VA Hospitals

[Maggie2]

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.

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

[kmchugh]

Originally posted by cheerfuldoer

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.

Renee

You know I love you to death, but read some of what I posted earlier. The VA has become an uncaring, unprofessional institution. Keep the Veteran's Administration, but close the hospitals. They are no longer providing any kind of quality to the veteran. I've taken care of more than one vet in a civilian hospital who preferred to be sent home to die rather than be transferred to the VA hospital for treatment. The institutional mindset of VA healthcare has become so malignant that the only cure I see is closing the VA.

Kevin

[TitaniaSidhe]

I have been a nurse in a VA for the past 14 years. I came to the VA directly from college-RN,BSN- as a graduate nurse. I work locked psych admissions. Upon first coming here I was horrified at many things I saw, not counting narcs, stock meds in the med rooms rather than unit dosing, incompetent docs, nurses, etc., blatently impaired employees who were ignored or covered for....I could go on & on.

I chose to stay on at the VA for several reasons, b/c believe me I did consider leaving. They pay far above anything else in my area & where else can I have the job security in addition to 5 weeks paid vacation per year. More important than all of that was the fact that if every good nurse quit/left who would the patients be left with? I may not be able to change the system but I have been able to be a part of changing the unit I work on & the staff I work with. Like every branch of the government change comes VERY slowly & in VERY small amounts, but change does come. I have seen some change for the better over the years but the VA still has a long way to go. I do think that if the particular facillity is connected with a college/ is a teaching facillity the standard fo care seems to be a bit higher than those facillities that are not.

It is true that the VA equiptment is years behind the private sector.

It is also true that a vet will not be prescribed a med which is "not formulary" despite the fact that it may be the best med for that patient. 95% of the meds I give are generic & sadly lacking in comparison to the brand name drugs. Bottom line is $ but then is the bottom line not also money in the private sector as more & more local hospitals become managed by large corporations? Perhaps it is not quite as blatant as at the VA but it is true.

There is also a HUGE shortage of professonal & paraprofessional staff at the facillity where I work. For example I have worked my unit as the only RN for 24 acute psych patients with only 3 NA's in addition to myself. In the nursing home facillity we have I have seen 1 NA for 20 patient all of which are total care. No one could provide quality care under such conditions. How the hell can I give meds, chart & runs groups or provide 1:1 interactions with all 24 patients while at the same time manage any behavioral or medical crisis that may arise in one 8 hour shift? Just can't so I do as best I can to provide the care & attention I can- usually by sacrificing the charting much to admins disapproval....lol.

Another huge problem with the system seems to be that the more incompetent a person seems to be the higher they are promoted. The administration is very political & very corrupt. They say our mission is patient care but the real mission is about how much money they can save by cutting all those things that would have a major impact on raising the quality of patient care so that at the end of the year they can show they have saved $ to Washington & get a big bonus to their salary.

I agree with the statement that many government workers suffer from a major case of attitude, believe me I have been on the recieving end of plenty of this & I work there! Just try and get any kind of answer or help from Human Resources....lol, what a joke. *sigh*

I feel bad when I read about the treatment some of the vets have recieved at a VA & how they would rather seek their care elsewhere but I certainly can understand why they would feel this way. I can only hope that I have managed to make a samll difference in those who have passed under my care over the years. I stay & continue to fight the good fight for if all of us who cared left, then who would the vets have left to help them...

[TigRN]

I can't remember who said it earlier in this thread - but there are plus' and minus' at any large healthcare organization. Much of what most of you have complained about can be seen in places like Kaiser. I had a co-worker whos husband was to go in for simple outpatient knee surgery. He was overdosed on pain medication because the nurse failed to do vital signs and note that he had been given meds in the PACU. He died about 3 hours after surgery.

The VA does have it's issues - we are funded by the federal government and if they decide not to give us money - well we don't get it. Only in the last few years have we been able to start billing 3rd party insurance companies - but often times the Vets are unwilling to tell us they have insurance - we can't bill medicare like private hospitals so we are often stuck between rocks and hard places. Often times our patients are sicker than what you see in private facilities simply because of the nature of our population.

I agree that we have several employees at all VA hospitals that have that Government Employee attitude - but it's not just the hospitals. As a supervisor I deal with it on a regular basis. And, it is extremely frustrating that it does take what feels literally like an act of God, the President and the Pope to fire someone that would have been fired immediately in a "normal" facility.

I could probably go on and on -- but keep in mind that all VA's are not the same - and all employees in the system are not the same. I have had patients come in and request that I be their nurse even though they were not part of my assignment. I have had patients come back to see me when they were discharged. I have a poem hanging on my office wall written by one of my oncology patients to me before he was discharged and a stuffed dog brought back to me by the father of patient who died. Not all of us are bad nurses and many of us care for the patients like they were our own family. But you are right, many of us get burned out because we feel we have to pick up the slack for those that are just "government employees" for the well being of the patient.