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Durham VA addresses viral Facebook post showing long wait in emergency department

After being besieged by a viral Facebook post that showed a veteran waiting for hours on the floor to receive treatment at the Durham Veteran Affairs Medical Center’s Emergency Department, hospital officials released the results of an internal investigation on Friday.

The internal investigation was completed Thursday night after the hospital reviewed surveillance footage and spoke to all of the parties shown in the Facebook post. The Durham VA confirmed there was a complaint about the timeliness of the visits as well as rude behavior by a nurse, though its own investigation found that the patients’ wait time was appropriate based off the number of people being seen in the emergency department.

The VA said two of the three veterans depicted in the photo did not lodge complaints about the timeliness of the visit, though a third veteran did say his wait was too long.

The Facebook post was shared by the wife of former U.S. Marine Stephen McMenamin, who was at the Durham VA for treatment. The post, which was posted online on Friday, Feb. 24, shows three veterans waiting for treatment with one lying on the floor, and alleges rude treatment by a nurse.

The VA said Friday was an especially busy evening in the emergency department and due to the official review of that evening’s incidents it will be revising its “surge plan” as well as placing more recliners in the waiting room. The surge plan would include providing “juice and snacks” to waiting veterans.

The VA said it has also taken appropriate action with the nurse who exhibited rude behavior.

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. The names of the veterans and the nurses working at the time were not released due to the hospital’s privacy policies.

“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 Durham VA Health Care System. “Nothing less is acceptable in our medical center.”

VIRAL FACEBOOK POST

The original Facebook post was uploaded by Hanna McMenamin, the wife of a former U.S. Marine, on Friday, Feb. 24. The post quickly went viral on the social media website and has been shared more than 142,000 times and has 18,000 comments.

Hanna McMenamin called the scene“very disturbing,” which is why she uploaded the photos. 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 the man’s condition.

“This gentleman sat in the waiting room in extreme pain for hours upon hours with very little attention paid to him,” she wrote.

She also wrote that the man was treated rudely and ignored by the nurse and eventually decided to lay on the floor.

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 moving to the floor again.

“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 approximately 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, Ken Goldberg, Durham VA chief of staff said.

TRIAGE EMPLOYED

Goldberg said the review of the incident found the veterans in the photos were treated appropriately, according to the assessment tool, which dictates the sickest patients are treated first.

“The patients I reviewed were all triaged appropriately by emergency department staff, although patients with less severe problems did wait longer than we would have hoped on that very busy day,” he said.

There are times when patients with lower levels of sickness and pain will wait six hours, Goldberg said.

Seekins said that the Durham VA, which has 3,400 staff members and treats 70,000 patients a year, is always evaluating ways to decrease wait times and that patients will continue to be treated by the severity of their assessment.

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 recent years into 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.

The VA also said it substantiated rude behavior by a registered nurse, whose name wasn’t released, and that appropriate actions were taken. Charges of rudeness rather than negligence were issued to the nurse.

The exact punishment of the nurse was not revealed.

Officials wouldn't name the nurse or what she said to earn a complaint, but a spokesperson did state that negligence is considered a more severe charge than rudeness and that past performance is considered when determining employee discipline.

The nurse in question has 30 years experience, no previous complaints and is considered a strong employee, Greg Eagerton, chief nurse executive at the Durham VA, said.

Eight nurses were working in the emergency department the evening the incident happened. Eagerton said that this was an appropriate amount of nurses for the number of people being treated in the emergency department.

“I can’t go into detail about what was found by the fact-finding team, but what they did find was not in line with what we expect from our staff,” he said. “Therefore if we do not meet those standards, we address them.”

Zachery Eanes: 919-419-6684, @zeanes

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