Summary: Pursuant to a congressional request, GAO evaluated nursing personnel's concerns about working conditions at the Department of Veterans Affairs' (VA) Medical Center in Albuquerque, New Mexico, focusing on: (1) staff shortages; (2) pay; (3) patient care and safety; and (4) management attitudes.
GAO found that Albuquerque Center management: (1) steadily reduced the nurse vacancy rate from a February 1988 peak of 45 vacancies for registered nurses (RN) to a July 1989 vacancy rate of 21 RN, 11 licensed practical nurses, and 1 nursing assistant; (2) granted flexible work schedules, increased entry-level salaries and the pay scale, approved differential pay, and hired additional staff, but did not always timely fill vacancies and additionally authorized positions; (3) conducted salary surveys to determine its competitiveness with area hospitals; (4) could not act on such pay issues as administrative differential for head nurses, special pay advances, pay differential for nursing assistants, and recruitment and retention bonuses without VA headquarters approval or legislation; (5) increased awards to nurses for superior performance; and (6) has not addressed concerns regarding poor inventory control, a high number of nursing staff injuries, temporary assignment of nurses to other wards, excessive paperwork requirements, and physical requirements for newly hired personnel and injured personnel returning to work. GAO also found that: (1) the nursing shortage did not seriously jeopardize patient care and safety; (2) VA corrected many of the quality-of-care deficiencies the nurses noted; and (3) monthly meetings between Center personnel and the union representing Center RN did not generally address difficult issues, and the union expressed distrust of Center management.
