Tacoma General nurse honors veteran patients

Daniel Keene, RN, honors and cares for each of his patients, but the veterans among them have a special place in his heart.

At MultiCare Tacoma General Hospital, he’s leading an effort to offer a flag draping and honor walk to each veteran who passes away at the hospital.

Keene’s passion grows out of his own experience as a service member and veteran. He left the military in 2012 after serving as an Army medic for more than a decade.

Nursing school was a natural next step in Keene’s career. He completed a senior practicum in the Tacoma General neurotrauma intensive care unit (ICU) and has now spent more than five years at the hospital.

“It’s a great group of nurses, and everyone is really professional,” he reflects.

An idea takes root

Keene’s work to honor veterans reflects the spirit of teamwork at Tacoma General. He credits MultiCare chaplain Jim Cornwell with sparking the idea.

Cornwell learned in January 2022 that a patient who would soon be compassionately withdrawn from life support was a veteran. Knowing Keene is also a veteran, Cornwell asked him to place a flag pin on the patient.

Instead, Keene suggested they drape the patient in a flag and provide an honor walk, as is custom in many Department of Veterans Affairs (VA) hospitals. Cornwell agreed, and Keene took the initiative to find a suitable flag in time.

“Each honor walk is special. They’re all emotional. It’s a privilege to show respect to someone who has served their country and offer condolences to their loved ones.”

Honoring this patient gave Keene the idea of paying respects to every veteran who passes away at Tacoma General. Along with a flag draping, he would provide a final salute and escort the patient during an honor walk to the nearest elevator.

When Keene realized how many flags it would take to do this equitably, he realized he needed help.

“Initially, I was supplying flags myself, but that became too expensive,” he says. “They can cost around $60 apiece. I reached out to my [Veterans of Foreign Wars] chapter in Puyallup to see whether they could supply flags, but they were not able to donate money to an individual. The VFW commander suggested I start a nonprofit so I could raise money, so I formed the nonprofit Valhalla Flag Project in February 2022.”

One of the first flags Keene purchased under the nonprofit was used to honor Pierce County Deputy Dominique Calata, who was killed in the line of duty in March 2022.

“That one is special to me,” Keene recalls. “A nurse in the ICU at St. Joseph Medical Center, where Calata was treated, knew that I was starting the nonprofit and wanted a flag for him. I ran out at 11pm one night to make sure he had the flag.”

The Gary Sinise Foundation, which honors veterans and Gold Star families, donated 75 flags to Keene’s nonprofit in June 2022. This gift created a supply to keep on hand, which removed some of the pressure to find flags in time.

The following month, Keene participated in Mosaic: Tacoma’s Arts and Culture Festival to raise funds for the Valhalla Flag Project. A group of veterans, including two other MultiCare RNs, volunteered alongside him for four hours.

From left, veterans Karah Clark, Daniel Keene, Mallory Somerville and Matt Dustin raise money for the Valhalla Flag Project.

Tacoma General now donates to his nonprofit for each flag, and keeps one on each unit. The hospital announces honor walks about 15 minutes before they occur, allowing staff to line the hallways and participate in paying respects. Loved ones can choose to walk behind the patient and have a private moment at the elevator.

Watch an honor walk for a patient

After the honor walk, the patient’s family can decide what happens to the flag. It can travel to the funeral home for use as a burial flag, or Keene offers to bring it back to the family before they leave the hospital.

He works to spread the word among staff about the option of these final respects. That way, they can help identify veterans and ask whether they would like this honor.

Keene does whatever he can to support a veteran’s loved ones, offering a VFW information packet on VA benefits and sharing his email address in case the family has questions.

Joining forces with other nurses

A small group of nurses at Tacoma General — most of whom are veterans themselves — now participate in this work of honoring veterans.

So far, Keene has personally conducted over 30 honor walks and is aware of about 60 total performed at Tacoma General since early last year.

“Each honor walk is special,” he says. “They’re all emotional. It’s a privilege to show respect to someone who has served their country and offer condolences to their loved ones.”

Mallory Somerville, RN, a fellow veteran who works at MultiCare Good Samaritan Hospital, agrees. She notes that many veterans share a special rapport.

“During these honor walks, there isn’t a dry eye in the area,” she says. “Daniel and I are both Army combat medics who became nurses. He’s very persuasive in involving others in this work, and he’s moving mountains to offer last respects to patients who are veterans. Only a small minority of Americans serve in the military, and we have a lot of shared — often intense — experiences. We take care of our own.”

Somerville adds that all patients receive the same high level of care, regardless of veteran status.

As for Keene’s work, the VFW is a great partner, she says. They’re integrated with the community, and Keene provides a crucial link to reach patients.

“He can bring that community support into the hospital as an insider. That was especially important during COVID-19 when we couldn’t have family at the bedside,” Somerville recalls. “Sadly, some of these patients would pass away alone, and one of the last sources of comfort we could give was a flag for the family members.”

She recently nominated Keene for a DAISY Award, which rewards excellent patient care and remarkable compassion in nursing.

In her nomination, she writes, “Daniel’s thoughtfulness and sensitivity to our veteran population is something I must share with you … to showcase exemplary acts of selfless service, integrity and honor.”

Bringing honor walks to more patients

In the interest of equity, Keene hopes to improve the process of identifying veterans and paying respects. Doing so would allow more visibility for staff and more time to speak with patients and their families.

“I want to bring more awareness of this option and make sure that no patient slips through the cracks,” he says.

In addition to requesting a report of current veteran patients, Keene has suggested pop-up notifications in MultiCare’s electronic medical record that would alert providers about the option of an honor walk at timely points of care — such as when they place a patient on comfort measures or enter a time of death.

Other MultiCare hospitals also honor veterans who are patients. MultiCare Yakima Memorial Hospital offers a pinning ceremony in the presence of the patient’s family, preferably while the patient is able to share a story about their service.

Learn more and donate

Keene intends to continue his work honoring veterans at Tacoma General and beyond. If you’re interested in supporting his efforts, either in person or financially, please visit the Valhalla Flag Project website.