A March 19, 2026 letter to the Alaska Board of Nursing raises detailed concerns about Providence Alaska Medical Center’s (PAMC) virtual nursing program and delegation practices, including lack of evidence-based support, unclear role delineation between virtual and bedside nurses, and instructions to patient care technicians (PCTs) that appear inconsistent with 12 AAC 44.950 delegation requirements. The commenter argues that virtual nurses are being described as supervising large volumes of delegated tasks without realistic oversight, and that PCTs are being told to rely on each other before involving nurses, potentially bypassing required RN supervision.These concerns suggest the Board may need to clarify how existing scope-of-practice and delegation rules apply to virtual nursing and AI-enabled models, and whether new regulations or formal guidance are warranted to protect patient safety and nurse licensure. While there is no procurement yet, the Board and hospitals will likely need external support for policy development, workflow redesign, training, and technology governance to implement safe, compliant virtual nursing programs. Vendors with expertise in clinical operations, telehealth/virtual nursing design, and regulatory compliance can help health systems and the Board build defensible models that align with Alaska regulations and the Board’s Decision-Making Framework.

The commenter explicitly connects virtual nursing and delegation to future AI deployment in healthcare, framing this as an area where the Board’s decisions now will set precedent for more powerful technologies. This expands the scope beyond PAMC and suggests a need for statewide frameworks on virtual/AI-enabled nursing practice.