When a nurse manager at a Veterans Affairs medical center in Albany, New York, saw a patient being unnecessarily kept in restraints for seven hours, she couldn’t remain silent.

“I had to speak up for my veterans and for the nurses,” Valerie Riviello said on the Federal Drive with Tom Temin and Emily Kopp. “I first went to the hospital’s patient safety officer and my supervisors.”

But Riviello now says she’s facing retaliation from her co-workers because of her actions as a whistleblower.

“I’m being retaliated against … for taking a patient out of restraints that did not need to be in restraints for the length of time,” she said.

Riviello’s case is just one of many whistleblower disclosures from VA facilities around the country. The Office of Special Counsel investigates many of these cases and has challenged VA on its handling of whistleblower charges.

In a letter to President Barack Obama, OSC’s Carolyn Lerner said more than a quarter of all cases the OSC refers for governmentwide investigation come from the VA.

“We currently have over 50 pending cases, all of which allege threats to patient health or safety,” she wrote. “Too frequently, the VA has failed to use information from whistleblowers to identify and address systemic concerns that impact patient care.”

Patient-centered care?

Riviello said she has observed practices that often aren’t in the best interest of the patients.

“It’s a step away from patient-centered care, and it’s more physician-driven care,” she said. “I see things happening just for the convenience of the physicians.”

In November 2013, Riviello told her supervisors that “patient S” had been unnecessarily kept in restraints for seven hours. She said a doctor at the medical center wanted to keep patient S in restraints, even though Riviello, along with other nurses, determined that the patient was calm and did not need restraints.

“Nurses are required to assess and reasss patients every 15 minutes for their ability to be released from restraints,” Riviello said. “We are to release them as soon as possible. They are to be restrained only for imminent danger to self or others.”

After discussing with one of her supervisors over the phone, Riviello and her colleagues released the patient from restraints.

But the doctor who had requested the patient remain in restraints voiced anger over Riviello’s actions.

When management at the medical center refused to hear Riviello’s concerns, she sought the assistance of law firm Tully Rinckey.

Lawyer says whistleblower ignored

Cheri Cannon, who is handling Riviello’s case, said she filed complaints to VA’s inspector general regarding the treatment of the patient.

“Unfortunately, the IG will not even acknowledge that they have our complaint,” Cannon told the Federal Drive.

She also wrote letters to the VA leadership in Albany, concerning Riviello’s job status and the retaliation against her.

“They basically blew her off and didn’t respond to our letters,” Cannon said. “They did not really seem to want to respond to [Riviello’s] concerns about her 28-year career and how it was being impacted by the behavior of senior leadership at that center.”

Although Riviello is still employed at the medical center, she has been reassigned to a “special project.”

“I’m to work on that eight hours a day, and I’m not to have any clinical contact or have anything to do with what’s happening on my unit,” she said.

VA secretary: Whistleblower retaliation ‘unacceptable’

A VA spokeswoman declined Federal News Radio’s request for an interview about Riviello’s claims, citing the ongoing nature of the case.

However, acting VA Secretary Sloan Gibson has expressed concern over the agency’s handling of whistleblower cases.

“I want to make clear that intimidation or retaliation against whistleblowers — or any employee who raises a hand to identify a legitimate problem, make a suggestion or report what may be a violation of law, policy or our core values — is absolutely unacceptable. I will not tolerate it,” he wrote in a statement.

OSC’s Lerner said she is “encouraged by the recent statements from acting Secretary Sloan Gibson, who recognized the significant contributions whistleblowers make to improving quality of care for veterans.”

But Cannon said the root of the issue lies in communication between the department and regional hospitals.

“The local officials are not paying heed at all to what the acting VA secretary is saying, which is that he will not tolerate reprisal against whistleblowers. … He has put out a lot of statements on this issue, but unfortunately that message is not being received,” Cannon said. “No real systemic changes are going to occur — not only in the treatment of employees, but in the treatment of patients — until the VA here in Washington gets serious with the hospitals themselves.”

Riviello echoed Cannon’s sentiments and said the VA needs to speak more with frontline staff.

“I think the VA headquarters should have more oversight over what’s happening at the individual VAs,” Riviello said. “Nurses are very important. They work 24/7 with veterans. And they are disregarding our input and our assessments. I really don’t think they understand truly what is going on.”

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