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  1. Grumme, Valarie S. MSN, RN, CCRN
  2. Barry, Charlotte D. PhD, RN, NCSN, FAAN
  3. Gordon, Shirley C. PhD, RN, NCSN
  4. Ray, Marilyn A. PhD, RN, CTN-A, FAAN


Advances in health care and communication technology have expanded nursing practice to nontraditional environments that preclude the physical presence of the nurse for a caring encounter. An increasing number of nurses are creating and maintaining nurse-patient relationships and practicing in a diverse range of specialties in virtual/distance environments. Can nursing presence as a caring modality be "real" in a virtual/distance environment? A new ontology of nursing presence is offered that transcends people, place, space, and time.