Testimony by Ann Converso, RN, President, United American Nurses, AFL-CIO, Before the Subcommittee on Health, House Committee on Veterans’ Affairs, Legislative Hearing...

I would like to thank the chairman, ranking Republican member, and members of the committee for the opportunity to provide testimony for the Legislative Hearing on H.R. 4089, H.R. 4463, H.R. 5888, H.R. 6114 and H.R. 6122. My name is Ann Converso and I have been a registered nurse in acute medical/surgical units and later I.V. therapy at the VA Western New York Health Care in New York's VISN 2 region for more than 30 years. I have also been an active member of my union, the United American Nurses (UAN), AFL-CIO, during that time. I am testifying today as the President of the United American Nurses, a union representing registered nurses -- 6,000 of whom are VA nurses.

There exists a health care crisis in our country regarding the shortage of registered nurses. A 2002 report by the Health Resources and Services Administration states that by 2020, hospitals will be short 808,416 RNs. In a 2002 survey by the United American Nurses, three out of every ten nurses said it was unlikely they would be a hospital staff nurse in five years. The VA health care system has by no means been immune to the shortage.

As nurses leave the VA system, new nurses are not joining the VA at comparable rates, and patient load is increasing. In its own report, "A Call to Action," the VA states that it must replace up to 5.3 percent of its RN workforce per year to keep up with RNs retiring. By all accounts, that is not happening. In its website documentation of system-wide capacities, VA statistics show that between 1996 and 2002 the number of full-time-equivalent RNs went down by 8.4 percent. During that same time period, the number of "unique patients" treated at the VA went up by 55 percent.

In my years as a VA nurse, I have experienced several nursing shortages firsthand. I believe I speak for other VA nurses when I say that we love our jobs and the important work we do in caring for our nation's veterans. With that said, registered nurses are leaving the bedside in favor of the many other job options now available to us, from clinic jobs, outpatient jobs, computer jobs, quality management, doctors' offices, pharmaceutical jobs or leaving nursing entirely. A contributing factor causing registered nurse to leave the VA is problems they are experiencing with section 7422 of title 38.

Congress amended Title 38 to provide medical professionals who work at VA facilities with collective bargaining rights, which include the rights to use the negotiated grievance procedure and arbitration. Under 38 USC, section 7422, covered employees can negotiate, file grievances and arbitrate disputes over working conditions except “any matter or question concerning or arising out of”:professional conduct or competence (defined as direct patient care or clinical competence; a peer review; or the establishment, determination, or adjustment of employee compensation.

Increasingly, VA management has interpreted these exceptions very broadly, and has refused to bargain over significant workplace issues affecting medical professionals. Recent court decisions are upholding VA’s broad reading of Section 7422, even when management raises it after completion of the arbitration process.

Congress passed this law in 1991 to strengthen the bargaining rights of VA medical professionals. By its own admission, the VA recognizes the critical role that health care professionals play in improving quality of care. According to the VA Office of Nursing, “VA nurses have been widely recognized for their instrumental work in initiating, developing, implementing, and monitoring the practices and policies that made VHA one of the world’s foremost authorities in patient safety and quality outcomes evidenced by performance measures – an exceptional achievement by any assessment.” (DVA website, April 30, 2007)

In practice, VA health care professionals have a shrinking role in quality assurance and patient safety. Too often, the Human Resource staff is making health care decisions instead. The VA’s current 7422 policy goes directly against good medicine and Congressional intent. Employees leave the VA for other public and private health care systems where they have more rights, which in turn pose’s a threat on recruitment and retention at the VA. Congress needs to amend section 7422 of Title 38 to ensure that the VA complies with Congressional intent and that registered nurses are able to care for veterans with dignity, respect and the basic bargaining rights they were intended to have.

To address this problem, Chairman Filner has introduced H.R. 4089, a bill that would improve collective bargaining rights of registered nurses in the Department of Veterans Affairs. This legislation has strong bipartisan support and currently has 22 cosponsors. I would like to thank Chairman Filner for introducing this legislation and let the Committee know that the UAN strongly endorses it. The UAN strongly urges members of the committee to support and work for the passage of this important legislation.

Thank you again for opportunity to provide testimony regarding this important issue. The UAN looks forward to working with the committee to protect registered nurses and the veterans they take care of.

Source: United American Nurses, AFL-CIO