Tell me about VA Hospitals.

[Smarmie Doofus]

My brother... late 50s, Viet Nam era, Navy... just had a stroke. He's self-employed ( or was) and long ago gave up private medical insurance 'cause it cost too much. He's close to penniless, so he's gone to the VA Hosp in the Bronx, NY for medical care in the last few years.

Had a serious stroke this week and is currently speechless. Was driven by friend to the VA and remains there in and out of ICU.

Anyway, I've seen worse hospitals but I'm troubled by the rep VA hospitals, and this one in particular, have. ( Remember the scene from Born on the Fourth of July? Yecchhh.)

It's modern, the MDs are reasonably accessible and the support staff seems generally polite and helpful.

My question: is it different from the patient's point of view? Is this the best place for him to be? What are his options?

Be gentle, folks; we're in a difficult position here.

[efhmc]

1. I think that they are horrible but better than nothing.

[cynatnite]

2. My suggestion

Keep in mind these people do get overworked and are bogged down with policies that change often and they have to keep up. Sometimes a little sugar can go a long way.

If all else fails, see if there is someone else you can deal with who is more sensitive to your situation.

Another option, is you can call the VA administration themselves. The people we've talked with have usually been very helpful and informative.

Lastly, changing VA hospitals is one. Give this some serious thought. He's getting his care there and changing can be a major upheaval and I wouldn't recommend it unless there are no other options.

The people we've dealt with in VA hospitals have been really good to us and they've helped cut through a lot of red tape. I can't say enough good things about them since they did so much to help my family.

Good luck and my thoughts are with you.

[Smarmie Doofus]

15. Good, concrete options. Thanks.

[ultraist]

3. So sorrry to hear about your brother.

I wish him a speedy recovery. I'm not familiar with that hospital so I can't offer any opinions except to say, there are some excellent doctors at some of the VA hospitals.

You may want to find out what treatments they are doing and compare that to what type of things they are doing at the most reputable institutions. You probably can do this research online. Also, keep an eye on his meds. Oftentimes, nurses are overworked and don't notice when dosages need to be adjusted or different meds need to be ordered, in between the Dr. visits.

Good luck, it's so stressful having a family member with an emergency medical situation. I wish you the best with it.

[Smarmie Doofus]

16. I'm impressed by the MD's so far; and surprised, frankly. Thanks.

[tinonedown]

4. Funds cut under Rep leadership

Increased under Dem leadership. Not steadfast rules, but over time this is the way it has panned out.

[hue]

5. To help your Brother

The best way to help your Brother or anyone in any hospital today is for the Pt. to have visitors come every day and ask serious questions. If someone in the family knows about medicine and can ask good/the right questions, the stall will realize that someone is aware of whats going on. If a Pt. has no visitors, and it seems no one is interested in the Pt. the staff seems to follow suit.
Without knowing more about your Brother this is the best I can say. I have been a nurse for over 30 yrs. and family interest is a big motivating factor for good care.
But usually VA hospitals are understaffed so even the best of nurses have to cut corners and prioritize their Pts.

[bobbieinok]

10. my dad was in hospital 4 months, out 2 1/2 years, in 4 months and died

it was very clear what you say

"The best way to help your Brother or anyone in any hospital today is for the Pt. to have visitors come every day and ask serious questions. If someone in the family knows about medicine and can ask good/the right questions, the stall will realize that someone is aware of whats going on. If a Pt. has no visitors, and it seems no one is interested in the Pt. the staff seems to follow suit."


It made me really concerned for my possible future

[Rick Myers]

6. I've been in GREAT VA facilities, and REALLY BAD ones

Cleveland... horrible...

Youngstown (out patient)... pretty bad...

Indianapolis... very good...

Minneapolis... excellent...

[cynatnite]

8. Same here

Oklahoma City...bad (It's been a while so maybe it's better than what it used to be)

Wichita...good

Johnson City, TN...Excellent

[Andy_Stephenson]

7. Dude...

apply for state medical coupons and medicade tomorrow.

If he is penniless he should be able to get the help he needs. As long as he has no assets.

[diamond14]

9. someone who loves him should BE THERE EVERYDAY...family or friends

and that applies to any hospital, where the patient is unable to communicate to medical personnel in a coherent and lucid manner...


at all hospitals today, all across America....patients in your brother's condition are LEFT without much help...mostly because hospitals are understaffed and overworked, and have many other patients whose relatives pester the staff MORE than you....


you've got to BE THERE everyday, and everyday, ASK LOTS OF QUESTIONS of medical personnel...make certain that EVERY SINGLE DAY, his sheets are cleaned and changed, his bathroom is disinfected, his body is cleaned and his body functions are taken care of (eating, urinating and crapping)...nurses and nurses aids do this stuff, and often they skip some people (oh, they look OK today), because they are OVERWORKED, underpaid and understaffed....and high turn-over...

if nobody watches out for him...he can get BED SORES, other nasty infections, and all kinds of urinary tract stuff, and skin sores, etc....and that's all just for starters....


SECOND: be nice to the staff....they are going to take of your brother, but you need to be kind to them, and motivate them....too many people YELL at the staff....thank them often and sincerely, because their work is NOT EASY.....

get to know the DOCTORS who care for your brother...and ask them LOTS of QUESTIONS....doctors can make important REFERRALS, but often don't if nobody asks....Doctors give ORDERs to nurses....so that your brother's rehabilitation can begin....DOCTORS also examine your brother's condition and determine the treatment that will or will not be given....you MUST talk to the Doctors, and discuss your brother's options...YOU are now your brother's keeper....you can leave him there alone, or you can stand by with him as he recovers....you can ALWAYS ask for a second Doctor's opinion, and for REFERRALS to specialists....Doctors can order MORE TESTS.....

lots of times, just being there, and asking questions, moves the STAFF to like "OPEN THE MEDICAL RECORD, and read the orders" "recall that a special test was ordered and the patient hasn't been taken to the CAT-scan yet, so now, they will do that" "ooops....the nurses forget his injection today, so now they'll do it" and LOOK AT every single injection and medication to make certain it's been double-checked, ask the nurse to double-check or show you the container (mistakes in medications, injections is a HUGE problem, can be fatal, people get tired, overworked, night shift, etc.)


and after a while, the staff will KNOW that you'll be there EVERY DAY, and that YOU CARE, and the staff will be on top of the situation lots more...because a family member is THERE....Doctors, too...continuously TALK to the Doctors, because you now represent your brother, his interests, his life....and actually, Doctors like it when a family member takes responsibility, because for many people (rich and poor) the families frequently abandoned them at the hospital door.....THANK them, and make them proud of what they are doing, and you'll get alot more help for your brother....


at any hospital, there are special staff for rehabilitation AND for discharge home care AND for hospice, etc. But, you must FIND THESE PEOPLE, because they can help and advise you...but they too are OVERWORKED and understaffed and underpaid....so it's not like they are going to out and FIND YOU...there are also FAMILY counselors for YOU....YOUR brother's Doctor can order any services that he thinks are needed....Your brother's Doctor SHOULD be opening your brother's medical chart EVERY SINGLE DAY, and writing some more notes in there....ask him about it EVERY DAY....it's a PROCESS....ask every day about the sheets, and look at the bathroom, and look at your brother's body, to see if it's clean....and ask the nurses if any tubing has to be replaced, and if it's working correctly (I.V. drips, urinary catheters, etc.)...and ask the Doctor about your brother's progress....let them know that you are your brother's representative, and sign any necessary papers...ask for advice...ask and ask more for advice....then you can judge better what to do after getting as many opinions as possible....ask the nurses 'do patients like this recover well?'....older nurses have seen a LOT of patients like your brother, and can be blunt at times, but their experience can be invaluable to YOU....ask about life-support, and talk about it, so you can be calm and clear what your brother would want if that time comes....





it's won't be easy....I ran the whole gambit as my Mother died from cancer...for almost a year..in and out of hospitals....my brother is a Medical Doctor, a radiologist....it's just one of those MAJOR challenges in life.....IMO, you're always better to STAND with your brother....some in my family just abandoned my Mother in her dying days...and now, they are all in psychiatric counseling or on heavy prescription drugs.....while I feel OK about it all, even though it can be stressful and challenging at times....everybody gets to DIE at some point, and going through the process can be a good learning experience....my Mother died peacefully in my arms in her living room, in her big pink chair....as my medical doctor brother said: a Charmed Death (at the time, I wanted to punch him, but as time went by, I realized how charmed it really was, compared to a lot of cold impersonal hospital deaths, tubed up, and scared)....



my thoughts are prayers are with you...it's a lot of work...but it's something you should do for your brother....

[Smarmie Doofus]

14. Thanks for taking the time and trouble to write this.

[Auntie Bush]

20. That's such good advice. Thanks for posting. I just wish I had

KNOWN all that this winter when my husband was in the hospital for two months recovering from major surgery and complications. If it wasn't for my brother...a retired General Surgeon...my husband wouldn't be here today. He insisted the hospital fax him all of his medical records and low and behold they called in three specialists and started tube feeding him the very next day. They were covering their ass...big time. They knew someone in the KNOW was checking on them and they'd be held accountable. What a difference in his care after that! I could write a book about it. I was guilty of not talking to the Dr's. enough. I was more concerned with visiting him and TRUSTED his Dr's. were doing everything possible. Turns out they weren't! You should also mention that this is especially important advice if you are on Medicare. By the way...MDH is home now and recuperating nicely.

I hope everyone out there reads/remembers/saves this post.

[diamond14]

24. here's a TRUE story....about 20 years ago, my sister had a miscarriage

while I was visiting (about 500 miles from my home)....so her husband, Don, took her the hospital...I told them NOT TO WORRY that I was perfectly capable of taking care of their TWO young children, for any length of time while they went to the hospital...


the kids and I had a lot of fun, but TWO days later, I was VERY WORRIED about my sister, having heard NOTHING from her or from her husband Don...

I called the hospital several times, but they wouldn't talk to me about her condition (except to say she was admitted) because I'm just a sibling and NOT the next-of-kin, which is her husband Don (guess I'm a second level next-of-kin).....and nobody at the hospital had seen Don....


so I was concerned about BOTH my sister, and her husband Don...

still caring for TWO young children, I made a desparate PLEA over the phone to a nurse at the desk, on the floor where my sister was....I was absolutely CERTAIN that Don was there...the nurse was absolutely CERTAIN that nobody had come to visit my sister and that Don wasn't there.....finally, I begged the nurse, assuring her that Don was there somewhere....and the nurse was kind enough to go out to the 'waiting area', which was outside her area of patient care...AND THERE WAS DON....still sitting there for TWO days...just staring straight ahead...WORRIED about his wife....


Eventually, I found out that my sister had lost lots of blood and almost died, while the nurses were concerned that NOBODY came to visit her, and she had asked many times about Don.....they said it's unusual for someone so young to have NO visitors, but they ALL LAUGHED when they found Don, no books, no magazines, just staring straight ahead...several nurses told my sister that they had WALKED RIGHT BY HIM a lot, and didn't know WHAT TO THINK about the guy...my sister recovered and went on to have a third healthy child...



Many years later, when my Mother was dying, I saw so many people like that in these BIG hospitals....they don't know what to do....they are worried and concerned, and some have never been in a hospital before...and often the staff doesn't even know they are there.....if the family could work with the STAFF, everyone could be more comfortable in very stressful situations (which every hospital is)....

[riverwalker]

11. good experience here

in Minnesota. My Dad had major surgery, AAA repair 15 years ago at local VA. I am a nurse as well (at another non-VA hospital), so I had my eyes and ears open. I was very impressed.

[UTUSN]

12. Since You Asked, VA = Bureaucratic Hades Coupled with

Testosterone Hades.

[sandnsea]

13. Find a stroke support group

I'm imagining there must be one. That way you can compare the treatment and progress your brother is getting to people in other facilities. If you can't find one or don't have time to find one, PM me and I'd be glad to hunt around your area and see what I can come up with. I'm good at that sort of thing.

[Cleita]

17. Last VA hospital I was in was when I had to take a neighbor

to the one in West Los Angeles. It's a very nice and modern facility, but not all vets can be treated there, it turns out, only those with specific problems. They found so much in the way of untreated illnesses with this neighbor that they kept him there for a month and then discharged him when they couldn't do anything more for him.

He was able to go back for a laundry list of medication and this is where it got tricky. There were times he had to wait in line for hours for his prescriptions to be filled. He died shortly afterwards from advanced cancer and heart disease.

[SoCalDem]

18. My friend received great care while he was at Pettis

He had a terminal brain tumor, and was there for surgery a couple of times, and then for a long stay before he died at 40 yrs old :cry:

The nursing staff and hospital workers were very helpful, and the doctors he had were good too.. He was pleased with his care

[Auntie Bush]

25. I sorry SoCalDem

That must have been so hard on everyone. A friend of mine died of brain cancer this October and it was tough.

[SoCalDem]

26. He was a great guy, and for a few years we all though he would make it.

He never lived to see his son get a scholarship.. It was very hard to see him suffer though, and death was a relief for him.

[doc03]

19. My father was in a public hospital for 6 months and slipping

in and out of a coma if you don't know Medicare terminates after 6 months. On the day the Medicare ran out 3 Doctors called my mother in and told her we should take him home that he could only live a few more days at best. My uncle was an officer in the VFW and he arranged to have my father transfered to the Oakland Veterans Hospital in Pittsburgh. The conditions were sad in the veterans hospital, patches sewn in the sheets and crowded rooms but they had access to Presbyterian University Hospital in Pittsburgh just a few blocks away and my father got one of the first implantable defibrillators there and he lived for 7 years after that. He had his defibrillator put in 1982 and lived to July 1,1989. Good luck!

[raysr]

21. The VA is

my only source of health care. I go to the Seattle Hospital. They have alot of student doctors. The place is PACKED day and nite. I'm not going for anything serious so I can't comment on that. But the care I have gotten has been good and the meds are reasonably priced for co-pay. I'm very glad it's there.
It's depressing though, because all you see there are sick people, in a civilian hospital most of the patients are in rooms out of sight. There are MANY elderly patients, Many in wheelchairs.

[CAG]

22. I work at the Oklahoma City VA

and I would be a patient there in a heartbeat (unfortunately, my health insurance requires me to go to a private for profit "malpractice" center). The medical records are entirely digital, doses are given by bar code technology, which is the safest way to avoid medication errors, the physicians are from academia researchers just across the street at the college of medicine (as with many VA's, as opposed to the 55 year old private doc who hasn't picked up a new england journal in 20 years, but gets all of those great lunches by the drug rep babes), and employees such as myself have an inherent feeling of pride that we're not only taking care of patients, but patients who have stood in front of bullets for all of us.

HOWEVER, thanks to President Cheney and his sidekick W, their wonderful 2% annual increases in the VHA budget happen to put quite a strain on a system where 1) healthcare industry costs continue to go up 10-15%, 2) the Cheney/Bush recession sent droves of otherwise middle-class veterans into the system to receive more cost-effective care, 3) theres all of the non-healthcare costs as well (disability, pensions, housing support, etc), and 4) the afghanistan/war on terror and the halliburton/Iraq folly have sent a whole new fresh crowd of youngsters who weren't lucky enough to have their rich daddy get them into the Texas champaigne air national guard.

[Auntie Bush]

27. Your last paragraph is well worded and so true.

Kick for the morning crowd because this thread contains some important information for anyone who has someone in ANY kind hospital. Be sure to read Diamond14's post. It could save your or a loved one's life!!!!!

[Smarmie Doofus]

23. Yet more proof that DUers are a special breed...

Your kindness knows no bounds. Thanks, all.

[NewJeffCT]

28. A recent study has indicated that VA hospitals are better than non VA

First off, I'm sorry about your brother.

I'm sure quality varies from hospital to hospital, but a recent study published in Slate magazine indicated that VA hospitals, on average, provide better care for veterans than the population at large gets from non VA hospitals. And, this is in spite of veterans not being as healthy as the general population.

Unfortunately, I do not have the link to the study or a direct link to the article in Slate.

[Ironpost]

29. My experience with the VA is nothing but good.

I spent a week in the VA hospital in Muskogee due to a blood clot and couldn't have been treated any better anywhere. The best part is they do follow up and practice preventive medicine. I say to you he is where he will be helped the most... forget the horror stories of old. My heart is with you and he.