Abusive work environment claims at St. Cloud VA

ST. CLOUD, Minn. (KMSP) - The entrance to the St. Cloud VA medical center is lined with trees and its vast green space looks like a park.  But if you ask staff what it's like inside medical center, the feedback can be ferocious.

Union Vice President Jane Nygaard said the atmosphere is toxic. She is the only person who dared to speak on camera about the culture.  "People are afraid," she told the Fox 9 Investigators. "If things don't get better or get turned around a bit, at some point it could impact patient care and we certainly don't want that to happen."

Privately, some doctors and nurses tell the Fox 9 Investigators it's an "incredibly abusive" atmosphere where a fear of reprisal from management runs deep. In fact, federal records obtained by Fox 9 show 26 physicians resigned from the center between 2011 and 2013.

Impact on Patient

What does this mean for the 37,000 veterans who come to the St. Cloud VA for their health care?   Consider the case of Doug Larson, a legally blind vet, who served in the Marines. "I almost died," he said. "It was the worst pain I've ever had in my life."

On a Sunday night this summer, Larson was rushed to Centra Care hospital in St. Cloud.  The VA doesn't have an emergency room. Doctors weren't sure if he was having a heart attack. They wanted to keep him overnight and run some follow up tests.

But Larson says he was concerned he would get stuck with an enormous bill. So he insisted on going the next morning to the St. Cloud VA where he knew he was covered.

"You look back now, I should've stayed but I thought the VA would take care of me the next day, especially with those kinds of symptoms," said Larson.  But that did not happen. Larson couldn't get an appointment at the VA until Tuesday.  I thought there was a lack of urgency on their part," he recalled.

The veteran's Tuesday afternoon appointment ended up being with a nurse practitioner, instead of a doctor. Medical records show no follow up tests were done to see if the severe pain Larson had experienced was related to a heart attack. An independent expert who reviewed the case for the Fox 9 Investigators, says an EKG and a blood test should have been ordered. Instead, Larson was given a prescription of Nitroglycerin to help with any future pain and he said he was in the exam room less than 10 minutes.

That same evening the pain came roaring back. His girlfriend called 911 and he was taken by ambulance to Centra Care. Doctors discovered a blocked artery and he underwent surgery to have a stent installed. The VA won't discuss the case, even though Larson has offered to sign a release authorizing them to do so.  "I don't care how many veterans you talk to out there, they'll tell you the VA's cure for everything is a pill," said Larson.

According to insiders, it's not uncommon for providers to work 60 to 80 hours a week.  Documents obtained by the Fox 9 Investigators show in 2013 each doctor saw a large increase in their number of patients. A survey last year of VA Centers in the region revealed St. Cloud's employees experience high burn out rates.

St. Cloud VA Response

VA management declined to be interviewed. In a prepared statement, they said during the period when 26 doctors resigned "patient safety was not compromised."

As for the turnover and burnout issues: "We have taken the review findings seriously and have instituted numerous actions to correct the deficiencies noted."  Management also says patient loads for doctors are decreasing. Efforts are underway to recruit more physicians and improve the work environment.