Nearly one in 10 VA registered nurses quit in 2014, GAO says

Nearly one in 10 VA registered nurses quit in 2014, denting the department just as it’s trying to ramp up its efforts to treat a surge of veterans and correct the waiting list scandal that had led to some veterans being denied timely care, according to a government watchdog report.

Veterans Affairs needs to hire about 40,000 new nurses just to keep up with the additional patients, but 9.1 percent of the existing R.N. workforce quit last year, the Government Accountability Office said.

And 20 percent of the VA’s nurses will be eligible to retire over the next four years, said the report released Friday.

The Veterans Health Administration had been trying to hire nurses and figure out ways to keep them, but the programs aren’t being studied properly so the agency has no idea how well they are working and what more can be done, the report said.

“Without evaluations of its collective system-wide initiatives, VHA is unable to determine to what extent its nurse recruitment and retention initiatives are effective in meeting VHA policies and the Veterans Access, Choice, and Accountability Act provisions, or ultimately whether VHA has an adequate and qualified nurse workforce at its medical centers that is sufficient to meet veterans’ health care needs,” the report said.

VHA nurse recruiters have also said they feel they are not supported by the administration and often don’t receive real training that leaves them uncertain about how to do their jobs properly.

The medical centers reviewed by the GAO say that these recruitment and retention programs have been helpful, but the watchdog group was unable to substantiate that claim because of the lack of information about the programs’ efficacy.

Only one program is undergoing any substantive evaluation — the RN Transition to Practice program, which trains registered nurses that have only a year or less of professional experience. The program, which is set to expire in 2016, is required to be offered by any hospital that hires new nurses.

But because of a lack of budget for this, some medical centers have opted simply not to hire any newly credentialed nurses so that they don’t have to offer the program and pay for it.

However, that was just not an option for more rural medical centers that have a hard time hiring nurses, because there are only so many qualified ones in the area. As a result, they could not always find enough qualified instructors to train the nurses they did hire with less than a year of experience.

Nurses who left the VA cited better jobs in the private sector and unhappiness with the federal department as major reasons.

“Officials from one medical center and its union reported high levels of nurse dissatisfaction with medical center leadership as a result of recent investigations, including by VA’s OIG, examining access to care issues in the facility,” the report read.

The VA has been under fire since early 2014 when it came to light that more than 40 patients had died waiting for care at a Phoenix hospital. After the scandal, former chief Eric Shinseki was ousted and replaced with current head Robert McDonald, who has struggled to change the perception of the agency. His new deputy, Dr. David Shulkin, has been leading the Veterans Health Administration since June.

The VA said they would act on the GAO’s recommendations to develop a better process to monitor and evaluate how these recruitment and retention programs were working in order to improve them. The GAO also suggested that the agency train its recruiters.