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Acting VA chief blames staffing shortages for Augusta woes

Thursday, July 10, 2014 5:43 PM
Last updated Friday, July 11, 2014 1:00 AM
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The acting secretary of the Department of Veterans Affairs said Thursday that the main reason for scheduling problems at the Charlie Norwood VA Medical Center is a shortage of clinicians, adding that too few nurses and doctors has created more work, stress and higher turnover at the Augusta hospital.

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Acting Veterans Affair Secretary Sloan Gibson said vacancies have put more work on hospital employees, and many have left.  TODD BENNETT/STAFF
Acting Veterans Affair Secretary Sloan Gibson said vacancies have put more work on hospital employees, and many have left.

“It should not take so darn long to hire someone,” Sloan Gibson said during a visit to the hospital, part of a nationwide tour of VA facilities he is taking to speak with veterans and employees about obstacles to providing timely, quality care. “We need to make sure we’re talking to staff more frequently and understanding their needs. The employees here truly care.”

Gibson said he had a standing-room-only meeting with hospital staff and that the top complaint was that leadership was not engaged enough with rank-and-file personnel to improve operations.

Because of longstanding nursing and physician vacancies at the medical center, Gibson said, employees have had to take on extra responsibilities, which is causing many to leave for better jobs.

“In the business world, you cannot operate like that,” he said.

The hospital’s nursing service has 782 full-time positions, 151 of which are vacant, said Clare O’Geary, the deputy nurse executive.

Augusta VA spokesman Pete Scovill said 27 of the hospital’s 157 full-time physician positions are vacant, including chief of staff and surgery, according to job postings.

Through the help of Georgia Regents Uni­ver­sity, which the Augusta VA works with as a teaching hospital, Director Bob Hamilton said, the medical center has identified a strong candidate and should have a new chief of staff by next month.

Gibson said hospital leadership is increasing recruiting efforts and accelerating hiring in dermatology and neurology specialties, where constraints have been identified.

He said the success of the hiring efforts will be reflected in an ongoing audit of VA wait times.

Gibson said that as of July 2, Augusta officials have reached more than 400 veterans and reduced the number of those waiting at least 90 days for an appointment from 26 patients to two. The number of new enrollees who have not had an appointment in the past decade despite requesting one has decreased from 133 to 45.

In achieving the hospital’s top priority of getting veterans off waiting lists and into clinics for medical appointments, Gibson outlined a list of measures that are being taken. They include:

• Increasing overtime and adding evening and weekend hours to see patients. Gibson said additional capability has been identified in the optometry clinic and that a Saturday clinic will be opened this month, creating
room for 12 more appointments each session.

• Coordinating with the community to increase available services in certain specialties such as ear, nose and throat; ophthalmology; dermatology; and neurology.

• Ensuring that $250,880 from the VA’s budget is awarded to Augusta to accelerate access to care.

• Increasing the use of established contracts with community partners and adjusting primary care physician workloads to better schedule veterans waiting to be seen by a doctor.

Gibson said that after eliminating electronic wait lists, the VA plans to turn its focus to systemic issues and address instances of willful misconduct by holding the guilty accountable.

Most notably in Augusta, he mentioned the 4,500 delayed gastrointestinal consultations and the three cancer-related deaths in 2011. He also showed concern about the four open retaliation cases the Office of Special Counsel is investigating in Georgia, one of which might include former primary care physician Raymond Kostromin, who has filed a formal complaint alleging that he was targeted for removal for speaking up about delays in
gastrointestinal referrals at the Augusta VA.

“That’s absolutely unacceptable,” Gibson said of the hospital’s botched gastrointestinal clinic. “That is not consistent with the standards of care, not here or anyplace in the VA.”

Gibson said he can’t take any personnel actions until the VA’s Office of the Inspector General has completed its review. However, he said he has not been to a location that is working more aggressively than the leadership in Augusta to resolve its problems.

He said the hospital has placed a daily focus on identifying gastrointestinal patients and scheduling them for screening endoscopies.

“Working through these processes is one of the ways we earn back trust,” he said. “The other way is through more robust communication and transparency.”


With the recent lapses in care in the Department of Veterans Affairs, national health organizations say broader certification guidelines for physicians and granting full-practice authority for nurses could attract more people to apply for VA jobs.


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nocnoc 07/10/14 - 08:16 pm
The Augusta Facility 5 years ago

initially found the time to attend to my father-in-laws problems.

But towards the end,3 years ago they kept farming him out to other locations, and they kept using the Paperwork not in order excuse to delay him being seen.

Down Town VA even refused to accept a Court Appoint Guardian certified document issued from the Probate Judge here in Augusta,
as proper documentation.

That's when we saw the writing on the wall and started using Tricare and Ft. Gordon as much as possible for med's and outside doctors.

He died March 2012

bclicious 07/11/14 - 04:08 am
Jeeze; ya think?

It's the federal unionized Government. It's own regulations dictate how and when they can hire for a position. In short, a person quits, and it might take a lifetime to hire a replacement. As best I can tell, it looks the Augusta VA is about 40 Nurses short, which attributes to a good portion of it's shortages. They are having a job fair on the 17th of July if ya'll know anybody who is looking for a job as a Nurse.

hoptoad 07/11/14 - 07:19 am
After working for the

After working for the government many years, I saw people spending their time reading newspapers, playing games on the computer, taking long breaks and lunch hours and chatting at the water cooler. Many did not even have more than a 2 or 3 hours a day workload. It wasn't a matter of them not wanting to work, it was a matter of over hiring as the more people under a supervisor, the more money his department was alloted and the higher grade he/she could achieve.

I also saw people get promoted to positions that they were not qualified to hold. The military supervisors looked the other way if they had a problem civilian employee because of the red tape involved in getting rid of that employee. The military boss knew he/she would be PSCing and would not have to deal with the problem. Therefore, employees were forced to put up with these problem co-workers. These factors took away employees' incentive to give 100% and some developed a negative attitude.

A shortage of nurses may be part of the problem, but poor management and office personnel who are either unqualified, have an attitude, troublemakers who cannot be fired, or workers who just don't care are the bigger problem.

The VA budget is enormous, but everytime there is a problem with one of the departments of government, their excuse is they need more money - even when it is obvious they waste millions.

bclicious 07/11/14 - 07:53 am

So, there is no need for any additional funds within the VA? I think not. Sure, there is always room to improve due diligence for the existing funds, but the math doesn't add up for all the people getting out of the military at the end of 2 wars, and the largest R.eduction I.n F.orce (RIF) since WWII.

As for the way the VA is ran policy wise; there is huge gapping space for improvement. With that in mind; can any of you show me a stellar U.S. government organization where they are a model of organization and production? I think not.

So, I am a 3 time Veteran of OIF, and I do feel that America has a debt and obligation that can never be repaid or fulfilled. With that in mind; I do think there is room for improvement, but we need to be pushing for reform, and yet more support of the VA.

From what I read in general, you would think that most people would rather have the VA disbanded, and then completely contracted out.

AFjoe 07/11/14 - 08:23 am
Change you can believe in.

What is needed is a change in attitude by most of the Govt. workers.
They think you are there to serve them. Enough said.

jimmymac 07/11/14 - 09:21 am

The VA should be disbanded and the vets given a stipend to get insurance they choose for themselves. The bloated upper ranks of the VA siphons a huge amount of funding and offer very little in return. If they used the bonus money the bosses get and pass it onto nurses to increase their pay they'd have no problem finding nurses to fill vacancies. The funding is adequate but as with most government agencies the union's control the business of the agency and make it impossible to have the vets welfare first as it should be.

hoptoad 07/11/14 - 10:33 am
It may very well be that the

It may very well be that the VA may need additional funds down the road. But the problems have to be fixed first to determine whether or not more money is needed. I have a feeling if it was "cleaned up" there would be a lot more funds going to help our vets.

redapples 07/11/14 - 10:59 am
Another of many broken

Another of many broken systems.

Time1 07/11/14 - 01:08 pm
bclicious The VA is not short

The VA is not short of nurses and are the largest employer of RN's in the USA. The problem is half of them are in administrative positions and never lay a hand on direct patient care. There is a shortfall with Physicians but with better leadership that will change. I say put RN's back to work and make most of their duty's hands on patient care only. As far as the rest of the staff run it like a business---be productive or be shown the door.

Bizkit 07/11/14 - 02:05 pm
I want to work for the

I want to work for the federal govt. you can't get fired and if something goes wrong it is never your fault- even if you did it. Much better than the private sector. I' d like to blame everything that has gone wrong on another person- you know like Obama does with Bush. I think I will- I'm innocent of ever have done anything wrong- anything wrong is not my fault because Obama did it. Yep after13 and a half years if blaming Bush we can now confidently blame everything wrong on Obama for the next ten years. What goes around comes around.

corgimom 07/11/14 - 03:46 pm
How do you force physicians

How do you force physicians to work for the VA?

Lots of doctors don't want to do it, and I don't blame them.

bclicious 07/12/14 - 06:15 am
Um yes they do...

Time1 I'm sure where your getting your intel, but there are well over 40 openings for Nurses at the Augusta VA. There is in-fact a nursing hiring fair on July 17th at the Downtown Division of the VA. The Augusta VA has contracted out 30 Nurse contractors to cover down in the mean-time. Please, feel free to look at any jobs board at either division of the VA and confirm what I am saying.

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