Virtual nursing often serves as a natural pathway for nurses who want to continue practicing but are ready to step back from the bedside.
But when Meka Douthit Ingram, DNP, RN, is hiring, she leans on a seven-letter acronym — RESULTS — she developed over roughly 20 years of nursing leadership experience.
Dr. Douthit Ingram is the systemwide director of eICU, virtual nursing and centralized cardiac monitoring at Greensboro, N.C.-based Cone Health. She shared more about her virtual nursing hiring strategy during a Sept. 16 panel at Becker’s Health IT + Digital Health + RCM Conference in Chicago.
The system’s virtual nursing footprint extends well beyond traditional admission and discharge support, with its eICU serving as the foundation. Launched in 2006, the eICU provides 24/7 nursing coverage for an average census of about 135 patients, with virtual nurses entering patient rooms by camera roughly 15,000 times per month to support monitoring, rounding, sepsis response, donor cases, mentoring and education.
Cone Health expanded the model in 2020 to include virtual wound and ostomy nurses, who work with bedside teams on assessments and recommendations. In 2023, it deployed virtual nursing on a neuro progressive care unit and went live with telestroke support in 2025. Virtual nurses also support the system’s hospital-at-home program.
Dr. Douthit Ingram looks for a minimum of three years’ experience in new hires. Across her team, that adds up to more than 300 years of collective nursing experience.
Here is how she breaks down RESULTS:
- R — relationship. “I can’t teach camera presence,” Dr. Douthit Ingram said. A nurse needs the innate ability to build rapport the moment someone taps the camera and must earn that person’s trust in whatever is unfolding on the other end.
- E — empowered. Virtual nurses have to own the situation and work it out themselves rather than waiting for direction.
- S — situational awareness. The nurse has to be in tune with what is happening in real time and prioritize the correct next step.
- U — understanding. Nurses have to know their role on the care team and present as true partners to bedside staff. Virtual nurses are in the chart: they catch the order that was overlooked and details AI tools don’t capture. Knowing how to raise that with a bedside nurse matters as much as catching it.
- L — leader. Virtual nurses lead in the moment, solve problems independently and make decisions confidently. Dr. Douthit Ingram’s staff have clinician access and troubleshoot their own technology, often fixing problems faster than IT.
- T — teamwork. “It takes teamwork to make the dream work,” she said, describing nurses willing to follow, document or do whatever the shift requires.
- S — sink. The final letter reflects her motto across all virtual services: “We’re not going to let you sink. We’re going to get through it together,” she said. In hiring, she looks for people who are committed to that shared standard.
Trust is the precondition for the whole acronym, Dr. Douthit Ingram said. She secured administrative alignment on one message early: “We augment care at the bedside. We don’t replace it.” Without trust, she said, a health system has cameras and equipment nobody uses.
