Tuesday, December 3, 2019

Succeeding in a Career as a Telehealth Nurse

Feature Writer


Telehealth Nursing: An Essential in Our Hyperconnected World

The telehealth nursing industry is a booming job market that allows for flexibility and virtual collaboration between health professionals. Remote nurses are able to treat patients and monitor their condition and progress with the help of audio and visual accessories, computers, and telephones. They are especially adept in cases of pre- or post-surgery, monitoring disease management, and care coordination. This comprehensive guide provides insight into what it takes to be a remote telehealth nurse and how to be successful in the field. 

In this article

Remote telehealth vs. call center telehealth

No telehealth nurse looks the same. The flexibility of the field is one of the most notable advantages of the career path; telehealth nurses work in a number of environments: 
  1. Live Videoconferencing (Synchronous): In this type of nursing there is a live, two-way interaction between nurse and patient with the use of audiovisual telecommunications technology.
  2. Store-and-Forward (Asynchronous): As the name suggests, the health history is recorded and accessed by the provider through a communications system.
  3. Remote Patient Monitoring (RPM): Communication technologies transmit personal health and medical data from the individual in one location to the nurse, who uses the information collection to assess care and related support. 
  4. Mobile Health (mHealth): Health care practices and education supported by any mobile communication device (cellphones, tablets, PDAs). Can include everything from targeted text messages to wide-scale alerts.

Benefits and Considerations Before Becoming a Remote Nurse

Efficiency and affordability for patients

As reported by the American Hospital Association, 76% of United States hospitals use telehealth practices because of the perks it can provide. Meeting with a remote nurse is great for non-emergency visits such as minor injuries, primary care, and remote patient monitoring, and thus telehealth practices save people money and the hours they would have spent in the waiting room. The University of California Davis determined, by examining 18 years of their own clinical records, that telemedicine visits ultimately saved patients nine years in travel time and $3 million in costs. An additional benefit of telehealth practices is their ability to broaden the scope of the health care system and increase options for rural patients (provided their internet connection is strong).

Flexibility and freedom for nurses

The societal benefits of telehealth nursing are obvious, but what can it do for you? Simply put: mitigate stress. You aren’t juggling patients, handling bodily fluids, and running from one patient to the other. But beyond that, nurses find that they can focus on patient care and leave the red tape of traditional facilities behind. According to a 2017 survey of registered nurses, 44% of nurses say they often do not have the time they need to spend time with each of their patients. In addition, 55% of nurses stated they suspect that the physically demanding and sometimes emotionally draining nature of nursing is affecting their health. Telehealth practices are a unique avenue that offer nurses another way to do what they love without sacrificing the value they put on their patients or themselves. 

Challenges and Benefits of Remote Nursing

Telehealth nurses still experience all the typical challenges remote workers face: problems with focusing, detaching yourself from the job, and the feeling of being disconnected from coworkers. An additional perceived long-term barrier to consider is the opportunities for advancement. This is not to say there are none, but remote nurses are sometimes required to be more proactive and seek out advancement more often than traditional workers. Luckily, telehealth nurses are not limited to one small area of nursing and can transition between sectors and advance in leadership roles, albeit in a process that differs slightly from traditional hiring.

Challenges Remote Nurses May Face

Freedom and lifestyle flexibilityFeelings of isolation
Less stressful than traditional optionsOpportunities for advancement may seem tricky
Widens the scope of health care, particularly in remote areasPotential for long hours and odd shifts
Ability to focus on personalized patient careMust depend on the patients’ description of symptoms
Increased patient satisfactionMay need to mitigate 911-like panic/helplessness of someone calling in with an emergency
No exposure to blood or bodily fluids
Call centers are a common work environment, which may not be ideal for every nurse
No contact with needles or injectionsPrimarily sitting or standing in one place for long hours
Low physical demand

Who Can Become a Remote Nurse?

If you are interested in pursuing a career in telehealth, you must either have a licensed practical nurse degree or a registered nurse degree with a nursing license. Most companies also like to see you have a minimum of one to two years of on-site nurse experience.

Remote Nursing Opportunities



National Pay Average

Additional Details

Expected Growth (2016-2026)

Remote Triage Nurses

Minimum bachelor’s of science in nursing (BSN). Also required to pass the National Licensure Examination For Registration Nurses.

Average: $70,302

Range: $64,149 -

$ 79,505

Remote triage nurses are required to determine the level and type of care a patient needs. They must be able to decide purely by speaking over the phone.


RN Case Managers

Typically a minimum of a bachelor’s of science in nursing (BSN) is required, while there are some with an associate degree in nursing (ADN). This is rare. In most cases, RN case managers hold a master’s of science in nursing (MSN). Having a case management

Average: $64,000

Lowest 10%: $ 47,830

Highest 10%: $ 83,870

RN case managers are registered nurses who assess, plan, implement, and evaluate patient care. Unlike other nurses, case managers also focus on being fiscally responsible.


Nurse Auditors

Minimum bachelor’s of science in nursing (BSN).

Average: $72,885

Lowest 10%:


Highest 10%:


Nurse auditors run reports to locate and resolve mistakes or errors on various medical accounts


Remote Nursing Instructor

Must have a bachelor’s of science in nursing and a valid nursing license. Several years of work experience is required.

Average: $61,322

Range: $45,000 - $82,000

Nursing instructors are responsible for educating aspiring nurses about patient care, and expected to design a curriculum and lectures.


Quality Assurance Nurse

Associate’s or bachelor’s degree in nursing.



QA nurses review hospital nursing practices and documentation, and implement change as needed.


Legal Nurse Consultant

Bachelor’s of science in nursing (BSN). Additional LNC training.

Average: $70,000

Legal Nurse Consultants work with law professionals to assist on medical malpractice cases, insurance fraud cases, worker’s compensation, etc.


Medical Writer

Bachelor’s or Master’s degree in Journalism or English.



Medical writers have two paths available: scientific medical writing or marketing medical writing.

How to Land the Job

Proving remote-worthiness

As with any remote job, employers like to see examples of past remote experience on your resume, so regardless of what field your remote work was in, be sure to highlight it appropriately. Any level of remote working experience is worth mentioning, even if you only sporadically worked at home when you had a doctor’s appointment or were out sick. Don’t panic if you haven’t had a remote job – plenty of telehealth nurses didn’t before they transitioned into their current roles. Having tangible nursing experience is the real key to landing a remote job in the field, which is why we spoke to the experts, remote nurses, and others with expertise in the field.

Any level of remote working experience is worth mentioning.

Brenda Glover, a telephone triage nurse for Nurse Telephone Triage Service, spoke about realizing her need to work from home and taking to the internet to research her options. She acknowledged that some companies do like to see remote nursing experience, but it isn’t the end-all-be-all. What companies deem most important, she said, is being a good nurse. “A well-rounded nurse who has a varied background usually does well. Because not only are you relying on protocols, but you’re relying on personal experiences.” 

Nurses find that they can focus on patient care and leave the red tape of traditional facilities behind.

Brenda also sites being technology-savvy as one of the most important skills. She describes telephone triage nursing as “a fast-paced position that requires a lot of being able to multitask and listening to somebody talk and being able to move from one screen to the other.” Telehealth nurses must be critical thinkers who are practiced in how to press for information from patients about signs and symptoms they may be experiencing. Thinking on the fly and prioritizing patient needs by the level of urgency is an everyday staple in a remote nurse’s life. 

Essential skills for remote nurses:

  • A passion for nursing and solid clinical knowledge
  • Strong assessment and communication skills
  • Ability to easily adapt to new technology
  • Patience to troubleshoot issues that arise
  • Ability to multitask on a dual-screen computer and navigate various systems
  • Typing while speaking with patients
  • Ability to convey empathy and understanding using tone of voice

Ask the Experts: FAQ

How do you find a remote nursing job?
There are numerous online resources that connect nurses with remote options. There are companies all across the country that hire remote nurses, some exclusively. 
  1. Aetna – A highly recognized health care insurance company, Aetna hires for a variety of remote workers, including RN case managers and nurse consultants.
  2. DaVita – Focused on kidney care, DaVita hires remote case managers.
  3. Humana– One of the most well-known health care companies, Humana hires for care managers, telephonic CCR, case managers, and clinical advisors.
  4. Anthem – A health benefits company, Anthem offers a variety of teleworking nursing positions.
  5. Cigna – An insurance company, Cigna hires registered nurses as consultants, writers, educators, and clinical care managers.
  6. CareNet – Providing 24/7 health care, CareNet frequently offers RN positions. 
  7. UnitedHealth Group – UnitedHealth Group consistently posts positions for registered nurses all across the country.
  8. Healthfirst – Based in New York, Healthfirst offers both home office and onsite nursing positions.
  9. FoneMed – A telecommunications provider, FoneMed hires across North America.
  10. Nurse Telephone Triage Service – An RN-owned company, Nurse Telephone Triage 
What do you need to become a telehealth nurse?
First and foremost, becoming a remote or telehealth nurse requires both a nursing degree and a nursing license. Liz Greenberg, PhD, RN-BC, C-TNP, CNE, an associate clinical professor at Northern Arizona University and a past president of the American Academy of Ambulatory Care Nursing (AAACN), described finding her own passion for telehealth nursing through her experience in an after-hours pediatric clinic, in which she was charged with answering calls from patients parents and caregivers. She cites a passion for nursing and a respect for patients as the basis for every nurse’s journey into telehealth and encourages them to gain “an in-depth understanding of how to assess and communicate solely via technology.”  
What is the transition from traditional nursing to telehealth nursing like?
When asked to reflect on her transition to remote triage nursing, Brenda Glover described a process of trial and error with a lot of patience sprinkled in. When she started in the industry, there was very little computer use, everything was notated in charts. She went on to say that, “It has been challenging, but it’s been rewarding. Because I now feel very secure in the role and I feel like I could troubleshoot just about anything.”
Dr. Greenberg’s response was in a similar vein. Describing it as difficult at first, she said she got to a point where technology became a tool that she needed to connect and provide care to her patients. 
Does the company provide the hardware used?
 Dr. Greenberg said while companies usually provide the equipment, nurses are able to negotiate the use of their own equipment if they choose, provided it meets all the requirements. The equipment and services provided by the employer are completely dependent on the company you work for. While some companies may cover your computer and devices, others may require a nurse who works from home to not only provide their own computer and phone, but internet service too. On the bright side, if you do end up having to provide your own equipment, you can claim it on your taxes. You can even deduct some — maybe all — of the expenses of your internet connection as a part of your home office expenses.

“My personal belief is that the human connection provided by nurses via remote communication is highly valued by individuals who have health concerns and or questions.”

– Liz Greenberg, PhD, RN-BC, C-TNP, CNE
What does someone considering telehealth nursing need to know?
For Dr. Greenberg, “I think the biggest thing to know is that this is often an independent practice – one that relies on assessment and critical thinking and the breadth and depth of both the nurse’s education and experience (in life and in health care). Depending on your practice (e.g., triage, advice, remote monitoring, care coordination) your decisions may be guided by standard orders, decision support tools, or care guidelines but you must be comfortable and confident when those guidelines need to be overruled for safety.”
Dr. Greenberg also spoke to the interdisciplinary communication that is required for some areas of telehealth nursing. Appreciating and understanding what other team members bring to the table is just another facet of communication for a telehealth nurse.

Creating a Successful Workspace

Safe, secure, reliable internet: key for remote nurses

The internet is your lifeline. Not only does it allow you to do your job, but having a seamless internet experience presents professionalism and ultimately may make or break your ability to advance. If you hope to be a successful remote nurse, having a fast and reliable internet is a must. Without a strong internet and phone connection, remote nurses cannot meet the basic requirements of their jobs.
The Health Insurance Portability and Accountability Act (HIPAA) requires that all technology used during patient care have compliant software for encryption and privacy, to protect electronic medical records and patient information. Mobile devices and tablets that are used in medical care are also required to have a secure configuration that will protect data. Patient information should never be accessed from an unsecure device. The use of Virtual Private Networks (VPNs) in health care allows patients and health care professions to remotely access to health information safely. A VPN is an extension of a private network that can be accessed over a public internet connection. Using authentication steps and encryption mechanisms, VPNs add another level of security and privacy to a nurse’s public network. 
Internet typeProsConsWhich is best for telehealth nurses?
Fiber OpticExtremely fast and reliable internet connection with no data caps. Great for hosting servers and complex cloud-based systems.Very limited availability, mainly found in cities. Higher cost than other options.Best
CableHigh speed and very reliable. Internet not dependent on cable, but uses the same wiring.Neighborhoods share bandwidth, which may lead to connection issues during busy times. Cheaper than most options.Better
DSL (Digital Subscriber LineWidely available from multiple providers. Dedicated bandwidth that is not shared.Low speed with performance based on proximity to provider. One of the cheaper options.Good

Testing your internet 

Telehealth nursing is dependent on technology. Testing your internet speed will tell you if your connection is able to support and sustain that type of work. Thankfully, it’s easy to test for both urban and rural areas. When testing your internet speed, you’re assessing the latency, download speed, and upload speed performance. But before you start, there are some steps you need to take to ensure you get the most accurate reading. First, always restart your computer to shut down any residual apps running in the background that may slow down your latency rate. Then, disconnect from any virtual private network (VPN). VPNs or data-saving apps will slow down your connection and give you an inaccurate reading on the test. It’s important to test your connection more than once so you get the best idea of your status. 
  • Speedtest.net – One of the most established and popular options. It allows users to keep a record of previous tests for comparison. 
  • Fast.com – Operated by Netflix, fast.com offers an ad-free interface.
  • Xfinity Speed Test – User-friendly interface that isn’t cluttered with ads or pop-ups. 

What to do if you’re experiencing internet issues 

  1. Reset your modem and router. 
  2. Assess the placement of your router. The farther away you are from your router, the weaker your signal will be. Being as close to your router as possible will result in the best wifi connection.
  3. Use a mobile hotspot. Acting in lieu of a modem or router, a hotspot distributes internet connection to your devices.
  4. Use a wifi extender. Wifi extenders plug into your router and are designed to repeat your wireless signal and expand its coverage.
  5. Still having connectivity issues? This step-by-step guide walks you through exactly how to troubleshoot your connection.
According to Brenda, her company in particular requires that their nurses have a back-up plan for if they are having internet issues. In her case, nurses are required to go to another location with reliable connection to work until their personal connection is up and running again.

Addressing your phone service needs

Depending on the remote nursing role, a landline telephone can be used exclusively to speak with patients or in conjunction with the internet and other telecommunications tools. While computers, custom software and audio/video feeds are necessary for a remote nurse to have, some patients are limited to only their phones. Some employers will set you up with phone service through their systems, which will likely be cloud-based. If they don’t provide a phone service, then consider shopping around yourself or using a cloud-based service so your phone is as reliable as your internet. 

Setting Yourself Up for Success

Nurture a healthy avenue of communication with coworkers

To be a successful remote worker, creating an open line of communication is essential. Many remote workers can attest to the feelings of isolation and being left out of things that go on in the office. The walks to get coffee and the convenience of tapping your coworker on the shoulder with a question are often taken for granted. Build connections with coworkers and regularly plan meetings to chats with them. Communicating as much as possible is key to still feel like part of the team. Organizations such as the American Academy of Ambulatory Care Nursing and the American Telemedicine Association are focused on advancing the telehealth field and providing support for those in it. Creating connections through these organizations is another way to feel involved. 

Set a schedule and stick to it

Patient and self-care are tightly intertwined for telehealth nurses. Self-care takes many forms: eating and exercising, social interaction, and routine. Without the need to begrudgingly sit in traffic your mornings are wide open, and there’s a lot of ways to spend your time, which can be a problem for some people. That’s why it’s important to set a schedule for yourself, regardless if you work day or night. Create a routine and stick to it, or at least as well as you can if you often work different shifts. Establishing a time for meals, breaks, and physical fitness is not only great for your productivity, but for your sanity too. Making time for exercise can sometimes feel like a hurdle but it’s especially important for remote workers.

Quick Self-Care Tips for Remote Nurses

  • Stream your workout classes. A great option for nurses who work irregular or odd hours. 
  • Find a network of friends who work remote and set up a weekly happy hour, lunch or coffee date to schedule face-to-face interaction. 
  • When your shift is over, get out of the house! A change of scenery helps you mentally put away work so you can enjoy your personal time. 
  • Have a separate workspace in your home.