Questions about Veterans Hospitals

  1. I have a couple of questions about the VA hospitals that I hope someone can help me with. At our small county hospital, we get a male patient in sometimes with a significant medical history. He has cardiac problems, COPD, renal insufficiency (you get the picture). He is a military vet and in his mid 60's. Usually this guy presents with c/o angina and/or SOB. After we do the usual cardiac/resp work-up to r/o anything acute it usually comes down to admitting the guy for tele monitoring and serial enzymes. The last time this guy came to the ER it was the same situation. The pt wanted to go to the VA hospital for his care. The ER doc called the VA and gave them the patient's current info and his history. The VA refused to accept him. We have had this happen before with this patient where the VA won't accept him. So we admitted him to tele at our facility. My questions are: Is the VA capable of handling acute cardiac events? Do they have teles and ICU's? I guess I was just wondering what kind of patients does the VA work with? Do they handle acutely ill vets, or just chronically ill vets? Any info on this subject would be appreciated! PS- Two days after this guy was admitted to our facility he experienced an MI, and went into CHF for me. We ended up intubating him and transferring him to a larger facility for more specialized care. Wasn't 15 minutes after I got this guy transferred the VA called me for an update on this patient! I figured they weren't interested in him two nights before, so why would they be interested now? I just told them he was transferred, nothing else. Didn't update them on his status, or where he had been transferred to. Figured they didn't have a need to know.
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    About deespoohbear

    Joined: Aug '01; Posts: 2,276; Likes: 42


  3. by   BadBird
    I don't know about the area you live in but in Pittsburgh the VA does have acute care , nursing home, and psych hospitals. I do not work for the VA but I also have had patients admitted to our ICU because the VA did not have any beds available. I was told once they are admitted to another facility it is near impossible to transfer them to the VA. I have also had very sick terminal patients discharged from VA and told nothing else could be done for them and then admitted to other community hospitals. I wonder is the VA is dumping patients that are costly to care for?
  4. by   deespoohbear
    I don't think this was a case of no beds available. I think it was just a case of them not wanting to accept him because of his med history and the fact that he has the potential to be a train wreck. I find your comments very interesting about the VA in your area. Maybe this is the way it is across the nation, and not just here in Indiana.
  5. by   debbyed
    In my experience we have been unable to get patients transferred to the VA. hospital after business hours (9-5). Sometimes we are told to admit the patient to our facitity, other times we are told to hold the patient in the ER until the next morning (NOT).

    Never worked for the VA. so I don't know the whole story, just know that it is next to impossible to get patients transferred there.
  6. by   horsin' around
    I work for the VA in OK City as a student nurse. I know that at our VA (every hospital is different with a different administration) that we handle just about every kind of patient. We have CICU, MICU, etc and often take transfers from the other hospitals that are caring for our acutely ill verterans. I have not heard of turning away a veteran at our facility unless we were full (hasn't happened yet). We do sometimes have procedures done at other hospitals at the Health Science Center because we do not have the facilities, or sometimes the skill, to perform the procedure. Everyone that I know at the VA hospital goes above and beyond to help out our veterans. Our veterans love us and want to come to our hospitals because of the comradery they experience with their fellow veteran patients. OH, and when there was flooding in TX the VA hospital was the only hospital left open. The other hospitals in the area dumped all of their intensive care pts (especially those without insurance) on the VA and would not take them back after they reopened.
  7. by   ucavalpn
    I work for a VA in NC - Our hospital has CCU, MICU and a SICU . As far as I know there is no reason a Vet can not be transfered from a community hospital to the VA. WE get transfers all the time . Only thing I can think of would be if they were not service connected . Some services are not available to non-service connected Vets .
  8. by   night owl
    Our VA handles acute, chronically ill, psych, geri psych. We have an ICU, CCU, ambulatory care clinics, visiting nurses to go to the homes, an ER dept. Legally the VA cannot refuse a veteran unless they have a full house and then they have no choice but to refer them to the nearest civilian hospital. At our VA Nursing Home Care Unit if the resident becomes critically ill and he is alert and oriented, the Dr. asks the resident which facility he prefers to go to because it's the veteran's right to make that decision. Otherwise, he is transported to the VA ER. From there the decision is made to admit him/her to ICU, CCU or to the acute medical unit. We also have a rehab unit, an alzheimers unit and a respiratory unit. Our veterans get the best possible care that we can provide for them. I haven't heard of vets being turned away except for one incident about 10 years ago... A veteran came into A&D and wanted to be admitted to the alcoholic unit. Needless to say, he was intoxicated. The unit was full and he was told this. He then pulled out a gun and started to shoot up the place. They cuffed him and threw him in the back of the cruiser and off to jail he went. After that, A&D was decked with bullet proof glass! Luckily, no one was injured or killed in that incident.
  9. by   nynurse1
    very interesting.....
    cant even think of why they wouldnt accept him.....
    i do know that long ago lol
    as a student i saw the worst burn case in my life and watched as the va hospital staff actually healed this man.
    and i had to take transfers and do themas part of my training.
    i wonder if someone goofed there and did somthin they shouldnt have?
    or if this man when there before had signed out?
    i do know one man on the detox unit when i was a student had signed out numerous times in past was on his chart and was belligerent and one day they refused him when he came in saying he was not cooperative of the care they gave.....
    thats all i have to say on this subject lol
    i can see why you are perplexed bout this
    i would have been too
  10. by   Michelle_nurse
    Hi there,

    I worked in the veterans hospital in Canada, last I heard it was the only one left in Canada. It is LTC, the pts live there till they die in most cases. If they are ok'ed by the doctor, they can go away on pass, even on vacation to Europe if they are healthy enough. This hospital is their home, and it is decorated like a cozy home.

    Some are sicker than others and if a real problem happens and we are not equiped to handle it, the pt is right away transfered to a general hospital, either by ambulance or taxi (/C an escort).
    We do not have an ER, OR, ICU or anything like that. We have 6 psych wards, and various dept's such as physio/ergo, psychology, dentist, clinque, inhalo, but nothing for emergencies. There is only a dr. on call in the hospital on evenings and nights. For the pts on dialysis, they are sent a few times a week with an escort to the general hospital half an hour away in down town Montreal. (even their lunch is packed for them to go)

    The veterans where I work, are treated the best. It is only $600-700 a month to stay there with EVERYTHING included. We also have top of the line equipment, and the nurses are really spoiled. I have never heard of a pt being turned away, we have around 550 pts in the hospital, and they will be doing major renovations costing 68 million dollars to make the hospital more homey and to suit the needs of Alzheimers pts. (80% have this).

    I really love it, and it makes it difficult to go work somewhere else, cause we are trully spoiled. I want to also work on a general post op floor for experience since I am a new grad......I guess we'll see.
  11. by   Cubby
    Since I work at a LTC for Vets, thought I could put my 2 cents in here. We frequently have patients refused for treatment at VA for a number of reasons. Sometimes "the powers that be" don't see the emergency as an emergency and we have to transport the pt. to a private facility then the VA will deny payment!!! Sometimes they divert to other areas just like Regular Hospitals-doesn't happen often though. If your guy is a frequent flyer I would tend to suspect he fits in the #1 senario. But if he really needed the help I can't begin to tell you why they would not take him. Don't ya love bureaucracies?
  12. by   Huganurse
    This question may give an important clue to give you an answer.