Examining Nurse Practitioner Experiences in Delivering Virtual Care During the COVID-19 Pandemic: A Mixed-Method Study

BackgroundThe COVID-19 pandemic required Nurse Practitioners (NPs) in Fraser Health Authority (FHA) to rapidly pivot to virtual care health services. Most NPs had little to no education on providing virtual care and there is a paucity literature on how to best deliver this type of care.PurposeThe purpose of this study was to explore the experiences of NPs in FHA who were required to rapidly integrate virtual care into their practice due to the COVID-19 pandemic, while considering competencies and supports needed to integrate virtual care successfully into NP practice.MethodsThis mixed-methods study purposively sampled 41 NPs in FHA in urban British Columbia. Methods consisted of electronic surveys, and semi-structured interviews and focus groups. Data was analyzed using an interpretive description approach.ResultsThe study found a significant increase in the use of virtual care during the pandemic, with NPs reporting improved efficiency (68.3%) and comfort in virtual care delivery. However, challenges were identified in relational practice, confidence, and workflow, particularly in maintaining therapeutic relationships and conducting physical assessments. Themes from qualitative data highlighted the need for targeted education, standardized protocols, and improved technological infrastructure to support virtual care integration.ConclusionThe findings underscore the complexity of adapting to virtual care and emphasize the importance of training, policy development, and system-level supports to enhance its implementation. These results provide critical insights into the competencies required for virtual care and inform future strategies to improve its integration into NP practice in Canada and beyond.