Clinical Report: Variability in Nursing Roles and Responsibilities within VHA

Overview

This study evaluates the roles and responsibilities of RNs and LPN/LVNs within Veterans Health Administration primary care settings. Findings indicate differences in the types of activities performed by RNs compared to LPN/LVNs, with RNs engaging more in care coordination and administrative tasks.

Background

Understanding the roles of nurses within the Veterans Health Administration is crucial. The VHA operates under a patient-centered medical home model, which emphasizes team-based care. However, the lack of clarity in nursing responsibilities may hinder effective practice.

Data Highlights

Key Findings

• 3284 nurses responded to the survey, including 1940 RNs and 1363 LPN/LVNs.
• RNs reported higher involvement in care coordination and administrative tasks compared to LPN/LVNs.
• LPN/LVNs were more frequently involved in immunizations and health care screenings.
• RNs allocated significant time to care coordination and triage, while LPN/LVNs focused on health care screenings.
• Both RN and LPN/LVN roles showed considerable overlap in responsibilities.

Clinical Implications

The findings highlight the need for clear delineation of nursing roles within the VHA to optimize patient care and staffing. Understanding the distinct responsibilities of RNs and LPN/LVNs can inform training and operational strategies.

Conclusion

This quality improvement study reveals that RNs and LPN/LVNs share many responsibilities, while their activity patterns differ.

Related Resources & Content

1. JAMA Network Open, 2026 -- Nursing Activities and Role Variation in Veterans Health Administration Primary Care
2. Journal of Hospital Medicine, 2023 -- Quality of hospital medicine care in Veterans Affairs hospitals versus non-Veterans Affairs hospitals: A systematic review of comparative studies
3. MDSpire News, 2024 -- Are Key Patient Concerns Going Undocumented?
4. MDSpire News, 2024 -- Wait Time Equity Elusive in VHA Specialty Care
5. JAMA Network Open — Attrition of Women Veterans from Veterans Health Administration Care: Insights from Primary Care Practitioners in Women's Health
6. VHA Directive 1406(3) -- Primary Care Management Module
7. VHA PACT Handbook 1101.10(2)
8. Nursing Activities and Role Variation in Veterans Health Administration Primary Care | Health Policy | JAMA Network Open | JAMA Network