The virtual nurses can provide help with general, non-urgent inquiries by phone, Zoom, secure chat and/or email

By Alexandra Macgregor

For many people, the first days, weeks and even years of their career can feel daunting, regardless of how much education and training is under their belt. Nurses are no exception, which is why Hamilton Health Sciences (HHS) decided to launch an innovative new program called the Virtual Nurse-to-Nurse (N2N) Support Line.

Staffed by experienced, senior registered nurses (RNs) with previous charge nurse or educator experience, the Virtual N2N Support Line provides additional on-demand night and weekend support for RNs and registered practical nurses (RPNs). The virtual nurses can provide help with general, non-urgent inquiries by phone, Zoom, secure chat and/or email. This model mimics how nurses support their peers on the floor in an in-person capacity. The virtual nurses do not provide direct patient care.

“Recently, I was working an overnight shift when I encountered a new-to-me evaluation for a post-stroke patient,” says Jacqueline Mallari, a nurse who has been working at HHS for 18 months and currently cares for acute medicine patients at HHS’ Juravinski Hospital and Cancer Centre. “The evaluation used a specific acronym – STAND – and I needed help understanding what the letters stood for. That’s when I decided to call the Virtual N2N Support Line.”

Upon calling the Virtual N2N Support Line, Mallari was able to connect with a virtual nurse who had a lot of experience with the STAND evaluation. “She explained the procedure to me step-by-step and answered all of my questions,” says Mallari. “Sometimes in nursing you encounter medical procedures or acronyms that you can’t Google – you need a more experienced person to explain them to you. I was very grateful to the Virtual N2N team for supporting me in that situation.”

The impetus to innovate

Nurses are essential to patient care, but in recent years, a high number of nurses have retired or left the profession for other reasons. This has created staffing challenges for hospitals around the world, including HHS.

“The purpose of the Virtual N2N Support Line is to provide nurses with a safe and judgement-free space to call after hours, when we know in-person staffing resources are more limited,” says Kara Langdon, Manager, Virtual Care. “The N2N program enables HHS to retain some incredible experienced nurses who in turn are helping the next generation find their way in this rewarding yet challenging career.”

Beginning in early April, the program was piloted in select units at HHS’ Satellite Health Facility, West Lincoln Memorial Hospital, Juravinski Hospital and Cancer Centre, and St. Peter’s Hospital. As of August 1, the Virtual N2N Support Line is available to nurses at all adult sites. To date, the Virtual N2N Support Line has received more than 200 calls.

Leaving retirement to give back

Many of the virtual nurses are retirees with a passion for nursing who want to give back and support their peers. Darlene Creed, who retired from being a critical care and Rapid Assessment of Critical Events (RACE) nurse after 37 years, says that’s exactly what made her want to join the N2N program.

“I was excited to be a part of something so positive and supportive, especially for novice nurses,” Creed says. “Nurses are often required to think on their feet, and their shifts are typically hectic. Making a quick phone call to the Virtual N2N Support Line allows nurses to debrief with a more experienced nurse and gain the appropriate information or guidance they need to obtain the best outcomes for their patients.”

Like Creed, John Sheppard came out of retirement to join the Virtual N2N team. Having worked at HHS for more than 45 years, Sheppard says it was his daughters – also HHS nurses – who encouraged him to become a virtual nurse. “They said I was always good with the young ones and happy to share my knowledge,” Sheppard says, adding that he has really enjoyed being a part of a team again, meeting new people, and getting re-acquainted with many old friends and colleagues.

Sharing experience and making an impact

Any nurse at any HHS site can contact the Virtual N2N Support Line for help. Some of the reasons why a nurse might reach out for support include non-urgent clinical guidance questions related to their patient assignments, such as patient condition changes or medication administration, preparing for an escalation, understanding clinical scenarios or decisions, and policy or procedural inquiries. Nurses can also reach out for social support and to debrief with a peer during a challenging shift. If a concern is related to a specialized area of patient care, the Virtual N2N team will help nurses get connected to the appropriate unit resources.

“We’re a safe and non-judgmental sounding board for nurses,” says Creed. “We’re here to listen and use our experience and knowledge to provide relevant, timely and constructive guidance and support.”

“I would tell a new nurse to call us for anything, even if it seems mundane, silly, or unimportant,” adds Sheppard. “We’ve all been rookies at one time and we’ve all had self-doubts. Nursing is a stressful job, and you can always give us a call, even if it’s just to validate that your thinking is sound.”

Francesca Schaaf and Gillian Crawford are resource nurses at Juravinski Hospital and Cancer Centre who supported the Virtual N2N Support Line from its inception. “We see the support line as an extension of what we offer,” says Schaaf. “We feel good knowing that when we leave at the end of the day, there is someone that our staff can reach out to.”

“Given the staffing challenges that HHS and many other hospitals are facing, peer-to-peer support for new nurses at the bedside is limited,” adds Crawford. “The Virtual N2N Support Line bridges that gap on night shifts and weekends.”

The Virtual N2N Support Line is available to nurses at all HHS adult hospital sites.