Nursing Staff Recruitment and Retention in the VHA System
Portland Community College, Portland, Oregon
(Dr. Jesus “Jess” Carreon, President)
Testimony before the Veterans’ Health Administration
Los Angeles, California, Field Hearing, April 30, 2003
I have been directly involved in the debate over the education of nurses in this country for more than 20 years, as a community college administrator and president. Moreover, I am here today as a community college president and Chair-Elect of the American Association of Community Colleges Board of Directors. My interest, and that of my colleagues, in the issue stems from two primary concerns – meeting the needs of the students and addressing shortages in the workforce that will continue well into the future.
We at Portland Community College want our graduates to be able to get jobs and fill the needs of the workforce. We also want our ADN graduates to be able to go on for Bachelor’s and Master’s degrees if they are able and want to advance their education. Toward that end, we support life-long and continuing education for nurses and always have. Our ADN nurses are well qualified. They pass the NCLEX-RN exams at the same rates as BSN nurses. They have the same kinds of clinical experiences as BSN nurses, and may be even more clinically competent than their BSN colleagues in providing patient care. Community College Associate Degree graduates also have several other attributes – they tend to be older, more stable and reliable, and many already have degrees in other fields and are making nursing a second career. Further, community college graduates represent a large percentage of the nurses of color in the profession, and bring a breadth of experience and dedication to the field of nursing. Compared to Bachelor of Science nursing programs, associate degree programs allow students to move into the workplace faster and at a reduced cost.
We all know we have a critical shortage of health care workers in this country. We also know that the majority of nurses currently in the workforce had their initial educational experience in an associate degree nursing program. With this point in mind, we at Portland Community College find it very disappointing that the VHA’s hiring and salary progression policies do not value the associate degree nurse. This is of concern, given the shortages in the field, the high quality of educational preparation of the associate degree graduates, and the diversity they bring to the profession.
The VHA’s current policies are based on the unvalidated premise that more formal education automatically equates to better performance. In that case, we encourage the VHA to base employment and advancement policies on the quality of the job performance and continuing education of its nurses, rather than solely on the attainment of advanced degrees. In fact, there are no data or research indicating that associate degree nurses perform less competently on the job than do BSNs. The requirement that VA hospital nurses have a BSN clearly prevents associate degree graduates from nursing employment opportunities, and ultimately deprives the VA Hospitals from attracting well-educated and highly qualified nurses.
Portland Community College placed many of our nursing students at the local VA Hospital for their clinical experiences until 1994. However, because of the initiation of educationally discriminating hiring practices, we stopped sending our students there for clinical experiences. With the current hiring policies, the VA cannot hire our graduates and so is deprived of many well-qualified experienced nurses who are capable of providing outstanding patient care. We believe that for almost a decade none of our graduates has gone to work for VA Hospitals because of this change in policy. How shortsighted on the part of VHA.
In summary, my recommendations to VHA are as follows:
1. Employ new associates degree graduates at the same level, Nurse 1, Level 1, as baccalaureate nurses.
2. Provide pay rates and promotional opportunities for all nurses based on skills, job performance, and standardized continuing education criteria.
3. Develop a policy for advancement of associate degree nurses and opportunities for continuing education for all nursing employees.