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the office of special counsel, or the inspector general's office under whistle-blower protections instead of their union contract. They can report patient safety issues, anonymously or not, to the joint patient safety reporting system. "If something happens, we have ways to help them address it," said Walden, the CCC nurse. "The VA has handbooks that are pretty comprehensive." Westmoreland agreed. "We hold them accountable to the hand- books that they've got. And they've got a million of them! We show the nurses the options they have now and show they can use them." "I still tell the nurses, we still have our avenues—it's just a differ- ent way to do it," said Uzuegbunam. "Use the VA handbook. They are constantly violating their own handbook." The nurses observed that managers often are not versed in the VA's own policies and just blindly follow upper management's orders to union bust. In this manner, VA nurses have continued to stand up for their colleagues in all types of situations. Many have successfully gotten discipline reduced or dismissed for other nurses. Fallon and West- moreland have pushed back against management's attempts to prevent them from exercising their First Amendment rights to speak to the news media. Walden said the CCC nurses, who do telephone triage when vet- erans call, have gotten management to back off from implementing ever-draconian limits on average call handling times by making and distributing flyers to members, veterans, and the community. Even though nurses can't post the flyers or hand them out at work doesn't mean they can't send them electronically to everyone's personal email addresses or make sure veterans groups get them so that they can barrage supervisors by phone and email with support for the nurses. "It works. People call," said Walden. "It's always a bonus when we get the veterans to call." When Uzuegbunam discovered during recent performance eval- uations that managers were ordered to give nothing higher than a "satisfactory" rating, she appealed the designation and presented her case. "I'm not 'satisfactory,'" said Uzuegbunam. "I am doing things above and beyond. I have a doctorate, I educate and teach and present continuing medical education courses outside the VA. They were pissed off at me for challenging it." Though she believes she should have gotten her typical "outstanding" rating, they still had to rewrite her evaluation to reflect a "high satisfactory" ranking. So she won. W hy suffer within the VA system? All the VA nurses agreed that they choose to stay and fight because they care deeply about taking care of their veterans. "All of the nurses that I work with care a lot about the veterans," said Quinn. "Honestly, it's pretty nice to be part of a health care community where we're all taking care of patients together. The cases I remember are the ones where I was able to get a really nice win for them, to connect them with services they need, or to catch a medication that is too high or too frequent, and to have it reverse their symptoms. To have an 'Aha!' moment with." Even though VA leader- ship has not targeted clinical staff for layoffs, the nurses report that the system has failed to replace RNs that they have lost through attrition, that the infamously slow hiring process has been made even slower because they have elimi- nated human resources positions, and that RN workloads and responsibilities have skyrocketed due to elimination of unit secre- taries, housekeeping staff, transport staff, and all those support positions that keep VA facilities running so that nurses can provide clinical care. Understaffing is rampant. "There are chunks of time where we don't have ANY housekeep- ing staff, or people to do CT scans, to do transport, answer the phones, page doctors," said Fallon. "Nurses are absorbing those tasks. That alone significantly impacts care. Clinical care is really being affected despite them saying that's not the case." Fallon was quoted in a March 2026 New York Times article saying that sometimes her hospital regularly does not have enough ultrasound technicians available and must send patients outside of the VA system to the pri- vate sector—what the VA calls "community care"—for services. Quinn also reports that nurses are very worried VA facilities like hers are losing services as they lose staff. "We don't have pulmonol- ogy anymore, which is important for the ICU," said Quinn. "We lost dermatology. We lost half the podiatry staff. We lost at least half of our GI doctors, we don't have enough radiologists either. We're run- ning clinics on bare bones. Not only are we trying to manage more patients with fewer staff members, but the patients have more com- plex conditions and needs as time goes on." She cited VA health coverage of veterans exposed to burn pits as an example. The nurses fear that conservative Republicans' endgame of com- pletely privatizing the Veterans Health Administration will be the result of losing so many staff and services. Ultimately, the VA will not be able to provide the care—not because they don't know how or don't excel at caring for veterans—but simply because there will be no one left to do it. To the VA nurses, sending their veteran patients to typical private-sector health care settings would be a travesty. Walden, whose own brother is a veteran and on whose behalf she has had to fight to get a proper diagnosis and care, said that private- sector health care does not understand the culture of veterans. "They know their team, they trust in the VA and it's almost like a social setting for them," said Walden. So for their veteran patients, the VA nurses continue to wage war against the union-busting Trump administration. It is difficult, but "nurses show up for patients. We do hard things all the time," said Fallon. Surrender is not an option. "Does the department attack us? Yes. Will they continue to attack us? Yes, they will," said Westmoreland. "But we will always be a union." Lucia Hwang is editor of National Nurses United. 14 N A T I O N A L N U R S E W W W . N A T I O N A L N U R S E S U N I T E D . O R G A P R I L | M AY | J U N E 2 0 2 6 "We don't need anyone's permission to act as a union. This administration will not be around forever. This is temporary."