Ever since Florence Nightingale brought her intrepid band of nurses to care for English soldiers during the Crimean War in 1854, nurses have been on the front lines of caring for soldiers and then, when they become veterans, tending to their visible and invisible wounds of war and military service. In so doing, nurses—whether men or women—have risked their lives and health to care for their patients.
On Saturday, January 24, another nurse sacrificed his life to protect the sick and vulnerable when he joined thousands of other ordinary Minneapolis residents to protest the occupation of their city by federal immigration agents. Alex Jeffrey Pretti didn’t know that, after attempting to help a woman whom ICE agents had assaulted with pepper spray, he would be brutally murdered. But he was killed, not because he was filming ICE agents or because he happened to have a licensed and permitted firearm, but because he was fulfilling his oath as a nurse.
Pretti was not only a nurse but an employee of the Veterans Health Administration who had dedicated his career to caring for military veterans. Interviews with VHA employees show that they have not only been devastated by the killing of one of their colleagues, but also by the administration’s response to it.
President Trump has vacillated between calling Pretti an assassin and calling for a full investigation of his death. Deputy White House chief of staff Stephen Miller accused Pretti of being a “domestic terrorist,” and since-demoted U.S. Border Patrol official Gregory Bovino alleged that Pretti “wanted to do maximum damage and massacre law enforcement.”
A VA nurse who works in a West Coast hospital told the Prospect that it has been “devastating” to see high-level administration officials malign their colleague. What has been even worse is the response of their immediate boss, Secretary of the Department of Veterans Affairs Doug Collins.
Collins did not even bother to send out an email acknowledging the shock and horror of the more than 400,000 employees who serve under him. “There was nothing in my in-box about this on Monday morning,” one VA employee told the Prospect. Collins’s only response to Pretti’s death was on social media, and it was, the employee said, not helpful.
All Collins said was: “We can confirm Alex Pretti was a nurse at the Minneapolis VA Medical Center. As President Trump has said, nobody wants to see chaos and death in American cities, and we send our condolences to the Pretti family. Such tragedies are unfortunately happening in Minnesota because of state and local officials’ refusal to cooperate with the federal government to enforce the law and deport dangerous illegal criminals.”
“As a veteran, a union member, and a VA nurse, I am shocked by this response,” said the nurse, who preferred to remain anonymous for fear of retaliation. “That could have been me in Minneapolis, that’s exactly what I would have done, try to help someone who’d just been injured.”
On Reddit, VA employees have been lamenting the “deafening silence” of VA leadership. On one post, an employee wrote, “What’s been especially troubling is the silence from VA leadership—particularly Secretary Doug Collins … Morale in health care is already fragile. Many of us are burned out, short-staffed, and emotionally stretched thin. Seeing a fellow VA clinician die in such a public and troubling way, and then hearing nothing from the top, feels like abandonment … silence in moments like this doesn’t feel neutral. It feels like a choice.”
Many VA employees believe this “choice” is grounded in a failure to appreciate the value of their work and the sacrifices many of them make to work with veterans. As the VA nurse told the Prospect, “Like Alex Pretti, we definitely sacrifice a fair amount to come to work here. We could get paid way more in the private sector.”
In the private sector, the nurse added, most RNs also work with far less complex patients. As studies document, veterans are older, sicker, poorer, and have more mental and behavioral health conditions than private-sector patients. A 2021 report from Brown University’s Costs of War project underscored that the open-ended global war on terror has produced the most disabled cohort of veterans in American history.
A VA neurologist explained that some of these veterans suffer from the “defining injury” of the war on terror, which is blast injury. Patients come to the VA with post-concussive syndrome as well as severe PTSD. These affect the frontal lobe and lead to problems of aggression and lack of impulse control. Like so many VA employees, this doctor says, “I have had patients spit on me, throw urine on me, and sometimes even be physically assaultive.” In an effort to create what the VHA calls “a culture of safety,” it has developed an elaborate Prevention and Management of Disruptive Behavior (PMDB) program to protect workers and patients alike. “We stick with it,” the neurologist said, “because we want to care for veterans and we hope the VHA has our back.”
VA employees argue that over the past year, this is no longer the case. Too many see the vilification of Alex Pretti to be a continuation of other administration attacks on their work, as well as the public health care system they value. When DOGE began its work, for example, VA employees, like other federal workers, received an email from the Office of Personnel Management known as the “Fork in the Road” memo, urging them to resign. (The email was sent one year ago today, on January 28, 2025.) In answer to their many questions, VA employees were told that “the way to greater American prosperity is encouraging people to move from lower productivity jobs in the public sector to higher productivity jobs in the private sector.” Translation: In working to care for veterans, they were doing unproductive work.
Almost as soon as Secretary Collins took up the reins of the VA, he informed VHA employees that 83,000 of them would soon be fired. Although he backtracked on those cuts, other Collins policies, including hiring freezes and caps on staffing, have created the kind of short-staffing and hostile work environment about which the VA employee complained in the Reddit post. A Senate Democratic report released this week have led to 40,000 jobs lost, plummeting morale and worsening care for patients.
A VA physician told the Prospect that leadership in Washington is even trying to stop grieving VHA employees from honoring their slain colleague. When workers at the Minneapolis VA Medical Center wanted to hold an honor walk for Alex Pretti, a VA physician in Minneapolis told this doctor they were informed that “it can’t happen.”
While the American Federation of Government Employees (AFGE), Pretti’s union and the union for thousands of VHA employees, is calling for the firing of DHS Secretary Kristi Noem and Stephen Miller, some VA employees believe this doesn’t go far enough. They want to see Collins fired for what they consider to be his broader failures of leadership and his “inhumane” response to Pretti’s death.
A vigil outside of the VA headquarters at 810 Vermont Avenue NW in Washington has been announced for today at 6 p.m. Eastern time.
VA patients are also appalled by these developments. Arlys Herem, 77, struggled to find words to explain how she felt about Pretti’s death. “It’s just devastating. I feel it as a Minneapolis resident concerned about ICE agents taking over our streets, as a VA patient, and as a veteran and as a nurse who served in Vietnam.”
Herem spent four days in the Minneapolis VA Medical Center after suffering from anaphylactic shock. “I don’t know if Alex Pretti was one of my ICU nurses,” she said. “He probably hadn’t come to work at the VA yet, but I can tell you that the nurses there were super knowledgeable and competent. I was, for them, a pretty easy patient but other patients were not. As ICU nurses they were essentially managing every organ system in patient’s bodies. It’s such complex work, managing medications, complex technology, and then dealing with patients’ families.”
“What I do know,” Herem continued, “is that Alex Pretti died doing nursing work. His last words on this Earth were uttered to an injured woman: ‘Are you OK?’”