Nursing Staff Recruitment and Retention in the VHA System
St. Louis Community College, St. Louis, MO
(Karen Mayes, RN, MSN)
Testimony before the Veterans’ Health Administration
Chicago, IL, Field Hearing, April 24, 2003
St. Louis Community College has a 40-year history of Associate Degree Nursing education. We excel in the preparation of our graduates and our graduates excel in our community and beyond. Our graduates, as well as Associate Degree in Nursing graduates nationwide, have consistently performed at or above their baccalaureate counterparts on the national licensure examination. No evidence exists to demonstrate that the quality of patient care provided by Registered Nurses differs depending on where the RN is educated (associate or baccalaureate degree program).
The majority of registered nurses begin their education with an associate degree. The Associate Degree in Nursing prepares nurses to practice in a profession that has endless opportunities. We, as associate degree nursing educators, believe these opportunities need to be expanded by the provision of career advancement in the Veterans Health Administration based not only on continuing education, but also on job performance.
Through the National Nurse Education Initiative, the Veterans Health Administration is spending an average of $11,000 to educate associate degree registered nurses to the baccalaureate level. This same funding could provide an associate degree education for two generic nursing students, thereby providing a relatively quick workforce of very high quality.
The Nursing Qualification Standard that requires a Bachelor of Science in Nursing (BSN) for promotion up the career ladder within the VHA system is a dis-incentive for experienced, dedicated ADN’s to join the VHA. Although many of our graduates do eventually continue their education for an advanced degree, many need some time to recover their lives, having sacrificed much time away from their family, community, and work, in order to be successful in their nursing program. In my 20-year tenure at St. Louis Community College, I have known only a handful of our graduates to seek employment at the VHA. I trust that the BSN requirement for advancement will further disenchant future graduates from seeking the VHA for employment, in spite of the many very positive qualities of the VHA. Furthermore, ADNs with many years of valuable experience practicing nursing have no incentive to join the VHA as the VHA system will not customarily recognize or reward experienced RNs under the guidance of its new nursing qualification standards.
The American Association of Community Colleges (AACC) strongly supports continuing education for all community college graduates. Community colleges work closely with the communities they serve to meet their healthcare needs. Community colleges are currently supporting a nursing initiative through the American Association of Community Colleges to expand opportunities for Associate Degree Nurses and enable community colleges to expand nursing program enrollments. The nation and VHA cannot meet the critical need for Registered Nurses without the contributions of community colleges in educating the nation’s nurse workforce. The nation’s healthcare system recognizes the value of the Associate Degree Nurse and employs them along side their four-year counterparts, the VHA should do the same.
Nurses provide service to their patients during the happiest of times, during the saddest of times, and during the most challenging of times. We are asking for the same opportunity so our associate degree nursing graduates can provide their service to those who have served our country, our veterans.
Recommendations to Improve the VHA
1. Promote RNs within the VHA system based on job performance and continuing education.
2. Support continuing education for all RNs.
3. Develop a policy for advancement of Associate Degree Nurses, utilizing educational opportunities.
4. Implement a RN to MSN program to address the faculty shortage.
5. Encourage experienced RNs to work for the VHA.
6. Provide a career path for RNs that encourage them to continue to practice within the VHA system.