Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: THURSDAY, February 27, 1992 TAG: 9202270171
SECTION: VIRGINIA PAGE: B1 EDITION: METRO
SOURCE: LESLIE TAYLOR STAFF WRITER
DATELINE: LENGTH: Medium
UNION CITES TROUBLES AT SALEM VA CENTER
Employees at the Department of Veterans Affairs Medical Center in Salem on Wednesday echoed the union president's claims that thework environment is in "total disarray" and patient care is deteriorating.Employees charged that:
Nursing services are short-staffed.
Some staffers are being directed to move patients out to meet a mandated reduction in bed space.
Hidden video cameras have been installed in day rooms, the pharmacy and other places to monitor patients and employees.
Even as they were considering a proposal to provide care for non-veterans, top administrators were treating the center like "big business," neglecting the care of veterans. (That proposal was retracted last week).
The employees requested anonymity for fear that speaking publicly would violate a VA policy that prohibits employees from any action that could lower the public's confidence in the federal government.
"This is the worst I've ever seen," one 10-year employee said.
VA officials in Salem were surprised at the employees' allegations.
Of the nursing shortage, Pat Clark, Salem VA public affairs director, said the center is working to fill 30 vacancies on the nursing staff.
Of the video cameras, Clark said: "When we have patterns of allegations on issues like patient abuse, theft from patients, drug diversion for other illicit activities, we get authority from the U.S. attorney's office to use video equipment." Clark declined to elaborate.
Of moving patients to reduce the bed count, Clark said no veterans are discharged simply to clear bed space. Patients are thoroughly reviewed by a "treatment team" before they are discharged, she said.
The employees' allegations came on the heels of comments made by Alma Lee, president of the 600-member American Federation of Government Employees union at the Salem VA center, at a news conference This is the worst I've ever seen. A 10-year employee Wednesday. Lee maintained that a lack of leadership has led to a medical center "totally out of control."
"This shoot-from-the-hip approach to management has created nothing but confusion and low morale for employees," Lee said. "Patient care has deteriorated to its lowest point in the history of this facility."
Lee's concerns are rooted in changes related to the scheduled April 3 opening of a new $50 million facility at the VA center, designed to consolidate acute medical and surgical beds into one building.
The move will result in the temporary closing of at least two long-term-care wards. That means a temporary loss of almost 100 beds for veterans, Lee said.
"The long-term impact of these decisions is fewer beds for patients and reduction in quality care," Lee said.
Clark said local VA center directors have the authority to temporarily close units for up to 30 days. The Salem center has asked for official approval from the central VA office in Washington, D.C., to close the beds for four to eight weeks.
Union representatives have met with VA officials monthly to discuss movement from the old facility to the new. But Lee claims the meetings have been disjointed.
"Every meeting is different," she said. "Every meeting there's a different plan."
Clark maintains that changes in the plan can be expected. Once the plan is put in motion, "you run into things you don't expect and you have to change," she said.
"We feel quite comfortable with the planning that's taken place," Clark said. "We understand there are still some concerns on the part of [the union] and we have to be sensitive to those concerns. Maybe we need to take a second look."
Many of the center's programs have been reviewed by the central office in Washington, Clark said. The office has made recommendations for changes, particularly in the areas of long-term care, psychiatry, surgery and ambulatory care, she said.
But Lee maintains that the central office is acting not on its own in recommending changes but on recommendations that originate at the Salem VA. She cited the rural health project as an example.
The project and another at a VA hospital in Tuskegee, Ala., had enraged veterans' groups since it was announced late last year. The groups claimed the projects would allow some non-veterans to receive care and undermine the treatment of veterans.
Salem medical center officials had defended their project as an effort to provide basic health services to veterans in remote communities who find it difficult to travel to Salem.
VA officials in Washington killed the project Friday.