Nursing squeeze tightens at Western State

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Standard of care affected, cuts in nursing, and then we have schools churning out graduates who can't find a job. Can anyone else see the picture? http://www.newsleader.com/article/20...+Western+State

The squeeze on Western State Hospital staff, particularly nurses, is reaching a critical point, an internal memo said.

The hospital, which faces additional funding cuts in Gov. Robert F. McDonnell's budget, has an increasingly difficult time meeting federal standards for nursing care, the hospital's director, Jack Barber, said in an e-mail to staff members, a copy of which was obtained by The News Leader.

McDonnell's budget would cut Western's funds by $1.2 million next year. That comes on top of $5.1 million of cuts over the past two years.

The budget leaves untouched the funding for Commonwealth Center for Children and Adolescents, which had been a target for shutdown in 2009 and 2010.

Federal standards require 5.5 hours a day of nursing care for each newly admitted patient and five hours a day for longer term patients.

"While we have been able to maintain caseloads for professions and the NHPPD (Nursing Hours Per Patient Day) standards, our margin has shrunk and all but disappeared," Barber told hospital staff.

"Support departments are beyond thin and become short staffed" when staff have to call in sick or take vacation, he said.

The hospital has had to drop some therapy groups and supports for patients, Barber said, and the hospital does not have the resources it needs to intervene more effectively when patients clash.

Even so, there has been no increase in injuries or incidents of aggression, while the incidence of isolating or restraining patients has held steady, Barber said.

"I know when I talk to people at Western State, they're concerned that there's nowhere left to cut," said Del. Richard P. "Dickie" Bell, R-Staunton.

"I'm going to do my best to make sure they aren't cut," he said. "We talk about core services of government, and I think mental health is a core service."

The hospital's director of community services, John D. Beghtol, said budget decisions were made by the Department of Behavioral Health and Developmental Services' central office and the governor. Beghtol would not comment on the budget decisions.

Despite suggestions from the department that McDonnell close mental health hospitals in Falls Church and Danville, the governor's budget would keep them open, but cut their funding by a combined $860,000.

The budget increases grants to localities for community services by $11.3 million, mainly for substance abuse services, adds $10.1 million to the budget for training centers for people with intellectual disabilities and $24.4 million to the budget for the Center for Behavioral Rehabilitation, which treats sex offenders.

"We must do better in completing the long-term plans set out over a decade ago to transition appropriate mental health consumers from institutional to community-based settings," McDonnell said of his budget.

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Also related from WHSV: http://www.whsv.com/home/headlines/I...112631299.html

An internal memo sent to the employees at Western State Hospital reveals the strain budget cuts have had on the staff.

Since 2009, the hospital's budget has been reduced by more than $5 million.

For decades, Western State Hospital has been known as a haven of treatment for Virginians suffering from mental illness. John Beghtol has worked there for 33 years and says its reputation is strong.

"We're not encountering any criticism of Western out there. It's just not there. Even though we're under stress, the staff just keep delivering," comments Beghtol.

Surprisingly, the stress the staff is under isn't because of the 600 severely ill patients they treat each year, many of whom come directly from jail. Instead it's because of the 126 jobs that have been cut because of the budget.

"We're quite concerned about more and more of our employees being asked to take on additional duties," says Beghtol.

He says the employees have risen to the occasion so far.

"Many parents and relatives are very complimentary of our care, but they also share our concern. How far can we go down," asks Beghtol.

Gov. Bob McDonnell's proposed budget has $1.2 million cut this year. That cut has already been anticipated by WSH, but it will push the hospital close to its limit.

"The key is that nursing hour per patient day. We're closing in on it. We're maintaining," says Beghtol.