Inside the Virtual Nursing Movement Changing Healthcare Forever (With Dr. Bonnie Clipper)

Welcome to Club Nurse. I'm Colton Lord, your host. By you being here today, it shows me that you are someone who wants to learn, grow, laugh, connect, and just let your emotions flow. We are here to share real stories and hear real life experiences from real people. You are not alone in this, and Club Nurse is here to show you that. Don't forget to follow the show and share today's episode with someone you love. Now let's dive into today's conversation. Hello everybody, welcome back to the Club Nurse Podcast. Uh, I have with me today Dr. Bonnie Clipper. I actually met Dr. Clipper at the health conference in Las Vegas in 2024, uh, where we were able to kind of, uh, collaborate and chat about Bonnie's career. Dr. Clipper, would you like me to refer to you as Dr. Clipper? Bonnie, how would you like me to refer to you?

Please call me Bonnie.

Bonnie, okay. Um, yeah, so we, uh, were able to kind of talk about Bonnie's career a little bit as we highlighted some of the, some of the things that she has done in her career, which has been really amazing, especially for nurses. So, if you don't mind, Bonnie, just introducing yourself to the audience and kind of telling us a little bit about who you are.

Hey, you bet, Colton. Thanks again for having me today. It's always fun to chat with you. Bonnie Clipper. I am a nurse, been a nurse for a very, very long time. I essentially moved into leadership positions because I wanted to make changes and had recommendations and learned that no one listens to you unless you are either far more influential or have a leadership position. So moved up through those roles for quite a while. I was the chief nursing officer for over 20 years. I was the first vice president of innovation for the American Nurses Association. I have worked for a startup. I've owned my own company since 2019. And I love being in this space because I think healthcare is so broken that we can only make it better.

That's right. That's right. Were you, were you at the health conference in Vegas this year or were you not there?

I was. Oh, you were there?

Okay. Okay. I didn't, I didn't see you.

Really interesting and amazing, huge, huge overwhelming space.

Yeah. So it's like once I feel like once you leave there, it's like it takes a few days to even recover. It's, it's a lot, but it's, it's a, it's a lot in a good way. Uh, were you able to catch any of like the Nurse Hackathon or anything like that?

I did check out a lot of new technologies there. I did not go into the hackathon this year.

Okay. Okay. Yeah. There's, there's so much to see. It's hard. It's impossible to catch everything. Uh, so kind of going back on what you were talking about as far as Um, kind of talk to us about the Virtual Nursing Academy, what it is and kind of how you got into, or what inspired you to start the Virtual Nursing Academy.

Yeah, the Virtual Nursing Academy is really a one-of-a-kind way to educate and enable hospitals and health systems so that they can understand how to build and launch and optimize a virtual care model. And so what we do is we really take a holistic approach. Model. So we're Switzerland around technology. We don't sell the technology. Instead, we work with leaders that are interested in creating a virtual care program or a care model. I started this in, um, 2022, coming out of the pandemic. Since about 2020, I spent hours and hours and hours on tons of phone calls with chief nursing officers to help them figure out How do we use the technology that we have? Some of it during the pandemic was a matter of organizations that were literally gobbling up as many baby monitors as they could to put in patient rooms so staff didn't have to go into those rooms, or even putting GoPros on bike helmets on a nurse to go into a room and stream to physicians or providers or other nurses what was going on. So Having helped a lot of my colleagues, chief nursing officers during the pandemic, at the end of that, I came out thinking, this technology continues to grow and proliferate. There's a demand, there's a need for people to help them understand how to create the care model. So, that's when I came up with the concept and literally created a ton of content that I could use as a consultant. That was an incredibly interesting journey because I packaged it all up and I was reaching out to hospitals to sell it to them as a consulting opportunity. And what I learned is that hospitals were super cash-strapped, a lot of financial pressure. They still didn't want people in the hospitals and they wanted a way to do it themselves. So I created the Virtual Nursing Academy out of all of that work by literally taking all of my content and breaking it into 6 modules. They kind of follow a sequence and turned it into an educational opportunity.

Nice. I love that. And kind of going back to what I have found being at Health and just around all these nurses who are really, as they say, just innovating and finding solutions. And I think what I have gathered from now being there my second year is just how important it is for nurses to be in the conversation and how we really all have these just like natural entrepreneurial brains because we constantly have to innovate at the bedside. Or even if you're in leadership positions in nursing, like you're constantly having to innovate and, and to be resourceful with what you are given, which is not a lot, a lot of times. Um, and so I love to hear those stories and kind of how people like you are able to, um, just like have these ideas, see, see the holes that are in healthcare, and there's many, and just make, um, you know, this amazing kind of business from that. So I think that's great for people, especially nurses, to hear.

Yeah.

So why we have you on today is to kind of talk about This new strategic partnership that you have with Colette Health. So can you kind of tell us what is Colette Health and why is this new partnership with the Virtual Nursing Academy and Colette Health so important?

Yeah, Colette Health is an amazing company and they provide virtual care platforms, whether it's observers or whether it's virtual nursing or any discipline, they provide really cool technology to allow you to do that. So for me at the Virtual Nursing Academy, I began looking at partnerships about 6 months ago to figure out who is it. than I can actually collaborate with that can leverage this work and allow it to grow bigger and actually help more people and go farther. So it took months to identify who would be the right acquisition target or partner to work with in this process. And they were a great match. They're amazing people, but also the technology is perfect because we're working with organizations. We can use the Virtual Nursing Academy to assist them and their clients. And we use the Virtual Nursing Academy across every other vendor that's out there because people continue to reach out and want the education around how do you build this care model. So I only see us growing and increasing in scope the number of organizations that we work with. The demand continues. Worked with over 30 hospitals and health systems at this point. I've just updated the, the content again. So literally we continue to keep it fresh and new and up to date. And we're continuing to work with more hospitals in space. So it's a pretty cool thing to watch. They've been a great partner.

That's amazing. So kind of walk us through what, what exactly is— when you're talking about these partnerships with these, with these health systems and these hospitals, what exactly— like when a health system comes to you, like what exactly are they looking for that you are stepping in to help them with, that you're kind of walking them through?

Yeah, that's a great question, Colton. So organizations reach out, they sign up on the Virtual Nursing Academy site. Sometimes we have 1 or 2 people, 3 people, sometimes we have up to 30 people. Generally speaking, we work with teams of humans that come out of health systems. So that's everyone from chief nursing officer, chief nursing informatics officer. We have the nurse leaders on the med-surg units that will be the client units of virtual nursing, and we have leaders on the virtual nursing side. We also have nurses, med-surg nurses, and virtual nurses. We've had informaticists, we've had IT people, finance people, quality people. It's not uncommon to have some other disciplines participating in the academy because they're interested in taking their discipline virtually in the future. So what we do is we work with these teams, we educate them. So our content is evergreen content. It's essentially accessible 24/7. So it's on demand. And then we also can provide group team advising where we work specifically with an organization and we'll kind of walk them through a whole variety of questions and use cases. And it's essentially like a consulting session that happens kind of in rapid succession. We'll do a couple of those for a team and we really try to keep them between the guardrails. We can't tell any organization how to implement Because every single organization is very different. The technology is different, the staff is different, the physicians are different, the patients are different. So there's not kind of a one-size-fits-all in virtual care, but every single virtual care model is customized. So what we're able to do, we literally have myself and, and a couple coaches that I work with, and we're able to hop on a call and have the team on this call. And through the guided questions that we ask and the roadmaps that we use, We're able to get a sense of, are what they are talking about something that seems viable and feasible? Is it going to work? Or do we need to kind of course correct and point them in a different direction? So we're not going to tell you how to do it, but if you're heading in a direction that we've not seen work, we would say something and say, hey, really think about this or that because we've not seen that work. Instead, you might want to go this direction. So, we do a whole lot of literally coaching to keep people between the guardrails to be successful.

OK. So, you're kind of, you have a lot of like leadership people coming to you. You kind of help them with this format or foundation that they're going to use, and they bring that back to their team to kind of implement that?

Yes, absolutely. So, we're teaching them to fish, if you were to simplify this. So, we don't want to do it for them, but we want to teach them the thought process behind it. We give them the tools of how to do it, how to talk about it, how to socialize it, how to measure So, we do a lot of that kind of work because at the end of the day, you don't want to be dependent upon consultants. There are consultants that will create your virtual care model for about a quarter of a million dollars in engagement. They'll create it for you. That's a lot of money. Instead, we really want to teach organizations how to do it for themselves.

OK.

So, they can iterate and, and move and kind of bob and weave as they need to as things become dynamic and change.

Okay. Do you have any that come to mind? Um, and you don't have to give like the organization name, but any like success stories of people that, uh, you know, you've, you've brought through this academy that have then implemented it into their, into their company, um, that they've been able to make like huge changes? Like, do you have any specific examples or are you able to give any?

Yeah, we've worked with several organizations that have attended the Virtual Nursing Academy and gone back to adopt their technology, put in place maybe admission or discharge or patient education, and are now cruising along and finding it to be very effective. So those are really good for us because we also go back and kind of ask. I've done a lot of calls kind of a couple of months following the V&A to say, hey, is there anything you learned that was helpful or anything that we should change or improve? So it's good for us to get that constant feedback as well. The other thing I can tell you is the corollary of that. There was an organization very, very, very early on, and they were interested in setting up a model Whereas every one of their med-surg nurses would rotate through the command center or the box and be the virtual nurse at some point in the schedule. That's not something that we've seen work. Instead, it's a very focused scope of work. Virtual nursing is a specialty. You can't just throw everybody in the box.

Yeah. Yeah.

And nationally, 3 years is pretty much the minimum threshold that a nurse has to have in experience to to be a safe virtual nurse. Some organizations even make it 5 years. So we shared that, and the organization was pretty insistent, and they wanted to move into all of their med-surg staff would rotate through the box. And, and we've heard about a year later, they've kind of hit the pause button as they go back to reformulate that.

And for, for people who don't know, like, what is, what is a virtual nurse essentially doing? Are there several different things? Or is there— are they like, what exactly are they doing? And like, especially in this, when you say this med-surg nurse is going through the You say the command?

The command center, box, hub, whatever you call it. Yeah.

So what do they— what does that mean?

Well, typically speaking, a virtual nurse is someone that is part of the care team and works with the same amount of collaboration, compassion, thought process as the direct care staff or the direct care nurse that's on site. So it's someone that's going to be an adjacent part of the care team. Maybe I'm in the room at the end of the hall, maybe I'm in an office building on campus, maybe I'm in another state, but they are working within their scope. So it's a licensed licensed registered nurse. We all have a scope and standards that we have to follow. We also are accountable to our license. So we work in tandem to collaborate with that direct care nurse to provide the best care to the patient.

Okay, so they're, they're kind of— it's like another set of eyes kind of that they're kind of helping to watch things.

Yeah, absolutely. And this is a really great point, um, Colton. So I've done some publishing on this, and generally speaking, there's 2 care models. There is what I call an ADT model, an admit, discharge, and transfer model. It's not a sexy name, but It's essentially a very transactional role where if I was your virtual nurse today on your unit, I might be assigned 1 or 2 units, 3 or 4 units, it depends on the volume. I might be picking up all the discharges today.

Hmm.

So when a discharge goes in the queue, I can see that whether it's Cerner, whether it's Epic, Meditech, I can kind of pick up on that.

Hmm.

And then I would go in and complete the documentation. I could pop into the patient's room on the television set and literally do the discharge and that education. session with that patient and take that off your plate. The other care model is what I call a care partner model. And that might mean that if I was your virtual nurse and Nurse Colton and Nurse Mary and Nurse Jennifer on the units today, I might say, I'm on your team with each of you. So the 3 of you, maybe you have 6 patients, 7 patients. I might be working with you and Mary and Jennifer. And for you guys, I'm going to be doing your admits, your discharge, your patient education, And Colton, because you've been here less than a year, if you have any questions, ping me and I'll support you on those. And Mary, because you have a chemo patient, I can do your dual nurse verification today. So, it's a little bit more detailed scope, so it's deeper across fewer nurses. And the transactional model is very, very broad and just literally allows me to kind of click along. It's a huge benefit when it comes to offloading documentation.

Yeah, that's, that's huge. That's actually something, something that I found, um, just going kind of back to health again, was a lot of these, uh, new AIs and just, and things that, uh, are coming out or nurses are coming up with or companies is just really helping with a lot of that documentation to save time on that. And essentially, again, what this is just from kind of my outlook, it seemed like the idea behind most of these things was to really get the clinician, the nurse, more time with the patient, more time at the bedside, um, versus so much time And documenting, as we all know we have to do. So I think things like that, again, it's just saving the primary nurse at the bedside more time to have more time at the bedside and safer care. And I feel like that leads then to safer outcomes for the patient, saves the hospital money. And so it's just kind of a trickle-down effect to all these different things, correct?

Absolutely. And you're spot on. I mean, the technologies today that include kind of ambient listening allow us to start start documenting conversations we're having with patients.

Yeah, yeah.

And not only document all of the garbage in every word we say, but essentially the AI part of it dismantles that and puts it into a really cohesive, cogent paragraph, if you will, that actually makes sense and indicates what the conversation is conveying and what we're doing. And as the human in the loop, we're the adult in the room. We're continually responsible to make sure that what the AI just spit out is accurate and I'm approving it.

Yeah.

So that's on us our license. But this is amazing technology and it continues to refine all the time.

Yeah, yeah, I totally agree with that. So I was looking through the press release that was put out, and this is a quote from you. You said, this strategic acquisition represents a pivotal moment in healthcare delivery. By joining Colette Health, we can provide a robust foundation that empowers nursing teams and nurse leaders to build sustainable virtual care programs while advancing patient care through technology-enabled solutions. Why is this so important? I know we kind of touched on this, but why is this, why is this so important?

This is a great question. It's because Colette has such great, a great reputation in the space and also such good technology that partnering with them and this acquisition, strategically, it makes sense for us because obviously we're able to scale this and to increase the scope far better working with someone that is well-known in this space versus continually chugging along on our own. So this partnership is going to be incredible for us, not only to increase and broaden our reach across the, the United States far more than we've been able to do on our own, but it's also smart because they're a technology vendor. So in that space, what's important to think about there is that we can get immediate feedback on what's changing with technology, and those might lead to things that we need to update or change in our content or do differently.

Okay. Thank you for that. So a lot of fear that I have noticed around AI, uh, especially with nurses, and I think a lot of that comes from maybe just misinformation, a lack of education for, for people, and also just maybe things that people are reading in the media. Um, I know that there's been a, a lot of things out that we've even kind of published on nurse.org that have been said, you know, from people like Elon Musk, like there's this Tesla robot that, and he directly said this can replace nurses. And so I think that causes a lot of fear with, with nurses.

Yeah. Yeah.

And, uh, what I, and I, and I even admittedly, when this all first started coming out, I felt a little bit like, oh, like this, this is uncomfortable. But I think when you start having more conversations and you start just listening to things more, um, and kind of being more open to it, now I'm at a point where I feel AI really is, really is a tool to really help. And again, kind of going back to just giving the nurse more time with the patient at the bedside. Uh, and so I wanted to kind of get your outlook on this. Like, what do you think that, like, as nurses, how, how can we become more open to AI as a tool This is a fantastic question, Colton.

So if you, if you think about this, every single day we see positions that have been eliminated as a result of AI. So I completely understand why our knee-jerk reaction is to be a little bit concerned and quite honestly fearful. There was a recent study that was published, and it came out by Microsoft. I actually saw it on LinkedIn. And you can Google this. But what they did was they looked at the did is they ranked positions, professions, roles, jobs, whatever you want to call them. And what they did is said, here's the 25 that are most at risk of being replaced by AI, here's the 25 that are least likely to be replaced by AI, and then in the middle there's a whole bunch of other jobs. So nursing was far towards the end of least likely to be replaced by AI. And part of the reason for that is that our jobs are complex. Accountants are at the low-hanging fruit part of AI because much of it is repetitive, redundant work. And once you master that, you can actually be quite effective in getting that job done.

Mm-hmm.

On the flip side, from a nursing perspective, our job is a complete mishmash of hard skills and soft skills. So yes, there are some technologies that could help offload what we do, such as the ambient listening and the documentation, and using Muse scores to help us with sepsis or predict arrhythmias, things of that nature. However, there's a tremendous amount of work that we do that's soft skill related. Who is talking to patients and families? Who is in the room having conversations to pull together the medication with the education, with the care plan, with the documentation? So I do not see in the next 10 or so years that nurses are going to be replaced by robots. Will we ever? I don't think we know.

Yeah.

I don't think we know what these robots can do. If you think about it, and I was just watching something this morning about this very fast development of what we call kind of embodied AI or humanoid robots, how is that funny-looking, skinny-legged robot going to get a patient out of bed?

Yeah.

Without toppling over, right? How are those gonna do run into a room and help rescue a patient?

Yeah.

So I think that that's a ways off. Will it ever happen? I don't know.

Yeah, yeah.

It's too hard to predict. But I think right now, that's not the space we need to worry about. Instead, let's figure out what does make sense for us to adopt AI for in our jobs. Because as we all know, nursing is really complicated and we have forever felt as though we are not properly staffed to give the care to the patient that the patients deserve. So now is that opportunity. We're not going to get more people because A, they're incredibly expensive, or B, they don't exist.

Mm-hmm.

So how do we use technology to offload what it can to allow us to spend the time that we've been asking for with the patients? So I feel like that's where we are in this space right now.

Yeah, yeah, I think so too. And yeah, kind of, it is, it's kind of humorous if you start to think about these situations that a robot might be in, you know, imagine a robot trying to deal with like a combative patient, like what—

A dementia patient.

Like, what are they gonna do? And yes, of course, things can advance as we've seen how rapid this has advanced already. But as of right now, it's kind of, it's kind of humorous to even imagine a world where that's possible. So I think that's helpful. Again, I think that a lot of, a lot of this really is just fear and rightfully so, you know, it's people's livelihood, their wellbeing, it's how they make a living. How they support their families. So I think that's why people are so afraid of AI. And I think kind of what I've thought about too is, okay, this is great. You know, even if we have these in our, in our systems helping us, giving us more time at the bedside with our patients, then I'm like, well then the hospital system is just gonna be like, okay, well since that's alleviating that time, here's another patient for you. But that's where it's good to have unions and things that kind of step in to help, help with those things. Um, but I think overall, I, I do think that It's something that's really going to help us as a profession overall, if we can learn to accept these things with, with more open arms and just be more open-minded to it. And that doesn't mean not to voice your concerns and speak up. I think it's very important to do that, be a part of the conversation, but not being just like so closed off to it that you're not, not open to things changing.

And I think what's important about what you just said is that nurses need to be involved in designing the processes and having input into the technology. But our default position cannot be no.

Yeah.

We have to start with, okay, I'm resigned to the fact that we might be doing this. I might not like it. Now, how do we get involved to make it as tenable and good for me as a nurse as possible?

Yeah.

So I think that if we continue to be the, the knee-jerk no people, I don't think that's good for us. Yeah, I think we have to figure out how do we get to, yeah, we can work with this, now here's what it needs to look like in our organization.

Yeah, that's, that's perfect that you said that. It's actually a great segue into my next point that I wanted to make to you, uh, was I, again, I kind of went back and listened to our last conversation that we had done on the NurseConverse podcast through nurse.org last year, uh, and something that you had said was even if you're not in a position to be an entrepreneur, Be an intrapreneur in your own organization, offer ideas, solutions, and get involved. So, what does that mean to you? And do you still agree with that statement?

Oh, absolutely. I think that hospitals have— many of them provide amazing infrastructure around shared governance. That's the perfect place for some of these conversations to occur. If there's an innovation council in your hospital, ask if you can be involved. Ask how you can participate in any demonstrations or product demo verifications so that you can get input very early in the process and start to get a sense of what's coming to your organization. Even if the opportunity to provide feedback isn't there, it gives you a sneak peek of what your organization is looking at so you can learn as much as you possibly can about it. And then you begin to think, how is it that you are going to adopt this? What does it mean to your role? What are all the implications of this? And how can nurses be involved in the design and development I totally agree.

I think it's easy to sit there and, you know, we all complain and have opinions about our jobs in healthcare. It's just if you're gonna have those opinions and voice them, I think it's important to get involved and let your voice be heard. Because you really never know the impact that you may have just by simply speaking your truth or something that you've noticed in your system or just in healthcare overall. So I think that's a really great point. Uh, do you, do you have anything else that you want to make sure the audience knows about Virtual Nursing Academy, your partnership with Colette Health? Is there anything, AI nursing, anything that you want to leave with the audience that we did not cover?

I think bringing the Virtual Nursing Academy into the Colette Health family is gonna be like rocket fuel for us. It's really gonna help us to grow and scale who we reach to the Virtual Nursing Academy, how many organizations we can impact. And at the end of the day, for us, it's always about the patients. And that's one of the things that was complete synergy between the Virtual Nursing Academy and Colette Health. It's always about improving care for the patients, and the absolute ideal way to do that is by helping to make it easier to provide good care for those that are providing the care. So this was the perfect opportunity at the perfect time for us.

It's amazing. Well, thank you so much, Bonnie. Where can people find you? I know, I know you're on LinkedIn. Is that kind of where you're most active on social media?

Absolutely. Colton LinkedIn. You can find me under Bonnie Clipper, and I'm always happy to entertain questions and to help people understand what we do at the Virtual Nursing Academy.

That's amazing. Well, thank you so much for your time, Bonnie.

Thank you, Colton.

From the bottom of my heart, I wanted to thank you for being here at Club Nurse. I hope you gained something valuable from today's episode, and if you did, remember to share this episode with someone that you love. Follow me on social Follow me on socials @NurseDaddies or ColtonLord17, and be sure to follow nurse.org to stay informed with all of the hottest healthcare topics. Until next time, take care of yourself the way you take care of everyone else. Love ya.

Bye.