How Avera is using virtual nursing to tackle rural workforce strain

For Sioux Falls, S.D.-based Avera Health, the promise of virtual nursing lies in keeping rural hospitals staffed and sustainable. Recruiting nurses in smaller communities has long been a challenge, and the system sees remote roles as one way to extend careers, ease workloads and give bedside staff much-needed support.

“In our regional hospitals, being able to recruit nurses is even more challenging than it is in some of our larger facilities, and the role that the nurses play in those facilities is so impactful,” Kristine Becker, Avera’s director of virtual health, told Becker’s. “By offering a virtual nursing solution, it just gives another career path, or maybe extends the careers of some of these nurses.”

The program began as a pilot two years ago at Avera McKennan Hospital & University Health Center — the health system’s largest hospital in Sioux Falls — and at Avera St. Mary’s in Pierre, S.D. The contrast between the sites highlighted how flexible the model could be. In the larger facility, virtual nurses picked up admission assessments, discharge education and medication reconciliation. In the smaller one, they became mentors for newer staff, lending experience and guidance that might otherwise be hard to find.

“Our virtual nurses are really experienced nurses, and so those nurses can provide some mentoring to some of these rural nurses, because they maybe are newer, or maybe they don’t experience the same kind of variety of things that a larger facility would,” Ms. Becker said.

Feedback from bedside nurses pointed to everyday benefits. At St. Mary’s, nurses said having a virtual colleague meant they could finally take lunch breaks — a seemingly small shift that Ms. Becker said helped reduce burnout. Avera has paired those anecdotes with metrics, tracking satisfaction, retention and patient outcomes. At St. Mary’s, for instance, nurse retention nearly doubled after the program began, and across facilities, patient falls decreased when remote staff monitored higher-risk patients.

“All of those things are really important not only for the outcomes themselves, but for the sustainability of a program like this,” Ms. Becker said.

For a system that has used telehealth since the early 1990s, applying it to nursing marks a new phase. Instead of primarily extending physician specialists into rural areas, Avera is embedding virtual nurses into the daily work of hospitals — a model Ms. Becker said she believes will outlast the current workforce crisis.

“I really see it as the way care will be delivered, kind of in the future,” she said. “We think of it as a standard of care in the facilities where we have it, it’s just part of the way we deliver care.”

Health systems across the country are piloting similar models, positioning virtual nursing as a way to help strained bedside teams. Avera’s experience suggests that for rural hospitals, where every nurse carries weight, the approach may be less an experiment and more a strategy for survival.

“The challenges we face with nursing in our rural areas is not unique to Avera,” Ms. Becker said. “But we really believe that something like virtual nursing will help support the nurses we do have by providing them extra tools, extra support, extra virtual eyes and ears in those patient rooms.”

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