By Salena Wright-Brown, Shauna Haynes and Sandee Foster, Central Arkansas Veterans Healthcare System
The mission of the Department of Veterans Affairs is to fulfill President Abraham Lincoln’s promise “to care for him who shall have borne the battle, and for his widow, and his orphan” by serving and honoring the men and women who are America’s Veterans. The VA’s four primary missions are: Health Care for Veterans, Educating Health Care Professionals, Research and Providing Support in Times of Emergency.
The Central Arkansas Veterans Healthcare System (CAVHS) is a large, busy VA health system. Its two hospitals, located in Little Rock and North Little Rock, and eight community-based outpatient clinics serve an average of 65,000 Veterans from Arkansas and surrounding states.
The organization provides a wide range of inpatient and outpatient health care services, including disease prevention, primary care, surgical procedures, extensive mental health programs, rehabilitative care and other specialties.
Staff at CAVHS use multiple modalities, including traditional face-to-face visits, home-based services, integrative medicine, telehealth services and other techniques to connect with patients.
At the core of the organization are the nurses that call CAVHS home! There are over 3 million registered nurses in America; with more than 80,000 RNs, APRNs, LPNs/LVNs and nursing assistants, The VA is the nation’s largest employer of nurses.
More than 1,000 nurses work at CAVHS. These nurses are recognized and honored with local, regional and national awards throughout the country, including 12 of the “40 Great Nurses Under 40” and 7 of the “Great 100 Nurses in Arkansas.”
Dr. Salena Wright-Brown, Associate Director for Patient Care Services for CAVHS, emphasizes the impact that CAVHS nurses play in meeting the VA’s core ICARE values of Integrity, Commitment, Advocacy, Respect, and Excellence. “CAVHS nurses fulfill the mission by serving Veterans and understand as an organization we only exist to serve America’s heroes.”
Thirty percent of employees at CAVHS are Veterans themselves. They make an impact in the lives of the Veterans and are valuable members of the many multidisciplinary teams dedicated to the four missions of the VA.
CARING FOR VETERANS
When you ask CAVHS nurses what are the best things about caring for Veterans, the answer is often “the stories!” Veteran nurses share a connection with their patients that facilitate conversations about military service. Sometimes, these conversations may not even have been shared with the patient’s family.
Dawn Moore, Associate Nurse Executive for Surgery Service and an Air Force and Navy Veteran of over 35 years, says the narratives that her comrades share are “living history.” She recalls her most memorable patient, a Veteran who served in the Navy alongside President John F. Kennedy. The Veteran shared his story of “taking care” of the Navy Lieutenant Kennedy, ensuring that his PT boat guns were in operational order. (He also kept the Lieutenant out of “hot water,” at times.)
Years after the war, this Veteran and his wife were traveling through Texas and ran into the Navy Lieutenant and his wife while they were campaigning for the presidency. The Veteran approached Kennedy, and he immediately recalled the Veteran and the help he had provided, then leaned toward Jackie, whispered in her ear, removed the campaign button from her jacket and presented it to the Veteran.
While taking care of this Veteran one evening, Moore says the patient leaned toward his nightstand and removed a handkerchief. Wrapped inside was the campaign button he had received from President Kennedy.
Stories like this are a frequent occurrence at CAVHS, as staff are caring for those who helped write America’s history.
The camaraderie and relationships that form between Veteran patients and Veteran nurses are very moving to witness. Jessica Fulbright, Army Veteran and 6D medical-surgical unit RN, puts it well, “I enjoy the solidarity I have with every Veteran!” Fulbright explains that her mission in the Army as a Medic was to help soldiers through illness or injury. When her obligation to the military was over, she set out to continue to help past and present comrades in the same way.
EDUCATING HEALTH CARE PROFESSIONALS
After World War II, the VA set out to help meet the changing needs of America’s health care delivery system by educating future health care professionals. Since that time, the VA has conducted and continues to conduct the largest education and training effort for health professionals in the United States.
Amelia (Amy) Dawson, a nationally certified oncology nurse at CAVHS, followed in her father’s footsteps and joined the Arkansas Army National Guard at 17, serving as a Blackhawk helicopter pilot and warrant officer. Dawson, an Operation Iraqi Freedom Veteran, obtained her nursing degree upon return from Iraq with the goal of caring for her fellow brethren and living her life in a manner that honors those who sacrificed for our country.
She specifically mentions her friends and members of the Blackhawk crew, with call sign “Easy 40.” These heroes were lost to enemy fire while in Iraq. Dawson believes she serves their memory while serving Veterans as a nurse. She began her career at CAVHS in 2011, after graduating and serving a deployment to Kosovo.
She credits her desire to work on the oncology unit to her time as a student nurse at the facility. She is one of the more than 127,000 health care professionals each year who receive at least part of their training at a VA facility.
Observing the day-to-day interactions between Dawson and her patients can only be described as intriguing. She can be seen sitting down beside her patients and listening to their concerns and fears while providing the reassuring presence and touch that are important parts of nursing.
Dawson feels strongly that oncology nursing is a “calling.” This is evident in the compassion she shows in all situations, but especially when a Veteran’s battle is nearing its end. Family members who have lost loved ones to this horrible disease remember Amy Dawson by name and the comfort that she provides during their grief.
The VA has been on the forefront of groundbreaking research for decades. CAVHS continues the VA tradition of research and innovation that began long ago with the first liver transplant, and the development of computerized medical records and barcode medication administration.
These research efforts continue today with advances such as the hydraulic self-leveling walker for use on stairs or inclines. CAVHS is one of just 32 facilities (out of the 150 VA facilities) selected as a national innovation site.
At the forefront of CAVHS’s Innovation Squad is Perry MacLaird, Patient Safety Manager and Air Force Veteran. MacLaird’s distinctive experiences in the military as a meteorologist helped grow an attitude of assuming responsibility for the surrounding environment and avoiding complacency.
When he noticed a nurse struggling to push a patient in a bed while pulling an IV pole, he said, “There has got to be a better way.” This led to his partnering with other members of the VA Innovators Network and designing an IV hitch. The device, which attaches the IV pole to the bed, frees up the healthcare worker’s hands for patient transport. There is currently a patent pending on this device developed by MacLaird and nursing staff at CAVHS.
Research takes another form at the Community Living Center (CLC) at CAVHS, which is an example of an innovative environment providing quality care in a homelike setting. With programs and practices in place like the Snoozelen multi-sensory room for dementia patients, a research-driven fall prevention program spearheaded by staff nurses, and an in-depth recreational therapy program that includes woodworking and other therapeutic creative arts activities, it is no surprise that CAVHS’s CLC holds an overall quality rating in the first quintile, meaning it performs better than 90% of other VA sites in the nation.
Dara Penn, RN, works in the CLC and is a 3rd generation Veteran whose grandfather served in World War II, father in The Gulf War and husband in Operation Enduring Freedom. After serving in the Air Force for four years, she knew she wanted to continue serving her country through caring for her fellow Veterans.
Penn, whose leadership on her unit is a significant reason why Veteran care in the CLC ranks so highly, is also a member of the Innovation Squad and strives to improve Veteran care daily. She says she loves the unique environment of the CLC because the Veterans are there for an extended period, which enables her to form lasting, meaningful relationships with them and their families.
SUPPORT IN TIMES OF EMERGENCY
When Hurricane Harvey brought devastation and flooding to our neighbors in Houston, scores of CAVHS employees stepped up to assist in many ways, including answering the phone lines when CAVHS assumed responsibility of the regional helpline and volunteering to travel to Houston to work.
One of those who answered the call was David Hathcock, a Registered Nurse in the Medical Intensive Care Unit/Coronary Care Unit. Hathcock is an Army Veteran who served from 1989-1992 as a Personnel Administration Specialist with the Artillery Battalion. He has a unique and extraordinary career path and provides a real example of perseverance and determination.
In 2003, Hathcock was homeless and living in a local transitional housing shelter when he enrolled in the Compensated Work Therapy program at CAVHS and was hired as a bed washer. He graduated from the program and was offered a housekeeper position in the Environmental Management Service in 2004.
Working closely with nursing staff as a housekeeper cleaning rooms, the nurses began encouraging him to consider nursing school. He used online tutorials for three months to self-teach the math skills he needed to pass the pre-requisites for the LPN program at Pulaski Tech.
Hathcock then entered the LPN program in 2006, graduated in 2007 and was the first male to be awarded the “Outstanding Student Award.” He continued his career with CAVHS as an LPN on a medical-surgical unit and was well-known for his compassion and connection with Veterans, as well as his excellent clinical skills. This is evidenced by his selection as the 2010 Secretary’s Excellence Awardee in the LPN category for CAVHS. Hathcock was not only the facility winner, but was also selected to represent the region (Arkansas, Oklahoma, Mississippi, Texas) in the LPN category.
He continued his professional development and graduated in 2014 with his Associates Degree in Nursing from the University of Arkansas at Little Rock.
During Hurricane Harvey, the Michael E. DeBakey VA Medical Center in Houston needed nursing support. Hathcock volunteered, without hesitation, to drive a van with five other staff to Houston to provide support.
With only a day’s notice, he and his colleagues left Little Rock and drove all night to arrive in Houston the following morning. Hathcock was assigned to work in the step-down unit and for two weeks served alongside the Houston staff taking care of Veterans. One Veteran’s family was so appreciative of the excellent care he provided that, on his last day, they surprised him with a balloon bouquet.
Hathcock not only cared for the Veterans, but also for the staff. When he arrived, the staff mentioned that the grocery stores were running out of food in their neighborhood and they had minimal food to support their families stuck at home. Soon after hearing this, Hathcock selflessly brought all the snacks sent from Little Rock and prepared bags for the employees to take to their families. When asked, he will tell you that what he does best is “serve his fellow Vets.”
Staff members at CAVHS are dedicated to our Veterans, each of whom has earned the right to receive high-quality health care through their service to our county. VA nurses help fulfill that debt every day through their service to Veterans. But there are special nurses – Veterans themselves – who continue to serve through their personal commitment and dedication to the VA mission.
Nursing has long been recognized as the most trusted profession; nursing at CAVHS is truly filled with Heroes Caring for Heroes.
This article was authored by proud staff members at CAVHS: Salena Wright-Brown, PhD, MNSc, APRN, RN, Associate Director, Patient Care Services; Shauna Haynes, MSN/ED, RN, OCN, Associate Nurse Executive/Nursing Excellence; and Sandee Foster, DNP, RN, Chief Nurse Executive/Nursing Service. You may reach this team at Shauna.Haynes@va.gov.
The above article is from Arkansas Hospitals, a custom publication of Vowell, Inc., which also produces Arkansas Money & Politics.