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Michael E. DeBakey VA Medical Center - Houston, Texas

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Nurses at Houston VA Make Long-term Commitment to Care for Veterans

July 7, 2004

Nurses at Houston VA Make Long-term Commitment to Care for Veterans

Compared to nationwide staff RN vacancy rate of 15%, MEDVAMC's rate has held steady at 1.7%

Released: 2004/07/7

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"I feel good working for our nation's heroes. They deserve the best. I enjoy working here - I feel like the veterans, my co-workers, my supervisors are my family. Everyone is so supportive in getting things done. The Chief Nurse Executive Ms. Leftridge always has her door open to listen and solve problems," said Nursing Unit 3B Charge Nurse Irma L. Vives, RN. Vives (above) has been a nurse on MEDVAMC inpatient units for 20 years. MEDVAMC chief nurse executive developed a three-part plan to recognize and support staff RNs who have demonstrated commitment to working on inpatient units. The initial results of this plan have been encouraging. The RN vacancy rate at the MEDVAMC has held steady at 1.7 percent. This number is remarkable when compared to the results of the 2002 American Health Care Association Nursing Position Vacancy and Turnover Survey, which found nationwide, the vacancy rates among staff RNs averaged 15 percent.

photo by Bobbi D. Gruner, MEDVAMC Public Affairs Officer

HOUSTON, TX - It is a recognized fact that availability of nursing staff has a significant and critical impact on patient care outcomes, especially in an inpatient setting. With many VA nurses approaching retirement age and the nationwide nursing shortage, the Michael E. DeBakey VA Medical Center (MEDVAMC) is examining ways to improve financial and professional incentives to attract and retain a qualified work force.

As the focus of health care has evolved and changed, the demand for staff in outpatient settings has increased. Many registered nurses (RNs) have transferred to these settings, leaving a large number of vacancies on inpatient units. With input from staff nurses and MEDVAMC nursing leadership, the MEDVAMC Chief Nurse Executive Deloris Leftridge developed a three-part plan to recognize and support staff RNs who have demonstrated commitment to working on inpatient units.

The initial results of this plan have been encouraging. The RN vacancy rate at the MEDVAMC has held steady at 1.7 percent. This number is remarkable when compared to the results of the 2002 American Health Care Association Nursing Position Vacancy and Turnover Survey, which found nationwide, the vacancy rates among staff RNs averaged 15 percent.

The first part of the plan included hiring 10 patient support clerks (PSC). These multi-skilled workers provide support on the inpatient nursing units and are responsible for such duties as escorting patients, providing clerical duties, and running errands off the unit. These tasks can sidetrack RNs and take them away from the patient bedside. The PSCs are assigned to different units each day in order for all units to benefit from their services.

The second part of the plan centered around hiring five admission nurses. On average, the MEDVAMC admits 30 to 50 patients each day. RNs are responsible for completing a lengthy, computerized nursing admission assessment screening on each patient. The new admission nurses now assist with completing the admission screens before patients arrive on the units. Unit staff members still admit patients that the admission nurses are unable to see, but these specialty nurses have made a very noticeable and positive impact on RN workload, taking care of 50 percent of daily admissions.

Under the final part of the plan, RNs on inpatient units now receive a monetary bonus each quarter.

In addition to this three-part plan, Leftridge identified another area where nursing staff could be better used. She saw that during each tour of duty, nurses made numerous trips to the pharmacy for medications and supplies. Leftridge investigated the use of automation to relieve these long hikes and discovered robotic couriers.

These "helpmates" transport medications and supplies from the pharmacy to various nursing units within the hospital, decreasing the time-consuming errands nurses needed to run. MEDVAMC is the only hospital in the Houston area to have these robotic helpmates.

MEDVAMC nursing executives have already seen the advantages of having the robots work in the facility. The amount of time nursing staff spend away from the unit to obtain missed or discharge medications has been dramatically reduced.

The MEDVAMC's three-part plan to attract and retain highly skilled and essential nursing staff and the new state-of-the-art robotic couriers all mean more efficient use of valuable nurses, better customer service to veterans, and improved patient care.

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Point of Contact: VHAHOU Public Affairs

06/17/2004