‘Help Us Care For Ourselves’: Nurses Picket For Scheduling Flexibility At Martinsburg VA

Nurses working overnight at the Martinsburg VA Medical Center (VAMC) crossed paths with their morning-shift colleagues Friday at the crack of dawn. Sporting red shirts and handmade signs, they exited the facility’s front gates and joined their peers across the street on the picket line.

Just outside hospital grounds, staff members affiliated with the National Nurses Organizing Committee (NNOC) gathered to call attention to scheduling practices they say are unsustainable. As they chanted on the roadside, passing drivers blared their horns in support.

A typical nursing shift in the United States lasts 12 hours, according to the American Nurses Association. This can mean entering a hospital before the sun rises, and leaving after it has already set. Nurses generally work six of these shifts in a two-week period, for a total of 72 hours on the clock.

But a typical work week in the U.S. is 40 hours. Some hospitals, like the Martinsburg VAMC, require nurses to pick up an additional eight-hour shift to round out the pay period. Nurses on site say these shifts can even require overtime.

Beverly Simpson is an acute care infection prevention coordinator at the Martinsburg VAMC. She said working several day-long shifts in a single week is a tall order.

“We continually lose ourselves in the service of our vets,” Simpson said. “All that we’re asking is to help us care for ourselves.”

Nurses on the picket line are pushing for a form of scheduling flexibility known colloquially as “72/80.” It allows nurses to drop their additional eight-hour shift, maintaining full compensation and benefits for working 72 hours per pay period.

The policy is not without precedent. Title 38 of the United States Code outlines federal policies on veterans’ benefits. Under the title, health care facilities administered by the U.S. Department of Veteran Affairs (VA) are eligible to implement 72/80 with the department’s approval, although they are not required to do so.

The Martinsburg facility already practices the policy in its intensive care unit (ICU). But nurses across the hospital’s departments say they want it expanded.

U.S. Navy veteran Jack Tennant has served as a registered nurse at the Martinsburg hospital for 32 years, and helped organize Friday’s picket. He said eight more hours out of his scrubs each week would greatly improve his quality of life.

“Nurses work really grueling shifts,” Tennant said. “It’s really hard to take care of ourselves and take care of our families when we are working so many hours.”

The 72/80 policy is practiced more widely at some VA health care facilities, even in West Virginia.

At the Louis A. Johnson VA Medical Center in Clarksburg, three departments have implemented the policy, according to a statement from VA Press Secretary Terrence Hayes emailed to West Virginia Public Broadcasting by a representative.

This includes the ICU, the medical surgical unit and the float pool — a department of nurses who alternate between different sections of the hospital each shift.

According to Hayes, VA health care facilities adopt the 72/80 model “wherever possible.” He said the policy “remains in effect” for the Martinsburg VAMC ICU, and “will continue to be considered should recruitment or retention issues for inpatient registered nurses arise.”

But Hayes said the VA has already taken significant steps toward improving recruitment and retention, with current staff in mind. Currently, the VA employs 122,000 nationally, “the largest nursing workforce in the country and in the history of [the] VA,” he said.

Hayes added that the VA’s nurse turnover rate outperforms the private sector.

Still, on the ground at the Martinsburg VAMC, nurses like Simpson and Tennant say they feel overworked, and struggle with work-life balance. This can make it difficult to attend doctor’s appointments or fulfill family obligations, they said.

Plus, Tennant said nurses working overtime after long shifts can be a safety issue, making flexible scheduling more important.

“They’re already fatigued,” he said. “Fatigued nurses are at a much higher risk of making mistakes.”

Christle Young, an ICU nurse at the Martinsburg VAMC, has experienced the 72/80 scheduling model firsthand. She said the extra time helps her better serve local veterans.

“I work nights. That extra day coming in, it’s not a day off,” she said. “I sleep that day, and then I only really have one day off.”

Young said expanding the 72/80 policy across the Martinsburg VAMC would help other nurses better care for themselves and boost morale.

“We want to watch our kids grow up. We want to care for our elderly patients. We want to play bingo on Tuesday, whatever it is,” she said. “But the facility doesn’t allow us that flexibility.”

In his statement, Hayes agreed that evidence shows the 72/80 model “reduces burnout, improves satisfaction, improves retention of experienced nurses and also decreases turnover [and] the use of unscheduled leave and overtime.”

He said the VA plans to expand it to the Clarksburg hospital’s emergency department, but additional expansions will be considered on a case by case basis.

Meanwhile, Martinsburg members of the NNOC say they have been pushing for change at their own facility for more than a year. They began surveying their fellow nurses in September 2023 and found widespread dissatisfaction over current scheduling practices, Tennant and Young said.

Young said the nurses collected a petition with more than 200 signatures from coworkers in favor of implementing the 72/80 policy, and drafted a “mock schedule” with plans for how to implement it.

When the nurses brought these documents to hospital administrators, Young said no commitment to reconsidering current scheduling policies was made.

“It is still falling on deaf ears,” she said. “So we’re outside today to make some noise.”

Hayes did not directly address any previous scheduling policy discussions between the VA and the NNOC-represented nurses. But he said the VA continues to support staff members and their union representatives, including National Nurses United, the NNOC’s larger-scale affiliate.

“We greatly value our collaborative working relationship with our union partners and remain aligned in our goal to strengthen our nursing workforce,” he said. The VA “deeply appreciates our partnership with National Nurses United and will continue to work with them directly to resolve their concerns.”

Martinsburg nurses with the NNOC, however, say the hospital has not taken enough effort to reevaluate scheduling policies. Tennant said Friday’s picket marked the first union action taken at the Martinsburg VAMC since it was founded in 1944.

And, until changes are implemented, he said it is unlikely to be the last.

“We’re willing to do whatever we need to do,” he said.