Nursing Staff Recruitment and Retention in the VHA System
Delgado Community College
(Patricia Egers, RN, MSN)
Testimony before the Veterans’ Health Administration Field Hearing Held in New Orleans, LA, on April 3, 2003
Charity School of Nursing of Delgado Community College has had a rewarding, positive relationship with the Veterans Administration (VA)/Affairs Medical Center in New Orleans for greater than 30 years. At the VA, in addition to a rich and deep clinical education, our student nurses learn to appreciate our country’s history, the services that our veterans perform as well as understand how being a veteran impacts the rest of the service person’s life. VA clinical experience provides our students and faculty an opportunity to serve those who have served us.
After making these heartfelt remarks, I must state that I, as an associate degree educator, am very disappointed in the hiring and promotion policy instituted nationwide by the Department of Veterans Affairs. The Nurse Qualification Standard discourages associate degree nurses from committing to working in the VHA. Indeed, these nurses who have achieved licensure passage rates equal to those of their four year baccalaureate counterparts and have proven to provide quality patient care that cannot be differentiated from that provided by nurses with baccalaureate degrees cannot advance within the nursing profession after 2-3 years of working as a registered nurse. This comes at a time when Patricia Benner’s novice to expert research shows that nurses are coming into their own.
The associate degree (AD) graduate has much to offer the Veterans’ Health Administration. They are nurses because they want to be at the patient-side providing knowledgeable care. Indeed, the NCLEX-RN first time pass rate shows no difference between associate and baccalaureate degree graduates.
The 2000 HRSA survey indicates that in 2000, the majority, or 60%, of nursing graduates earned an associate degree. With numerous choices of workplace opportunities, one must ask, why would an AD graduate choose to work in the Veterans' Health Administration when the hiring and promotion policy “holds them back”? The VHA is losing the opportunity to bring nurses from Delgado Community College and other associate degree programs into its system. These nurses are excellent, professional nurses who wish to provide patient-side care and continue to grow in their roles as the demographics of the AD graduate suggest that the graduate does not return to school immediately following graduation. In addition to repaying monetary debts, the AD graduate is frequently ready to repay her/his family for the time sacrificed as the degree was pursued.
Additionally, according to HRSA statistics, 15.6% of AD graduates hold a previous associate, baccalaureate or master’s degree. Many AD students pursue nursing as a second career. These students may or may not return to school to earn an additional degree following completion of the AD nursing program. While the health care system across the nation often recognizes and rewards the continuing education that registered nurses pursue, which enables them to grow and expand professionally, the VHA fails to do so. The VHA fails to reward life long learning and meritorious performance from its nurses in its promotion policy.
I am a proponent of higher education and continuing education and appreciate the benefits education affords to my profession. Delgado Community College graduated approximately 400 registered nurse graduates in the last two years, not one of them chose a VHA as a workplace. You have missed out on some excellent caregivers.
Recommendations to Improve the VHA
1. Hire new AD and BSN graduates at the same level-Nurse 1, Level 1
2. Promote based on performance and continuing education
3. Investigate hiring and promotion strategies to attract experienced ADN graduates who can utilize the educational opportunities that Veterans Affairs provides.