This week the House Committee on Veterans' Affairs has held a series of hearings on issues that are impacting veterans and their families. The subject of today's hearing, veteran suicide, also touches on the issue of veterans seeking care at VA facilities only to find misplaced resources, poor communication, scheduling issues and near-misses on procedures that are being administered by less-skilled medical personnel.
Recently, a veteran in the Inland Empire region of southern California contacted me regarding his health care at a local VA hospital. Having served in the Army in the early 1970s, this veteran was subjected to an inoculation delivery system that later was found to be a catalyst for the transmission of hepatitis. This veteran has been treated since for the hepatitis C virus.
Expecting to see his GI/liver specialist for an appointment at the VA, he was instead met by a nurse practitioner, who ended up advising that he receive hepatitis A and B inoculation shots as part of his treatment. By what now seems like a fortuitous occurrence, he was not able to receive those shots early that day, and in a visit to his primary-care physician that afternoon, he was told that a liver test should have been run and that the shots could have been extremely damaging to his immunity. Once again, this veteran would have received inoculation that would jeopardize his health.
Only a daily basis, veterans assuming they are going to see tenured doctors are met with nurse practitioners due to the turnover at the VA. The VA is simply not able to compete with the private sector to attract doctors and has been forced to use its existing resource of nurse practitioners to provide care to veterans.
At times, due to changes in the name-badge identification of these healthcare providers, the patient may be unaware of whether they are being treated by a doctor or some other medical professional. The badges and uniforms have been become so similar, if not misleading, that patients may be unaware of the role of the medical professional who may be treating them.
The need for tenured doctors is obvious: Their education and experience are needed to make diagnosis and provide a treatment plan that provides the best healthcare outcome for the veteran who comes to see them. In the absence of this expertise, we end up with veterans who may have their medical problems exacerbated, or perhaps even receive fatal treatment.
A recent piece on Politico highlights the consequences of inexperienced nurses providing care while also underscoring the treatment of whistleblowers who have brought to light these unsafe practices at the VA:
"After reporting hundreds of cases, eventually about 20 [percent] of the ER nurses actively began to impede care of my own ER patients. Those nurses stopped initiating protocol orders for me, providing me with verbal patient reports, handing me EKGs, and answering basic questions I asked," [Katherine Mitchell, a 16-year VA employee who worked at facilities in Phoenix] wrote.
Mitchell said she raised concerns that inexperienced nurses were missing signs of "internal head bleeding, strokes, heart attacks, pneumonias, and dehydration" in patients at the ER.
Iraq and Afghanistan Veterans of America has been trying to raise awareness of the issues that are plaguing veteran health care, as have other veterans' organizations trying to use this opportunity of national exposure of practices at the VA to bring much-needed changes to VA care and procedures.
In a year when we have had a national conversation about providing health care and ensuring that all individuals have access to health coverage, it is unfortunate that we have overlooked the individuals receiving care at our nation's VA facilities. The lack of funding and oversight for the VA not only puts veterans' health in jeopardy but leaves those who are working hard at our VA facilities to provide quality care with their hands essentially tied behind their backs.
If how people are to judge our country is by how we take care of those who need medical care, we are certainly failing our veterans.