The VA employs some 82,000 nurses, making it the largest employer of nurses in the country, and while the department will need even more in the years ahead, problems persist in how it fills those positions, GAO has said.
GAO said the VA nurse hiring practices issue is a long-standing one, citing a 2002 law requiring VA to develop a nationwide policy on staffing levels and skills mixes for the operation of its medical centers. Ultimately in 2010 the VA required each center to use a standard methodology and nurse staffing plans.
VA’s nurse cadre has grown by 13 percent over the last five years while annual turnover increased from 6.6 to 8 percent; the department projects it will need to hire about 40,000 more through 2018 to keep up with the growing demand for veterans’ care atop that turnover. Falling short of that staffing need would degrade patient care quality as well as morale of the nurses who are on board, GAO said.
In a review of seven medical centers, however, GAO found that all of them had experienced problems in developing and executing their staffing plans under the 2010 directive—some of which they were able to overcome, and some of which persist. Six of them, for example, cited lack of needed data resources while another six cited difficulty in completing and understanding training. Time constraints, budgetary constraints also were commonly cited, as was the general slowness of the hiring process itself.
GAO also found shortcomings in the way VA headquarters assessed the centers, and monitored and evaluated their compliance, among other issues.
The report is here: http://www.gao.gov/assets/670/666538.pdf
