How do VA hospitals compare to civilian hospitals?

[Stephanie Bennett, BSN]

I have worked in civilian hospitals and I’m trying to get a job working in the VA. I am wondering how VA hospitals compared to civilian hospitals as far as nurse to patient ratio‘s and support. When I worked in the civilian hospital I was constantly worried about my license because we were understaffed and caring for a very high acuity patients on our MedSurg floor.

[jfratian, DNP, RN, CRNA]

I'm sure there are exceptions as there are many VA facilities.  Having worked at several VA hospitals, I can say generally the nursing workload is less than a comparable sized civilian hospital.  This is especially true at joint VA-DOD facilities where the military often supplies way more people than you need.  The reason here is very strong nursing unions within the VA that mandate ratios and workloads similar to California hospitals.  

You should really try to ask nurses who actually work at the facility you are looking at.  My broad characterization might not apply to every single facility.  One downside to VA employment is the very long and cumbersome on-boarding process which takes months longer than a civilian hospital.  

[Jeckrn1, ADN, BSN]

After working in civilian, military (DHA) & VA hospitals one big difference between civilian & government hospitals is there is no call offs no matter how low the census is. Also, the benefit package is way better on the government side. At the VA you start off with 26 days of vacation & 13 days of sick leave a year, defined pension, matching TSP (401K) up to 5%, multiple health insurance plans.  DHA has the same benefits but vacation days start out at 13 days a year. Wages can vary by location and years of experience but generally if you are in the system long enough your wages will be higher on government system. One big draw back is the red tape and trying to improve how things are done. 

[OUxPhys, BSN, RN]

On 11/24/2021 at 10:36 AM, Jeckrn1 said:

After working in civilian, military (DHA) & VA hospitals one big difference between civilian & government hospitals is there is no call offs no matter how low the census is. Also, the benefit package is way better on the government side. At the VA you start off with 26 days of vacation & 13 days of sick leave a year, defined pension, matching TSP (401K) up to 5%, multiple health insurance plans.  DHA has the same benefits but vacation days start out at 13 days a year. Wages can vary by location and years of experience but generally if you are in the system long enough your wages will be higher on government system. One big draw back is the red tape and trying to improve how things are done. 

Ha! This is so true. The nursing supervisor would rather you stay and do nothing then give you the day off if the census is low. It is also very true when they say it takes forever for things to get done, damn near impossible to change/improve things, and the amount of people who still have jobs that wouldn't have jobs anywhere else. Even with all that I still wouldn't work anywhere else. 

On 11/15/2021 at 12:11 PM, jfratian said:

I'm sure there are exceptions as there are many VA facilities.  Having worked at several VA hospitals, I can say generally the nursing workload is less than a comparable sized civilian hospital.  This is especially true at joint VA-DOD facilities where the military often supplies way more people than you need.  The reason here is very strong nursing unions within the VA that mandate ratios and workloads similar to California hospitals.  

You should really try to ask nurses who actually work at the facility you are looking at.  My broad characterization might not apply to every single facility.  One downside to VA employment is the very long and cumbersome on-boarding process which takes months longer than a civilian hospital.  

Workload is less if your staffing is adequate. Currently at my VA the workload is burning people out and they still have not offered regular staff any incentive other than OT to work in these conditions despite paying travelers $95 and $120/hr. I also seem to need to get a job at the VAs you worked at since my VA the union is horrible, 

[jfratian, DNP, RN, CRNA]

May not be practical where you live, but look for joint DOD-VA facilities.  It's always lower acuity because it's usually on a military base.  The military nurses always get the short end of the stick, and therefore the VA nurses often have it pretty good.  

[shanbanana]

Have any of y'all ever worked over in Landstuhl by chance? I understand the bennies and pay but am unable to find anything online about their schedules. Are schedules kind of consistent for RN's across the Federal hospital system for specific types of units?

[Demo, BSN]

The VA is tough, while the census and acuity is lower the administrative burden can be oppressive at times and the unions seems to retain less than stellar personalities. I used to be pro RN union units I worked at a VA facility.

[OUxPhys, BSN, RN]

On 5/14/2022 at 4:00 PM, Demo said:

The VA is tough, while the census and acuity is lower the administrative burden can be oppressive at times and the unions seems to retain less than stellar personalities. I used to be pro RN union units I worked at a VA facility.

The problem at my facility is that the only union there is AFGE and as you stated they do a better job of retaining less than stellar employees more than anything. However I was surprised to find that some VAs have both the AFGE and ANA for nurses (AFGE does little for RNs at my facility).