With SDSU’s help, the VA is training modern-day Florence Nightingales to care for America’s war veterans

Five years ago this month, the United States invaded Iraq and created a new generation of war veterans.

Figures from the Defense Department indicate that since October 2001, 1.6 million American servicemen and women have been deployed to Iraq, Afghanistan and other countries to support the War on Terror. Nearly 4,000 were killed and at least another 1,900 suffered physical wounds. Moreover, Army studies indicate that up to 25 percent of returning soldiers display symptoms of serious mental health problems.

Nurse educator Rebecca Long, left, checks medical
supplies with students Kim Wraye, center, and
Estee Manio-Botine.

“This new generation of disabled veterans promises to be among the painful, expensive legacies of the Iraq war,” wrote Ken Dilanian, a former foreign correspondent for the Philadephia Inquirer.

Add these returning troops to the nearly 12 million surviving veterans of the Korean and Vietnam wars and Operation Desert Storm, and you have a sizeable group that will require specialized healthcare for decades to come.

But as veteran numbers grow, the nursing population continues to shrink, especially in California, where the per-capita ratio of nurses is the lowest in the country.

The Center for California Health Workforce Studies, based at the University of California, San Francisco, estimates that California’s nursing shortage will worsen through 2030, ranging from about 100,000 to more than 122,000 full time equivalent (FTE) nurses.

Partners with the VA

Hoping to recruit new nurses to care for vets, the Department of Veterans Affairs has partnered with four universities – including San Diego State – to establish a new VA Nursing Academy.

SDSU’s School of Nursing was chosen from among 42 applicants to participate in the venture with the VA San Diego Healthcare System. The School of Nursing’s director, Catherine Todero said the excellence of its programs and graduates made SDSU a natural choice for this high visibility program.

“Additionally, our proposal addressed a key issue in creating new nursing professionals – that is, the shortage of nurse educators,” Todero said.

The VA Academy grant will provide advanced practice nurses to help up teach and supervise SDSU students at San Diego’s VA hospital. Universities often have difficulty recruiting teaching nurses because they cannot match the salaries paid to advanced practice nurses.

With these new nurse educators and funds from the VA, SDSU can accept up to 20 additional students into its baccalaureate nursing program for each year of participation in the academy. (The School of Nursing expects to enroll approximately new 110 students in fall 2008.) In return, the VA San Diego Healthcare System hopes to recruit 15 nurses annually from the SDSU program.

Students in the academy will benefit from hands-on clinical experience, including opportunities for externships, virtual/simulated learning and professional training in a variety of specialties, such as mental health, women’s health, geriatrics, home care and spinal cord injury.

The SDSU Model

The VA Academy program in San Diego is modeled on a longstanding collaboration between SDSU’s School of Nursing and the VA San Diego Healthcare System (VASDHS).

In 2000, San Diego State launched Nurses Now, an initiative designed to address the nursing shortage in San Diego.

Rebecca Long, left, and student Kim
Wraye examine patient Lester Patton in
the VA San Diego Medical Center.

Local hospitals together gave SDSU’s School of Nursing several million dollars to hire additional faculty, and subsequently expand enrollment – by a whopping 80 percent in the last seven years. As a result, SDSU has graduated 300 additional nurses equipped to staff San Diego hospitals and healthcare systems.

A government entity, the local VA hospital was barred from donating dollars to Nurses Now. Instead, it developed an in-kind agreement through which VA advanced practice nurses were “released” to teach SDSU nursing students.

“Our existing collaboration with SDSU through Nurses Now was the foundation of our proposal,” said Carole Hair, program director of the VASDHS education service.

Other current Nurses Now partners are the Children’s Hospital and Health Center, Kaiser Permanente, Scripps Health, Sharp Healthcare, Tri-City Medical Center and UCSD Medical Center.

Legislative Efforts

While the VA Academy addresses the national shortage of healthcare workers trained to care for vets, California legislators are working to alleviate the dearth of nurses in the country’s most populous state.

State Senator Jack Scott has introduced a bill that would authorize California State University (CSU) colleges to independently award the Doctor of Nursing Practice (DNP) degree, which trains nurses for advanced nursing practice and prepares faculty to teach in postsecondary nursing education programs.

By allowing all California state educational systems – the CSU, the University of California, and California Community Colleges – to educate nursing faculty, the bill would add significantly to the total of nurses qualified to teach in the state.

In 2006, the American Association of Colleges of Nursing (AACN) found that 42,866 qualified applicants were turned away from baccalaureate and graduate nursing programs due primarily to a lack of nurse educators and scarce funding.

Rebecca Long, an advanced practice nurse at the VA San Diego Medical Center, and now a nurse educator for the VA Academy, has her own take on the benefits of teaching nurses to educate nursing students.

“What I love about this role,” Long said, “is that I’m able to continue to provide expert care via my clinical experiences with students and patients at the bedside. At the same time, I enjoy the exposure to an academic environment with opportunities to participate in lecturing and committee work. It really is a win-win for everyone, especially the students.”

Related information

• U.S. Department of Veterans Affairs
• Forecasts of the Registered Nurse Workforce in California
• CA Senator Jack Scott

Credits

• Story by Coleen Geraghty
• Graphics by John Signer and Jeff Ernst
• Photos by Tom Farrington