SHERIDAN – Due to staffing shortages, Sheridan Veterans Affairs Medical Center is temporarily shifting emergency care access to walk-in primary care services and limiting the number of patients on some inpatient medical units starting June 13, Sheridan VA officials announced earlier this week. The planned change could result in additional patients for Sheridan Memorial Hospital.
For George Kennah, a disabled Army veteran and Sheridan County resident, the abandonment of traditional urgent care services is another barrier to getting care at Sheridan VA.
“The [Sheridan VA’s] the services are important to me and my friends who served and other veterans, those I don’t know,” Kennah said. “It becomes frustrating to see services cut [when] the sacrifice is not cut for veterans.
What’s changing at the Sheridan VA?
The Sheridan VA is shifting current staff assignments to other areas of patient care, resulting in changes to access to emergency care at the VA and decreased patient counts in some center hospital care units medical, said Kristina Miller, Sheridan VA public affairs and congressional liaison.
Rather than using the Sheridan VA’s designated emergency care entrance in Building 71 North, Miller said patients seeking prompt care at the facility should call 307-672-3473 and select the option. 2 twice, a combination of button presses leading to appointments and leaving a message for the patient’s provider. They will receive care in Building 71, which is the Sheridan VA’s main entrance and where patients typically check in for appointments. If advance notice is not possible, patients should enter Building 71 between 7:00 a.m. and 4:30 p.m., where they will be received on a walk-in basis.
By some clinical definitions, Miller said, this walk-in care isn’t considered urgent care.
But Miller insisted the change — which she described as an internal staff reorganization — would not significantly affect many patients at Sheridan VA. Since the facility’s emergency care did not provide round-the-clock services, Miller said it was not a heavily used service.
Similarly, Miller said patients can access necessary hospital care and medical services at Sheridan Memorial Hospital and other non-VA entities under the John S. McCain III, Daniel K. Akaka, and Samuel R. Johnson VA Maintain internal systems and strengthen integrated external networks. of 2018 – or the VA MISSION law. These benefits — which also cover VA patients receiving emergency care at SMH because the Sheridan VA does not have an emergency department — have led some Sheridan VA patients to choose to access emergency care at SMH instead, Miller said.
“We don’t think it will impact a ton of people,” Miller said.
In addition to the change in urgent care offerings, Miller explained that the Sheridan VA will also reduce the number of patients served in certain units of the facility, based on the average daily number of patients counted over the past year. .
The Sheridan VA Medical Unit, which serves veterans requiring acute medical care and hospitalizations for common conditions such as pneumonia, heart failure and falls, will reduce its patient cap from 10 to five patients, on the basis of an average daily count of 4.92 for the past year.
The Acute Psychiatry Unit, which provides care for veterans in mental health crisis, will reduce its maximum patient population from 20 to nine, based on an average daily count of 5.22 for the past year.
Finally, Miller said Sheridan VA officials would limit the population of the Mountain View Community Living Center, a nursing home, to 20 out of 35, based on an average daily patient count of 21.82 during the month. past year.
These personnel changes will take effect on Monday.
What causes these changes?
The cause of personnel changes in the emergency and medical units is the lack of properly trained nursing staff.
Like medical facilities across the United States, Miller said the Sheridan VA is suffering from a shortage of nurses. Recently, low staff numbers at the Sheridan VA have forced many nurses to work significant overtime. Moving staff from emergency care and other medical units should help facility nurses maintain a healthier workload and provide safe patient care.
“What’s really important to us is maintaining the quality of care they deserve and expect from us,” Miller said. “These changes…are based on maintaining the level of care they should receive while…managing staffing levels appropriately.”
But the problem may not go away with personnel changes. Sheridan VA officials are currently training new nurses and students coming out of Sheridan College to add additional nurses to take on the workload, Miller said, but the facility still has a significant number of openings for new nurses. nursing positions.
Part of the staffing shortage is also related to the Department of Veterans Affairs’ COVID-19 vaccine requirements. Anyone who did not wish to receive the vaccine had to apply for an exemption from the VA’s Office of the General Counsel, the department’s national legal entity, who would make recommendations on whether to approve or deny the request for exemption. exemption. Now, Miller said, the office’s recommendations are coming back and requiring staff members who requested exemptions to make decisions about their future with the VA.
If the Office of the General Counsel recommends denial of a COVID-19 vaccine exemption, Miller said the staff member requesting the exemption has three options: move into more administrative roles without direct patient care; receive the vaccine; or exit the Sheridan VA installation.
“We are seeing some unfortunate losses,” Miller said. “I know people who were absolutely dedicated to our mission to care for veterans…but had to make the decision that was right for them.
The staffing change is temporary, Miller said, and will be lifted with enough nursing staff. But Sheridan VA officials do not know when urgent care services and inpatient units will return to pre-staffing levels.
How will Sheridan VA’s service delivery changes affect Sheridan Memorial Hospital?
Sheridan Memorial Hospital officials are unsure how the changes at Sheridan VA will affect the hospital, SMH CEO Mike McCafferty said.
SMH officially learned of the planned changes during a conference call Thursday morning, McCafferty said, during which Sheridan VA officials shared the number of patients likely to be affected by the change.
According to McCafferty, Sheridan VA officials anticipated that SMH and other local urgent care facilities would need to absorb six to eight additional urgent care patients per day, an amount the hospital can incorporate into its own daily load. of patients.
“It’s something we can easily absorb,” McCafferty said.
For SMH, McCafferty said, the real uncertainty comes from dwindling patient counts in Sheridan VA’s Medical Unit and Acute Psychiatric Unit. While the Sheridan VA plans to reduce medical unit capacity from 10 to five and acute psychiatric unit capacity from 20 to 9, McCafferty said the impact of those decreases on SMH remains unknown.
In particular, McCafferty said he was concerned about SMH’s ability to absorb patients in acute psychiatric crisis, as SMH is not designed to provide inpatient psychiatric care and there is limited infrastructure nearby for behavioral health care. If the decrease leads to additional behavioral health care needs for SMH, McCafferty said it could further strain an already overburdened system.
To manage the possible surge in patients due to rearrangements at Sheridan VA, McCafferty said SMH plans to be in daily communication with the hospital’s medical and emergency care departments as well as officials. from VA. Hospital officials will continue to maintain staffing levels to meet any influx of patients and will continue to assess the impact of the change at Sheridan VA, McCafferty said.
What do veterans think of these changes?
For Kennah, the shutdown of urgent care services represents further frustration in trying to use Veterans Affairs’ medical and disability services.
The most irritating part of the change, Kennah said, was the lack of communication between the Sheridan VA and the veterans in their care. Although Kennah said the facility has the ability to contact all veterans they care for – Sheridan VA staff did so to notify veterans of their eligibility to receive the COVID-19 vaccine. – the establishment did not contact him to inform him of the changes to the service offers. Kennah only found out about the impending personnel change by chance: A nurse mentioned it while he was on the Sheridan VA campus receiving treatment.
Sheridan VA officials did not respond to requests for comment from The Sheridan Press on how the medical center notified veterans of the planned emergency care redevelopment. Miller said the Sheridan VA plans to put up signs at its facilities indicating changes in urgent care service offerings.
The other problem with the change in personnel, Kennah said, is the Sheridan VA’s lack of accountability at the local and state level. Staffing issues exist at health care facilities, the veteran said, but Sheridan VA can modify or discontinue services without local or state input, which community hospitals like SMH cannot do.
“They don’t have to answer to anyone for that. They can just pass it on to local groups that don’t have that ability to…shut down their services,” Kennah said.
For Kennah, the change in urgent care services is an example of the Sheridan VA failing to meet her expectations.
“I signed a contract when I enlisted that I would have VA services when I was done…” Kennah said. “As a veteran, I expect our other veterans who come back worse than mine to be taken care of, no questions asked.”