Exploring the competencies nurses need to work in virtual wards

Introduction

The world changes every day due to new technology. This change benefits all jobs, including nursing (Norman et al., 2023), which is a demanding profession that saves lives. Nurses often feel overwhelmed when many patients have urgent needs. Sometimes, they cannot accept new patients because of insufficient beds and the heavy workload. To address issues like this, virtual wards were created using technology like apps, wearables, and other medical devices to provide hospital-level care at home (Kastengren et.al 2024). However, this development also brings new challenges for nurses. According to Wheeldon (2023), nurses struggle to adapt to remote patient care. This raises concerns about their ability to manage the development process effectively, considering their competence, workload, and the need to ensure patient safety.

According to Vallée & Arutkin (2024), virtual wards are a significant change in how healthcare is delivered. Virtual wards aim to improve patient outcomes and help manage hospital capacity (Kastengren et.al 2024), especially as healthcare systems face increasing pressure worldwide (WHO, 2025). Virtual wards have been proven to increase patient comfort- and satisfaction and enhance recovery (Kastengren et.al 2024; Wells and Gatfield, 2024) via e.g. reduced infection risk and better sleep. It is essential for nurses to understand their role in this development and to have the competence needed to care for patients in virtual wards and via digital care models. As education has been proven to directly affect patient safety (Aiken et al. 2014), it is essential that nurses gain the relevant knowledge and competence at all time. Nurses need to combine clinical competence and -skills with technology and communication to provide safe and quality care to patients in the future (Wells and Gatfield, 2024). 

This blog was authored by one of the authors of a bachelor’s thesis (Ndongfack & Shiri, 2025), which conducted a thematic analysis of 20 peer-reviewed scientific articles. The thesis examined the competencies required for registered nurses to practice effectively within virtual ward settings and developed recommendations to inform nursing education and professional development. Selected articles from the review are presented here to illustrate the key themes identified: digital literacy and technological proficiency, remote clinical decision-making and critical thinking, patient engagement and health coaching, ethical and legal considerations, and telecommunication and virtual interaction skills.

Virtual wards and registered nurses’ competence

As stated, virtual wards allow patients to receive hospital-level care at home (Kastengren et.al 2024) using digital technologies like telemedicine and remote monitoring. A care model that is already utilised in e.g. Sweden. This care model aims to improve patient outcomes, reduce hospital crowding, and increase healthcare system efficiency (Chen et al., 2024, Kastengren et.al 2024). There are three main types of virtual wards: hospital-at-home, telemedicine-based care, and remote monitoring. All these types rely on digital devices and healthcare professionals to monitor patient health, manage treatment, and provide consultations, as shown by Norman et al. (2023). Nurses play a crucial role in successful virtual wards and digital care solutions as experts in their field (van Houwelingen et al., 2019, Wells and Gatfield, 2024).

Nurses monitor patients' vital signs, coordinate care, educate patients, and facilitate communication between healthcare professionals and patients (Norman et al., 2023). In virtual wards, various barriers may arise when managing complex clinical conditions such as heart failure, hearing impairment, and cognitive dysfunctions, as well as addressing the effects that virtual care delivery may have on patients’ self-confidence (Greene et al., 2024). Overcoming these challenges requires advanced clinical competence, digital competencies, and comprehensive professional knowledge.

Virtual wards have greatly improved health management (Kastengren et.al. 2024). With telemedicine, virtual wards, and remote monitoring, nurses can reach more patients more easily and patient satisfaction and care quality within the models has been proven good (Kastengren et.al. 2024). Digital tools support this process. However, challenges arise in managing these virtual wards and digital care solutions, raising questions about nurses competence and skills within the specific area.

Nurses must have a good understanding of digital tools and technology because they offer a wide range of healthcare services and play a central role in the care process e.g. providing general check-ups, access to specialists, medication management etc. (Vallée and Arutkin, 2024). Nurses should not only know how to operate the equipment used in virtual wards and healthcare. Nurses working in virtual wards should have knowledge in basic IT skills such as software and hardware, feel confident in using technology, adapt to virtual care tools, and include telehealth in their daily work to be able to provide high-quality care (van Houwelingen et al., 2019).

Digital skills and technology knowledge are crucial also for engaging and coaching patients, as many of them are elderly and not digital natives. Building trust in a digital environment is essential. If patients do not trust the system, it can hinder their recovery. Therefore, RN must establish genuine contact with patients to support and motivate them throughout the entire care process. A clear coaching method can help achieve this.

Additionally, nurses must follow ethical and legal guidelines in all interactions (van Houwelingen et al., 2019). They need to protect patient data during communication, respect patient autonomy, and ensure privacy in virtual conversations. Maintaining confidentiality, obtaining informed consent, and respecting patients' choices are vital in virtual care and require training and knowledge.

Conclusion

The review of the skills nurses needs to work in virtual wards shows that these wards represent a new beginning for remote patient care and a need for updating competence among nurses. Nurses should embrace this change, as it not only lowers their health risks but also helps them improve their problem-solving skills and develop their competence. Exploring the competencies nurses need to work in virtual wards, found that digital literacy and technology skills are the most important abilities for nurses in virtual wards. These competencies are essential tools for promoting good health among patients and preventing risks using virtual care models and portable devices. Nurses also need to be competent in communicating remotely and making remote clinical decisions, while at the same time thinking critically, which allows them to perform their duties on time, safely and effectively.

Ndongfack Sidoline, nursing student, Arcada UAS

Mary Shiri, nursing student, Arcada UAS

Pauleen Mannevaara, Ph.D. student, Senior Lecturer in Health Care, Department of Healt care, Arcada UAS

Lotta Eronen, Ph.D., student, Senior Lecturer in Health Care, School of Business and Healthcare, Arcada UAS

References

Aiken, L. H., Sloane, D. M., Bruyneel, L., Van den Heede, K., Griffiths, P., Busse, R., … Sermeus, W. (2014). Nurse staffing and education and hospital mortality in nine European countries: A retrospective observational study. The Lancet, 383(9931), 1824–1830. https://doi.org/10.1016/S0140-6736(13)62631-8  

Chen, H., Ignatowicz, A., Skrybant, M., & Lasserson, D. (2024). An integrated understanding of the impact of hospital at home: A mixed-methods study to articulate and test a programme theory. BMC Health Services Research, 24(1), 1–17. https://doi.org/10.1186/s12913-024-10619-7  

Greene, L., Rahja, M., Laver, K., Wong, V. V., Leung, C., & Crotty, M. (2024). Hospital staff perspectives on the drivers and challenges in implementing a virtual rehabilitation ward: Qualitative study. JMIR Aging, 7(1), e54774. https://doi.org/10.2196/54774  

Kastengren, M., Frisk, L., Winterfeldt, L., Wahlström, G., & Dalén, M. (2024). Implementation of Sweden's first digi-physical hospital-at-home care model for high-acuity patients. Journal of Telemedicine and Telecare. Advance online publication. https://doi.org/10.1177/1357633X241232176  

Ndongfack, S., Shiri, Mary. (2025). Exploring the competencies Nurses need to work in virtual wards: a Literature Review. https://urn.fi/URN:NBN:fi:amk-2025051612346  

Norman, G., Bennett, P., & Vardy, E. R. L. C. (2023). Virtual wards: A rapid evidence synthesis and implications for the care of older people. Age and Ageing, 52(1), afac319. https://doi.org/10.1093/ageing/afac319  

Vallée, A., & Arutkin, M. (2024). The transformative power of virtual hospitals for revolutionising healthcare delivery. Public Health Reviews, 45, 1–12. https://doi.org/10.3389/phrs.2024.1606371  

van Houwelingen, C. T. M., Ettema, R. G. A., Kort, H. S. M., & Ten Cate, O. (2019). Hospital nurses' self-reported confidence in their telehealth competencies. Journal of Continuing Education in Nursing, 50(1), 26–34. https://doi.org/10.3928/00220124-20190102-07  

Wells, E., & Gatfield, T. (2024). Virtual wards: Benefits, challenges and required skills. Nursing Times, 120(10). https://www.nursingtimes.net  

Wheeldon, M. (2023). Virtual wards versus hospital at home: Care models for older people. Evidence-Based Nursing, 26(4), 163. https://doi.org/10.1136/ebnurs-2023-103727  

WHO. (2025). Ageing and health. https://www.who.int/news-room/fact-sheets/detail/ageing-and-health