Last month, President Joe Biden signed into law the Sergeant First Class Heath Robinson Honoring Our PACT Act, a bill that expands the Department of Veterans Affairs’ high-quality health care and benefits to an additional 3.5 million veterans exposed to toxic chemicals during their service. The bill is another hard-won step toward fulfilling our national promise to, as President Abraham Lincoln put it, “care for him who shall have borne the battle.”

As a VA nurse, I understand that promise. This work is personal to me – my husband is a retired Army veteran and I’ve worked as a nurse in the Augusta VA Medical Center in Georgia for 34 years. Day in and day out, VA nurses – many of whom are veterans themselves – provide the highest-quality health care to veterans and their families. The passage of the PACT Act expands that care to millions more, and we are glad to see that veterans’ toxic exposures will finally be treated as a true cost of war.

But in order to support these additional millions of veterans, Congress needs to act immediately to give VA nurses the same rights as nurses in other hospitals. It can do so by passing the Veterans Administration Employee Fairness Act (HR 1948), sponsored by Rep. Mark Takano, a California Democrat who is chairman of the House Veterans Affairs Committee, and Sen. Sherrod Brown, D-Ohio. The bill would provide the same collective bargaining rights to VA health care professionals as other federal and private sector employees, giving registered nurses in VA hospitals the tools to speak up for patient safety and care. This bill will reduce turnover, increase staff levels, and improve the care that veterans receive.

My union, National Nurses United, stood alongside the many veterans, veterans service organizations and members of Congress who fought tirelessly over many years to make the PACT Act a reality because nurses understand how critical VA care is to our nation’s heroes. According to a recent study by Stanford researchers, veterans taken by ambulance to VA hospitals had survival rates at least 20% higher than veterans treated in non-VA hospitals.

The high-quality, holistic and veteran-specific care received by patients in the VA is a testament to the dedication and expertise of the clinicians working in these facilities. Unfortunately, it is already getting harder and harder for the VA to recruit and retain talented clinical professionals, due in part to a statute prohibiting VA nurses and other clinicians from having the same collective bargaining rights as nurses in private sector facilities, many state, county and municipal facilities, and Department of Defense hospitals.

Advocating for our patients often requires speaking up to management about issues in the hospital that affect patient care and bringing those issues to the bargaining table to get them fixed – for the good of both the nurse and the patient. Without the ability to have a full voice on the job, VA nurses consistently face working conditions that harm both nurses and patients, ranging from unsafe staffing levels to too many patients for the nurse practitioner in the Patient Aligned Care Team (Primary Care Clinics) encouraged by prolonged hiring processes to pay discrepancies between nurses doing the same job. 

Just last year, the Denver VA changed nurse schedules without any warning to nurses or patients, creating gaps in time where veterans couldn’t receive care from nurses who were completing their rounds. The nurses wanted to bring this issue to the bargaining table to discuss it with management but were unable to do so due to the current law preventing collective bargaining over any issues related to patient care. 

For registered nurses, union advocacy and representation allow us to focus on what we do best: caring for our patients. Without full collective bargaining rights, nurses’ ability to speak out on behalf of patients is reduced and threatened, and we are constrained from advocating for the highest quality of safe patient care that our veterans deserve. As workers on the front lines of patient care, nurses must have the ability to advocate for our patients and ultimately improve the quality and standard of care provided by the VA as well as the recruitment and retention of our peers.

As of the last quarter of FY 2021, the VHA had 8,577 nurse vacancies, and that was before the passage of the PACT Act that is set to bring millions more veterans into the VA system and into our care. Congress must pass the VA Employee Fairness Act immediately to ensure that those patients receive the highest-quality care possible from clinicians at the bedside who are free to speak up over patient care issues. 

Nurses are the heart and soul of any hospital, and there is no substitute for the care and attention that we provide for our patients. VA nurses want what is best for veterans. Providing nurses and other clinicians with full collective bargaining rights is the best way to ensure that problems in our VA hospitals are addressed and that our nation’s heroes receive the highest standards of care.

Irma Westmoreland is a registered nurse who has worked at the Augusta VA Medical Center for 34 years.

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