Registered nurses (RNs) are the largest group of healthcare providers employed by the U.S. Department of Veterans Affairs’ (VA) healthcare system. RNs are relied on to deliver inpatient care, but VA medical centers (VAMC) face RN recruitment and retention challenges. The Government Accountability Office (GAO) performed a Web-based survey of all VAMC nurse executives; interviewed VA headquarters officials and VAMC nursing officials, and conducted RN focus groups at eight VAMCs visited by GAO.
The GAO report states that VA’s ability to retain its RNs is adversely affected by two main factors. First, inpatient RNs reported that they spend too much time performing non-nursing duties such as housekeeping and clerical tasks. Second, even though VAMCs were authorized in 2004 to offer RNs two alternate work schedules that are generally desired by nurses--such as working three 12-hour shifts within a week that would be considered full-time for pay and benefits purposes--few nurse executives reported offering these schedules; therefore, few RNs work these schedules.
Specifically, according to nurse executives GAO surveyed, only about one percent of many inpatient units offered alternate schedules and less than one percent of RNs actually worked these schedules. The availability of flexible work schedules--for example, working eight 10-hour shifts over a 2-week period--are more widely available among VAMCs but are still limited, according to GAO’s survey of nurse executives. Nursing officials and RNs noted other factors affecting retention such as reliance on supplemental staffing strategies--for example, RN overtime--and insufficient professional development opportunities.
