Nurses to rally and picket at Veterans Affairs headquarters in Washington, D.C.

Registered nurses who work at Veterans Affairs (VA) hospitals around the country will hold a picket and rally on Thursday, June 6, at the Veterans Headquarters in Washington, D.C., to call on the VA to lift what is in effect a hiring freeze that has contributed to more than 66,000 vacancies across the health system, announced National Nurses Organizing Committee/National Nurses United (NNOC/NNU) today. NNOC/NNU nurses across the country say the freeze is putting patient safety at risk and undermines the VA’s commitment to providing veterans with high-quality, integrated, veteran-specific care that only the VA has the experience and expertise to provide.

One of the most troubling examples of the short staffing is playing out in VA intensive care units where the standard of care should be to have one ICU nurse care for no more than two patients and, depending on acuity, just one patient.

“Last December the VA determined that 57 additional nurses were needed in order to meet the VA’s own safe staffing requirements,” said Jordan Le Blanc, an ICU nurse at Rocky Mountain Regional VA Medical Center in Aurora, Colorado. “Because these positions were never posted nor filled, the VA is now using a crisis nursing model where one ICU nurse cares for three patients with the help of a nursing assistant or a nurse without ICU experience and knowledge. This crisis model means nurses are unable to provide the optimal time, care, and dignity to each of these critically ill patients. In addition, the staffing crisis has forced us to cut the number of ICU beds from 18 to 12, which means the veterans are diverted to other hospitals.”

Who: VA registered nurses from across the country
What: RNs to hold informational picket and rally
Where: Department of Veterans Affairs headquarters, 810 Vermont Ave. NW, Washington, D.C. 20420
When: Thursday, June 6 — Picket at 12 noon, Rally at 12:15

According to the VA’s section 505 data, as of mid-March there were currently 66,000 vacancies across the health care system, of which more than 13,000 are nurse positions. Notably, the VA Office of Inspector General found in August 2023, that 92 percent of VA facilities reported severe shortages of nurses. While the VA has refuted the reports of a hiring freeze, calling it a “pause,” job offers are being rescinded and positions are not being filled or posted to ensure this is a “net zero growth” year for VA employees.

“In Tampa, the VA invested in a new tower with 136 beds, but we have not seen that investment in staff,” said Justin Wooden, an ICU nurse at James A. Haley Veterans’ Hospital in Tampa, Florida. “Right now, our ICU nurses are being pulled to help out in units across the hospital. Too often nurses are being asked to work in units where they lack the specialized knowledge, experience, and skills to provide optimal care to that specialized patient population. In addition, because we have no transport teams, or nursing assistants in ICU, when we have to take a patient off the floor to get a procedure or get blood, another nurse is then caring for three ICU patients. These stopgap measures are not safe for our patients, and undermine the care the VA and the nurses have committed to providing our veterans.”

In Albany, New York, nurses say the lack of ICU nurses poses a serious problem when there are emergencies in other units.

“As ICU nurses, we are expected to respond to code blues, rapid response calls, and stroke codes but we can’t leave our unit when we don’t have enough nurses to watch our patients,” said Tom Bewick, an ICU nurse at Albany Stratton VA Medical Center in Albany, New York. “Right now, we’ve had emergency room nurses come and care for our patients, but this puts patient safety at risk as these nurses don’t have the specialized experience and skills that we do to care for such fragile and complex patients.”

In April at the VA New York Harbor health care hospital in Manhattan, New York, the lack of staff nurses led to two nurses caring for 15 patients on a medical-surgical unit, (by comparison, California’s safe-staffing law mandates no more than five patients for one nurse in a medical-surgical unit.) Following the 12-hour shift, one of the nurses was then mandated to stay and work overtime as there were not enough nurses scheduled to work that night.

“We are worried sick about what is going to happen to our hospital in mid-June when 70 percent of our float pool nurses will be sent to work in our community living center (CLC),” said Shana Rivera, a registered nurse at the Cincinnati VA Medical Center. “The nurses in the float pool were hired to fill in the gaps in the medical-surgical and intensive care units and once they’re moved, that will create critical shortages throughout the facility. It is a nightmare.”

Even as nurses face this current staffing crisis, studies continue to highlight the high quality care that veterans receive through the VA, a difference that can mean life or death. A study published last December found that veterans who were hospitalized in the VA system had significantly lower 30-day mortality for heart failure and stroke compared with those in non-VA facilities. A 2022 study found that mortality rates are far lower for veterans who are treated in VA emergency rooms than for veterans who are treated in other hospitals.

Nurses understand the VA is currently facing an existential threat as a result of the private sector siphoning off billions of dollars from the VA, and the department is now cutting services and refusing to hire much-needed staff.

This privatization of veteran care was unleashed by the passage of the 2014 Choice Act and the 2018 MISSION Act and currently, there are estimates that the VA owes between $4 and $5 billion to the private sector. The VA’s own “Red Team” Executive Roundtable analysis reported the cost of care to the private sector rose to $30 billion dollars in fiscal year 2023. The authors noted the cost of this private sector care “threaten[s] to materially erode the VA’s direct care system and create a potential unintended consequence of eliminating choice for the millions of Veterans who prefer to use the VHA direct care system for all or part of their medical care needs.”

Fearing further unchecked privatization and citing the lack of oversight or scrutiny of private providers, nurses are opposed to the Senator Elizabeth Dole 21st Century Healthcare and Benefits Improvement Act (H.R. 8371). The proposed legislation would allocate nearly a billion dollars of taxpayer money to be spent on  private-sector care. Nurses say this money would be better spent resourcing and strengthening the VA.

“We know we at the VA are best qualified to care for our nation's veterans,” said Irma Westmoreland, a registered nurse at Charlie Norwood VA Medical Center in Augusta, Georgia. and NNU vice president and Veterans Affairs chair. “But we need the resources to be able to provide care that honors their services and their sacrifices. When we don’t have enough staff we are effectively cutting services to our veterans. That is why we are calling on the VA to lift this hiring freeze, so we can get back to doing what we do best: providing holistic, specialized, veteran-centric care to our nation's heroes.”

NNOC/NNU represents more than 15,000 registered nurses at 23 VHA facilities across the country, many of whom are veterans themselves.

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