An investigation after a viral Facebook post showed a veteran lying on the floor waiting hours for treatment has found patients’ wait times were appropriate given the patients’ level of sickness and the emergency-department traffic that day, Durham Veteran Affairs Medical Center officials said Friday.
The internal investigation was completed Thursday after the hospital reviewed surveillance footage and spoke to all of the parties shown in the Facebook post.
The VA said only one of the three veterans depicted in the photo said his wait was too long.
The original Facebook post was uploaded by Hanna McMenamin, the wife of a former U.S. Marine being treated at the hospital, on Friday, Feb. 24. The post has been shared more than 142,000 times, with 18,000 comments.
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The VA said Feb. 24 was an especially busy evening but due to its review it will be revising its “surge plan” as well as placing more recliners in the waiting room. The surge plan will include providing juice and snacks to waiting veterans.
The VA said it has also disciplined a nurse who exhibited rude behavior. Officials wouldn’t name the nurse or describe her punishment, but a spokesman said past performance is considered when determining employee discipline.
The nurse has 30 years experience, no previous complaints and is considered a strong employee, said Greg Eagerton, chief nurse executive at the Durham VA.
Eight nurses were working in the emergency department the evening the incident happened. Eagerton said this was appropriate for the number of people being treated in the department.
At the time of the event, the emergency department was treating 49 veterans; 23 were in the process of receiving care and 26 were waiting.
“As a daughter of a World War II veteran who also received their care here, it saddens me that we did not meet our own expectations that every veteran would receive dignity and respect at all times,” said DeAnne Seekins, director of the medical center. “Nothing less is acceptable in our medical center.”
In her post, McMenamin said she uploaded the photo because she found the scene “very disturbing.”
She wrote that a man was yelling in pain and falling out of his chair and that the sick veteran did not get attention until her husband approached a nurse about him.
VA officials said they reviewed surveillance of the incident and that the man who was lying on the floor was approached by staff at least two minutes after every time he moved from the chair to the floor. The man was given a blanket and offered a recliner, which he sat in for a while before returning to the floor.
“I want to reassure you that the veteran that was lying on the floor was not neglected,” Seekins said. “We spoke personally with the veteran and he stated that he was on the floor because it was more comfortable for him. He said he was extremely satisfied with the care that he received and his experience.”
The three veterans pictured in the photos spent about six hours in the emergency department, and two of the veterans were eventually admitted to the hospital. This was deemed an appropriate amount of time spent in the emergency department based on a standardized assessment tool, said Ken Goldberg, Durham VA chief of staff.
Goldberg said the review of the incident found the sickest patients were treated first, “although patients with less-severe problems did wait longer than we would have hoped on that very busy day.”
At times patients with lower levels of sickness and pain will wait six hours, Goldberg said.
Seekins said the Durham VA, which has 3,400 staff members and treats 70,000 patients a year, is always evaluating ways to decrease wait times.
In recent years, the VA system has come under fire for long wait times at its medical centers, and in a 2014 national audit, the Durham VA had the longest average wait time in the country for patients making mental health appointments, at 104 days.
In response to those findings, the Durham VA has invested heavily in decreasing wait times for appointments, and last year it said its wait time is down to 3.58 days for mental health appointments and 8.91 for specialty-care appointments.
Statement from Medical Center Director DeAnne Seekins
The following is a statement from Durham VA Medical Center Director DeAnne Seekins:
“On Friday evening, Feb. 24, photos were taken in the Durham VA Medical Center’s Emergency Department during an extremely busy time. We provided care to approximately 130 veterans that day. When the photos were taken, there were approximately 50 patients in the Emergency Department area – 23 receiving care and 26 in the waiting area. The photo posted on social media depicts one veteran lying on the floor and several others waiting to be seen.
“I became aware of the incident on Saturday evening and took swift action. We immediately began investigating the allegation. The next morning, my nurse executive contacted the concerned family to get additional details about the situation. Their concerns included timeliness of care and a staff member being rude. I would like to thank the McMenamin’s for caring enough to bring the situation to our attention.
“As a result of the allegation, we removed the employee from patient care. Our staff also reviewed the medical records to ensure the appropriateness and timeliness of the clinical care provided to our patients. We also identified a team to investigate the allegations of rude behavior by a staff member.
“The entire investigation concluded yesterday evening, and as promised, I am here to provide an update.
“Unfortunately, our team substantiated the allegation of rude behavior from one of our employees, which runs counter to our values. As a result, we have taken the appropriate disciplinary actions based on the incident.
“Despite our employees’ failure to meet the high standards we demand when it comes to serving our Veterans, I want to reassure everyone the veteran pictured lying on the floor was not neglected. We spoke personally with the veteran. He stated that he was on the floor because he was more comfortable there and was in fact extremely satisfied with his quality of care and experience. We also reviewed security footage of the incident. Each time the veteran repositioned himself from a chair to the floor staff responded in less than two minutes providing a safe, more appropriate area for him to rest. They also provided him a warm blanket and footstool for additional comfort.
“Our executive leadership team attempted to reach all the veterans visible in the photo and were successful in speaking with two of the three. The second veteran also indicated his satisfaction with his quality of care and experience. Another veteran who was in the area during the incident has since come forward to provide his input regarding the high quality care he received during his visit to the Emergency Department that night. The third veteran has been actively engaged with his treatment team throughout the week. The investigation also determined that the wait times for all veterans seen were appropriate based on their clinical assessment.
“Veterans come to us in their most vulnerable moments – when they are sick and at times in excruciating pain. They deserve a safe and comfortable place while waiting for care and to be treated respectfully at all times. Our review of the incident has brought to light some additional steps that we will take to improve the comfort of the Emergency Department. We plan to add additional recliners, and implement a surge plan for high-volume days that includes providing patients with juice and snacks while they wait. Furthermore, we will strongly reinforce our ICARE values of integrity, commitment, advocacy, respect, and excellence to all staff. As the daughter of a World War II Veteran, it saddens me that we didn’t meet our own expectations that every veteran deserves to be treated with dignity and respect. Nothing less is acceptable in our medical center.
“I am grateful to live in a community that cares so passionately about our veterans. I want to thank all of you, and all of our veterans who entrust us with their care. It is truly an honor to serve.”