The president of the American Association of Nurse Anesthesiology (AANA) issued the following statement in response to a bill designed to prevent Certified Registered Nurse Anesthetists (CRNAs) from practicing to the full extent of their licensure in the Veterans Health Administration (VHA). AANA President Dina Velocci, DNP, CRNA, APRN, is calling on Congress to reject this “dangerous legislation and support our veterans’ access to the highest quality care.” Full statement:
“Today, allies of the American Society of Anesthesiologists introduced a bill to deny, delay, and disrupt veterans’ access to care in the middle of a public health emergency. In a direct attack on CRNAs, who have been serving on the front lines of the COVID-19 pandemic, the bill would limit the ability of the Veterans Administration (VA) to allow CRNAs to provide care to veterans. The bill would benefit physician anesthesiologists at the expense of our veterans and in denial of all available evidence and data. Reports from the VA Office of the Inspector General have shown dozens of facilities citing shortages of anesthesia staff, and on the ground evidence shows that overly onerous supervision requirements have caused delays and denials of care for veterans.
AANA strongly opposes this misguided legislation that would only serve to hurt veterans’ access to care. All available evidence shows that CRNAs working independently are the most cost-effective method of anesthesia delivery and the safest, which is why CRNAs are able to practice independently in every branch of the military and why 49 states do not require the involvement of physician anesthesiologists in CRNA practice. This is why multiple Veterans Service Organizations (VSOs) supported CRNA full practice authority in 2016 and why several VSOs have testified in support of national standards of practice that would allow CRNAs and other providers to practice to the top of their scope.
The move to eliminate CRNA full practice authority within the VA is being done without the health and wellbeing of our nation’s veterans in mind. While CRNAs provide the most cost-effective and timely access to highest quality care, we do recognize the need to have both physician and nurse anesthesiologists providing anesthesia collaboratively to our veterans, moving away from antiquated delivery models that have one qualified provider overseeing another qualified provider. Any model that unnecessarily restricts CRNA practice will only increase costs, delay care, and adversely affect veterans. At a time when the healthcare system is seeing overwhelming levels of retirements and burnout, stressing the workforce, and limiting care, the ASA and their allies are seeking to further limit care and put veterans at risk for their own benefit.
This is an unconscionable bill meant to slander nurses and hurt veterans.”
More than 1,100 CRNAs currently work in the VA. CRNAs have historically provided much of the anesthesia delivery to active-duty military in combat arenas since World War I and predominate in veterans’ hospitals and the U.S. Armed Services, where they enjoy full practice authority in every branch of the military. CRNAs have been in high demand during the pandemic, due to their skill in ventilator and airway management, as well as anesthesia and pain management. Information on CRNA safety and cost efficiency is available at anesthesiafacts.com/the-research.
Every VAMC has a designated women Veterans program manager to help women Veterans access VA benefits and health services
Women are the fastest-growing segment of the U.S. Veteran population, and we’re ready to provide them with high-quality health care delivered by dedicated women’s health providers.
To encourage servicewomen who are transitioning out of the military or are new Veterans to enroll in VA health care, we’ve kicked off a new, online women’s health transition training program. The training provides a detailed look at all of the VA health services and programs available to women Veterans. The program also covers information about eligibility, how to enroll in VA health care, and how to connect with other women Veterans.
The training is designed to complement VA’s Transition Assistance Program (TAP) and is based on an in-person and virtual program started as a joint effort between VA and the Department of Defense.
Some of the health services available to women Veterans include reproductive care, maternity care, cancer screenings, whole health and mental health services for issues including military sexual trauma, domestic violence, post-deployment adjustment and post-traumatic stress disorder.
Every VA medical center (VAMC) has a designated women Veterans program manager to help women Veterans access VA benefits and health care services. Each VAMC also has a health care professional available by phone 24/7 to answer health-related questions and offer advice.
Advancing women’s health
A lot has been happening on the women’s health front at VA, which increases our need for professionals in this field. For instance, we’re partnering with other federal agencies, academic institutions and private health care companies to improve prevention, treatment and outcomes for women Veterans with cancer. We created the Women’s Health Mini-Residency for Primary Care Rural Providers and Nurses. The program aims to increase skills related to women’s health among nurses and providers serving rural communities. Research on women Veterans’ health is expanding, and deployment and post-deployment health research is now a major part of the VA women’s health research portfolio.
We’re also actively recruiting more health care providers with expertise in women’s health to participate in these initiatives and help serve the growing number of women Veterans seeking care.
Dual mission
If you want to serve Veterans and are interested in promoting and protecting women’s health, VA is the place for you! Not only will you get to fulfill a rewarding dual mission and win the gratitude of Veterans you care for, you will:
Receive excellent benefits, including a generous health care and retirement plan.
Have opportunities to advance your education and career with financial support from VA.
Be able to contribute to innovations and research that improve the health and quality of life for all Veterans.
New nurses can say good-bye to first-job jitters knowing they’ll have a year of dedicated time to train, learn and grow through VA’s nurse residency program.
Instead of typical on-the-job training, participants in the program have 100% protected training time for 12 months. Hundreds of nurses at more than 100 residency programs across the nation go through the program each year.
The only nursing traineeship model of its kind, our Office of Academic Affiliations (OAA) Nurse Residency Program is designed to help newly licensed registered nurses (RNs) and nurse practitioners (NPs) prepare to address the unique health care needs of Veterans.
“What benefited me the most from doing the OAA RN residency was the ability to ease myself into practice at a controlled pace while simultaneously learning additional skills,” said residency graduate Nathaniel Cline, BSN, RN, who is now a surgical intensive care unit nurse at Birmingham VA Medical Center.
Ease the Transition
The program is “a bridge from a solid academic foundation to clinical practice, and it allows new nurses to focus on identifying their strengths and weaknesses, and enhance their skills and knowledge,” said Director of Nursing Education Jemma Ayvazian, DNP, ANP-BC, AOCNP.
Graduates leave the program as competent, confident health care professionals with the “knowledge and skills to successfully practice in today’s complex, fast-paced health care environment,” Ayvazian said.
Though it’s not required, most decide to stay at VA when their residency is complete.
Now a medical/hematology/oncology nurse at the Milwaukee VA Medical Center, Kelsey Greuel, BSN, RN, not only stayed on at VA, but quickly moved into leadership roles. She now serves as Nurse Executive Council RN co-chair.
“The OAA RN residency program provided me with the tools and experiences I needed to become a well-rounded nurse, find my passion in nursing and introduced me to lifelong friends,” she said.
Supportive Atmosphere
Outside their residency, nurses will find a culture of support and camaraderie throughout VA. The residency program wasn’t in place when Ayvazian began her nursing career, but helpful mentors at VA were there to guide her.
“VA has the most diverse and dedicated team of health professionals, and I am honored and proud to serve shoulder-to-shoulder with them,” she said.
At VA, nurses are a key part of health care teams united by a common mission – serving the nation’s heroes.
“I never considered working anywhere else. Working at VA is more than just a place of employment for me; it has a deeper purpose and meaning,” said Ayvazian, who is married to a service-connected disabled Operation Iraqi Freedom Veteran.
Work at VA
Ease your transition into your first job with VA’s nursing residency program.
Working as a long-term care nurse at VA, you’ll help provide a home away from home for Veterans needing around-the-clock skilled nursing care
VA’s community living centers are a home away from home for Veterans in need of around-the-clock skilled nursing and medical care.
At more than 100 centers across the nation, we help Veterans get back on their feet, care for those suffering from dementia and other cognitive issues, and provide palliative and end-of-life care.
Working as a long-term care nurse with this unique patient population is a career that comes with plentiful rewards.
“Long-term care nursing is a specialty. Being in this trusted position as a long-term care health care worker is to be at the forefront of health care delivery,” said Melissa Lasley, RN, nurse recruiter for the VA Maine Healthcare System.
Consider a VA career
Lasley doesn’t just have one reason to consider a career caring for Veterans at one of our community living centers – she has 12 of them.
It’s rewarding. “After finishing a day of work in dementia care, I leave my shift knowing I made a difference in the residents’ quality of life. At times, it feels rewarding in small ways, like de-escalating an anxious resident or engaging them in an intervention. Other times, it’s by being with the resident during their final hours and helping them to connect with family members. In all ways, big and small, we make a difference.”
It’s refreshing. “Residents have often given up caring about what people think and, therefore, say exactly what they mean.”
It’s entertaining. “They have amazing stories. Even Veterans with relatively advanced dementia can recall events from distant past, and it can be good for them to do so, so just ask.”
It’s important work. “As of 2017, the number of Veterans living with dementia was more than 750,000. An estimated 420,000 additional cases were diagnosed between 2010 and 2020. This is a critical mass of heroes, each of whom deserves quality care.”
It’s an honor. “When working with seniors, we often come across those who have lived through loss, immigrations, wars and much more. With all their life history, I always feel thankful and honored that I am entrusted to get to know them and provide the best possible care I can.”
It’s challenging. “Working with clients with dementia is something that not only requires experience and training but continued professional development over time. There is so much to learn about working with this population and room for continued improvement.”
It’s a specialty. “Nurses can develop a sense of pride in becoming an expert in geriatric care, just as they can with any other specialty. When an elderly patient experiences trauma, goes into anaphylactic shock or contracts a urinary tract infection, the clinical picture is far different from that of a 30-year-old. Having the knowledge to quickly assess and treat problems can drastically improve the quality of life for our Veterans.”
It’s a learning opportunity. “Veterans teach us from the moment we first meet. Often, it is just by being witness to their story. Other times, Veterans take on a teacher-like role, which may help them feel empowered, autonomous or a reconnection with their sense of self. From my work in dementia care, I’ve learned that I shouldn’t take life so seriously, laughter and humor are key, courage can always be found, and feeling connected is everything.”
It’s about the moment. “The reality of working with Veterans who have dementia is they may not recall working with you or having met you the week prior. This means our goals and objectives often need to pertain to a resident’s quality of life within the given moment rather than from week to week.”
It’s all about connection. “Building a trusting therapeutic relationship with resident Veterans is of key importance, and building a connection sometimes takes more than verbal interactions. A typical conversation is not always possible. Sometimes, connection is accomplished simply through a calming presence and a gentle approach.”
It’s someone’s parent. “Yes, this is sentimental, but the Veteran geriatric population have some miles on them. They may have fought in wars, raised families and experienced loss. Call it karma or responsibility, but when I care for geriatric Veterans, I hope when my family members grow old and sick, someone takes good care of them too.”
It’s thought-provoking. “Making connections with Veterans who have dementia is about much more than following rules and standards on building rapport; it’s about an intuitive feeling they perceive from your intentions when you approach. After caring for many within the geriatric population and likely attending their deaths, it’s difficult not to be drawn into wondering what amends, regrets and triumphs YOU will have at the end of your life.”
Cutting edge of care
If you need a 13th reason to pursue a career in long-term care nursing at VA, consider this: our community living centers are on the forefront of change.
VA Maine and many other centers are transitioning to a more patient-centered culture based on the needs and preferences of Veterans. At VA Maine, they will be breaking ground soon on a “small house,” similar to the Green House models adopted at some of our other community living centers.
These cozy buildings are designed to house small groups of Veterans and include community kitchens and dining rooms, private rooms and bathrooms, and ample outdoor living space.
“All are an important part of the holistic approach to caring for our Veterans, providing a home setting they are comfortable and proud to live in,” Lasley said.
Work at VA
Give back to a generation of Veterans who has provided so much for their country. Explore a long-term care nursing position with VA.
In honor of National Nurses Month and in celebration of VHA’s 75th anniversary, VA thanks its nurses and highlights nursing career opportunities
VA nurses make a profound impact on the lives of Veterans every day – and this has never been truer than during the challenges of the COVID-19 pandemic.
“Our nurses have made extraordinary personal and professional sacrifices while providing heroic service to Veterans over the past year, going above and beyond to care for those in need during a global pandemic,” said Darren Sherrard, associate director of VA recruitment marketing.
By delivering the highest quality care to Veterans every day, they give us 112,400 plus reasons to celebrate this momentous occasion. Need another reason to celebrate? It could be you. Choose a nursing career at VA and make a lasting difference for Veterans today.
The heart and soul of VA
Nurses are at the center of VA care. We could not provide patient-centered, high-quality health care to millions of Veterans without the dedication and hard work of these invaluable medical professionals.
They work across disciplines and in all treatment settings, including hospitals, ambulatory and skilled nursing. They play a critical role on our Patient Aligned Care Teams (PACTs), helping coordinate the full spectrum of patient care. And they do it with compassion and capability that lifts the spirits of their patients.
We encourage nurses to advance in their careers and contribute to our culture of improvement and innovation. Nurses often rise to leadership positions, helping create new models of care, introducing new nursing roles and advancing existing ones. There are plentiful opportunities for nurses to collaborate with colleagues – sharing tools, evidence-based practices and the lessons they’ve learned.
“Each day I am honored to use the advanced expertise I have attained, as well as continuously seek new knowledge to fulfill our vision of advancing nursing and transforming health care,” said Heather Arredondo, DHA, RN, VHA-CM, program manager for professional standards boards in VA’s Office of Nursing Services.
Rich rewards
As a VA nurse, you’ll discover more than a job – you’ll discover a mission of service. You’ll enjoy a fulfilling career with competitive pay, perks and rewards that only add to the satisfaction of giving back to those who have given so much to our country.
You’ll have unparalleled opportunities for professional growth and plentiful chances to positively impact health care. In addition to the chance to move into a leadership role, you can advance your education, mentor and be mentored, and conduct research.
Other benefits include robust health insurance (including vision and dental), life and long-term care insurance, student loan reimbursement, continuing education and generous retirement. We also offer flexible scheduling, a generous leave plan and paid family leave for new parents.
What’s more, with one active, unrestricted U.S. license, you can practice anywhere in the country and move VA locations without losing any benefits or accumulated leave.
Work at VA
Are you ready to help us heal and care for Veterans so they can thrive in life after military service? Apply for a job as a VA nurse.
