1. Section Editor(s): Fulton, Janet S. PhD, RN, ACNS-BC, ANEF, FAAN

Article Content

The ever-increasing ability to work virtually is a result of advancing technology and growing options for connecting with coworkers and colleagues through video and phone conferencing, webinar seminars, wiki shared document preparation, cloud storage, and other innovative applications, and of course, e-mail. Working virtually can increase flexibility, maximize time, and avoid interruptions. Colleagues in multiple locations and different time zones can link up for program development, clinical projects, board meetings, or any other objective that, in days of yore, would have required face-to-face meetings, time consuming travel, and postal services for mailing and shipping.


Working virtually is an unfolding challenge. After investing in equipment and software comes the task of making it work. In workplaces with technology support, a user needs only fill out the meeting request, and it will happen. Well, maybe not. The amount of equipment may be limited and the requested date or time not available. Rescheduling can be facilitated by online calendar sharing, but there is always that person apologizing for not noting a "very important event" on the personal calendar. Start over with scheduling. Using personal equipment can provide more flexibility, but it is upon the individual to configure it and troubleshoot any snafus. Depending on a person's level of experience with technology, this may be easy or frustratingly difficult. Some devices may not be compatible with required software. Then there is the actual meeting event. A video virtual meeting may display all members clearly enough to see facial expressions and gestures of the particularly animated talkers, but then there are times when coworkers' pictures are the size of postage stamps, the video is grainy, or the audio is scratchy. Or, the opposite can happen, and a large distorted face fills the screen as if it were a close-up of a balloon figure floating in a Thanksgiving Day parade with audio blasting like a 1990s boom box at a beach pavilion. People enter and leave the meeting based on technological failures and operator error. For an interesting overview of a conference call, check Tripp & Tyler's "A Conference Call in Real Life" on You Tube at


After the meeting minutes and various project elements are circulated by e-mail-schedules, policies, outlines, drafts, and so forth. Maybe all the names on the e-mail string are familiar, maybe not. Let's say the team was to include the 6 people on the video conference, but there are 7 people on the e-mail. This one heretofore unknown name on the string is not listed in the minutes and is not in the system directory or committee roster. What is etiquette for inquiring about a stranger on an e-mail message? The work proceeds until a glitch occurs, and another virtual meeting is called. On the day of the meeting, 2 members are unable to join because, while scheduled, they are temporarily working from a regional campus with inadequate connectivity. Another new person joins the conference to help with the glitch and is introduced over garbled audio. Most of the meeting time is taken up with explaining the glitch, and unfortunately, the person with detailed information about the problem is at the regional site with no connectivity. But the meeting is scheduled, and so it proceeds, ending with a recommendation that the unknown person contact the unconnected person for more complete information.


As the work continues, so does the number of names on the e-mail string. Responses begin to reflect frustration. One message includes innuendos about the lateness of a draft; another complains about it going to the wrong person. "Don't send this me, it goes to Robert." Robert who? Oh, yeah, Robert is that seventh name on the e-mail from the first meeting. And who is Robert? And why can't someone just forward the document to Robert without the admonishing tone? Now, the most important thing to know about e-mail is when to step away from the computer mouse. Never put in an e-mail what can't be said in a personal conversation. E-mail never forgets.


A quick search of the Internet found lots of advice for conducting virtual meetings, but it largely reflected tips for conducting any meeting-set an agenda, introduce participants, start on time, make eye contact when speaking, and so forth. Well, the eye contact thing can be tricky, depending on the technology setup, as has been noted. One tip seemed particular insightful-don't sit in a leather chair; the microphone on most computers and phones easily picks up embarrassing sounds. Wow, glad to know.


Virtual work is here to stay because it offers huge advantages over in-person contacts. Technology has brought together teams of collaborators for solving system problems and developing innovative programs. It will continue to shape the future. In clinical care, technology has allowed telehealth options to provide healthcare access to geographically remote areas and to fragile, place-bound populations. But in the meantime, we have only begun to figure out how to manage human relationships in this virtual environment.


Missing from most virtual work settings is the ability to read nonverbal cues. In written communications, emoticons are a poor substitute for a real smile. E-mail does not easily transmit a wry tone or playful comment. In a virtual meeting, failure to respond to a question may be related to temporary loss of a connection, interrupting a speaker can result from transmission delays, and a loud, angry voice may be the speaker's attempt to shout over static. Technology is great when it works, but there are lots of hiccups that result from equipment, transmission, and operator error. Sorting out technical problems from interpersonal communication styles is the ongoing challenge of working in a virtual world.


The work of producing this journal is conducted exclusively in a virtual world. Included in this world are authors, editor, editorial board members, reviewers, journal staff, the publisher, copyeditors, and production staff. I have yet to personally meet most of the workers in this virtual world. My default etiquette is to say thank you to everyone contributing to the success of the journal, even those who are known only as a name on an e-mail string.