National Center for Healthcare Advancement and Partnerships
OCE Partnerships and COVID-19
2020 is Year of the Nurse, and VHA is hiring more nurses during the coronavirus pandemic
As the coronavirus pandemic has changed many aspects of daily life, the U.S. Department of Veterans Affairs (VA) has executed its “Fourth Mission” every step of the way—that mission is to improve the United States’ preparedness for response to war, terrorism, national emergencies, and natural disasters by developing plans and taking actions to ensure continued service to Veterans. The aim of the Fourth Mission is also to support national, state, and local emergency management, public health, safety, and homeland security efforts.
One of the ways VA and the Veterans Health Administration (VHA) have contributed to Fourth Mission relief efforts during COVID-19—a national emergency and matter of public health—is by hiring more nurses to support patient health care. VHA’s Office of Nursing Services (ONS) and VHA’s Workforce Management and Consulting Office (WFM) collaborated to hire and onboard more nurses, and also instituted best practices in surge support and crisis staffing models. This collaboration can serve as a model for many other health care professions who need to hire essential staff quickly.
“We knew that nurses would be the largest professional group we would need during this pandemic,” said Dr. Beth Taylor, VHA’s chief nursing officer. “But [we knew that] most likely, we would not have enough nurses.”
In March, VHA’s ONS and WFM worked together to conduct more than 2,300 screenings and interviews for nursing staff. Subsequently, 67 registered nurses, 15 nurse practitioners, three nursing assistants, two student nurse technicians, and one certified registered nurse anesthetist were hired in high-need areas as part of the Travel Nurse Corps (TNC), which is an internal pool of registered nurses who are available for temporary short-term assignments at VA medical centers across the country. These individuals were brought onto 120-day appointments as VA employees, and have an option to extend the employment beyond the 120 days if needed; several have been hired as full-time employees.
Once candidates reached the interviewing and hiring stages, ONS and WFM coordinated with professional nurses across the entire VA system who helped with interviewing, onboarding, credentialing, and deploying the nurses—this process, Dr. Taylor said, “couldn’t happen quickly enough,” and the team was doing something they had never done before, all in a “virtual space,” due to social distancing restrictions during COVID-19. Nationally, VA medical center staff are continuing to review the applications and offer positions to address local need.
Nurses are critical during a public health emergency such as COVID-19 because they “account for more than half of all the world’s health workers, and are at the forefront of fighting epidemics and pandemics that threaten health across the globe,” according to the World Health Organization (WHO), which has designated 2020 as the International Year of the Nurse and the Midwife. The year 2020 is the 200th anniversary of the birth of Florence Nightingale, the founder of modern nursing.
Dr. Tracy Weistreich, nurse executive for VHA’s Office of Community Engagement (OCE), was one of the nursing professionals who helped screen nursing candidates who had applied to staff positions.
“What the process highlighted for me was the amazing internal partnership between ONS and WFM, and the ability to mobilize the entire enterprise to pull in experts across the health care system to make this happen,” said Dr. Weistreich.
Dr. Taylor explained that VA sought flexibility with regard to nurses’ compensation during this exceptionally challenging time. During this hiring surge, VA was able to coordinate relief from salary caps and provide additional compensation to nurses in places such as Los Angeles or San Francisco, where there were large numbers of hospitalized Veterans diagnosed with COVID-19 and associated complications.
ONS was able to model aspects of surge and crisis staffing models for facilities that were trying to organize their local resources during the pandemic.
“People in the nursing world were really excited and enthusiastic,” Dr. Taylor said. During the COVID-19 pandemic, Dr. Taylor continued, “Everybody has said, ‘How can I help?’ Everyone was willing to step up and say ‘Of course.’ That’s something I think I will always take with me.”
Since this initial push of surge hiring during the pandemic, ONS has been working with the VHA Office of Healthcare Transformation to stand up an interprofessional group that will look ahead to how surge hiring will be used in the future.
“How should we structure gap coverage for nursing? What should it look like to position us in a way to achieve [VHA Executive in Charge] Dr. Stone’s vision of being a very agile learning organization and being able to meet the care demands of Veterans, regardless of what presents?” Dr. Taylor said. “We have an opportunity to evaluate all the dynamics that contributed to [the amount of nurses hired during the past few months], so VA will be in a much better place going forward.”
Dr. Taylor said it has been inspiring to see how nurses throughout the country have been working during the pandemic. One TNC nurse, she said, was deployed to the Indian Health Service in Arizona, and has been adapting to working in a very remote area with a specific population by learning the language that is spoken there. Another nurse, deployed to Chicago, used her language skills in French to read poetry to a French-speaking patient who was near the end of life
“That’s the epitome of what we do in nursing,” said Dr. Weistreich. “We remain flexible, we remain agile, we remain committed to taking care of the patient and getting done what needs to be done.”
To learn more about ONS, please visit: https://www.va.gov/nursing/.
To learn more about OCE’s partnership work throughout VHA, please visit: https://www.va.gov/healthpartnerships/.
Nurses who are interested in applying to work at VA should visit USAJOBS.gov.
Posted August 28, 2020