VA registered nurses sound alarm about new policy, demanding safe administration of medications and scheduling flexibility to increase staff retention

Registered nurses at the Cincinnati VA Medical Center in Cincinnati, Ohio will hold an informational picket on Thursday, June 29, to protest the administration’s refusal to address RNs’ deep concerns about the VA’s dangerous plan to put high-level ICU and progressive care unit (PCU) patients on medical-surgical units, contrary to the VA’s own policy, announced National Nurses Organizing Committee/National Nurses United (NNOC/NNU).

VA union nurses are sounding the alarm about implementing this new patient policy in medical-surgical units. ICU/PCU patients who need IV medications require constant monitoring, which med-surg RNs are unable to provide because they are assigned up to five patients. An ICU nurse’s patient assignment is usually one or two patients, allowing that RN to provide the higher level of care an ICU patient needs.

“Our veterans will become collateral damage as a result of our leadership's reckless and injudicious decisions to implement new policies that jeopardize the safety of our patients and place RNs' licenses at risk,” said Shana Rivera, ICU nurse at the Cincinnati VA. “This is irresponsible. Critical drips do not belong on a medical-surgical unit. This is not safe for patients or the RNs’ license.”

• Who: Registered nurses at the Cincinnati VA Medical Center
• What: Informational picket for patient safety, staff retention, and an environment free from intimidation.
• When: Thursday, June 29, 11:30 a.m. to 1:00 p.m.
• Where: Cincinnati VA Medical Center, 3200 Vine Street, near the hospital entrance

“Local management wants to implement a dangerous policy that is not done at any other VA or any other hospital that we have found on a medical-surgical floor,” Eric Cromer, RN on the medical-surgical unit at the Cincinnati VA. “It is unacceptable to assign ICU or progressive care patients to the med-surg unit. We should not put our veterans at risk like this.”

The union nurses are demanding that the VA stop its plans to place ICU/PCU patients on medical-surgical units. In addition, the hospital’s leadership is reneging on its promise to improve retention by providing RNs with flexible work schedules. To make matters worse, management has been engaging in intimidation tactics against nurses who bring up legitimate complaints.

“Incompetent, autocratic leadership that thinks nothing of veterans’ safety is another reason why RNs choose not to practice their profession at the Cincinnati VA,” said Cromer. “The lack of work-life balance and the delays in implementing scheduling flexibility is another reason nurses are leaving.”

“The decision of the executive chief nurse to continue to delay implementation of flexible scheduling to all inpatient units goes against the secretary's push to get this implemented for retention and recruitment purposes,” said Rivera. “Multiple RNs have already left the bedside. It costs more than $70,000 to orient new RN staff only to have them leave as a result of not receiving what was promised over a year ago and used as a recruitment hiring tool to get RNs in the door.”

The Cincinnati VA Medical Center nurses have been in negotiations since December 2022 for a new retention tool, with little to no movement on key issues. The RNs urge management to invest in nursing staff and agree to:

• Alternative work schedules, to improve retention
• Safe, high-level ICU/PCU IV medication administration that does not go against VA policy
• A safe work climate free from intimidation, which encourages nurses to bring up safety issues without fear of reprisal.

Nurses had previously informed management that:

• RNs were not going to be intimidated for speaking up for their fellow nurses and veterans, regarding scheduling flexibility or other matters
• Scheduling flexibility was important for nurse retention and that short staffing was dangerous for patients and nurses; VAs across the country have proven that scheduling flexibility works and improves work/life balance. 
• The nurse executive refuses to listen to nurses during bargaining.

“We want safe patient care for our veterans,” said Timothy Puckett, RN on the med-surg unit at the Cincinnati VA. “Our patients are heroes of this nation and we want to provide them with the same commitment to safety as they provided all Americans through their service.”

Nurses say that retention at the Cincinnati VA will continue to worsen. The delays to implementing flexible scheduling have already had an impact and the proposed policy to place ICU/PCU patients on the medical-surgical floor has made the situation even worse.

National Nurses Organizing Committee represents more than 600 nurses at the Cincinnati VA Medical Center.

National Nurses Organizing Committee is an affiliate of National Nurses United, the largest and fastest-growing union and professional association of registered nurses in the United States with nearly 225,000 members nationwide. NNU affiliates also include California Nurses Association, DC Nurses Association, Michigan Nurses Association, Minnesota Nurses Association, and New York State Nurses Association.