[Congressional Record Volume 150, Number 56 (Wednesday, April 28, 2004)]
[Extensions of Remarks]
[Pages E701-E702]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




   DEPARTMENT OF VETERANS AFFAIRS NURSE RECRUITMENT AND RETENTION ACT

                                 ______
                                 

                            HON. ROB SIMMONS

                             of connecticut

                    in the house of representatives

                       Wednesday, April 28, 2004

  Mr. SIMMONS. Mr. Speaker, today I am introducing legislation that 
would authorize several new and innovative initiatives to attract and 
retain nursing personnel in the Department of Veterans Affairs (VA).
  Since 1996, the number of patients treated annually by VA has risen 
by 70 percent. During this same period of growing demand for VA health 
care services, the number of nursing program graduates nationwide began 
to fall, along with the number of registered nurses employed in 
nursing. The latest U.S. Health Resources and Services Administration 
report projects that the shortage of nurses this year will reach about 
138,322 nationally, and will rise to about 808,416 in 2020.
  Today, about 7.6 million veterans are enrolled in VA health care and 
in 2010 it is estimated that this number will grow to approximately 8.4 
million. VA cannot meet the future health care burden for caregivers 
without an adequate supply of nurses in its 1,300 facilities. VA's 
nurse vacancy and turnover rates have greatly increased since 1998. 
Unless we create incentives and opportunities for experienced 
caregivers to choose VA as a professional career, our nation's veterans 
will suffer.
  First, my legislation would authorize a new initiative to improve 
VA's program for recruiting nurses through the use of outside 
recruitment, advertising, and communication agencies, and the use of 
interactive and online technologies. The federal government's 
recruitment process is not responsive to the market conditions for 
recruitment of nursing personnel. In order to address the human capital 
challenges in the VA, the Department needs better tools and strategies 
to plan, attract, assess, hire and manage its recruitment process for 
nurses. This pilot program would test whether such tools can fit VA's 
needs.
  The VA health care system has over 200,000 employees, ranking it 
among the top 25 largest employers as defined in the Hoover's Handbook 
of American Business. The VA health care system has more employees 
than, for example, Blue Cross and Blue Shield, the Kaiser Foundation 
Health Plan and Manor Care, Inc., and is the largest employer of 
registered nurses in this country. In the private sector, human 
resources professionals have developed and are successfully using 
internet-based recruitment tools, but VA's use of such tools is 
extremely limited. Forrester Research, an independent technology 
research company that provides advice about technology's impact on 
business, recently reported that 100% of Fortune 500 companies are now 
using online recruiting. It is in the best interest of VA to capitalize 
on this best practice of private industry. I believe that streamlining 
the recruitment process to offer nursing employment opportunities in an 
appealing and contemporary format will attract talented nurses to fill 
Department vacancies.
  The bill would enhance VA's ability to provide nurses flexible work 
schedules by authorizing three different options for alternative tours 
of duty to accommodate the personal needs of nurses to have more 
control over their schedules. Nurses are the front line providers of 
care and their continued dedication and support makes patients' lives 
better and doctors' jobs easier. According to an American Organization 
of Nurse Executives survey, a major cause of dissatisfaction in the 
nursing workforce is inflexible work schedules. Offering more family 
friendly schedules is critical to keeping experienced nurses employed 
in the VA.
  My bill would also clarify that the Department's policy for nurse 
recruitment should focus on the registered nurse's clinical 
competencies and direct patient care performance. If a nurse has 
presented or accomplished the required elements for VA employment, the 
lack of a specific educational degree should not be a factor in VA's 
hiring decision. Recent testimony before the National Commission on VA 
Nursing, established in Public Law 107-135, called attention to a 
concern that VA's policies under its nurse qualification standards 
discourage some nurses with associate degrees in nursing from seeking 
employment in VA because they are not judged for their experience and 
expertise, but are disqualified because they do not possess a 
baccalaureate degree in nursing.
  The American Association of Community Colleges reports that 62 
percent of employed staff nurses, including 45 percent in nurse 
clinician positions, 42 percent in clinical nurse specialist positions, 
52 percent in head nurse positions and 65 percent in nurse supervisor 
positions received their nursing educational preparation through 
associate degree or diploma nursing programs.

  Regardless of educational preparation, all nursing graduates must 
pass rigorous licensing examinations administered by state governments. 
Once licensed, they perform the identical scope of nursing practice 
under state law. A recent review of test data by the National Council 
of State Boards of Nursing indicates that the pass rates of nurses 
trained with associate and baccalaureate degrees are virtually 
identical. However, notwithstanding their years of bedside nursing or 
clinical proficiency, VA will not hire nurses above the entry Nurse 
Level I position unless they have baccalaureate degrees. VA is losing 
the opportunity to bring experienced, qualified nurses into its system 
because of this policy.
  Finally, the bill would make technical corrections and incorporate 
blind rehabilitation specialists in the list of certain positions that 
the VA is permitted to hire through use of the direct appointment 
authority provided in title 38, United States Code. The use of this so-
called ``hybrid Title 38'' authority enhances VA's ability to hire 
clinical staff in a timely fashion to maintain the necessary level of 
highly-trained staff.

[[Page E702]]

  It is vital for the health of our veterans that VA possesses the 
tools to employ and retain experienced nurses in the VA health care 
system. I look forward to seeing the VA nursing workforce grow as a 
result of the enactment of the measures contained in my bill and urge 
my colleagues to join me in supporting this important legislation.

                          ____________________