New virtual nursing model at Providence raises concerns for some nursing staff

ANCHORAGE, Alaska (KTUU) - Providence Hospital will be switching from a primary nursing model to a team-based model starting on Tuesday, according to nurses at the medical facility.

Under the new system, Providence bedside nurses in one of the medical-surgical units and the Progress Care Unit (PCU) will be teamed up with a tech nurse and a virtual nurse to care for five patients.

Patients in medical-surgical are usually stable and do not require being in an intensive care unit, while PCU patients require an intermediate level of care between the Intensive Care Unit and the med-surg unit.

Currently, nurses in PCU care for four patients, while nurses in med-surg can see anywhere from one to five patients.

“The work actually decreases, because the work is redistributed across those three team members, and so the patient is receiving better care,” Providence Chief Nursing Officer Carrie Peluso said. “They’re actually getting attention from three different caregivers, versus just the one.”

According to Peluso, a team-based model was a popular method during the 1970s and 1980s.

In 2022, Peluso said the hospital began looking at different models that can be used.

Peluso told Alaska’s News Source that she previously worked in a team-based model.

“For me, having moved from team-based to primary nursing, it felt more stressful because you were the sole person responsible for the patient,” Peluso said. “One of the most innovative pieces of this is that we’re adding in the virtual nurse.”

The news has brought concerns for others in the medical field. On Wednesday on the University of Alaska Anchorage campus, nurses opposing the new model held a press conference expressing their concerns.

“Adding an additional fifth patient to our assignment will jeopardize patient safety. There’s no other way to say it,” Madison Eckhart, a nurse at Providence, said. “[Providence] are claiming that they are not giving us a fifth patient because they are introducing a virtual nurse. The virtual nurse does not take the place of a bedside nurse.”

According to Eckhart, the new model would reduce bedside care.

“[The virtual nurse] does not take the place of someone at the bedside, assessing the patient and providing the important care,” Eckhart said. “We are standing up against these changes to our working conditions because we believe that our community deserves better. Bedside nurses are a patient’s greatest ally during a hospitalization. When we are stretched thin, patient safety is in jeopardy.”

Providence argued the opposite, noting that this would give them more resources and increase patient care. According to hospital staff, the virtual nurse would be similar work similar to a telehealth appointment.

Inside the patient’s room, a screen with a camera that is turned off allows the nurse to appear virtually for assistance — after “knocking” to alert their patient that they’d like to give them a check-up — and the nurse would appear on the television screen in the patient’s room.

“[Virtual nurses] can do some assessments, checking on pain levels, doing a safety assessment in the room,” Peluso said. “The camera ... is so good that it can zoom in, say, on a pupil, and really look at how the patient’s eyes are reacting.”

Each virtual nurse is required to have at least five years of experience. Nurses at the event shared that an unfair labor charge has been filed.