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VA nursing makes 'next generation of students,’ partnerships priorities

Monday November 5, 2012
Cynthia Caroselli, RN
Cynthia Caroselli, RN
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Priscilla C. Aponte, RNC
Long a supporter of educational opportunities, the Veterans Health Administration remains committed to ensuring future nurses and nurse leaders receive optimal clinical and research experiences through continuing and new collaborations with the country’s nursing programs.

"Educating the next generation of students is incredibly important," said Cynthia Caroselli, RN, PhD, associate healthcare system director for patient services and CNE at the VA New York Harbor Healthcare System, with hospitals in Manhattan and Brooklyn and a nursing home in Jamaica, N.Y. "It is part of our obligation as professionals, and it enriches our practice."

Affiliations also can increase recruitment and familiarize students with the Department of Veterans Affairs.

"We have a VA goal to be a learning organization, and part of being a learning organization is developing, enhancing and sustaining academic partnerships, which are key to the quality of care we are able to provide, our workforce development and succession planning, and what we ... are able to contribute to our professional practice arena," said Priscilla C. Aponte, RNC, MSN, CHHP, VHA-CM, associate program manager at the Center for Learning and Organizational Development at James J. Peters VA Medical Center in Bronx, N.Y. "The emphasis is on collaborations and affiliations."

Providing clinical education training to benefit the VA and the nation is a statuary requirement of the VA, added Mary Dougherty, RN, DNSc, MBA, director of the VA Nursing Academy in the office of Academic Affiliations in Washington, D.C.

"We believe it’s important to maintain a learning environment for all staff," Dougherty said. Last year, more than 1,200 students from about 30 nursing schools trained at the N.Y. Harbor VA, and 200 nursing students have completed clinical rotations at the 311-bed acute care and 120-bed nursing home at J.J. Peters VA. But the partnerships go beyond such placements.


Martha Greenberg, RN
"Our students obtain outstanding clinical and life experiences at the VA," said Martha Greenberg, RN, PhD, associate professor and chairwoman of the undergraduate department at the Lienhard School of Nursing in the College of Health Professions at Pace University, New York. "All of our students have gained an appreciation of the experiences of veterans from various campaigns. There are excellent resources at the VA."

The VA Learning Opportunities Residency accepts high-performing juniors attending affiliated colleges’ BSN programs. The students receive a paid summer internship, rotating through the facility, with the opportunity to remain during their senior year.

"The interns are paired with, at a minimum, BSN-prepared nurses and function in that role within the scope of practice," Aponte said. "They get a nice, rich experience through all specialties."

Students also complete a project. At N.Y. Harbor, students researched and presented projects about military sexual trauma, men in nursing and follow-up needed by patients taking warfarin.


Pat W. Stone, RN
"The students have a guided, well-nurtured experience," Caroselli said. "This is a not a fluff experience. It’s the equivalent of a high-level undergraduate course, and they eat it up."

Many of N.Y. Harbor’s nurses came through the VALOR program. Twenty-one of the 30 nurses who have completed the VALOR program at J.J. Peters VA have stayed at the VA. VALOR graduates also precept the incoming VALOR interns.

N.Y. Harbor also offers a senior immersion experience. In the final year, each student partners with a staff nurse. The student mirrors the nurse’s schedule, which students find eye-opening, Caroselli said. For instance, one student is working with an ICU nurse on nights.

J.J. Peters VA has developed a master’s-level Clinical Nurse Leader program in collaboration with Hunter-Bellevue School of Nursing in New York. Participating VA nurses, who received scholarships from the VA, participate in monthly clinical leadership meetings with subject experts, facilitated by Aponte and a Hunter faculty member, to support the classroom work.

"It was fabulous," Aponte said. "They were able to not only have practical examples for their schoolwork, but when they did their projects at the hospital, they did projects the medical center needed and benefited from."

Nine students have graduated from the program and continue to work at the VA as CNLs. Four RN students enrolled in the CNL program are expected to graduate in 2013.

Nurses pursuing doctoral degrees also develop new skills at the VA. Pat W. Stone, RN, PhD, FAAN, director of the PhD program and of the Center for Health Policy, and the Centennial Professor in Health Policy at Columbia University in New York, and her PhD students are collaborating with the VA at the national level, conducting research to better use nurses to improve patient outcomes and efficiency.

Columbia also has two PhD students who are Jonas Veterans Healthcare Scholars. May Uchida, MSN, GNP-BC, is working on a dissertation, "Comparative and Cost Effectiveness Analyses of Healthcare-Associated Infection Reduction in Nursing Homes," and Kendrick Cato, an Iraq war veteran, is interested in how informatics can improve healthcare.

"Besides clinical rotations, we are collaborating with the VA in other ways," Stone said.

Debra Anscombe Wood, RN, is a freelance writer.


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VANA reaches out

The VA Nursing Academy, a five-year pilot established in 2007 to increase faculty and BSN-prepared nurses, offers Veterans Affairs nurses an opportunity to teach in partnering nursing schools, which agreed to increase enrollment. It also focuses on innovation. The program has been extended for one year with plans to expand it.
“VANA would also provide an opportunity for a process synthesis, meaning we would have opportunity for practice redesign and operational innovations to benefit veterans, students and staff,” said Mary Dougherty, RN, DNSc, MBA, director of the VA Nursing Academy in the Office of Academic Affiliations in Washington, D.C. “The VANA [has] brought considerable value to the VA and the schools of nursing.”
The academy operates with 15 partners in geographically diverse sites. New York Harbor VA Medical Center and Pace University, both in New York, have participated in the past. Post-baccalaureate nurse residencies at four VANA sites grew out of the VANA.
Dougherty said the VANA has increased retention and recruitment. A significant number of VA nurses also went back to school for graduate degrees.
“It was positive for us in terms of the recruitment, and in terms of retention, the opportunity to explore a new side of nursing was valuable,” Dougherty said. “It created concentric circles of positive outcomes for the veterans, or patients, relative to practice redesign and positive clinical outcomes and to the staff in terms of enhancing the learning environment.”

— By Debra Anscombe Wood, RN