Reviving the Cadet Nurse Corps for VA SCI/D Centers
Recently, in a fit of nostalgia, I was digging through a box of old family photographs.
I’ve seen most of the photos before, but one black-and-white image caught my eye. Of the 12 members of my family standing on the porch of an old beach house in Ocean Gate, N.J., only three were still alive. One of them is my Aunt Dorothy.
My 98-year-old aunt is quite independent and dare I say, hip. Considering her adventurous and mildly rebellious nature, I was intrigued as to why she was wearing what looked like a drab military uniform.
I texted the image to her hoping to learn more about it, and her response was, “That must be 1945 because I’m wearing my cadet nurse uniform. It sure was ugly!”
It turns out she had joined the United States Cadet Nurse Corps, which was a World War II-era congressional program to address a nursing shortage at home while more experienced nurses were deployed overseas.
Aunt Dorothy says she received government subsidies for tuition, uniforms and a stipend. In exchange, she pledged to serve as a nurse for the duration of the war. Eventually, she received her nursing degree from the University of Pennsylvania and specialized in psychiatry.
The program ended in 1948, with more than 124,000 nurses graduating from participating schools. They were praised for preventing a nationwide collapse of our nursing system.
Could a World War II-era program be modernized to fix the current nursing shortages at the Department of Veterans Affairs (VA) spinal cord injury and disease (SCI/D) centers? I think so.
Unlike the periodic nurse shortages we’ve experienced since the early 1900s, the current nationwide shortage has lasted longer than any other shortage, and its magnitude is greater than ever before.
According to the U.S. Bureau of Labor Statistics, the American Association of Colleges of Nursing, the National Institutes of Health and the National Council of State Boards of Nursing, this unprecedented shortage is partly the result of a decades-long failure to invest in the nursing industry.
In regard to the impact these nursing shortages have had on SCI/D centers, vacancies have led to increased overtime hours for nurses, resulting in turnover, burnout and reduced morale. Staffing shortages have also forced reductions in the number of available beds at almost all VA SCI/D centers.
According to Paralyzed Veterans of America (PVA), the VA’s SCI/D system of care has been short hundreds of nurses for the past few years, with total staffing vacancies hovering around 35%. In his March 4 testimony before a joint session of the House and Senate Committees on Veterans Affairs, PVA National President Robert L. Thomas Jr., says, “The department has been concealing its vacancy problems through the use of overtime which, if taken away, may reveal much more serious staffing issues.”
For decades, the VA has resisted the idea of recruitment pay, specialty pay and retention pay, which has made it impossible to maintain adequate staffing. And, to make matters worse, the VA has a habit of floating nurses from its SCI/D centers to other departments, leaving behind stressed-out nurses being told to do more with less.
As a patient, I get a little nervous when I know the hospital is operating beyond its capacity. After all, that’s when administrators start cutting corners, mistakes are made and the quality of care diminishes.
That said, I think there are three components to the original Cadet Nurse Corps that, if included in a modernized program, could significantly alleviate the nurse shortage at VA SCI/D centers:
n Increasing the pipeline of new nurses: The original program aimed to boost admissions in nursing schools and expedite training. By providing financial incentives and support for nursing students, a modernized program could encourage more individuals to pursue nursing careers and specialize in SCI/D care.
n Targeted recruitment and specialized training: The new program would prioritize recruitment of students interested in working with veterans and in SCI/D specialties. This would involve partnerships with schools to develop a specialized curriculum at VA SCI/D centers. This would ensure new nurses are better equipped to handle the unique challenges and needs of SCI/D patients.
n Improved retention and recruitment within the VA: By offering a structured path to a fulfilling career working with veterans and specializing in SCI/D care, the program could potentially improve both recruitment and retention rates of VA nurses. This could lead to greater continuity of care and improved outcomes for SCI/D patients.
The success of the Cadet Nurse Corps during World War II offers a powerful precedent. It was a great career opportunity for individuals who wanted to pursue a career in nursing like my Aunt Dorothy, and I’m sure her patients appreciated having access to the care she provided.
I think that by adapting this model to the current need in SCI/D care, a new program could be a strategic investment that strengthens the SCI/D nursing workforce and ensures better care for patients like you and me.
Let me know what you’re thinking at al@pvamag.com.
