VA problems are in most hospitals

Nurses Activism

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The National Patient Safety Foundation made this shocking admissions last year: "psychological safety of the workforce... conspicuously absent or considered optional in many care-delivery organizations..Under these conditions, it is difficult for caregivers to to meet the challenge of making health care safe for patients they serve...makes it clear that the manager, or person in the gradient of hierarchy above the worker, possesses interests that are more important than the planned efforts of the health care worker."

Arizona Republic description:

" workers who asked not to be named because they fear retribution...current and former staffers allege that employees who point out flaws-or try to improve the system from within-are bullied by bosses who won't acknowledge the system is broken because to do so would damage their careers. Retaliation against whistle-blowers, discrimination and mismanagement have caused an exodus of nurses and doctors, insiders said, so that remaining employees are chronically overworked and stressed out."

Does any of this sound familiar?

Specializes in Dialysis.
The fact that different people have different experiences at various VA hospitals demonstrates that the problems at one VA hospital, are, well, the problems at that particular VA hospital.

That's precisely the problem. If I think hospital X is a bad hospital I can pick and choose to go to another hospital. If I think the Memphis VA is bad I can go where? 200 miles to Nashville? 300 to St Louis? The infuriating part about the cath lab story I told is that pt's would drive up to a hundred miles to reach the Memphis VA passing hospital after hospital that had a cath lab. Just so they could experience delays and incompetence.

Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
That's precisely the problem. If I think hospital X is a bad hospital I can pick and choose to go to another hospital. If I think the Memphis VA is bad I can go where? 200 miles to Nashville? 300 to St Louis? The infuriating part about the cath lab story I told is that pt's would drive up to a hundred miles to reach the Memphis VA passing hospital after hospital that had a cath lab. Just so they could experience delays and incompetence.

Best thing that can happen is for the media to cover situations like you describe. The VA is very adverse to negative publicity.

Specializes in Hyperbaric Medicine and Wound Care.

As a VA Contract Nurse AND as a Veteran who uses the VA, I can proudly state that my care has been exemplary within the Desert Pacific Region (VISN 22). As to Phoenix, it would seem that they have an access to care problem, which is completely different from a negligent care problem. Never in my career have I seen such animosity thrown at a gigantic health care organization as I've seen thrown at the VA. Conversely, never in my career have I worked with such dedicated nurses and staff. Not to get political, but, the hundreds of thousands of Vets coming in to the system from Iraq and Afghanistan are putting a humongous strain on the system. I would suggest that you write your representatives and insist that they appropriate adequate funding to the VA, and tell them with certainty to stop playing political games with Veteran's Health Care. Rant over.

Specializes in Dialysis.

VA budget for 2015 is 163 billion. Number of veterans served by the VA is 8.76 million. That's 18,607 dollars per veteran per year. The DHHS states the cost of private insurance through health exchanges is 3,936 a year. Why not give each veteran an 18,000 dollar voucher and let them decide which system is best?

Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
VA budget for 2015 is 163 billion. Number of veterans served by the VA is 8.76 million. That's 18,607 dollars per veteran per year. The DHHS states the cost of private insurance through health exchanges is 3,936 a year. Why not give each veteran an 18,000 dollar voucher and let them decide which system is best?

Is that 163 billion only for VA health care? Or are all the pensions paid the vets and other programs included in that?

Is that 163 billion only for VA health care? Or are all the pensions paid the vets and other programs included in that?

and does that budget include the expenses of administrating the program, namely...staff? My guess is yes. And the cost of running a healthcare facility (medical centers, surrounded by outpatient clinics) isn't going down anytime soon.

Specializes in Dialysis.

“We don’t have no where else to go, that’s why we go,” said John Williams, a Vietnam vet who says he knows many people who complain about doctors not keeping appointments and problems with medications.

Memphis VA Center Deaths Under Congressional Investigation | WREG.com - News, Weather and more for Memphis and the Mid-South

Specializes in Vents, Telemetry, Home Care, Home infusion.

VA Office of inspector General is responsible for monitoring the VA system. Multiple reports are available here: VA Office of Inspector General

Specializes in Education, research, neuro.
That is such bull. Absolutly NOT true at all. I used to work at the Minneapolis VA and observed several nurses and a physician get fired.

OK... you guys appear to be talking apples and oranges. Apparently it's not that hard to get rid of doctors and nurses at a VA. But the executives are quite another kettle of fish. After a complaint has risen to the level of an investigation that has proven the executive culpable for some wrong-doing (which takes who knows how much time...) the executive once "fired" has 30 days to notify the VA that they are invoking an appeal. Now, this appeal process makes the investigation look instantaneous. These can go on for years. It's also politically dangerous for elected representatives to mess with this because the Federal Employees unions give (or withhold) much money to campaigns.

VA scandal: Why hasn't anyone been fired yet? - CNN.com

And doesn't this explain the wide variation between the VA's being discussed here. Right? Quality comes from the top. You have a good executive, he/she runs a tight ship and sets the standards for everyone below them. Or you get a crook who will cook the books so they can get a bonus and to h*ll with the veterans.

I think everyone here has a piece of the truth. But...

I'm an absolutist. I want choice. When I can make decisions about my health care, I can bag the government hospital or not. With no choice, I'm vulnerable. I don't know which VA is good or bad and which chief executive gives a d*mn whether I live or die. And even if I did know that the VA to which I'm being sentenced is lousy, I can't do a thing about it.

That's the depressing part for a veteran.

Specializes in Critical Care.
OK... you guys appear to be talking apples and oranges. Apparently it's not that hard to get rid of doctors and nurses at a VA. But the executives are quite another kettle of fish. After a complaint has risen to the level of an investigation that has proven the executive culpable for some wrong-doing (which takes who knows how much time...) the executive once "fired" has 30 days to notify the VA that they are invoking an appeal. Now, this appeal process makes the investigation look instantaneous. These can go on for years. It's also politically dangerous for elected representatives to mess with this because the Federal Employees unions give (or withhold) much money to campaigns.

VA scandal: Why hasn't anyone been fired yet? - CNN.com

And doesn't this explain the wide variation between the VA's being discussed here. Right? Quality comes from the top. You have a good executive, he/she runs a tight ship and sets the standards for everyone below them. Or you get a crook who will cook the books so they can get a bonus and to h*ll with the veterans.

I think everyone here has a piece of the truth. But...

I'm an absolutist. I want choice. When I can make decisions about my health care, I can bag the government hospital or not. With no choice, I'm vulnerable. I don't know which VA is good or bad and which chief executive gives a d*mn whether I live or die. And even if I did know that the VA to which I'm being sentenced is lousy, I can't do a thing about it.

That's the depressing part for a veteran.

Most veterans (>75%) already have or use coverage options other than the VA, so I'm not sure what you mean by arguing they need to have the option not to use VA coverage.

Specializes in Critical Care.
Specializes in Education, research, neuro.

Those of us who use "coverage options other than the VA system" have paid out of our own pockets for access to other health care. The "options" are not a feature of the VA system. The VA does not have a titration system that allows veterans to use a little of this or a little of that type of health care. To be independent of the system, to be secure in our health care requires us to pay the freight for private health insurance. Just like non-veterans.

You will note. I spoke for myself. I said that I have a fear (and I think a reasonable one) of becoming vulnerable to venal people... and study after study indicates that some upper echelon VA executives (BTW: a non-trivial number of them) are, indeed mendacious, self-serving, sociopaths (i.e., people who are incapable of empathizing with or seeing the humanity in others.) Further, I noted that the rules of their employment make it almost impossible to discharge them, requiring a very high threshold of proof (far higher than that required to fire a nurse or doctor) and a grievance procedure that makes them almost bullet proof.

The veterans who have been most damaged and betrayed by the system that sets up these parameters, have been those who became dependent upon the system. I know it's ridiculous, but a lot of GI's actually believed the stuff they were told when they were young, healthy and fighting our nation's wars. They planned their lives and their health care around what they were told to expect from the VA health system.

That 75% of veterans, like me, have been reluctant to believe the promises and propaganda and have arranged their lives to be less dependent on the system strengthens my point. It doesn't detract from it.

And God bless those VA's and those veterans who have given and received excellent care.

For me, it's not a matter of public policy. It's simply a matter of trust.

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