Inclusion Equals Innovation: How Our Diverse Workforce Offers Better Care

Inclusion Equals Innovation: How Our Diverse Workforce Offers Better Care

The VA knows that inclusion equals innovation. By ensuring that every Veteran receives care that matters to them and their whole health, VA providers and staff get to know each Veteran personally to provide better care tailored to the patient’s health and wellness goals.

All Veterans are different, and health care is not one-size-fits-all. However, diversity in VA personnel helps bridge the gap in health care disparities, an attitude adopted at the very top of their organization.

And the more diverse the VA workforce, the more tremendous success they’ll shareAnd the more diverse the VA workforce, the more tremendous success they’ll share

“To ensure a welcoming environment for Veterans, we must foster fair and inclusive VA workplaces where the experiences and perspectives of our diverse employees are valued,” says VA Secretary Denis McDonough. “The success of our mission depends on everyone being able to contribute their expertise, experience, talents, ideas, and perspectives.”

Investing in Inclusion

The Office of Academic Affiliations (OAA) plays a significant role in developing VA’s diverse workforce.

Healthcare professionals just starting in their careers can take advantage of health professions training and scholarship programs designed to increase job opportunities at VA for racial and ethnic minorities, improving healthcare experiences and outcomes for these groups.

OAA manages affiliations with more than 1,800 unique colleges and universities, including nearly 200 minority-serving institutions (MSIs). Approximately 20,000 health professions trainees from MSIs come to VA each year.

Additionally, the Veterans Healing Veterans Medical Access & Scholarship Program provides full scholarships to 12 Veteran medical students at Teague-Cranston Act and Historically Black Colleges and Universities in exchange for a four-year service obligation at VA.

Inclusion Leads to Innovation

The VA’s academic affiliations put them in a unique position to mentor and fund researchers from disadvantaged backgrounds who are motivated to make a difference in their communities, broadening career opportunities for those seeking to join the VA’s team.

Additionally, the VA recognizes that scientists and trainees from diverse backgrounds and life experiences bring different perspectives, creativity, and individual enterprise to address complex health-related problems. So the VA has developed funding opportunities in mentored research for junior VA investigators from underrepresented backgrounds. These research supplements pair early-career investigators with established VA researchers.

The supplements, supported by the VA’s Office of Research and Development (ORD), have led to research into virtual reality technology to help Veterans with mild cognitive impairment and repurposing existing drugs to treat substance use disorder, among others.

The Road Ahead

Supporting diversity, equity, and inclusion among the VA staff is an ongoing effort and a challenge that will continue in the future. As the VA celebrates its successes, they look ahead to further efforts that support and recruit a diverse workforce.

By integrating best practices into all the VA does to expand access to world-class healthcare services and to improve policies and procedures to reflect the diversity of those they serve, the VA continues to strengthen its efforts toward a safe and respectful workplace and healthcare environment.

Serving the most diverse group of Veterans in history, the VA reaffirms its commitment to hiring staff that reflects that diversity, ensuring that VA employees feel supported and providing equitable healthcare access for all.

VA Offers Nursing Opportunities For Education and Training

VA Offers Nursing Opportunities For Education and Training

With all that nurses do for our patients, it is only fitting that we do just as much for them, supporting nurses as they grow in their VA career.

Whether at the bedside of a Veteran or working in an outpatient clinic, our nurses deliver quality care and lead the way in innovating how we provide nursing care. Nurses also develop patient safety initiatives, conduct research to improve care delivery, and help guide the next generation of nurses.

Academic partnerships

VA and schools of nursing around the country offer academic affiliations. These collaborative efforts between VA facilities and the country’s finest nursing schools provide students with clinical experiences that specifically address the unique needs of Veteran population and prepare them to excel in careers at VA.

These partnerships offer nursing students a comprehensive and intensive four-year clinical training. The programs create a stronger, mutually beneficial relationship between nursing schools and VA facilities by giving students the opportunity to engage with faculty and ultimately provide better patient care as they put classroom concepts into practice.

By the end of the program, graduates are fully accustomed to the culture and mission at VA and ready to care for our Veterans.

Transition to practice

For over a decade, VA has promoted Registered Nurse Transition-to-Practice (RNTTP) residency programs to provide a transition from school to the more complex clinical environment for RNs with less than one year of experience.

The comprehensive 12-month curriculum explores the clinical, leadership and professional dimensions of nursing at VA. Post-graduate RNs perform the typical roles, duties, patient care activities and procedures that are carried out by nurses on our team.

Availability varies by location, so contact the nurse educator or nurse recruiter at a facility near you for more information.

Financial aid

VA offers eligible employees and students nursing scholarships to advance their education and skills training through the following programs:

  • The National Nursing Education Initiative (NNEI), a component of the Employee Incentive Scholarship Program, funds the pursuit of bachelor’s and advanced degrees for VA RNs.
  • The VA National Education for Employees Program (VANEEP) is offered to employees in a clinical program pursuing first-time licensure in a clinical occupation. Participants can earn their degree faster by attending school full time, with VA covering not only some education costs but also replacement salary while they are enrolled.
  • The VA Learning Opportunities Residency (VALOR) program provides an opportunity for outstanding college nursing students to develop clinical competencies at an approved VA Medical Center. VALOR is designed to increase participants’ clinical skills, clinical judgement and critical thinking while caring for our nation’s Veterans. This program provides opportunities for learning with a qualified RN preceptor. Students must have completed their junior year in an accredited baccalaureate nursing program. VALOR students are offered up to 800 hours of salary dollars.

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.

A Magnet Moment: The Pursuit of Excellence in VA Nursing

Over the last 20 years, hospitals in the United States have become increasingly focused on the Magnet Recognition Program® (MRP), a national initiative honoring hospitals that have achieved the highest possible standards of excellence in nursing and patient care. The process of designating outstanding health care facilities as Magnet hospitals first began in the early 1980s during yet another international nursing shortage. Even though many hospitals were struggling to fill their nurse staffing needs, it was apparent that a few facilities were somehow unaffected by the shortage. An investigation of these hospitals, sponsored by the American Nurses Association (ANA) identified 14 key standards and qualities that truly set these facilities apart from the crowd.

As a result, ANA—through its credentialing body, the American Nurses Credentialing Center (ANCC)—developed what is now known as the Magnet Recognition Program. This program recognizes hospitals, medical centers and health systems which, like a powerful magnet, have the ability to attract and retain more registered nurses and other health care workers. Most importantly, the Magnet recognition is more than just an award: It is a systematic approach to the ongoing pursuit of excellence in patient care.

More recently, medical centers within the Department of Veterans Affairs (VA) have decided to join their private sector peers in the pursuit of this coveted recognition. Of the 155 VA medical centers (VAMCs) in the U.S., only three have earned the Magnet designation. The first was James A. Haley Veterans’ Hospital in Tampa, Fla., followed by the Michael E. DeBakey VAMC in Houston, Texas, and most recently, Portland (Ore.) VAMC in 2007. The medical center where I am employed, Overton Brooks VAMC in northwest Louisiana, has also decided to join the ranks of these prestigious facilities by pursuing Magnet status.

One of the criteria for Magnet recognition is that at least 20% of all direct care staff nurses hold a current nursing certification in their area of specialty. Simultaneously, there is also a national initiative within the VA’s Office of Nursing Services (ONS), encouraging certification by at least 25% of a VA facility’s direct care nursing staff.

Certification is the formal recognition of a nurse’s specialized knowledge, skills and experience that promote optimal health outcomes. It is documented by successful completion of a national standardized certification exam and adherence to practice standards identified by a professional nursing organization in a defined clinical area. It represents a benchmark and indicator of increased clinical knowledge and experience, analogous to board certification in other disciplines. Nursing certification is not a routine competency expected of all nurses practicing within a certain specialty (e.g., CPR training).

Benefits of Certification

For VA hospitals, the benefits of certification are exponential to the organization, the individual nurse and, most importantly, to the veterans we care for. Certified nurses are more competent, accountable and confident in their practice. Moreover, studies have shown that certified nurses practice in a manner that is most likely to improve patient outcomes.1 Other research has revealed that three out of four patients are much more likely to select a hospital employing a high percentage of certified nurses.2

Furthermore, nurses who hold a certification report higher levels of empowerment, which is a characteristic associated with job satisfaction and intent to stay in their current position.3 High percentages of certified nurses are found in facilities that have a reputation for recruiting and retaining the best nursing talent—for example, 26.4% of nurses in Magnet hospitals are certified.4

For the individual VA nurse, becoming certified in your competency area can:

•   validate your knowledge and expertise;

•   build confidence in your professional ability;

•   demonstrate that you meet high national standards;

•   demonstrate your dedication to nursing as a profession;

•   provide opportunities for career advancement;

•   validate you as a credible resource for your colleagues and patients; and

•   promote personal growth and satisfaction as a professional nurse.

Nursing certification is reflective of the Veterans Health Administration (VHA)’s current transformational performance measure to distinguish VA facilities as learning organizations, charged with creating an integrated and synergistic educational environment for all staff. In addition to the MRP, certification is used as an indicator of nursing excellence in other national health care recognition programs, including the American Association of Critical-Care Nurses (AACN) Beacon Award for Critical Care Excellence and the National Institute of Standards and Technology (NIST)’s Malcolm Baldridge National Quality Award.

Don’t Overlook LPNs

In general, hospitals’ efforts to increase their number of certified nurses have usually concentrated on professional nurses (RNs). But this overlooks the important role licensed practical nurses (LPNs) play in the VA health care system. Therefore, our medical center, in recognition of our LPNs’ system-wide contribution to patient care, is also including this group in our initiative to increase certification among all direct care nurses.

Overton Brooks VAMC currently employs approximately 75 LPNs serving in various areas, such as our primary care and specialty clinics, medical-surgical and mental health units, community-based outpatient clinics and community health nursing. In most instances, the LPN is working as a team member led by the RN. However, on many occasions the LPN is directly assigned to a specific provider, such as a physician or advanced practice nurse. This expanded role remains within the LPN’s designated scope of practice, in support of the veteran’s plan of care.

Several nursing associations and certifying boards, such as the Society of Urologic Nurses and Associates (SUNA) and the National Board for Certification of Hospice and Palliative Nurses (NBCHPN), offer various types of certifications for LPNs/LVNs. However, the VA Office of Nursing Services only recognizes two specific certifications offered by the National Association of Practical Nurse Education and Service (NAPNES) and the National Federation of Licensed Practical Nurses (NFLPN). The VA-approved certification offered by NAPNES is in long-term care (LTC) and the NFLPN certification is in gerontology. (See Table 1.)

The average age of a veteran at Overton Brooks VAMC is 60, and this near-geriatric population is increasing within the VA health care system in general. Therefore, it will be extremely beneficial for VA hospitals to have a pool of talented gerontology nurses on staff. For this reason, and in the absence of an LTC unit within our facility, we concentrated our efforts on the certification in gerontology offered by NFLPN.

This certification evaluates competency in four specific domains:

1. Phases of the Nursing Process: Gathering information regarding the patient; identifying the patient’s health needs and selecting appropriate goals of care; designing a strategy to achieve the goals established for the patient; initiating and completing actions necessary to accomplish goals; and determining the extent to which the goals have been achieved.

2. Areas of Patient Needs: Provision of coordinated and goal-oriented care; evaluation of patients’ basic physiological care; psychosocial, coping and adaptation needs of the patient; and developmental changes that occur in older persons.

3. Critical Thinking Skills: Identifying, gathering, discriminating and prioritizing data collection; discovering and then discerning the nature of relationships between concepts; determining how and why concepts are related; developing a process for establishing goals; and using problem-solving to achieve patient-specific outcomes.

4. Gerontology-Specific Topics: Nursing of elderly patients with physical and psychological disorders; special issues in gerontological care; foundations of gerontology; and promoting health and wellness in the geriatric patient.

Case Study: How We Did It

As the Magnet program director (MPD) for Overton Brooks VAMC, I was responsible for spearheading the LPN certification efforts. First, we sent out a call for participation to all LPNs within our medical center. The purpose of this initial call was to determine the number of LPNs who might be interested in certification, and in attending a dedicated review session to prepare for taking the gerontology certification exam. The LPNs were informed that all materials would be supplied by the medical center, the review session would be held on a Saturday and the test would be given at our facility, once again on a Saturday.

Answering this call for participation were 15 LPNs with varying levels of experience, employed in a variety of inpatient and outpatient settings. The LPNs were then asked to sign a letter of commitment acknowledging their individual willingness to attend the Saturday review session and the Saturday test. These were not scheduled workdays, and participating LPNs who worked on Saturdays were to use vacation time or request these days as scheduled days off. Unfortunately, this decreased the size of our participant group from 15 to 12. Even so, we moved forward with our initial plans to increase the number of certified LPNs.

Our next step was to obtain funding for the certification project. Initially, the project was discussed with nursing leadership, who viewed the certification in gerontology as a continuing education opportunity. Subsequently, the proposal was presented to the medical center’s executive leadership group, who determined that this very worthwhile professional development activity was appropriate for funding through continuing education funds. This enabled us to order the materials we needed.

Education Resources, Inc. (ERI) sponsors the certification testing and credentialing offered by the NFLPN. ERI has a long history of assisting practical nurses with various types of educational opportunities. The paper/pencil examination may be administered at the place of employment for LPNs or at an approved testing facility. Hence, the test was administered at our hospital and I served as the proctor.

ERI provided a review DVD, test booklet, pencils and proctor verification forms for each participant. They also provide each LPN participant with a diagnostic report, listing on the national LPN registry and individual certificates (for those who pass the exam).

When the DVD review materials arrived, my next job was to evaluate them to determine their adequacy in preparing our LPNs for this examination. I was qualified to do this because I have experience in working with practical nursing schools and NCLEX-PN® and -RN® preparations, and I hold an advanced degree in public health education and a doctoral degree in health policy. I also have more than 15 years experience in curriculum design, development and evaluation.

My initial review of the materials determined that further enhancement would be beneficial to this LPN group. Therefore, I developed our own additional review materials, including over 300 PowerPoint slides covering topics such as normal aging changes (physical and emotional), major disease processes affecting the elderly, and test-taking strategies. Additionally, the DVD was transcribed verbatim to a hard-copy format to facilitate adult learning.

As with any review course, it’s important to know your audience. Standardized review courses are generally tailored to a large audience. That’s why it’s so crucial to determine if the majority of your group members are functioning at the same knowledge level prior to conducting a group review.

In early May 2008, we conducted the review session with our 12 LPN participants. It lasted six hours, with three 15-minute breaks. Participants were encouraged to bring beverages and light snacks to the session; however, lunch was not provided.
The LPN group returned later that month to write a 105-item certification exam. They had two hours to complete the exam, though most were finished within one hour.

When ERI sent us the examination results, they arrived at my office in individual sealed envelopes to ensure confidentiality. In turn, the LPNs were notified that the results were available. Individually, each one came to my office, received their envelope and anxiously reviewed their results. Nearly all of the participants—11 out of 12—successfully passed the certification exam and are now proudly identified as certified LPNs in gerontology, holding the LPN, GC [Gerontology Certified] designation.

Cost-Effective and User-Friendly

The cost to our medical center was minimal. As itemized in Table 2, the estimated total cost was around $1,900. I volunteered a total of 12 hours of my time for the review session and the test proctoring.

In conclusion, this certification strategy has proven to be a worthwhile professional development opportunity involving a successful collaboration between direct care nurses, medical center leadership and our facility’s Education and Training Service, which provided financial resources. The benefits to our facility and our LPNs are evident. The group certification enabled us to:

•   increase the professional role of the LPN;

•   improve career advancement opportunities for these nurses;

•   help LPNs meet their personal and self-improvement goals; and

•   provide an avenue for LPNs to highlight their special skills and talents in gerontology.

We have rewarded each newly certified LPN with a within-grade step increase. The next phase of the project will be to replicate this user-friendly approach to group certification with other licensed nursing staff (RNs and advanced practice nurses), as well as unlicensed staff (nursing assistants and health care technicians). Our VAMC is well on its way to obtaining 20-25% certification among its direct care nurses—the first step in our journey toward achieving Magnet recognition.  n

References

1.  Cary, A.H. (2001). “Certified Registered Nurses: Results of the Study of the Certified Workforce.” American Journal of Nursing, Vol. 101, No. 1, pp. 44-52.

2.  American Association of Critical-Care Nurses and AACN Certification Corporation (2003). “Safeguarding the Patient and the Profession: The Value of Critical-Care Nurse Certification.” American Journal of Critical Care, Vol. 12, No. 2, pp. 154-164.

3.  Piazza, I.M., Donahue, M., Dykes, P.C., Griffin, M.Q., and Fitzpatrick, J.J. (2006). “Difference in Perceptions of Empowerment Among Nationally Certified and Noncertified Nurses.” Journal of Nursing Administration, Vol. 36, No. 5, pp. 277-283.

4.  Shirey, M.R. (2005). “Celebrating Certification in Nursing: Forces of Magnetism in Action.” Nursing Administration Quarterly, Vol. 29, No. 3, pp. 245-253.

A Win-Win Partnership, VA Style

Recruiting eager students into the future nursing pipeline has become easier in recent years, thanks to the profession’s efforts to publicize the nursing shortage and promote the benefits of nursing as an attractive career. But filling the pipeline does little good if it narrows at some point down the line so that the end product is reduced to nothing more than a trickle.

According to the American Association of Colleges of Nursing, in 2007 more than 36,000 qualified applicants were turned away from entrylevel baccalaureate degree programs in nursing schools due to an insufficient supply of faculty, clinical sites, classroom space and clinical mentors. And with a whole generation of current nursing faculty rapidly approaching retirement age, many of the nation’s top nursing employers are beginning to explore innovative new ways to make sure they’ll have enough professionally trained nurses to meet their future staffing needs and provide the best possible patient care.

That’s one of the goals behind the U.S. Department of Veterans Affairs Nursing Academy (VANA), a five-year, $59 million project launched in 2007 to provide a pipeline of highly educated nurses to serve the health care needs of the nation’s veterans. VANA consists of partnerships between selected schools of nursing and VA medical facilities throughout the country. In these unique collaborations, nursing school faculty provide education and other services at the VA facility, qualified VA nurses serve as faculty members at the nursing school, and the VA hospital provides enhanced clinical experiences for students. Currently, there are 15 such partnerships in the VA Nursing Academy, a name that represents a collection of collaborative efforts rather than an actual physical entity.

“The purpose [of VANA] is to increase the number of students that can be admitted to [nursing schools], increase the number of new graduate nurses at the VA hospitals and retain them once they’re there,” says Blanche Landis, PhD(c), RN, the VANA program coordinator at San Diego State University School of Nursing, which is partnering with the VA San Diego Healthcare System.

There are many benefits from the VA side in terms of improving the quality of care as well as elevating the practice of nurses within our organization,” adds Maude Rittman, PhD, RN, director of nursing at the North Florida/South Georgia Veterans Health System in Gainesville, Florida. Her facility’s VANA partner is the University of Florida College of Nursing, also based in Gainesville. The Department of Veterans Affairs, with 61,000 registered nurses, licensed practical nurses, vocational nurses and nursing assistants, has one of the largest nursing staffs in the world and is one of the country’s largest employers of minority nurses. VA nurses work at the department’s 153 medical centers and almost 900 clinics nationwide. The VA currently provides clinical education for some 100,000 health professional trainees each year, including students from more than 600 schools of nursing. Almost 22,000 of the VA’s registered nurses will be eligible for retirement by 2010.

Meeting Goals

The VA Nursing Academy’s Enhancing Academic Partnerships Program has four main goals:

  1. Expanding faculty and professional development at nursing schools and VA facilities;
  2. Increasing nursing student enrollment;
  3. Providing opportunities for educational and practice innovations; and
  4. Increasing recruitment and retention of VA nurses as a result of enhanced roles in nursing education.

To meet the faculty expansion goal, VANA provides funding for three full-time equivalent (FTE) VA-based faculty and two FTE school-based faculty in the first year of the program. Then it increases to six and four faculty respectively, until the last year, when the number drops to three and two respectively. This allows nursing schools to add and maintain enrollment of 20 more students for each five faculty members added, according to a national evaluation funded by the VA and conducted by the UCLA School of Public Health in 2008.

The second goal, increasing enrollment in nursing schools, has already been achieved at the University of Florida College of Nursing, which was one of the first schools to participate in VANA. In fact, enrollment has exceeded expectations, says Maxine Hinze, PhD, RN, the college’s VANA program director. Twenty-eight additional baccalaureate students were admitted in the first year of the program, and 24 additional students were admitted the second year. Enrollment has also increased in the accelerated BSN and RN-to-BSN programs, Hinze reports.

VANA’s third goal is in alignment with the VA’s overall mission of investing resources into becoming a learning organization, says Rittman. “This implies that people who join our organization continue to learn and grow within the organization,” she explains. “To me, this program is a step in that direction, in that we are implementing evidence-based practice [at our facility]. In our [VANA] model, [nursing school] faculty are actually embedded in the nursing unit and become part of the unit.”

Recruitment Results

This heightened emphasis on education and innovation is designed to not only improve patient care but also help boost recruitment and retention of VA nurses—the VANA program’s fourth goal. The VA believes that integrating nursing school faculty into its hospitals will provide more stimulating clinical and learning environments, increase VA clinical education opportunities and inspire more new nursing graduates to seek employment at VA facilities where they’ve had a positive clinical experience.

“The idea is that they will fall in love with [VA nursing] and want to continue on,” Landis says. “Students will become more familiar with the [VA] system, more familiar with veterans and will want to be more involved in the care of vets.”

The University of Florida College of Nursing and the North Florida/South Georgia Veterans Health System have a one-year nursing residency program as part of their collaboration, says Hinze. This also helps increase recruitment and retention. In its first year in the VANA program, the VA facility recorded a 92.3% retention rate, in that 36 of 39 new graduate nurses hired at the hospital were still employed there after one year. In contrast, median turnover rates for graduate nurses in general during their first year of employment currently range from 35% to 61%, depending on location.

“The first year of employment can make or break a nurse,” Hinze notes. The VA facility was also able to hire a larger-than-usual number of nurses with baccalaureate degrees after the first year of the partnership, Rittman says—18 to 20 as opposed to the normal six to 10. It also hired more new graduates than usual (39). And while the hospital hired only 24 new graduate nurses after the second year of the program, this was due in part to reduced turnover, meaning there were fewer jobs available.

“We had 70 applicants and could only hire 24 because our vacancy rate was lower,” Rittman explains. Although the VA Nursing Academy is not targeted specifically toward recruitment and retention of minority nurses and students, many of the VANA partnerships are located in areas with large minority populations.

“We have more Hispanic veterans [receiving care at our facility],” Rittman says, “and so we do like to hire Hispanic nurses and African American nurses [who can provide culturally competent care].” Nurses who work for VA hospitals must be U.S. citizens, she adds, and that requirement has at times prevented her facility from hiring promising international nursing graduates who have immigrated to the U.S. but have not yet had a chance to earn citizenship.

Because the Department of Veterans Affairs has a very high level of racial and ethnic diversity compared to the private sector—both in terms of workforce and patient population—it has long been an employer of choice for nurses of color. “It’s also a good environment for male nurses, because many of them have been in the military and have been medics,” says Rittman. “So the VA is a very comfortable place for them to be.”

Making It Work

To help ensure that the Enhancing Academic Partnerships Program is working effectively and accomplishing its goals, the VANA project calls for periodic program evaluations at both the local partnership and national levels. The evaluations include structure, process and outcomes assessments of clinical practice, education and program activities.

The 2008 national evaluation reported several challenges to making the program work, including assimilation of nursing school faculty into the broader organizational structure of VA facilities and assimilation of VA nurses into the academic culture of nursing schools. Other challenges included time-keeping for faculty, performance evaluations and reports that teaching required a more significant investment of time than VA nurses had anticipated.

But on the positive side, the evaluation identified beneficial spill-over effects, such as the strengthening of ties between VA facilities and their partnering nursing schools, opportunities for collaborative research, opportunities to expand simulationbased learning, sharing of advanced educational experiences, and increased enrollment of current VA nurses into graduate-level nursing programs.

Still another finding was that VANA’s innovative structure helps address one of the biggest problems contributing to the nursing faculty shortage—the fact that academic salaries are often much lower than what nurses can earn in clinical practice. Because the VA nurses who serve as nursing school faculty maintain their existing VA salaries, this provides an incentive for VA nurses with master’s degrees or other advanced training to become involved in teaching.

While VANA is clearly a win-win proposition for nursing schools, VA hospitals and nursing students, the program’s long-term goal is to improve care for veterans.

“The vets will ultimately benefit if [the nurses] who are providing the care have the best instruction, the best education and the support they need to develop [professionally],” says Landis. “All patients deserve the best care, but I think [veterans are a unique population with their own special needs]. This program exposes students to the [health care] needs of vets and certainly increases their understanding of those needs.”

For more information about the VA Nursing Academy, visit www.va.gov/oaa/vana.

Allied for Education

As of academic year 2009-2010, the VA Nursing Academy (VANA) comprises 15 partnerships between nursing schools and VA medical facilities:

 

VA Site
Nursing School Partner
Charles George VA Medical Center
(Asheville, N.C.)
Western Carolina University
School of Nursing
Birmingham VA Medical Center
(Birmingham, Ala.)
University of Alabama at Birmingham
School of Nursing
VA Pacific Islands Health Care System
(Honolulu, Hawaii)
University of Hawaii at Manoa
School of Nursing & Dental Hygiene
VA New York Harbor Healthcare System
(New York, N.Y.)
Pace University Lienhard School of Nursing
VA Pittsburgh Healthcare System
(Pittsburgh, Pa.)
Waynesburg University
Ralph H. Johnson VA Medical Center
(Charleston, S.C.)
Medical University of South Carolina
Edward Hines, Jr. VA Hospital
(Hines, Ill.)
Loyola University of Chicago
College of Nursing Michigan Consortia
(Ann Arbor, Battle Creek, Detroit, Saginaw)
University of Detroit Mercy and Saginaw Valley State University
Oklahoma City VA Medical Center
(Oklahoma City, Okla.)
University of Oklahoma Health Sciences Center
College of Nursing
Providence VA Medical Center
(Providence, R.I.)
Rhode Island College School of Nursing
James A. Haley Veterans Hospital
(Tampa, Fla.)
University of South Florida College of Nursing
North Florida/South Georgia Veterans Health System
(Gainesville, Fla.)
University of Florida College of Nursing VA Salt Lake City Health Care System
(Salt Lake City, Utah)
University of Utah College of Nursing
VA San Diego Healthcare System
(San Diego, Calif.)
San Diego State University School of Nursing
VA Connecticut Healthcare System
(West Haven, Conn.)
Fairfield University School of Nursing

Fed Start

For many minority nurses, completing a graduate degree is just the first step in planning their future career advancement. You may be considering a career in teaching or a higher-level position with your current employer. But don’t overlook career options in government service.

In the aftermath of 9/11, public health concerns about the bird flu epidemic and the devastation of Hurricane Katrina, the need for health care professionals with strong clinical backgrounds, innovative ideas and concern for the lasting effects of public policy decisions has never been more important in the management ranks of government. It is important for nurses of color to realize that their skills and experience can be used to develop federal health policy and strategy, just like they can be used to help patients.

Paid government internship programs are a little-known but highly effective option for getting into government on a fast track to senior management positions. The most prestigious of these federal internships is the Presidential Management Fellows (PMF) Program, which is administered by the U.S. Office of Personnel Management (OPM).

For nearly 30 years, the Presidential Management Fellows Program and its predecessor, the Presidential Management Internship Program, have been used as a recruiting tool to attract, hire and develop graduate students earning master’s, professional and doctoral degrees in all disciplines into high-paying, rewarding careers in the federal government. The program is perfect for master’s or doctoral students who have recently completed their degree or will complete their degree in the next 12 months.

The PMF Program provides Fellows with an opportunity to apply the knowledge gained in their graduate study by working on paid two-year internship assignments. These internships could involve national security affairs, health administration, nursing, public health, public policy, program management and many other areas that support the government.

Federal agencies that hire Presidential Management Fellows include the Centers for Disease Control and Prevention, the National Institutes of Health, the Department of Health and Human Services, the Department of Homeland Security, the Federal Emergency Management Agency, the National Science Foundation, the Bureau of Indian Affairs, the Department of Veterans Affairs and numerous others. After completing their two-year assignments, Fellows are offered permanent jobs at their agency or have the option to explore a permanent position at any other agency that participates in the program.

During their internships, Fellows are paid starting salaries based on their work experience and education level. Salaries can range from $38,000 (GS-9 level) to $71,000 (GS-12 level). In addition, many of the agencies offer benefits such as student loan repayment up to $60,000 ($10,000 a year) and financial support for earning an additional degree at the doctoral level.

Another benefit of the program is that Presidential Management Fellows receive guaranteed promotions over the two years of their internship. While the vast majority of PMF intern assignments are based in Washington, D.C., there are many opportunities for selected Fellows to work in other locations across the United States.

As members of the baby boomer generation continue to hit retirement age, a growing number of senior-level leadership positions will open up in government. At some federal agencies, 60% of the senior leadership is eligible to retire in the next three to five years. As these management positions open, former Presidential Management Fellows will be logical choices to fill them.

The Application Process

The application period for the Presidential Management Fellows Program is September to early October of each year. Specific deadlines are announced in the “How to Apply” section of the PMF Web site, www.pmf.opm.gov. As of this writing, the start date for applying to the PMF Class of 2008 is expected to be on or around September 1, 2007, with the closing deadline still to be announced.

There are several key things an applicant must know before preparing to apply for the program. First and foremost, the resume that one might use for a corporate job is different from the resume used for a federal government job–or in this case, a federal internship. In the corporate world, the maximum length for a resume is two to three pages. A federal resume should be much longer and more detailed, much like a curriculum vitae (CV) one would use in applying for an academic position. A federal resume should include such items as a job objective, professional awards, names of graduate courses completed and years of management experience.

If you have never applied for a federal job or prepared a federal resume before, an excellent resource is a book titled Government Job Applications and Federal Resumes: Federal Resumes, KSAs, Forms 171 and 612, and Postal Applications by Anne McKinney. This book, which should be easily available at your local bookstore or online, is a valuable tool that will help you learn the resume writing techniques and other skills that are critical for applying to the Presidential Management Fellows Program.

Options Abound: Other Federal Internship Programs Worth Exploring Emerging Leaders Program (ELP)
Department of Health and Human Services
NIH Management Intern Program
National Institutes of Health
http://internships.info.nih.gov/pimenu.html USAID Fellows Program
U.S. Agency for International Development

The first stage of the PMF application process involves filling out an online application. A key requirement is that you must identify a core faculty member or graduate advisor who will fill out an online nomination form to nominate you for the PMF program. When filling out your application, you must include the email address of the person you have asked to nominate you. Be sure to choose someone who can respond quickly with an endorsement once the Office of Personnel Management emails him or her to request the nomination.

Your online application will also require you to attach your federal resume and answer three questions relating to situations where you have demonstrated skills in teamwork, leadership and customer service. It is important to answer these questions in detail and provide an example of an actual work or academic situation that was complex, unique and challenging.

After your application has been submitted, the second stage of the selection process involves coming to Washington, D.C. for an assessment interview. You will be expected to wear professional business attire at the interview. This stage includes a formal interview process where candidates are asked to respond to three separate employee or organizational case studies–one in writing, one verbally and one in a group environment. The goal is to assess the candidate’s problem-solving, writing and public speaking skills as well as his or her ability to be a leader, follower and team player.

The Final Round

Candidates who qualify for the third stage are considered finalists and are invited to attend a government job fair, again in Washington. Being a finalist does not guarantee you will get a job. If you are selected as a finalist, you will receive a notification email that includes a list of the names, email addresses and phone numbers of all the agency representatives who will be interviewing candidates at the job fair. It is important to email them a resume and a cover letter requesting a PMF job interview, even before the job fair. Once you become a finalist, your goal is to get multiple PMF job offers to choose from.

Different government agencies have different levels of funding, which means some agencies have more flexibility than others in offering higher starting salaries, payment for relocation, student loan repayment and financial assistance for doctoral study. When you interview with an agency, be sure to ask about the availability of those benefits.

Once you are offered a PMF internship opportunity, there is one final hurdle to clear: the background and clearance process. Review your credit report in advance and make every effort to resolve any outstanding debts that could negatively impact your chances of getting an internship job offer. All government agencies will check a candidate’s credit with TransUnion and run a police record background check with the FBI. Charge-offs, credit accounts more than 90 days delinquent and unpaid judgments of more than $3,500 on a candidate’s credit report could stop him or her from passing the clearance process, which would make the candidate ineligible to participate in the PMF Program.

To learn more about opportunities available through the Presidential Management Fellows Program, visit www.pmf.opm.gov.

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