Registered nurse Valerie Riviello has worked 28 years at the Albany Stratton VA Medical Center, most recently in the psychiatric unit. She teaches at two local nursing schools, and has received many honors for patient care and safety, including the Florence Nightingale Award. Last fall, Riviello challenged the treatment of a female veteran strapped to her bed for hours on end, in violation of VA rules. As a result, she was stripped of her nursing duties. Now she’s one of 37 whistleblowers nationwide whose allegations of retaliation are under investigation by the US Office of Special Counsel. Riviello told her story to The New York Post’s Susan Edelman.
On Nov. 5 of last year, I started my shift on the psychiatric ward at about 6:30 a.m.
A female Navy veteran, a victim of sexual assault in the military, was locked in a two-point restraint — her right arm and left leg were strapped to the bedposts. She also had a belt tied around her waist to restrict her movement.
She had been restrained that morning because she was “disruptive and agitated.”
By 9 a.m., the veteran pleaded to be freed from the shackles. The nursing team and I made an assessment. We felt that she was ready to come out. She was calm and cooperative and taking her medication.
We reported our assessment to the attending physician, who did not agree. The doctor felt the patient was “unpredictable.” But we concluded she had no intent to harm herself or anyone else. She was in pain and wanted to use the bathroom — to bathe, wash her hair, brush her teeth.
We kept advocating for her release, which was met with resistance from the physician. At 1 p.m., the patient had wet herself, was sweating and aching from being in the same position for so long.
I called my supervisor, saying we planned to remove the patient’s restraints to let her shower and use the bathroom. He said, “It sounds like a plan.”
So, after a total of seven hours, we took off the restraints. The patient was very appreciative. She was trying to hug us, she was so happy.
But 30 minutes later, the attending physician learned about the release and was furious, demanding that we tie the patient down again. We refused, because there was no justification.
She was not imminently a danger to herself or others. Under VA policy, we’re supposed to place patients in the “least restrictive environment” and use restraints only as a last resort. In a case like this, where a woman had a history of sexual trauma and multiple medical problems, restraints would not help — and could even be harmful. It could bring up memories of her trauma, which could range from rape to sexual assault and leave her very vulnerable.
I learned from my nursing staff that the same female veteran was readmitted in February and was kept in restraints for 49 consecutive hours over Presidents Day weekend. They said the doctors didn’t want to come in to evaluate the patient, as required, if she was released and had to be put back on restraints.
Can you imagine being tied down for that many hours? Every minute that someone is restrained seems like an eternity.