these meetups where a bunch of tech heads are getting together and talking about these problems and ideas of how they can effectively disrupt the health care space. And there's so many people in technology who really, really want to disrupt this space. And the problem is they think that it's just as simple as well, everybody knows there's a nursing shortage, right?

And they're like, so we just need to get the nurses in. We just need to connect the nurses with the companies and that's all we have to do, right? Like, somehow the nurses haven't figured out how to get a job and it's like, No, no, no, no. You need to understand why there is a nursing shortage. There is not a shortage of nurses.

There's plenty of nurses. There is a shortage of nurses willing to work in this environment.

Bonnie Clipper

Well, so here's what I'll push back on. That's the greed factor in technology. They go for what's easy and they go for what they can solve for. I mean, I can't even tell you the number of people that reach out to me and they're like, Hey, we would just like 15 minutes of your time. We want to demo something.

We want to talk to you. We want to see if you'll be an advisor for this, an advisor for that. If I have one more of them, reach out to me. That is some kind of a you know, we are the best of the best for travel companies. Our app is better than anybody else's. It's purple compared to blue or it's striped compared to it, Right?

Like they all think they have the best thing in the world for matchmaking and finding salaries and bidding and jobs, you know? And I'll say what exactly what you just said. You're missing the point. The point is in finding work. The point is that the work has become so difficult and so challenging and sometimes so undoable. That's the problem.

Cara Lunsford

Right. And how can we disrupt that space? Because obviously, so many people think that the fast money. Right. The fast money is well, all these hospitals need nurses. So if we can give them nurses checking, there's the money. I think a lot of these companies that are trying to penetrate this space are quickly realize saying that if they make these promises, you know, will staff within X number of days or whatever.

They're quickly realizing that this is not a great model.

Bonnie Clipper

Well, and I think for people that are listening to this, what's important is that they hear I say there's a tremendous amount of opportunity to improve the work environment, the workflows and what happens as you practice nursing. That's where we need to disrupt, transform or come up with solutions. And I think to something you said a few moments ago is that as nurses, we have to stop going to events and stop talking to nurses.

Let's branch out and start talking to others. So you suggested tech and startup meetups. It's brilliant to go there, go to conferences that are not nursing conferences, go to Vibe, go to health, go to some of those other conferences because that will completely blow your mind when you see what people are coming up with and what is out there.

You also see how much value you can add as a nurse to really help that solution become perfected and truly make a contribution or improve the work that we do. The end of the game for me is nurses that are practicing their craft safely with good outcomes and enjoying what they do. That's where we can bring together technology, people and processes.

Cara Lunsford

Coming up in our next segment.

Bonnie Clipper

One of the things that I love about the virtual nursing space, particularly for inpatient care right now, it's literally the Wild West. There is good, there's scary, there's all kinds of stuff going on.

Cara Lunsford

So welcome to a segment we call the dot Spot, where you will hear more of your voice and a little less of mine. You can visit nurse dot com forward slash podcast to share stories, feedback and requests as a valued listener. You will also receive discounts on nurse dot com courses and C use by using code nurse dot at the checkout.

So I'm excited to introduce Laura Sparkman, a registered nurse with her master's in health administration. Laura shares with us how virtual reality will be changing the face of health care in the very near future.

Lora Sparkman

Imagine receiving your competency training in an immersive learning environment through virtual reality. Well, that is actually becoming a reality where you're taking the concepts that have evolved to almost looking like a movie in virtual reality and that you create this real world scenario where you're doing patient care tasks and engaging with your patient and you're learning behavior, memory, a muscle memory on some of the most important interactions we do as nurses, which is delivering patient care hands on bedside care.

Imagine you're putting on a headset and you're learning and you're practicing the proper technique of a central line dressing change or a peripheral I.V. insertion or a urinary catheter insertion, and you get to practice that in a safe environment in a virtual setting. That's what the opportunity is for all of us in the future.

Cara Lunsford

Nurses, they want to feel valued. And oftentimes in health care, we're not very valued. Our voice falls on deaf ears a lot of times, even with our fellow colleagues. We're not a great profession at respecting and honoring each other and being collaborative. And there's a reason why they say nurses eat their young. So it's amazing when you go outside of your own profession.

It's amazing how valued you can feel, because once you start enlightening people who are interested in the health care space, who are trying to disrupt it, and they have the knowledge and the know how and the experience with technology to do it, they're just looking for that subject matter expert. They're really looking for that person who has the inside scoop.

Bonnie Clipper

And imagine how much you can impact the care in your own organization as your own organization is bringing on more technology. Right. One of the things that I love about the virtual nursing space, particularly for inpatient care right now, it's literally the Wild West. There is good. There's scary. There's all kinds of stuff going on. I'll have seniors reach out to me and say, Hey, my CEO wants us to explore virtual nursing as a way to reduce labor expense.

And I have to say, okay, I'm hitting the panic button right now. Just to tell you, this is absolutely not a way to reduce your labor expense. In fact, you're probably going to increase your labor expense. However, where you are going to see savings in the return on your investment actually comes in reduced falls, reduce length of stay, reduce readmissions.

We're seeing data that suggests that nurses have an increased sense of satisfaction and engagement in these models. Now, because this is also new, there's somewhat limited data on does a virtual care nursing model for inpatients translate into increased retention? It looks like it based on the increase in engagement, the increase in satisfaction. But this is really new. We have to study it.

What is absolutely not going to happen is today. It is not going to allow you to reduce boots on the ground nurses or reduce your labor expense. We just are not there. Nor would I suggest that's what we use this amazing technology for.

Cara Lunsford

Yeah, absolutely. This is actually, I think, a great segway into what's on the horizon for us. Where do you see virtual nursing going and being a really great tool and how can technology help to solve this issue with moral injury? Being able to do the job that you signed up to do and be able to do it safely?

Bonnie Clipper

That's a really good question. Now, I am not a moral injury expert. I can tell you from the technology side, there are a lot of task inactivity based functions that we do not have to perform as a nurse, and I'm myopic around that. I'm really focused on registered nurses. So when you think about what are the things that you could take off a registered nurses plate?

Those are things like hunting, gathering, fetching. There are robots that do that right now. I mean, moxie from diligence is an amazing example of what can be done to take away those non value added tasks. And then think about the other parts of that which are how do we simplify and streamline documentation in the hour? We've been talking about this forever.

Every organization likes to think that they're special and makes all kinds of changes, whether it's Meditech epic, Cerner, you know, we have to customize, which continues to pull us farther and farther away from one of the core tenants that could be beneficial in each ours, which is extracting data for population health purposes. But the more we customize things, the more of a challenge that becomes.

Nonetheless, we still have to document the hell out of things. And I would argue we over document and put garbage in. But there are even ways to streamline that. If we use speech recognition technology, if we bought nurses a $10 earpiece and allowed them to narrate their nurse's notes or checkboxes through speech recognition tech write SRT, that saves time.

There was just a study that was released over the summer by one of my colleagues, Marianne Everett, and they found that in the nursing assessment alone, they saved 10% of the time by just using SRT and in your piece. So all of these little things are actually going to help us by providing a tool to do the jobs better and faster.

Now, here's the corollary. The corollary is that because we do things better and faster, we are not on a production line. We are not making a Tesla Toyota here. So a patient is not a patient is not a patient and a nurse is not a nurse is not a nurse. The production model that we adopted called TERT activity is a terrible model for us.

In fact, it never should have been adopted. And it's rather antiquated. Right. So looking at that model, it says we make widgets in a widget. A widget and a nurse is a nurse. So therefore a nurse should be able to make x widgets. We call them nursing hours per patient day. That has gotten us to this point that we are right now because human beings cannot safely provide all of the care tasks, activities, functionality that is necessary for a patient to have a good outcome.

So we first need to back that up and say, if that's not right, what is the right way to do this? There is some good work that is being done on workload, intensity, staffing, a.k.a. acuity based staffing. We all remember acuity based staffing. I'm certainly older than you and it's been around for a long time and we all could game the system and say, Ooh, my patients got lots of drains and tubes and all these things.

So all of my patients are really heavy. Well, that was acuity of the past acuity. Now actually just pulls directly out of the car and it can tell how acute our patients are and it can help us balance our assignments and balance our workloads. So at the end of the day, this really feels like it continues to be a triangulation of how do we find technology that allows us to leverage ourselves as a force multiplier to provide better care, better outcomes, and at the same time not reduce the number of nurses that are on the shift on the unit caring for patients because those things really aren't even part of the same equation.

So when we hear about organizations that want to deploy tech to lower their labor expense or reduce their headcount, you kind of miss in the boat because that's really not what the tech does. The tech actually allows the nurses to provide the nursing care we all dream of in nursing school. It allows me to actually have a conversation with the patient about their family, their dog, their grandkids.

It allows me to get all my documentation done during my shift. It allows me to make sure that the patient really does understand their medications or their discharge meds. That's what the tech allows us to do.

Cara Lunsford

That is exactly the point that I am constantly trying to make, is that if you don't truly understand the problem, then every single solution is going to miss the mark because you don't know why you're doing it. What you just said is perfectly explained and hopefully the people that are listening to this podcast and over time are hearing exactly what you're saying, like, this is why it's so important to get those nurses to have a seat at the table.

When you're an administrator and you're thinking about bringing new technology into your company, if you do that without the people that it is affecting, without their influence, this is vital information that you have to have because otherwise you are going to waste millions of dollars probably on technology and you're still going to have a retention issue.

Bonnie Clipper

I think you can take this step further as a nurse. Learn as much as you can about A.I., artificial intelligence and machine learning. It is going to help bail us out a whole lot, right? There are already platforms out there that creep along in the E.R. are they look at lab values, they look at vital signs. They look at a translational database of nurses notes, and they can identify patients that are pre septic well before they become septic and notify physicians and nurses so that we can intervene.

There are systems right now we talked a few moments ago about virtual nursing. What I'm going to quote here, the older way to provide virtual nursing for inpatients was literally to install cameras, microphones and speakers. What is really kind of emerging here that's very future facing is to turn our rooms into smart rooms. And eventually that means our facilities are going to be smart facilities.

There will be sensors, there will be cameras everywhere that pick up and observe what's going on with patients and staff not spying on us. It's really a matter of our tasks and activities being performed ambulation, hygiene, bathing, toileting because it can just be documented through the AI. That's the stuff that's going to be a game changer.

Cara Lunsford

Yeah, exactly. It's that double edged sword, right? Like, people are always like, Oh my God, big brother. And the problem is, though, is that we all benefit oftentimes because, hey, if I'm going to get ads and I'm going to get ads for the rest of my life, someone is going to be selling something to me. I would rather get an ad that actually resonates with me, something I want.

If someone's like selling me jockstraps, I'm not interested, you know? Sorry. There's none of that happening over here, so I don't need that stuff. Like this podcast, I'm always waiting for like nurse dot com to go. Maybe we need a new host, someone who doesn't drop jockstraps.

Bonnie Clipper

Well, but what's important here is that we're able to have a really honest and authentic conversation about this, because I think there are 4.3 million nurses out there shaking their heads going, I don't know how much longer I can do this. So I think we owe it to them to help say, the quiet parts out loud and to help people think out of the box, particularly those that might even hear a little pearl or nugget that they can take and do something with.

Cara Lunsford

Yeah, everything that we look at in the world, you can find a negative or you can see the positive right? There's always two sides to everything, but we don't throw the baby out with the bathwater. We try to embrace this technology, make it work for us. And to what you're saying, hey, if there is a camera in the room because it's documenting the fact that the bed bath was done and if the patient falls, we know why.

And that can somehow make my job easier and safer. I can't live my life worrying about, you know, is this going to be used punitively if they start using it punitively? They're going to have the same problems they've always had. So this is on them.

Bonnie Clipper

Well, so I would say this. Have you ever watched Ghost Adventures?

Cara Lunsford

I have not, but I'm going to now. Okay.

Bonnie Clipper

Well, okay. So years ago, I actually watched lots of this with my kids and there were certain devices. I am sure this is our who, but there were certain devices. When they would pull out, they would say, Oh, we can see the ghost in the corner. He's this and moving around behind you, you know, Watch out. Well, that's essentially what AI shows up as.

It doesn't show up as people. It's not a photo image of us in a room. It's the stick figures. And essentially it has such a good, uncanny ability because of the machine learning aspect. It learns patients patterns and caregivers patterns very quickly. So it can distinguish between purposeful movement and purposeful movement, which maybe an impending fall. Right. So that's the step that technology will do for us.

And I think the more we can learn about it and since we don't teach this in nursing school, a lot of it is on us right now as individual nurses. But the more we can learn about artificial intelligence, I think the more we're going to learn that it is a big benefit to our practice and how we can not only use it to help us.

Also, it will highlight to us, I believe, where the opportunities are that we have to get involved in the design, the structure, the utilization of it.

Cara Lunsford

Yeah, if you don't know what is out there and what people are creating, you're at such a disadvantage to bringing those solutions to your administrators, to your facility because you don't really know what's out there. Technology, as scary as it may be and as uncomfortable as it may be, to go to something where you're like, Oh my gosh, I am not going to know the language these people are speaking.

I'm going to be super uncomfortable because this is not my area of expertise. That's on us to do it because I promise you, a lot of the administrators and everyone out there, they're busy, too. They're not looking. They're not going to these events either.

Bonnie Clipper

Yeah. And there's so much that you can actually get that's free. If you go to Coursera, if you go to Ed X, even when you begin to Google topics, you'll come up with them and you'll find there are a lot of educational resources out there right now that are free to help you learn more.

Cara Lunsford

What do you want to say to people who feel like there's always going to be the people who are afraid that technology is going to make their jobs obsolete? Nursing can never be completely obsolete. Like you have to have that human element to effectively care for humanity, because it takes a person to really care for another person, to really understand another person.

But you know, there's always that fear, right? People are like, Oh, God, that's all I need is technology coming in and making my job obsolete. Now, they don't need nurses anymore. They're just going to have a robot that's taking care of patients.

Bonnie Clipper

Well, okay, Never is a really long time. So I don't know that I believe nurses will never be supplemented or replaced. It certainly will not be for 30 plus years. And the reason I say that is because there are programs out there that are artificial intelligence programs that really are very robust, and the professions that are likely to be replaced first are going to be pathologists and radiologists.

And in fact, this work is already ongoing. So in your own radiology department, in your hospital, you probably can learn that there are AI based overrides that are happening now that will change the work for radiologists. And the same is going to be true of pathologists. But there will always need to be a human in the loop for verification processes.

Computers are as smart as the algorithms that humans create. So, you know, just as an aside, there's kind of a very common example of how we create algorithms that are very imperfect, right? So there were some AI algorithms many years ago that were created to detect skin cancer or melanoma and have a really pretty decent prediction rate. Yet when you apply to people of color whose melatonin and skin color is different than the Caucasian people who were part of the trials that built the models, you can understand how it's so important that diversity is part of all of these algorithms and all of the models that we create going forward.

Because there's patient diversity, there's caregiver diversity. And I don't just mean of gender and color and thought process and religion and age, but we have to really build models that are very, very well curated. Otherwise we're building something that isn't going to be accurate or just right.

Cara Lunsford

And we can't possibly know everything like one person can't possibly look at every scenario and consider every nuance. We're just not there. We need to have, like you said, a diversity of thought and need to have these diverse minds because everyone's going to have something that they contribute and they're going to be like, Hey, did you consider that the melanin is always different?

You know, in this you have to include all those people and all those thoughts.

Bonnie Clipper

Absolutely. I mean, I keep going back to the education because so much of this is going to be important. And I'm one of those people myself that have done hours and hours of courses. And thankfully, I've been able to engage in many conversations with people that are experts in AI to truly help me understand it. I am not an expert and I, I have an understanding of how it works, what it can do and what it can't do.

So I think as we talk about solutions, particularly around the practice of nursing, we have to be very open minded as we build solutions that will help us provide better and safer care. I'm right now very, very help on using virtual nursing for inpatients. We're seeing it pull nurses back out of retirement. We're seeing it bring back disabled nurses that don't have to run the halls and lift heavy patients anymore, but rather can be that extra set of eyes and ears that can provide assistance over the shoulder, if you will, for the nurses who are, you know, the boots on the ground delivering direct care.

We're also seeing it have quite an impact when it comes to on demand preceptor ing for new grads, Right. I mean, preceptors are a huge challenge for all of us. People are burned out, don't want to do it. So there's tremendous upside on models such as virtual nursing for inpatients. We really just have to work through how to implement it and how to get it done.

Cara Lunsford

Is it being done in any any hospitals? Are they doing that kind of virtual nursing type of thing where.

Bonnie Clipper

Absolutely there's probably 300 to 5300 hospitals right now that have different versions of it running. Most of them utilize the cameras, microphones and speakers version. More and more are going live with ambient computer vision and sensors. But absolutely, we're seeing it deployed. I have seen shows that reach out to me almost weekly around like, Hey, now we just got approval for these millions of dollars of equipment.

Now we need help connecting the dots. We need to ensure that the process work actually maximizes the technology that we have and help us stand this up so that it works and does what it's supposed to. But absolutely, it's used all over the country right now.

Cara Lunsford

Speaking of nurses looking for jobs, I mean, like, that's a great job that probably a lot of nurses don't even know about. Oh, could I be potentially presenting some new nurses that are at X, Y or Z hospital and I don't even have to work in that state necessarily? Maybe. Or like, you know, I don't know if that's the case, but maybe if you have a compact license or you have something where you can work in a variety of states, maybe that gives you a little bit of flexibility in terms of like, I work in California, but I have a compact license and I can work in these other states.

And so I could apply for a virtual nursing job where I could work from home because a lot of nurses want to work from home.

Bonnie Clipper

Well, here's the challenge with that Right now, with where we are in technology, consumer grade wi fi is not stable enough for patient care, consumer grade electricity. It goes down sometimes. Right. You think about HIPA violations. If you have anyone that's an adult in your home and they walk by, that's technically a violation. We have to be thoughtful about conversations that we're having with patients with caregivers.

It's hard to find someone to hand off to for a break, to run to the bathroom, to grab a sandwich out in the kitchen. Right. So those are things that we're going to solve all that I totally believe at right now, the systems that I'm seeing do the best job are those that stand up, something that's called kind of a command center, a hub, whatever terminology you use.

Those are the ones that are really doing the best job today at creating a cadre of nurses that are literally kind of providing that oversight work, monitoring work, have access to the hours, and they work in tandem with the boots on the ground that are delivering the direct patient care.

Cara Lunsford

That makes a lot of sense. So they still may go, but they're just not running around. Their job is very specific to being able to have those conversations with patient that maybe the nurse that is running around from room to room trying to administer medications, get somebody to a procedure. Obviously doing like, you know, assessments, but then being able to communicate those assessments with the virtual nurse who then can collect information.

Is this kind of what you're.

Bonnie Clipper

Exactly right, because a virtual nurse can do a limited assessment. They can gather all kinds of data. Now, while they may not be present to look you in the eyes and see if you're clammy or dry or those kind of things, they can do a limited assessment where we're really seeing some of these amazing benefits, though, or the virtual nurse has the ability to spend time with patients on the admission documentation, the transfer documentation, the discharge documentation, med reconciliation.

Think about how quickly we move through that process. Patients that don't understand it or comply with their medications, they end up right back in the ED. So if you are a virtual nurse and you literally are able to have a ten or 15 minute uninterrupted conversation with the patient and their family, we're going to see fewer of those patients back in the emergency room.

So there's a lot of upside. But because this is all evolving very quickly, there's a lot of work that we have to do as nurses, I think, to put some guardrails around it. I feel incredibly grateful in the space. I'm able to work with a couple of different associations. Right now we are defining what a virtual nurses, we are creating standards, we are identifying competencies around, virtual nursing, so that we use the terminology in similar fashions across the country because right now it is a little bit different.

Cara Lunsford

Well, first of all, what an incredible podcast. I mean, we were able to touch on so many of the the issues that health care is facing right now. And so this has been just incredibly informative. I am so grateful for you, Bonnie, for having joined me on this podcast today. Is there anything else you want to say to the listeners?

Is there any other piece of information you'd like to share with them?

Bonnie Clipper

You know, I very much enjoyed spending my time with you, so I always love the opportunity to have these discussions because I hope that we're able to impart some new learnings and some new ideas on people that are listening. But I learned something as well. So I think you've done an amazing job today and I'm just really thankful to be a part of it with you.

Cara Lunsford

Thank you so much, Bonnie. Tell the next time because for sure, I'm going to be asking you to come back because technology is an ever evolving thing which is going to require me to bring you back on because we got to talk about what's going to be out in six months and a year from now.

Bonnie Clipper

Absolutely love to do it.

Cara Lunsford

All right. Thank you so much. Well.

Bonnie Clipper

My pleasure.

Cara Lunsford

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