‘Everything’s gone up.’ Nurses at Miami VA hospital rally for higher pay

Rhonda Harris doesn’t sleep much.

The registered nurse often works overtime at the Miami VA Medical Center, picking up shifts whenever she can. On her days off, Harris, who also has a nurse practitioner’s license, works in telehealth. She and her husband have three kids to care for, and lots of bills to pay, including their daughter’s college tuition.

“Everything’s gone up. My mortgage has now doubled since the beginning of the year so I need to work extra hours,” said Harris, 40, a charge nurse who lives in Cutler Bay and has worked at the hospital since 2018.

Other VA employees are also feeling the strain of inflation and rising housing prices. Earlier this month, a group of nurses rallied outside the Miami VA near Jackson Memorial Hospital to seek better pay, improved working conditions and quality care for veterans.

“I don’t think they’re doing enough to keep and attract nurses. That’s just reality. ... You can see it at the bedside — if you don’t have enough nurses, you’re not going to deliver enough care for the veterans,” said Riezl Paraiso, a critical care nurse at the Miami VA and the associate director of the Miami VA’s chapter of National Nurses United, the union of registered nurses, with more than 225,000 members nationwide. She’s worked at the Miami VA for nearly 14 years.

Registered nurses in the U.S. made an annual mean wage of $82,750, according to May 2021 data from the U.S. Bureau of Labor Statistics. In Florida, which has one of the highest numbers of registered nurses, the annual salary was $72,000 in 2021, the data show. In the Miami-Fort Lauderdale-West Palm Beach metro area, the annual salary was higher than the state average in 2021, but lower than the national average, at $74,220.

At the Miami VA, salaries were even lower. In 2021, a Grade 1, Step 1, registered nurse — often an entry-level job — at the Miami VA made $65,771, according to the Miami VA’s pay schedule. Miami VA registered nurses have pay scales of grades 1, 2 and 3 with 12 salary steps per grade. Most nurses at the Miami VA are Grades 1 and 2, according to the union. The grades and steps often have to do with education and performance.

“If you’re not paying nurses, if your nurses are so grossly underpaid that you can’t retain and recruit nurses, you’re not going to be taking care of veterans. It’s that simple, ” said Bill Frogameni, a registered nurse who works in acute psychiatry at the Miami VA and is director of the union’s Miami VA chapter.

The Miami VA didn’t answer questions about staffing, retention rates or provide examples of recent bonuses and retention incentives. A VA spokesman said questions on staffing, retention rates and examples of recent bonus and retention incentives for nurses had to be filed as a public records request. The Herald filed the request earlier this week but did not receive an answer to its queries.

Instead, the Miami VA forwarded a statement from the federal agency:

“We at VA are so grateful for the work that VA nurses do to deliver world-class healthcare to Veterans daily. This has been particularly critical during the pandemic, when nurses across the country risked their own lives to save and improve the lives of Veterans. One of VA’s top priorities right now is recruiting, hiring, and retaining our great nurses. To do that, VA advocated strongly for the PACT Act and RAISE Act — both of which have given us increased authorities to raise pay caps for VA nurses across the country,” said VA Press Secretary Terrence Hayes in a statement. “We have also maximized bonuses and retention incentives to reward VA nurses for their excellent work and keep them at VA, where they belong....”

Nonetheless, nurses say they are feeling economic pressures, especially with higher food, housing and gas prices.

Jacques Masse, 30, a registered nurse in the ambulatory surgery department at the Miami VA, is concerned about the rising cost of living in Miami, especially with a growing family.

“Better pay will mean a better life. ... Better pay means a lot to all of us. It means that we’re being appreciated, it means that we can actually care for our family and care for ourselves,” said Masse, who has worked at the VA for three years.

Masse said nurses received a 4.3% cost-of-living adjustment in January. At the Miami VA, Grade 1 registered nurses will be paid between $74,172 and $98,647 in 2023, depending on their salary step, according to the VA’s 2023 pay schedule. Grade 2 nurses will make between $86,692 and $115,292.

Pandemic hurt nursing shortages

Hospitals across the country have increased pay and benefits, including signing bonuses, to help attract workers during a nursing shortage exacerbated by the pandemic, when many nurses retired or quit, but the VA has trailed behind, union leaders say.

Miami VA nurses told the Herald that the lack of competitive pay is one reason why nurses have left the medical center. The union says the hospital lost 146 registered nurses and advanced nurse practitioners from the start of the pandemic through the end of 2021. Some left to become travel nurses or went to work at other hospitals.

Some VA nurses like Dina Walters and Lowella Baptista have had to get a part-time job to help make ends meet. Baptista, for example, left her more than decade-long career at Jackson Health, Miami-Dade’s public hospital system, to work at the VA in 2019. The VA offers a variety of benefits, including better job security, she said, but the pay isn’t enough. She’s still working part time at Jackson.

Harris, the RN who often works overtime, said a higher salary would help ease her family’s concerns.

“Better pay would be peace of mind,” Harris said, helping her “have a savings for my children, and for me, for my future, for my retirement and peace of mind and quality of life, being able to spend time with my family and being able to afford basic things.”