Nurses—specifically those who work at the bedside—are the backbone of the VA healthcare system today. In fact, with more than 80,000 registered nurses and nursing assistants, VA is the nation's largest employer of nurses.
Of approximately 42,000 SCI/D veterans in this country, only about 12,000 receive specialized care in VA. This means the overwhelming majority are either receiving sub-optimal care elsewhere, going without annual exams and preventative screenings, don’t know they are eligible for VA specialized care, or have been discouraged by the lack of access to VA care. This number increases when those with spinal cord diseases, such as Multiple Sclerosis and Lou Gehrig’s disease, are added.
While hardly anyone disagrees with the need to increase the number of nursing staff in the VA SCI/D system to keep up with patient demand, dispute continues on necessary additional staff. Some in VA argue the relevance of average daily census in determining future staffing needs, even though those censuses were capped and couldn’t possibly account for untracked, unmet demand. This specious argument needs to be exposed for what it is: solely a matter of cost, not patient need.
For others in VA and among veteran advocates, unmet demand is the precise basis of present and future VA SCI/D nurse staffing needs, in this case an additional 1,000 nurses (average of 32 nurses per facility), for which the cost of not doing whatever it takes to improve the system will increase exponentially.
As Warren Buffet once said, "Price is what you pay. Value is what you get." The same is true of VA health care. When it comes to assessing the price for taxpaying citizens to ensure those paralyzed veterans who served our country have their serious medical needs met, there is tremendous accrued value in achieving better clinical outcomes, creating a more sustainable nurse workforce—and, in some instances, saving a life.
That value far outweighs the cost of paying a heavier price later as aging paralyzed veterans wait longer for care and a detached VA leadership, and politically driven proponents of diminishing investment in VA eventually break the back of one of its most critical frontline functions—and it's our nation’s most disabled heroes who will pay.
Congress must fund the 1000-additional-nurses requirement so that paralyzed veterans who have no private sector alternative get full and timely access to adequate the VA specialized services they need to live and stay healthy.