VA Hospitals

Nurses General Nursing

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  1. What Type of Care does the VA provide?

    • 3
      Excellent Care
    • 6
      Above Average Care
    • 3
      Average Care
    • 8
      Below Average Care
    • 1
      Poor Care
    • 3
      Take a Nurse with You
    • 2
      Close the Place

26 members have participated

I am a Nursing Admin. in a large hospital in Atlanta. I work for an agency part-time to get a look at other hospitals and to work at the bedside. This provides me a look at what the bedside Nurse is coping with.

Recently I worked for the VA in Atlanta, several shifts over several weeks. I was shocked to see the horrible care they provide. Drugs weren't given as ordered, they were just rescheduled if they weren't there. Patients falls were a nightly occurance. Vital Signs were charted but not done. BG levels were charted but also not done.

I know this because I checked with patients and family. One patient fell and blacked both eyes. No Doc was called. The patient's side rails after the fall were left down. Then at the nursing station the charge Nurse stated " make sure you chart the rails were up.""I know they weren't but chart it anyway" to the Nurse providing his care.

:confused:

Every patient I had had complaints about the shift before or about the nurse that usually had them. I went to give one drug and the patient stated "what is this, I have never had this before". I rechecked the order and it had been ordered 6 days before. I then checked the MAR. It had been rescheduled over the past 6 days. As it turned out the drug was keep on the floor and available all 6 days.

The attitudes were terrible towards the patients. One patient called and said "I am having a seizure". I went to his room immediately. This was not my patient. His nurse didn't respond until I called the station again. 12 minutes before anyone else showed up.

I went to the Nursing Director. I filed a complaint. Nothing. I spoke with the Nurse Mgr. Again Nothing. I went to the Board of Nursing. They have NO authority at the VA. The VA is a Federal agency.

I worked with a few good nurses. But they were getting burned out with the ones who didn't work. The bad ones far out numbered the good ones....

I have never worked in any hospital that their level of care was this poor. I have been a Nurse for 30 years. I thought I had seen it all. Most of the Nurses I encountered would be fired at my hospital.

Has anyone else experienced the VA? What did you find?

Maggie RN MSN PhD

Specializes in Nephrology, Cardiology, ER, ICU.

Hi Maggie...First I want to say I am a Navy veteran and my husband is retired military. I worked for two years in the MICU/CCU at the VA in Indianapolis and we gave great care. I have personally visited the VA in Tampa, Florida and they recently received Magnet status. I am saddened that you had such a rotten experience. Please report it to the VA directly. You are right that there are some very poor nurses out there. I'll be honest too that it is almost impossible to get fired from the government. As our veteran population ages - more care is going to be needed and it must be excellent. Neither my husband nor I have used a VA facility as we are both fairly young and healthy (knock on wood).

I am so sorry you had that experience. But please do not make a generalization about VA hospitals. I work in Spinal Cord Injury here at the VA in San Antonio. I believe we provide excellent care to our veterans. I invite you to check us out when you are in town.

Specializes in ORTHOPAEDICS-CERTIFIED SINCE 89.

I can only speak to the outpatient setting of the nearby VA.

Both my husband and his brother are their patients. They have received very good and timely care.

They have diagnosed my BIL's neurologic condition and have provided treatment and therapy.

The physicians that we have dealt with have been very good. There are of course PGII and III who also work there, on rotation from the medical center that is affiliated with the Medical School (which is on the VA campus).

Another BIL spent 6 months inpatient there with Guillain Barre' and he has said the care for him was also very good. He was totally paralyzed for most of that 6 months and had no sign of skin problems, bowel problems or any other long term effects.

I believe that each floor of each VA Hospital is probably as different as each would be in a public facility. Painting all with the same brush is not fair or possible.

Specializes in Corrections, Psych, Med-Surg.

With any huge system (and the VA is the largest healthcare system in the US) there are going to be some bleak spots. Atlanta is apparently one at this time. No doubt there are a few others.

Please contact the VA in Washington, DC directly and relate what you saw and heard, for the benefit of us all. I have never been to Atlanta, however, so can not offer any personal comments about that facility. I am always sorry to hear when our veterans are receiving substandard care and I hope you will do your part to correct the situation.

For myself, I have worked med-surg at a VA in California and as a vet have received healthcare in two California VAs as well as in Oregon. I have also worked for Kaiser and received healthcare from them and several other companies over the years in several states.

For a number of years now I have chosen to use VA facilities whenever possible, regardless of employer-provided coverage elsewhere. "High quality" and "thorough" would be two words I would use to describe it, in my experience. When I have had a rare problem with the system, I simply wrote the medical director and they followed up.

Better staffed and better equipped than any of the other facilities I have used or in which I have worked. Since they were affiliated with teaching hospitals, I have been most impressed by the quality of physician staff as well. The VA also provides ongoing training, scholarships, and multiple incentives for CNAs to become LVNs, LVNs to become RNs, and so on through NPs, as it did for me.

Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac.

I think it varies. I hear the care at the VA here in St. Petersburg is pretty good.

I worked in Fayetteville, NC as a tech in the VA. The ratios were horrible for the night and evening shift. One free charge and two nurses and two techs for 32 patients. That's a 16:1 ratio. Meds were passed, and patients were cleaned and turned, but not assessments were done. Not one nurse held a stethoscope to a patient or did any kind of assessment, with ratio like that it was more like a LTC ratio.

The attitudes of a lot of the nurses was very poor, even though most of them had many years of experience working there.

That was a long time ago and I hope things have changed.

Specializes in MS Home Health.

I have had many home health clients have horrible experiences both in and outpatient. Getting ahold of someone in the clinics takes an "act of God" as they are just was overloaded and not enough staff.

renerian

My husband was a patient in the VA hospital in Dublin, Ga. when he was diagnosed with lung Ca in 1992. (This is prior to my becoming a nurse.) He passed away July, 1994.

Some of the things I saw there were awful. If a patient didn't have anyone to come see them or see about them the care was bad, as a general rule. I was with my husband every day, so he received excellent care.

In fact when he was transfered to Augusta, Ga VAMC, some of the nurses that took care of him in Dublin would call the hospital to check on him while he was in Augusta. They also called me at the hotel where I was to check on me. This was one of the many reasons I went into nursing.

IMHO, I think there are a few nurses who give sub-standard care no matter where they are employed. It is a sad fact, but a true one. And I think once a patient receives poor care, they tend to expect it everywhere they go. :confused:

Senility prayer: Grant me the senility to forget the people I never liked. The good fortune to run into the people I do like. And the eyesight to tell the difference

I would have to relate exactly the opposite of Sjoe. I am a disabled vet, and though I am required to receive some care from the VA for service related conditions, I try to avoid the VA for all but routine follow up care and meds. I have been to several different VA facilities, and have found a list of problems that just keeps getting longer.

Start with the "government employee syndrome." Everyone who works at a VA is a government employee, and therefore can only be fired by an act of God, and then only when the act is countersigned by the president, the pope, and some guy you never heard of. As a result, employees take the attitude that it doesn't matter whether or not someone received proper care. I put in 8 hours, and I go home. If something isn't done, if a med is missed, nothing is going to happen to me, nothing will be said. Besides, its not like that post joint replacement patient really needed that antibiotic or morphine. I get paid to be there and to breathe, not to be competent.

Funding cuts have damaged the VA almost beyond repair. Go to any VA facility, and you will find parts of the hospital in disrepair. You will find equipment that is two to three generations behind what many rural hospitals in the US have. Medications will wax and wane in their availability, as the drugs available at each VA change whenever someone comes out with something cheaper than what is already in use. Consider: I have primary hypertension, first diagnosed in the military. For that, I take atenolol and an ACE inhibitor. While in the military, the ACE inhibitor I was given was Vasotec. It worked, and my blood pressure was well managed. When I arrived at the Wichita VA, I was told "Sorry, but that's just too expensive, and our pharmacy does not carry it. We use XXXX." (I don't even remember what it was now, for reasons that will momentarily become clear.) For the next 6 years, I went through no fewer than 4 different ACE inhibitors, as prices fluctuated. Some worked, some didn't. Sometimes my BP was well controlled, sometimes it was less well controlled. I pointed this out any number of times to nurses and physicians, to no avail. Vasotec was too expensive, I'd have to settle for whatever they sent me. I have since moved, and am now (10 years later) back on vasotec, and my BP is again well controlled. I also have a knee injury, which will eventually require replacement. Forget ever getting any of the new COX II inhibitors, like Celebrex, at the VA. You get your choice of two; ibuprofen or naproxen. If they don't work, suck it up. If you develop gastric problems from this, we'll give you some carafate. We gotta save money.

How about other horror stories from my own experiences around the VA system? No problem:

-How about lab techs going from patient to patient, handling urine samples, drawing blood, working on the computer, without ever changing gloves? When I complained, I was told by everyone, including the medical chief of staff that as long as the lab tech couldn't see anything on their gloves, the practice was perfectly in keeping with universal precautions. The procedure was only changed when I threatened to go to the press. The patient representative said that, while there was no real problem with the practice, it did seem "kind of icky."

-How about the patient my wife took care of in the burn unit where she was an RN? This patient had second and third degree burns on his lower back, buttocks and thighs. He had had a relatively minor surgical procedure done at the VA, and was burned by a very old, poorly maintained K-Thermia. An outpatient surgical experience turned into a six week ordeal, with debridements, pain and suffering. Not to mention the burn scars he will now carry to his grave.

-How about the check-in desks at another VA? They are set up so that all patients must stand in line, for upwards of an hour, with no where to sit while waiting to check in. Think about that for a minute. We have a HUGE number of older veterans, and the military is great for creating orthopedic injuries. Standing in this line is a painful ordeal for nearly all of them. Too bad. We do have administrative things we have to do, and sometimes administration hurts.

-Speaking of those check in desks, how about the fact that whatever you discuss with the check in clerk can be heard by those standing in line behind you? And when I pointed this out, I was told "I guess we didn't plan very well for our remodeling, did we? Oh well, you guys aren't embarrassed to have others hear what you are talking about, are you?"

-How about the older gentleman (in his 70's, at least), a farmer from over 250 miles away, reduced to tears by the VA. He received a notice from the VA, to be present for an appointment at 8 AM on a given day. Not having a lot of money, he didn't want to stay in a hotel, so he got up at 3 AM to drive to the VA for his appointment. When he checked in, he was told by the clerk that his physician had decided to go to a conference, and he would be notified by mail when the appointment would be rescheduled. And oh, by the way, he'd better not miss the rescheduled appointment, or he could lose his benefits.

I have personal knowledge of each of these incidents. Generally, I witnessed them, or they happened to me. I left out the myriad of stories others have told me. Also, I have intentionally left out which VA facilities these incidents occurred in. I have been to several, and have found that each of these incidents could easily have occurred at any of the facilities to which I have gone.

The list goes on and on. There are, no doubt good VA facilities. There are no doubt good nurses and physicians working for the VA. But they are not, in my experience, the norm. The norm is that the VA has become antiquated. It is a creaking institution, with uncaring providers, snotty clerks, and ancient equipment. It is underfunded, and bureaucratic inertia has left it unable to change or adapt. It is time that the VA close all the health care facilities they run, and the care they provide be farmed out to local physicians and hospitals. In the long run, given the ever shrinking population of veterans in the US, there is no doubt that the care would be delivered at less cost to our government, and would be provided in a more sympathetic, effective fashion.

Not that I have any strong feelings about the issue.

Kevin McHugh, CRNA

wow kmc,

gosh, i had forgotten what it was like to go to the vamc. you hit the nail on the head and brought back memories. i too, have driven all night to have my husband at the hospital by 0800 , only to be told the appt had been cancelled and would have to be rescheduled. i had forgotten about the rudeness of the clerks when the vet "made it up to the desk". i remember having to wait all day for a script to be filled.

i do not doubt for one minute everything you say is true. i have experienced a lot of that myself, on behalf of my husband. i think it is a shame when people put their lives in harms way are treated like beggars or second class citizens.

i forgot to mention in my previous post that my husband had been to the va only 2 weeks before being diagnosed. he was an inpatient for approx 2 weeks. the day he was discharged, the doctor told him he had no sign of cancer. within 2 weeks he was in our local doctors office with hemoptysis. this doctor called the va doc and told him what test to run. it was then and only then they found the cancer. i do not know if it was an honest mistake or if there was a screw up with lab and/or x-ray.

thank you for your input. makes sad our servicemen and women are treated in such a degrading fashion, tho.

beer is proof that god loves us and wants us to be happy. ben franklin

Agree kmchugh. I am a veteran too and have lots of unpleasant stories to pass on. In one instance I had to write my congressman to get just the basic type of meds I needed from one VA facility. Don't even think about getting any med that isn't the cheapest they have on the shelf. If what they have doesn't work for you then just suck it up! I have Tricare and do not have to bother with the VA much. It kills me to see our military treated so shabby when they have given their all for their country. When I finish school, this is what I'd like to do -- take care of our own.

Specializes in Community Health Nurse.

I think the care will vary from good to less than good care depending on the facility itself........just like any hospital environment. We have the good, and we have the not so good.

Same with nurses. We have nurses who are good at what they do, and we have nurses who only work for the paycheck. :o

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