A Failure to Listen – The Hinge Upon Which Governments Fail or Thrive

AmidalaPadmé in “Star Wars: Revenge of the Sith” makes a powerful statement about the galactic war being fought, “This war represents a failure to listen.”  While Padmé insists that diplomacy is required, this is incorrect.  Diplomacy is the political game of charades, with smoke and mirrors of intelligence games.  Diplomacy fails because each sides agenda is more important than the words being spoken, which is why so much of the work done in diplomatic circles is done in “informal settings.”  Diplomacy fails to listen.

America is a Republic, rather America is a Constitutional Republic, where the rule of law as written is the supreme law of the land to which every citizen is bond.  In the world there are democracies, where the mob rules.  There are socialist governments where the fat of government is forcibly taken through taxation and doled out by the micro-ounce to those selected to win or lose.  There are still communist governments and monarchies where the leaders are pampered to the detriment of the citizenry.  Unfortunately, between these extremes are a host of other government types who borrow pieces from many government theories thinking they can escape the negative consequences of those government methodologies.

Yet again we find Padmé’s counsel appropriate and timely.  Before war begins, there is always a refusal to listen.  For example, it is historically accurate that the US Government had signs and warnings of the impending Japanese Attack on Pearl Harbor, but the US Government had stopped listening to adverse advice, and America paid dearly for that failure to listen.  Worse, war came, and hundreds of thousands paid in blood for that failure to listen.

Emotional OutburstThe Russians thought diplomacy was the appropriate approach to Nazi Germany; and Nazi Germany made the Russians pay in blood for the failure of the government to listen.  Even though history has regularly taught the Russians not to engage in diplomatic solutions with Germans.  This was hardly the first fight between Germany and Russian troops and governments.  Failure to listen, and the citizens suffered tremendously to overthrow both Nazi Germany and then the chains of Communism.

Consider again the relationship between Mexico and the United States, the Mexican Government has never been an ally or friend to the United States; yet, the governments refuse to listen to common sense, and throughout history, those people hellbent on destroying America have always found safe passage and refuge in Mexican borders.  History relates that the failure of governments to listen, is the root of the United States and Mexican sour relationship.

Cuba has suffered under Communism and Castro’s poor ideas because government leaders refused to listen.  Venezuela fell because the governments in power refused to listen to each other, bribed the electorate, stole elections, and now a once mighty nation is starving while their government leaders sit in luxury.  How many times will this story have to repeat before the citizens of governments learn, we must be able to speak freely, and listen appreciatively, if we are to survive, grow, and prosper.

For too long, the powers of the world who consider themselves above the law have worked to keep the citizens separated into fighting factions.  Every conceivable line that can be drawn to distract, separate, denigrate, and deride has been drawn, and the only people winning in this are those drawing the lines.  Republicans against Democrats, Homosexuals against Heterosexuals, religions aplenty all against each other, state to state, NFL/NHL/NBA/NASCAR and so much more adding confusion and noise to the problem and further separating people along ambiguous lines to keep them from talking and listening appreciatively to each other.

Nuclear FamilyHow many families cannot have a meal without choices of lifestyle and hostility ending conversation over a failure to listen?  Can a Chicago Bears Family survive long with a fan from Minnesota or Wisconsin?  What about the other choices people make in their lives, religious flavor versus another religious flavor; this simple line has been destroying nations since history began being recorded.  What do we see in the Old Testament; governments repeatedly failing because they stopped listening.

Please note, this is not a call to drop standards, accepting everything, and singing “Kumbaya,” while Rome burns, and society dies an ignominious death.  This is a call to cease destroying society and begin listening first!  Why were the riots this past summer so brutal and destructive; first the mob stopped listening, then they stopped talking, and then they started fires and terrorizing society.  Why did they stop listening; because they assumed no one heard them and cared enough to shift the paradigm, (patterns of thought and action all based upon selfishness and pride).

Darth and AnakinWhy did Anakin stop being a Jedi; he stopped listening, then he selectively listened, he began acting as a terrorist, and then he became Darth Vader.  This plot line of refusing to listen is so prevalent and obvious because humans continue to make the same mistake.  When we stop listening to each other, we stop talking; when we stop talking, we become overwhelmed by our own echo-chambers, and create the chaos that ultimately destroys our lives, our dreams, and our futures until we begin to lay aside petty differences and listen to each other again.

Listening has four distinct levels:

    • Inactive listening – Hearing words, seeing written communication, zero impact mentally. Mostly because your internal voices drown out the possibility for communication.
    • Selective listening – Hearing only that which confirms your own voices, opinions, and biases. While others are speaking, you are already forming your response.
    • Active listening – Show the other person you are paying attention, engage with meaning in a reply. Focused upon removing barriers to get your point across.
    • Reflective listening – Paying attention to intent and content, reducing emotion, two-direction as both parties are engaged in achieving mutual understanding.

Social Justice WarriorListening appreciatively is reflective listening, where we commit to listening with the intent to achieve mutual understanding.  Essentially, to improve government we must listen first with the intent to reach mutual understanding, before we ever open our mouths to speak.

The following are some launch points for improving listening in society:

  1. Understand your desire.  Know that your desire choices are determining your destiny.  If your destiny is not one you appreciate, return to desire, make different choices.
  2. Practice mental preparation based upon previous situations, to make different choices.  Listening is a voyage of discovery to reach a mutual understanding, but mental preparation is key to safely reach the destination.  Prepare, use a mirror, practice until what currently feels alien becomes familiar.
  3. Reduce emotion.  The principle of empathy and sympathy are destroying listening and only reflect the internal voices.  The volume of internal voices is silencing the ability to reflectively listen, necessitating the need to fake actively listening.
  4. Listen as you would have others listen to you.  This is an adaptation of the “Golden Rule” and remains applicable as a personal choice.  How you choose to listen will determine your destiny.
  5. Listening remains the number one tool you control and has application to written communication and verbal communication channels.  Body language is a non-verbal communication channel that can be heard as well as seen.  How are you communicating non-verbally which is interfering with your written and verbal communication attempts?

Leadership CartoonListening is a choice.  Listening is hard.  Yet, many people have pointed out that we have two ears and one mouth so we can listen twice as often as we speak.  Choose to reflectively listen, choose to reach a mutual understanding, watch society change.  It has been said that the US Constitution will hang by a thread, rule of law and the American Republic hang upon our decisions to listen appreciatively to each other and to stop allowing petty divisions to destroy ourselves, our families, and our American society.

© Copyright 2020 – M. Dave Salisbury
The author holds no claims for the art used herein, the pictures were obtained in the public domain, and the intellectual property belongs to those who created the pictures.
All rights reserved.  For copies, reprints, or sharing, please contact through LinkedIn:
https://www.linkedin.com/in/davesalisbury/

Communication – A Tool of Improving Call Centers, a Leadership Guide

A call center recently asked for some help. They have an “open-door” policy for employees to use. The call center meets all the designated training directives and compliance mandates. They believe they are the “best of the best” in providing customer support and have won awards from third-parties to back up these claims. Yet, employee churn remains high, employee morale remains low, and the leaders are becoming wary of the employment pool attracted to the call center.

ProblemsIn making observations, the consultant team tested the “open-door” policy and found that those sought were never in their offices even though the doors were open. The training was occurring, but the training offered had little to no value for the front-line customer-facing staff. It was generally considered a zero-sum game, providing time off the phones and causing stress and overtime costs. Worse, the front-line supervisors and employees’ perception was the existence of a chasm, separating them from higher organizational leaders.

Yukl (2010, p. 7) stated the definition of leadership as a “… multi-directional influence relationship between a leader and followers with the mutual purpose of accomplishing real change. Leaders and followers influence each other as they interact in non-coercive ways to decide what changes they want to make.” Fairholm (2001) built on the definition by Yukl (2010), insisting that leadership is a social event specific to the group of followers and leaders. Leadership and followership is a social contract; a call center is one of the most unique social environments possible. Due to this social environment, the leader who inspires communication is the call center leader who will be highly successful and train others to be highly successful.

Inherent to a fruitful and lasting social environment that promotes growth and development, leadership requires non-coercive methods to inspire and empower and provide aid to followers during change. Leadership in call centers is a social event specific to that group of followers, and leaders requiring mutuality in action to influence objectives being appropriately met. Coercion is a poison that infects like cancer into social environments; unfortunately, coercion is an easy trap to fall into as it is effective in the short-term.

Using the definition of leadership by Yukl (2010), we find why coercive leadership is ineffective; coercion cannot touch the followers’ hearts and minds to empower action towards objectives. A coercive action is any activity performed to harm or ensure the compliance of the action’s target. Coercive practices take many forms, from withholding benefits, including praise, to overt action, including threats and force. Coercive measures are used as leverage to force an individual or team to act in a way contrary to their individual or team interests. Covert coercion is rampant in many call centers and takes the form of restrictive policies, carrot/stick incentives, and human treatment policies that allow favoritism to rule instead of results.

Coercion is pernicious, and coercive practices are preventable. Yukl (2010) further elaborated that the follower only gives the coercive leader power out of fear or acts as a coercive agent to oppress others.  Furthermore, Yukl (2010, p. 137) specified that coercive leadership produces fear as the only motivator, and fear is dysfunctional, making nothing but more dysfunction in followers. Academic researchers often use the military as an example of coercive power and coercive leadership. Yet, having served in the US Army and the US Navy, I can attest coercion does not work in the military just as it does not work in any other industry. Coercive power is an acid destroying everything, building nothing, and dehumanizing people into animals.

The opposite of coercion is persuasion. Persuasion is the mode of being effective in collaboration, and persuasion requires trust and communication. Trust is an operational factor that builds the relationship between followers and leaders. It is the single most crucial factor in collaboration; but, collaboration and trust, as operational concepts, require two-directional communication to reach maximum effectiveness (Du, Erkens, Xu, 2018).

Internal-CS-Attitude-Low-ResCommunication as a tool in expressing confidence in the follower/leader relationship gains strength to clear misunderstandings and reach the desired consensus to meet organizational goals and operational objectives. The operational concept of trust and communication requires the third leg of the trust relationship agency. The follower needs to possess agency to act, informed agency requires training to employ, and the power and support of leadership to feel confident in action as detailed by Boler (1968), Avolio and Yammarino (2002). Which is where concepts meet reality, where theory is tested, and the leader is needed.

The following are proposed actions to build trust in organizations, improve communications, and empower the agency in employees to act. One of the worst things a leader can do when coercion is suspected is “trust exercises.” Trust exercises like standing a person on a chair and having them fall back into the team’s waiting arms. A call center leader colleague tried holding team and department meetings using “trust exercises,” and the result was best described as a catastrophe. The actions proposed are practical and can be employed in all call centers, including those working remotely due to COVID.

  1. Employ praise! Honest, truthful, fact-based, and reasoned praise is the most powerful tool a call center leader can employ to build people. With many call center workers working remotely, using praise as a recognition tool is critical to improving employee performance.
      • Use QA calls to issue praise.
      • Use non-cash incentives to recognize powerful deeds.
      • Make praise public through company newsletters and leadership emails.
      • Be specific, direct, and honest in your praise.
      • Be consistent in offering praise.
  1. Saying you have an “open door” is not enough, be the support mechanism your people need.
      • Respond to emails. Even if you cannot offer a substantial response immediately, personalize the email response, set a follow-up date, and meet those follow-up dates for additional communication.
      • Respond to employee questions with enthusiasm for listening and acting, not merely speaking.
      • Stop active listening; begin immediately to listen to meet mutual understanding through reflective listening. Mutual understanding and a promise to act on a concern are essential to support “open-door” policies; failure to listen and act is the number one failure of “open-door” policies.
  2. Training must change. If training is not a value-added exercise to the person receiving training, training has not occurred, resources have been wasted, and problems are generating.
    • Does your trainer know how to gather qualitative data from front-line workers to make curriculum developments?
    • Does your trainer know how to collect quantitative data from the training program to gauge decision-making in curriculum improvement?
    • What adult education theories are your trainers employing to instruct, build, and motivate adult learners who are employed?
    • How do you measure training effectiveness?
    • Does a “trained” employee know how to use trainers’ information to change individual approaches?
    • Do team leaders take an active role in training, or are they just “too busy?”

All these questions and more should be powering your training of the trainer discussions. If these questions are not being addressed, how will you, the call center leader, know your training investment dollars can return a positive investment? Training remote workers, especially, requires training programs that can motivate learners to change personal behavior. Thus, the training must have the ability to reach the student’s honor and integrity.

Leadership CartoonCOVID has provided many opportunities, and only through collaboration, communication, trust, and empowered agency, can help call centers to survive this difficult period. Regardless of how long the government shutdowns occur, your call center can survive, and call center leaders can prosper, provided they are willing to be leaders indeed, not managers in disguise.

References

Avolio, B. J., & Yammarino, F. J. (2002). Transformational and charismatic leadership: The road ahead. San Diego, CA: Emerald.

Boler, J. (1968). Agency. Philosophy and Phenomenological Research, 29(2), 165-181.

Du, F., Erkens, D. H., & Xu, K. (2018). How trust in subordinates affects service quality: Evidence from a large property management firm. Business.Illinois.edu. Retrieved from https://business.illinois.edu/accountancy/wp-content/uploads/sites/12/2018/03/Managerial-Symposium-2018-Session-IV-Du-Erkens-and-Xu.pdf.

Fairholm, Gilbert W. Mastering inner leadership. Greenwood Publishing Group, 2001.

Ruben, B. D., & Gigliotti, R. A. (2017). Communication: Sine qua non of organizational leadership theory and practice. International Journal of Business Communication, 54(1), 12-30.

Yukl, G. (2010, April 23). Leadership in organizations [Adobe Digital Edition Version 1.5] (7th ed.).

© Copyright 2020 – M. Dave Salisbury
The author holds no claims for the art used herein, the pictures were obtained in the public domain, and the intellectual property belongs to those who created the pictures.
All rights reserved.  For copies, reprints, or sharing, please contact through LinkedIn:
https://www.linkedin.com/in/davesalisbury/

A Dangerous Moment – A Warning!

A colleague of mine on LinkedIn said something that has me thinking.

“Divergent narratives are being weaponized to habituate people to increasing the threshold of violence.  A country should talk to each other not develop proscription lists.  Proscription lists dehumanize and demonize social or political opposition rather than engaging them in pragmatic ends towards the common good.  America is in a very dangerous moment.”

Consider for a moment the message my colleague is making.  Political thought that does not match that of another is automatically discounted, denigrated, and derided.  Social views of how to improve which differ from, even slightly, are castigated.

America is currently in the middle of a very contentious election count.  Where documented skullduggery, political shenanigans, and illegal activities are so egregiously apparent that anyone with eyes can see there is a problem.  Yet, to vocalize doubts, to ask for time to cull the fraud, and apply legal processes is being squashed while at the same time the narrative of “Unify the Country” is blared from every media outlet.

Just before the election, a member of the House of Representatives, Congresswoman Alexandria Ocasio-Cortez (AOC), made the following statement clear in a tweet.  “Is anyone archiving these Trump sycophants for when they try to downplay or deny their complicity in the future?”  This is a perfect example of proscription lists with the threat of weaponized government for those who disagree with AOC and her party.  How do we know this is true; within hours of AOC’s tweet, the “Trump Accountability Project (TAP)” was established to ensure no “Trump sycophant goes unpunished.”

The objective of TAP is “to make sure anyone who took a paycheck to help Trump undermine America is held responsible for what they did.” This objective should give every American pause and create concerns that America is falling into a totalitarian nightmare.  Worse, none on the political left are making any attempt to hide their agenda, to employ the “smoke-screen, and mirrors” tactics so common used by those with hidden agendas.  Sadly, TAP will not limit itself to President Trump’s administration officials and will include everyone who voted for Donald Trump as well as everyone who disagrees, dissents, or even asks questions.  How do we know this; Climate Warrior 7 tweeted a message similar in hate to that of Jennifer Rubin who writes for the Washington Post and MSNBC, saying,

Any [R]epublican “now promoting rejection of an election or calling to not to follow the will of voters or making baseless allegations of fraud should never serve in office, join a corporate board, find a faculty position or be accepted into “polite” society. We have a list.

 

If you know anyone who supported Trump please add their names to our database.  They will be dealt with in due course, once the appropriate legal framework can be put in place.” – Climate Warrior 7

Now someone could make a claim that these are two private citizens, exercising their free speech rights, and since there is no direct threat these two individuals are simply opining.  Yet, if that is the case, was Adolf Hitler’s book “Mein Kampf” simply a citizen expressing his personal views?  When a person makes another person an enemy, and then stops communicating with them civilly, there is danger that must be addressed appropriately.  When this is occurring across an entire nation, that nation is in a very dangerous moment.

Unfortunately, very few people are recognizing this danger and calling for civility.  Across the Spring, Summer, and fall of 2020, America has witnessed incivility, mob violence, terrorism, as nightly rituals where political leaders from all parties refused to renounce and vocally condemn the violence.  The media played their part in silencing the few who tried to speak up or speak out, while simultaneously cheering on and even participating in the violence.

Lack of communicating is a direct correlation to a lack of trust.  A lack of trust is further compounded by theft, non-transparency in government processes, and by the use of law to punish the innocent and free the guilty.  Where has this been witnessed; mask discrimination and criminalization, terrorists caught and released after causing damage and harm to a society Portland, Oregon and New York City, New York both come readily to mind.

Now, Joe Biden and Kamala Harris are broadcasting calls to unify and heal the country.  Why make these calls now, when they were begged to do so during the presidential campaign and they refused?  Where was the need for civil discourse when CHAZ/CHOP was being erected and people’s rights violated?  Where have Biden/Harris been while Portland, Minneapolis, and how many other cities burned, property was destroyed, businesses destroyed, and terror reigned?

America, we are in a dangerous moment!  But, this is one of those historic moments where either we rise together against the forces of tyranny and destruction or fall an unpitied sacrifice in a contemptible struggle.  How we, as a country, leave this dangerous moment is up to the individual citizens, banding together, putting aside the differences that forces would use to divide us, and standing up for our rights, our freedoms, and our families.

I choose to stand against this oppressive force which threatens to choke the life out of America and feast upon her remains.  I choose to stand with anyone who chooses to stand and not go quietly into the night of tyranny and oppression.  I choose to stand and defend that which I love, the United States of America, a free republic, under God!  Join me?

© Copyright 2020 – M. Dave Salisbury
The author holds no claims for the art used herein, the pictures were obtained in the public domain, and the intellectual property belongs to those who created the pictures.
All rights reserved.  For copies, reprints, or sharing, please contact through LinkedIn:
https://www.linkedin.com/in/davesalisbury/

 

Where is the Patient Advocate? – A Story in 3-Emails

Three secure messages, sent through the My Health eVet secure messaging system, all related to a need for VA Hospital services, and all reflecting something in common, the VA’s refusal to act.

First Email: Good Morning,

I have but one question, I would appreciate a timely and thorough response, within 24-hours. “Where is the advocacy from the patient advocates?”

Last Wednesday I needed to discuss the problems I am having with pharmacy refills, but was bounced off VA property because I can NOT Physically. Wear. A. mask! This is for patient safety concerns. Why am I being discriminated against and refused care at the VA Hospital and the patient advocates office is doing nothing to help improve this situation?

I was promised a letter from the VA Hospital Director over the incidents from June and July, still no response from the director or advocacy from the patient advocates. Why?

I need to be able to access the VA Hospitals services and cannot do so when the VA Police are enforcing a mask policy that puts my life in jeopardy! Without an adequate workaround to the mask policy, I suffer from refills that are delayed, and without the drive thru pharmacy, now have no recourse to develop a solution!

Why? Where are the Patient Advocates in standing up against the bureaucracy and demanding solutions for patient problems? Where are the Patient Advocates regarding the incidents from June and July, using hard evidence to improve VA Hospital performance?

Enough is enough! Where do I find a patient advocate?

Thank you!
Dr. Dave Salisbury

Second Email: Hello,

Is there a reason the drive-thru pharmacy is no longer?  I must get refills and the refill process through the mail is taking 3-5 times longer than normal; thus, reordering when you have a 10-day supply remaining is not good advice as I keep running out before the delivery is made.   Only because of the drive-thru pharmacy have I been able to stay ahead of medication emergencies with the refill process being broken.

Why? How do I get refills; when, because I cannot physically wear a mask, I cannot be seen in the VA ER or walk into the VA Pharmacy for refills?

I am thoroughly and completely out of two medications, they have both been reordered and I have no word on when they will arrive. The last refill on a diabetic medication took longer than normal (7-10 business days) to be received and I wonder when I should schedule reordering that medication with the added slowdowns and longer delivery times.

How do I gain refills when I have zero access to the VA Hospital and the refill process has failed to delivery on time?

Thank You!
Dave Salisbury

Third Email: Dr.

I do not know what is happening with pharmacy, but something must give! I reordered my refills with plenty of time since March 2020 through the Phoenix, VAMC, and I keep running out before the meds arrive!

Due to the continued increased symptoms, usage of medication increased, but the refill process has slowed, and without the drive-thru pharmacy I am stuck without access to pharmacy.  Especially, since I can never get a straight answer when trying to use the phone.

As of this morning, I had to wake up, and take the remaining dosage and two Advil for the crushing, horrible light sensitivity, facial pain, twitch bordering, headache! How do I get this refilled with the drive thru pharmacy out of operation, and the VA Hospital off limits because I cannot physically wear a mask?

I have, as if this writing 0330 27 October 2020, been out of one medication for two days, having taken the last pill on Sunday (25 October 2020)! One of the reasons why I had 90-day supplies, instead of the VA (policy?) 30-day supply in Albuquerque was because of this exact reason, I kept running out before the deliveries were made. I must be able to trust the VA Pharmacy Refill process, and the pharmacy refill process is untrustworthy, and currently in disarray.

I showed up at the hospital last week (21 October 2020) trying to have this conversation with pharmacy and was first kicked out of the hospital, then escorted off property because I cannot safely wear a mask and asked why.  I also asked for a copy of the mask policy, and had a supervisor turn himself into a pretzel trying to explain why he cannot produce a policy upon request. What do I do?

Thank you!
Dave Salisbury

Before leaving Albuquerque, NM., I had the privilege of being able to discuss certain topics with local hospital representatives.  I had the ability to talk to directors, medical department heads, patient advocates, and so many more dedicated healthcare professionals who work in in non-VA or government run hospitals.  Every one of them stated categorically that if their hospital was run like the VA Hospital system, they would have been fired, and more than likely legally charged with malpractice, shut down, and sued.

Let that sink in for a moment.  The VA Hospital purports to be doing a service for veterans, but the biggest problem in veterans receiving care is too often the VA Hospital system, and if a non-VA Hospital was run in a similar manner, criminal, legal, and other repercussions would sink that hospital system forcing the government to take over to “rectify the situation.”  Yet, this atrocious behavior is tolerated where the veteran’s hospital system is concerned; I can only ask why?

“The VA Hospital purports to be doing a service for veterans, but the biggest problem in veterans receiving care is too often the VA Hospital system!”

Why is it that every time a solution begins to show the promise of working, the VA bureaucracy stifles the momentum, destroys the people involved, and the veterans keep suffering?  A recent VA Advertisement on LinkedIn talked about how the VA is available with a ready hand to help, it was very well marketed, the advertisement was full of great phrases, sound bite captions, and solemnity; except too often the marketing hype does not reflect reality. Yet, the veteran, the spouse, and the dependents suffer!

Want reality in a VA Hospital, if you and your symptoms do not meet a predetermined checklist of boxes, you are considered the problem and the VA Hospital cannot/will not help you.  The VA Physician cannot issue a diagnosis, nor can the records of patient interactions have sway with the Veterans Benefits Administration for a claim determination.  America sends troops all over the world, places them in literally thousands of crazy environments, but the Department of Veterans Administration still demands cookbook medicine, checklists, and cookie-cutter one-size-fits-most medical practices.

Want reality in a VA Hospital, ask a bureaucrat behind a desk why the patient is being inconvenienced, and watch how fast that veteran is labeled as “The Problem,” and the veteran gets surrounded by the VA Police who then threaten, attempt to intimidate, and arrest/fine that veteran.  Average current time is less than 2-minutes!

Want reality in a VA Hospital, look at the lack of cleanliness, everywhere, and monitor how long spills, blood on walls, black “gunk” stuck in corners, etc. stays around.  I have personally witnessed blood spots lasting on doors and walls for months before being removed, even after complaining about the mess multiple times.  One incident, on an ER treatment room door, there was a roughly 2″ blood spot, dried, sticking to the back of the door, was there for 18-months before finally being removed. Yet, the VA Hospital system will always cheer, about cleanliness, friendliness, and helpfulness of VA Staffing.

Want reality in a VA Hospital, depending upon the tier upon service conclusion originally assigned to, you will experience a significantly different VA Hospital experience.  Even if the Veterans Benefits Administration changes your disability rating, you do not change treatment tiers, and receive reduced medical care accordingly.

Need hospital records, run the leviathan and draconian process of filing a Freedom of Information Act (FOIA) request, and wait.  Need to understand policies and procedures, there is a FOIA for that as well, but do not expect anything written down; because, the VA operates upon the philosophy that if it is written down, then you can be punished for not complying.  Not having operational procedures, patient care processes, standards of behavior, etc. written down provides a ready-made excuse for when the VA Office of Inspector General (VA-OIG) calls investigating.  In over 10-years of reading and commenting upon VA-OIG reports, this remains the number one excuse for failures to comply, dead veterans, and incompetence masquerading around as leadership.

Where is the media, the watchdog of society?  Where are the elected officials whose job it is to monitor the actions of the bureaucrats to ensure these problems do not begin, let alone thrive?  Where is the patient advocate’s whose job is to stand between the bureaucracy, and the patient, to aid the patient in completing tasks that the patient cannot do for themselves?  Where are the patient advocates who are supposed to be making suggestions for improvement based upon the data they collect from complaints and failures of hospital bureaucracy?  Where are the patient advocates in improving operational policies to protect the health and safety of patients, before that patient ever arrives at the hospital facility?

The VA has removed my access to the VA-OIG reports, it has been two-months since I saw a VA-OIG report in my email box.  This is standard practice for the VA, when problems arise, shoot the messenger instead of working to find and fix the problems, and this too is a reality at the VA!

© Copyright 2020 – M. Dave Salisbury

The author holds no claims for the art used herein, the pictures were obtained in the public domain, and the intellectual property belongs to those who created the pictures.

All rights reserved.  For copies, reprints, or sharing, please contact through LinkedIn:

https://www.linkedin.com/in/davesalisbury/

America: Unity is Our Strength

President Lincoln, quoted the New Testament, and said, “A house divided cannot stand.”

Since the 1960s cultural rebellions by the children of the day, America has been slowly and inexorably torn asunder.  We have been split along racial lines, in the name of racial equality.  We have been split along sex lines, in the name of love, peace, and harmony.  We have seen rabid separation along political lines to the point where a sitting president can feel safe in physically threatening the lives of political opponents and never be held accountable.  We have seen the dumbing down of America’s children through K-12 Education, and then the propagandization of those minds in colleges.  We have seen neighbors trying to help neighbors and had the fist of government, wielded by petty authoritarians, create angst and trouble.  We have witnessed a complicit and biased media throw away common sense for political power, and openly aid and abet criminals in their work of destroying America.

Worst of all, we have seen activist judges usurp power from the legislative and executive branches and creating laws for America from whole cloth.  Members of the House and Senate, the legislative branch, now regularly feel they can usurp the powers of the executive with the help of the judicial branch and their media cheerleaders.  We have seen the executive branch crumble, and American’s have died with no help ever arriving.

Social Justice Warrior 3All these problems and more have torn at the basic and fundamental power American’s have always held, unity.  Unity born of hope, fed a diet of accomplishment, nurtured with education and exposure to work.  The unity of farmers has seen America fed.  The unity of churches has seen America support religious freedoms and become a bulwark to religious beliefs.  The unity of schools of higher education kept standards for academic performance that paved the way for great minds to leave academia prepared to lead industries and stand against tyranny and oppression.  The unity of the states has allowed America to weather fires, floods, tornadoes, hurricanes, and every other natural disaster.

Unity of being “AMERICAN,” UN-hyphenated, whole, and linked with other American’s has seen compassion thrive, poverty fought, and hunger abated.  Americans, (Ah Me I Can) is a statement of power. The power of “I can” built the Panama Canal and changed the world.  When hundreds of people committed, who were and accustomed to the motivating power of “I Can” and stood shoulder to shoulder, two World Wars were fought and won, hundreds of brush-fire wars were scuttled and despots removed for the betterment of society.

When America forgot the power of “I Can” Vietnam fell into disarray and ruin and those who lost lives never came home.  Cuba and Venezuela have been lost to communism and tyranny.  The Ukraine has all but become a territory of Russia.  Alliances have been written off, red-lines crossed with impunity, and more people have lost their lives.  The political left was able to force shame upon the body of America, and in so doing captured power that never should have been theirs.  Refusing America, the ability of coming together and unifying after Vietnam, the political left kept pushing new powers of separation, new lines of contention, and new causes for concern until chaos reigns and terrorists can be called “peaceful protestors.”

Religion Quote 2America has suffered since the 1960s from the disease of disunity.  We have failed to grasp the power we all possess, which is exponentially greater than the sum of our individual numbers, when we boldly stand and commit to “I Can” America’s enemies quake and pale.  Combined, “I Can” does not become “We Can.”  Combined, the power of “I Can,” is a force greater than “We” because each person shoulders their own load, looks after their own families and friends first, and in doing so multiplies the power of “I Can” into the wonder and majesty that has lured millions of people to come to America and become citizens; that is unity in action!

        • A house divided cannot stand.  A house divided cannot long endure.  A house divided is weak and ready to be pushed over and destroyed.
        • A unified house can stand.  A unified house can long endure.  A unified house is strong and pushes back against all the winds that blow.

A principle that the political left has failed to grasp and refuses to believe, we can have differences in opinion and still be unified in purpose.  Americans have always been contentiously unified, we have regularly disagreed about ways and means, but until the 1960s cultural revolutions we remained unified in purpose, unified in belief, and unified under the rule of law.  America, we must return to being unified or we will lose this the Republic of the United States of America!

Consider how normal it has become to castigate California and New York for pushing America ever progressively leftist, socialist, and communist.  While states like Oregon, Washington, New Mexico, and others are quietly moving socialist at the same or faster rates.  Instead of fighting back against this intrusion, the political leaders have embraced something that is fundamentally anathema to the majority of Americans, the loss of America.  But, these politicians could do this, because the citizenry have been so wrapped up in petty separations foisted upon us by the same people trying to destroy us.  We have lost our purpose, had our unity shredded, and remain in danger of losing America.

The Duty of AmericansAn example, illegal immigration.  If you support the rule of law, and fair play, you would see illegal immigration closed for the good of all current and future immigrants.  But, between rabid and hostile factions, a complicit media, the person opposed to illegal immigration is castigated, denigrated, and derided; while, those who are for illegal immigration, law breaking, and chaos are heralded as heroes.  Simple right and wrong, many of us were taught at our parent’s knee, but the issue has been twisted and warped until confusion reigns and the issue now divides homes, families, and communities.

One might ask, what is the purpose of America; the US Constitution’s preamble gives this answer clearly.

“We the People of the United States, in Order to form a more perfect Union, establish Justice, insure domestic Tranquility, provide for the common defense, promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity, do ordain and establish this Constitution for the United States of America” [Emphasis Mine].

That is why America was created, the US Constitution written, and blood shed to establish this country. Establish justice, create domestic tranquility, improve the general welfare, secure the blessings of liberty for ourselves and our children, and provide a common defense, which leads to a more perfect union.  All this is possible through unity in purpose, where we the citizens of America understand the rule of law is a tool to meet our obligations.

Want to know how far we have fallen from being unified in purpose, look at the hostility heaped upon a person not wearing a mask in a grocery store.  Look at the vile and pernicious comments left when a police officer is killed.  Check out the hate and discontent when you simply praise on social media the sitting president for accomplishing peace deals in the Middle East.  That is where disunity and all the petty lines of separation have left America.

PatriotismToday’s America is full of hyphenated Americans, “Black-American,” “Irish-American,” “Mexican-American,” and the list goes on.  Today’s America is full of petty and pernicious lines of separation, Republican, Democrat, Atheist, Catholic, Protestant, and so many more.  Today’s America is full of hate, spite, envy, malice, and every type of egotistical maelstrom possible to keep feeding the fires that separate, divide, and destroy.  It has gotten to a point that what one watches, or does not watch on TV is now prey for creating and casting aspersions, insults, derogatory commentary, or worse physical/mental abuse and violence.

Why is America different, because our unity has always been our strength.  But, the strength of unity is like a muscle, if not used regularly it begins to shrink and atrophy.  President Lincoln said,

“A house divided against itself cannot stand.”
I believe this government cannot endure, permanently half slave and half free.
I do not expect the Union to be dissolved — I do not expect the house to fall — but I do expect it will cease to be divided.
It will become all one thing or all the other.
Either the opponents of slavery, will arrest the further spread of it, and place it where the public mind shall rest in the belief that it is in the course of ultimate extinction; or its advocates will push it forward, till it shall become alike lawful in all the States, old as well as newNorth as well as South.”

Right now, America is in the same place as when President Lincoln made these remarks.  We are divided; make no mistake.  Either the opponents of America will destroy America, shred the Constitution, and remake the laws to fit their own idiocy catapulting America in socialism and thence to communism.  Or.  America will unify, rediscover her purpose, discover she is strong, and begin to thwart the evil plans of her opponents who have been elected as political leaders, placed into professorships, and held in other offices of power by the enemies of the state.

Image - Eagle & FlagPresident Lincoln’s full address can be found here and represents a blueprint for how America found herself in the first Civil War.  Pray that we quickly learn the lessons of unity, that a second Civil War is not necessary!  America must put on her strength, what strength must she put on, unity of purpose.  Casting off the chains of separation, classification, and division, and embracing unity to conquer the political will and wiles of the socialists, communists, anarchists, and fascists who have taken advantage of America’s hospitality.

© Copyright 2020 – M. Dave Salisbury
The author holds no claims for the art used herein, the pictures were obtained in the public domain, and the intellectual property belongs to those who created the pictures.
All rights reserved.  For copies, reprints, or sharing, please contact through LinkedIn:
https://www.linkedin.com/in/davesalisbury/

Remember the Captivity of your Fathers: A Paradigm for Freedom!

RememberTo remember is to do something that is necessary or advisable which brings honor to the past and freedom to the present.  Remembering is the power of becoming aware that you are more than the singular person and many others have held a hand in making you, your personality, your strengths, and your weaknesses.  A greeting card reads, “I am a strong person, because a strong person raised me.”  Remembering is also the power that propels the person from their starting point into a glorious future.  Ralph Marston has the last word on remembering, “Remember why you started, remember where you are headed, think how great it will be to get there, and keep going.”

The Church of JESUS CHRIST of Latter-Day Saints, revers as scripture “The Book of Mormon: Another Testament of Jesus Christ,” in which the reader is encouraged to “Remember the captivity of your fathers” (Mosiah: 27:16; Alma: 5: 6; Alma 29:11-12; 36:2, 29).  The captivity originally spoken of was physical captivity, where a group of people had been militarily taken over by their enemies and were in physical bondage, slaves pressed into cruel service.  But, as this theme evolves the reader is encouraged to remember other types of captivity their fathers have been subjected to, as a means of more fully enjoying the freedoms and opportunities they possess, because of their father’s captivity and release from captivity.

To the person escaping Cuba as Castro came to power, the captivity of communism and the celebration of freedom in America is a tangible memory, and powers many a child to act.  The release from concentration camp captivity powered and motivates even to this day the children and communities where freedom now rings.  The captivity of those in the USSR powers the minds and freedoms of those living in Russia.  Problems still exist, but the freedom from captivity is worth remembering, and by remembering, honor is paid to those who suffered that captivity, by the growth and development of those present and in the future.

CaptivityCaptivity comes in many shapes, by many names, and is visible only through the suffering of those held captive.  For example, during a conversation with several older adults, I asked a question about the captivity of illiteracy and asked how many generations back in their families does it take to find an illiterate family member.  One very lucky person it was more than 8 generations, another said three, a couple said four, but a very elderly person in the back said 1, his parents never learned to read or write in their own native language or English.  This man is a Native American from a tribe in Northern Arizona, when I met him he was in his late 80’s.

As a child of 8, he was separated from his tribe, his family, and the reservation he knew, loaded onto a bus, and sent to Oklahoma for education.  He spent 10-months of every year for the next 10-years, going to school in Oklahoma.  During which time he never received a single letter from his parents.  Was not allowed to speak his native language, and all native culture was forbidden.  He credits this traumatic period of his life as the crucible for all the good that has come to him through education.  His children and grandchildren, all successfully completed college becoming engineers, lawyers, doctors, nurses, and more.  He had two great-grandchildren just entering college, and his first great-great-grandchild was soon to be delivered.

On the topic of remembering the captivity of his fathers, their illiteracy, he remembers every day in gratitude, even though his parents’ thirst for learning meant he endured such harrowing experiences to go to school.  The captivity of his fathers, drove and motivated him to ensure his progeny would not suffer the same captivity.

Another example, similar question about the captivity of their fathers, how many generations back before your fathers never left a small plot of land, whose only views of the world were restricted to that single plot of land.  One answered, his grandfather had been hated by his family for leaving a place of comfort in Scotland, for a rough life in the western states of America.  Many of his family only ever saw the titles, the land, the benefits, and wanted those things.  The family desiring these things never saw the captivity and the family remains broken and separate to this day.

What was the captivity the grandfather escaped from if he had land, titles, money, servants, etc.; freedom to grow, change, and become.  As long as his family stuck to the same life and ways of his fathers, they would have a comfortable physical life.  Herein lay the captivity and this gentleman tells his story as a caution about researching family history.  I have always held this story, not as a caution, but as a parable regarding individual choices.  Born into freedom and plenty, but requiring ceaseless toil, members of this gentleman’s family preferred captivity and luxury to hard work and accomplishment.

Government Largess 2I see the welfare state in America that strips pride and accomplishment and replaces it with appetite suppression, and I see millions in captivity.  A captivity that breeds wasted and blasted lives, people who have potential dying under government handouts, forever stuck in subsistence living and not knowing how to escape the captivity of their choices.  Where for the work requirement for welfare that same person would know and understand different lessons and potentially choose a different path; thus, discovering that through work captivity is broken.

I see the captivity of thought, children raised in homes as rigidly controlled as Nazi Propaganda, controlled by the captivity of hate and choices of parents, and becoming leeches and vermin to America’s health.  Consider upon the state of these children and weep for their lost innocence and America’s future.  These are the children in the streets since May throwing bricks, lighting fires, attacking helpless victims, and causing such tremendous violence upon the American Soul.  Look upon these children in mental captivity and remember, “But for the grace of God go I” (John Bradford).

Government Largess 4Other types of captivity our fathers suffered, and our children are suffering includes, mental/physical/sexual abuse, drugs and alcohol, criminal activity, gangs, single-parenthood, the loss of the nuclear family, technology, and so much more.  Why should a person remember the captivity of their fathers?  Because by remembering by recommit to not passing along that captivity to our children or communities.

The Old Testament carries a similar theme to remembering the captivity of our fathers, when the children of Israel were commanded to remember the Passover.  Yom HaShoah (יום השואה) and in English as Holocaust Remembrance Day, or Holocaust Day, is another holiday set apart for remembering the captivity of our fathers and recommitting to freedom from oppression.  Buddhism has Bodhi Day upon which the full day is set apart for remembrance and meditation.  Catholics have All Souls’ Day as a day for remembering the past, honoring the lives of loved ones lost, and recommitting to a brighter future.

LiberationThese holidays are mentioned, and more exist, to aid the reader in understanding the importance of remembering the captivity of our fathers.  America’s fathers have fought much, and bled much, suffering incredible injuries, all to make the future better.  Can we, the recipients of these sacrifices to shed captivity, do less and lose this great Republic, without suffering the indignation of our fathers in ages past?

Consider the frozen feet and fingers of Valley Forge; what was a little frost bite when compared with the glorious vision of freedom to the soldiers on duty there?  Consider the bloody battles of the Civil War, the fear, the anger, the soul shattering pounding of the guns; both sides consider themselves correct, both sides wanted a vision of freedom, but only one side could win, and in winning bring complete freedom to all the people of America.  Consider the soldiers, sailors, airman, and marines in Afghanistan, South Korea, Africa, and every other place America sends her military might, can we sit at home comfortable and not feel gratitude for their sacrifices, the cold they suffer, the wounds, the physical and mental strain?

Image - Eagle & FlagRemembering is an action, a thought process with impetus power to drive commitment and action in an individual.  Let us not forget the captivity of our fathers and by remembering act in a method that will secure liberty, justice, and freedom for our children’s children.  America is in danger of being lost; this great republic, blessed with a Constitutional form of government is in danger.  I for one, refuse to sit idly by and lose this precious country; I implore you to remember the captivity of your fathers, and join me in voting intelligently, join me in throwing off the shackles which threaten to bind us down in captivity to communist and socialist styles of governance.  Join me in taking back America!

© Copyright 2020 – M. Dave Salisbury

The author holds no claims for the art used herein, the pictures were obtained in the public domain, and the intellectual property belongs to those who created the pictures.

All rights reserved.  For copies, reprints, or sharing, please contact through LinkedIn:

https://www.linkedin.com/in/davesalisbury/

 

Republican Government: The Judicial, the Executive, and the Legislative

Disclaimer:  Calling America a Republic is the correct form of language to describe America’s Governmental system, it does not refer to the political party of the same name.  Referring to America’s government operations as democratic, does not refer to the political party of the same name.

The US Constitution set forth three separate and equal branches of government, possessing their own powers, authority, and processes for governing America.  The problem America is facing right now, the legislative especially, and the executive too frequently, have abnegated their powers to the judicial branch until it is quite common and acceptable for a Speaker of the House of Representatives to rely upon the judicial branch to ascertain intent of a piece of legislation, instead of fixing the legislation in the House of Representatives and the Senate.  So, since America’s schools have refused to teach this coequal system of government, and have bastardized the US Constitution, the following is produced.

The executive branch of government is where a person finds all the bureaucrats, or government employees, who exert the government influence through their decision-making authority granted them by elected officials.  This is one of the reasons why certain offices in government need both the Mayor, Governor, or President’s approval and the approval of an elected governing body, city council, State or Federal Senate.  The US Constitution put in place multiple checks and balances between the three coequal branches of government to ensure that no single branch could dominate all the branches or government.

The legislative branch, which includes city councils, state Houses of Representatives and Senators, and Federal House of Representatives and Senators, write the laws the executive branch is mandated to uphold and serve.  Thus, the will of the people in establishing laws through representation was established.  Therefore, legislators and senators have such tremendous power as to attract the special interest groups in our representative government.

The judicial branch does nothing more, or less, than interpret the constitutionality of a problem brought before a judge.  Criminal judges have a slightly different and more expansive role, but the constitutionality of an action remains the core and the boundaries of their power.

Inherent in the republican form of America’s government is the fundamental belief that there are boundaries and restrictions to action.  This is called the US Constitution.  Not to be confused with Federal, State, and Local rules, laws, and procedures.  A city ordinance is not the US Constitution and if that city ordinance is deemed unconstitutional for the state or federal constitution’s, a judge should declare as much and return the core issues to either the executive or legislative branch for correction.

We must be clear on this issue, the judicial branch can levy fines to encourage behavioral changes, but cannot, and should not, legislate from the bench.  Yet, when the legislatures refuse to enact laws that are fair, just, and timely, it has become common practice to run to a judge and get a judicial ruling.  Thus, causing chaos in the citizenry, and developing a new term for legal scholars, Lawfare.

Judicial Activism is where a judge declares that the US Constitution is a “living document” that should bend to every conceivable contemporary value.  Judicial activism removes the voice of the people from the legislative branches of government and interposes the opinions of a couple of judges as being more valuable than the will of the citizens.

Judicial restraint requires intestinal fortitude and limits the powers of judges to the US Constitution and state constitutions.  Judicial restraint is not popular and as such is regularly castigated by the media and those showing judicial restraint have aspersions, insults, and problems set before them.

Here are several examples of judicial overreach, e.g. judicial activism, that support the problem of legislatures or executives writing bad laws or executing poor policies, and demanding the judicial branch sort out the problems.  Where chaos in the citizenry ensued.

  • June 2015 – Horne v. Department of Agriculture, the Court ruled that a federal program requiring raisin growers to set aside a percentage of their crops for government redistribution was an unconstitutional “taking” under the Fifth Amendment.
    • An extension of judicial overreach from In United States v. Rock Royal Co-operative, Inc., 307 U.S. 533 (1939), the Court sustained an order under the Agricultural Marketing Agreement Act of 1937, 50 Stat. 246, regulating the price of milk in certain instances.
    • The Agricultural Marketing Agreement Act of 1937 was a New-Deal Agricultural order that allowed the government to seize personal property from farmers, dairymen, etc. and give it away, to regulate prices across America. This is the same time where the power of the USDA began to rise and property began to change its definition as elaborated by Charles Reich in the 1960s.
    • Judicial activism allowed the government to break the fifth amendment of the US Constitution, and the practice continues to this very day by bureaucrat’s hell bent on destroying personal property safeguards in the US Constitution.
    • The legal precedent was set by another case of judicial activism in the Pennsylvania Coal Co. v. Mahon 260 U.S. 393 (1922), was a case in which the Supreme Court of the United States held that whether a regulatory act constitutes a taking requiring compensation depends on the extent of diminution in the value of the property. This decision started the doctrine of regulatory taking and features prominently in the legal grounds for Eminent Domain.
  • June 2005 – Eminent Domain, Kelo v. City of New London by a 5-4 majority, it affirmed the city’s right to seize private land as part of an economic development plan—a redefinition of the “Takings Clause” under the Fifth Amendment. The US Constitution states clearly that, “private property [shall not] be taken for public use, without just compensation.”
    • Until this decision the Eminent Domain and Taking Clause had been strictly and rigidly defined. Five judges who believe in judicial activism opened this “Pandora’s Box,” and the havoc has been nonstop ever since.
    • What was in the “Pandora Box;” before Kelo, eminent domain had been limited to direct government ownership, excluding property transfers to private corporations. With Kelo, the question of whether economic gain, resulting from a “taking” for corporate interests, constituted “public use” finally came under Supreme Court scrutiny, and five judges declared that if a corporation has interests, those interests are the same as government interests.
    • As proven by Eminent Domain, corporate interests change with economies and when corporate interests change, the property holder does not get their property back, and if seized under eminent domain, the government can choose what the value of the property is worth.
    • Ever want to see the power of bureaucrats in action, look at the abuses that property owners have suffered through eminent domain. Ever want to see why judicial restraint is critical, look no further than the still undeveloped land in the Kelo case!
  • January 2011 – Obamacare, everyone should remember all the chaos that ensued in this political tug-of-war between the legislative branch and the judicial branch, with a healthy dose of political grandstanding thrown in for good measure by the executive branch.
    • A judge in Florida issued a decision in a case filed by 25 Republican Attorneys General and Governors striking down the Affordable Care Act.
    • Twelve federal judges have already dismissed challenges to the constitutionality of the health reform law, and two judges – in the Eastern District of Michigan and Western District of Virginia – have upheld the law. In one other case, a federal judge in the Eastern District of Virginia issued a very narrow ruling on the constitutionality of the health reform law’s “individual responsibility” provision and upheld the rest of the law.
    • Worse, there remain multiple issues in Obamacare yet to be decided by the courts because the legislature refuses to clarify, act, or even respond to judicial opinions.
  • Continuous Issue (1973) – Roe v. Wade, 410 U.S. 113, was a landmark decision of the U.S. Supreme Court in which the Court ruled that the Constitution of the United States protects a pregnant woman’s liberty to choose to have an abortion without excessive government restriction.
    • A little history on this subject, 1820s and 1830s abortions were common through the fourth month of pregnancy and herbs, pills, and other home remedies were prevalent for use. Then, the physicians of America and the government stepped in to prevent poisoning and assert control over home remedies, midwives, and other medical opinion providers of the time.
    • New York was the first state to legalize, or codify into law abortion, as a public health measure to improve the lives of women. But, the abortion industry had not begun targeting black and non-white communities.  The first women getting abortions mainstream were, a middle- or upper-class white married women.
    • Original feminists opposed abortion practices and wanted only voluntary motherhood through the “right of women to control sex with their husbands.”
    • The original laws banning abortion were enacted to humiliate women who had to discuss their bedroom affairs with the executive and judicial branch representatives.
    • Judges made the decisions to outlaw abortion, through judicial activism because it was taking the legislative branch too long to enact laws the special interest groups, the American Medical Association (AMA), wanted.
    • Judges then made the decision to make abortion on demand legal, through judicial activism, because again it was taking too long for the legislative branch to act and enact the appropriate laws.
    • Thus, judicial activism and abortion have a long and sordid history of causing chaos in America since at least the 1840s. Hence, when a person discusses Roe v. Wade they are only discussing the abortion on demand industry, and not the whole problem of judicial activism on this issue.
  • June 2015 – Homosexual Marriage. The executive branch of government, almost as soon as America was codified into law, began regulating marriage between a man and a woman, based upon Judaeo-Christian understandings of marriage.  By regulating marriage, the government gained a revenue source, a control mechanism for the behavior of the population, and set legal precedents for what is and is not considered a marriage by the state.  Each state adopted their own legal precedents, guidelines, rules, laws, and so forth leading eventually to 50-different opinions on marriage.
    • Important to note, nothing in the US Constitution requires the definition of marriage for all 50 states, nothing in the US Constitution prohibits the state executive branch to regulate marriage. The executive branch acted to regulate marriage licensing as a control measure on individual morality, e.g. the number of wives of husbands a person may have, marriage to animals being forbidden, etc.
    • Five judicial activists decided that all 50-states need to adopt homosexual marriage and exerted their opinion accordingly through the courts. This decision has trumped the executive and legislative branches of government, stolen the individual citizen’s voice, and created untold havoc and uncountable expenses for every person in America.
    • A marriage license and a driver’s license are both executive controls on the population through government setting rules, regulations, and policies. The definition of marriage is a state right’s issue, as the individual states claimed they have the right to regulate marriage when they individually began issuing licenses to marry or drive.
    • For or against homosexual marriage is a state right’s issue, not a Supreme Court, or Federal Government Issue. Hence, the judicial activism that drove this decision is the problem, not necessarily how the judges expressed their opinions.  This decision is a clear-cut example of needing to return a judicial decision to the states to decide through legislative action.

Judicial activism has been carefully cultivated into America, so that every time there is a problem, the solution is to grab a judge and demand a decision.  However, as shown herein, the courts are a gamble, and the worst that occurs is more societal chaos because a judge has overstepped their authority and made unequal the three branches of republican government.  Worse, that judge has rendered the democratic processes of the people’s rights to self-rule invalid, null, and void.

For example, Kelo should have been referred to the legislative and executive branches for a decision, as the “Taking Clause” was constitutional, but rigidly controlled.  But, because the judicial stepped in to “solve the problem,” through adjudication, chaos has ensued, which has forced, at a minimum, 40 different interpretations of the “Taking Clause.”  Which opens a minimum of 80-different potential decisions if the courts decide to take up the Eminent Domain issue again.  Talk about chaos!

The executive branch and the legislative branch must be held accountable for abnegating their duties.  This accountability occurs at the ballot box where the lazy and recalcitrant lawmaker is returned to being a private citizen.  Then, launching a judicially correct investigation into why that person abnegated their duties; especially, if personal enrichment occurred.  Judges are supposed to be held accountable through the actions of the legislative and executive branch taking firm action, not creating new laws.  The judicial branch oversees executive and legislative investigations only to ensure the US Constitution is properly followed.  Proper checks and balances!

However, there is a caveat to the US Constitution provided by the second president of the United States, John Adams.  “Our Constitution, [which includes all the separate state constitutions,] [were] made only for a moral and religious people.  It is wholly inadequate to the government of any other [type of person].”  Why has the executive and legislative branches abdicated their duties to the judicial; they are not inherently moral or religious.  Why has judicial activism exploded; the people in office are not moral or religious.

Thus, the solution for America is to begin hiring through the election process morally upright and religious people.  Every vote, in every election, matters.  Those on the political left understand this policy and use it as a weapon to create enmity and negate the power of the people to self-government and republican rule through democratic processes.  Make the time, get knowledgeable about candidates and issues, and then vote!

© Copyright 2020 – M. Dave Salisbury
The author holds no claims for the art used herein, the pictures were obtained in the public domain, and the intellectual property belongs to those who created the pictures.
All rights reserved.  For copies, reprints, or sharing, please contact through LinkedIn:
https://www.linkedin.com/in/davesalisbury/

August VA-OIG Updates: More SHAMEFUL VA Conduct.

I-CareDue to personal issues with the Department of Veterans Affairs (VA), specifically the Carl T. Hayden VA Medical Center (VAMC) in Phoenix, AZ I fell a little behind in June/July/August of 2020.  As I work to clear the backlog of completed Department of Veterans Affairs – Office of Inspector General (VA-OIG) reports from August, please keep in mind solutions to these problems are available. The failure of leadership to be held accountable, by the elected officials is staggering, and the lack of accountability and responsibility boggles the mind.  Without exception, I know the VA can be improved, developed, and saved.

August 2020 begins with an individual employee making a decision regarding healthcare decisions for a veteran at the Robley Rex VAMC in Louisville, Kentucky.  The VA has a process where individuals can be allowed to be surrogate decision-makers for a veteran who needs additional assistance.  This process works is legal and is a great tool for family and friends of veterans to play a significant role in the healthcare process of the veteran.  In this instance, the process failed, not because the process was bad, but because people did not do their jobs properly.

The VA-OIG assessed an allegation that providers permitted an individual with no legal authority to make medical decisions on behalf of a patient, and a host of other patient rights were trampled as documented.  “The patient experienced a three-week medical and mental health hospitalization with repeated episodes of confusion, agitation, and combative behavior. The patient was transferred to hospice care and died five days later.  The VA-OIG found that facility staff did not take the required appropriate steps to identify and confirm the eligibility of this surrogate.  The VA-OIG determined records did not contain sufficient documentation of physicians’ clinical assessments to support diagnoses and treatment decisions. Clinical communication and collaboration were inconsistent, insufficient, and negatively impacted the patient’s continuity and quality of care. Providers did not consistently document medication monitoring and oversight activities to ensure safe patient care. The patient’s transfer to hospice was completed without fully pursuing other diagnoses and treatment options and staff did not ensure the patient’s rights were upheld regarding involuntary admission and behavioral restraints. Facility leaders did not complete a thorough quality of care review to understand the reasons for the patient’s atypical hospital course and outcome” [Emphasis Mine].

Many times, the VA-OIG reports do not clarify all root causes due to employee privacy; however, from the report, the employees who repeatedly allowed the neighbor to make healthcare decisions were exceeding their legal bounds and made decisions that harmed the patient.  This veteran died and from the report, it is clear the veteran died confused, possibly due to medication changes, and the family was not notified in a timely manner because the neighbor, without legal and written authority, was allowed to make healthcare decisions for the veteran, even though there was written healthcare directives on file for a family member to make these decisions.  Utterly shameful behavior!

PatriotismThe Veteran Integrated Service Network (VISN), is a geographical grouping of VA Healthcare Systems, e.g. hospitals and clinics, under a combined leadership plan.  One of the tools the VA-OIG uses to monitor the quality of patient care inside VISN’s is called a “Comprehensive Healthcare Inspection Program (CHIP).  CHIP covers selected clinical and administrative processes all of which are deemed consistent with promoting quality patient care.  The CHIP occurs on a rotational 3-year periodicity and the focus is shifted slightly each 3-year cycle to, theoretically, encompass all administrative processes over time.  The VA reports the following are the specific areas that lead to quality patient care through administrative practices:

  1. Quality, safety, and value;
  2. Medical staff privileging;
  3. The environment of care;
  4. Medication management (specifically the controlled substances inspection program);
  5. Mental health (focusing on military sexual trauma follow-up and staff training);
  6. Geriatric care (spotlighting antidepressant use for elderly veterans);
  7. Women’s health (particularly abnormal cervical pathology result notification and follow-up); and
  8. High-risk processes (specifically the emergency department and urgent care center operations and management).

All of which is mentioned as an explanation providing details for the following VA-OIG inspection reports of CHIP received in August 2020.  A total of seven CHIP reports were received in August recording performance from inspections carried out.  These reports, while somewhat individualized for the specific VAHCS, reads like a carbon copy.  Repeatedly written procedures for standard operation are missing, staff training is inadequate or antiquated, risk analysis is not able to be competently and correctly conducted, patient safety issues abound, and the proper utilization of management processes remains glaring!

Root Cause AnalysisThe CHIP reports are so repetitive in nature, the VA-OIG recommendations are grouped, conveniently, into the eight administrative areas listed above.  According to proper management techniques, the VA-OIG then “encourages” the leadership team to select one or two areas for improvement and focus their efforts on leading change in those areas.  For example, if the VAHCS wants to improve in risk analysis, the leaders can begin by promoting training on properly conducting risk analysis online, hold meetings to review risk analysis procedures and begin to train and develop staff on improving n this area.

However, here is where reality meets theory, without written standard operating procedures risk analysis cannot be completed properly.  The bureaucracy protects itself and will thwart the implementation of written standard operating procedures as this removes designed incompetence that keeps the bureaucrat in power at the VA.  Thus, the root cause of improving root cause analysis is the lack of written procedures that measure performance against a single written standard.

CHIP Report after CHIP Report the same issues arise, are noted, recommendations from the VA-OIG are documented, and the same response is supplied; this represents the epitome of designed incompetence and the root of the problem the VA is facing.  Recommendations for improvement have been repeatedly provided and change can occur; but, not without dedicated leadership, not management, to thwart the bureaucratic quagmire that the VA has fallen into.

Leadership CartoonAnother regular entry on the CHIP reports is the following: “Employee satisfaction scores revealed opportunities for the Associate Director for Patient Care Services to improve employee attitudes towards senior leaders.”  Here is the problem, how many of the “senior leaders” are less than managers, promoted beyond their maximum level of incompetence, solely because they were the next warm body in line; too many!  When staff training is a repeated issue on CHIP reports, one must ask how employees are being measured?  Where are the written scorecards that reflect a process that was used to measure employee performance fairly and equitably?  Was the employee trained on how to perform their role according to the standards published?  Do the scorecards reflect that all employees have been trained, measured, and reported equally?

Guess what, since staff training remains a consistent problem, the staff leaders are the problem!  A major part of “Quality, Safety, and Value” is “Leadership and Organizational Risks.”  A lack of training in properly, timely, and correctly performing one’s role as hired is both a leadership and an organizational risk.  Failing to train employees is the absolute worst comment a leader should be informed of by a third-party inspection team.  Yet, the training of staff is consistently the root cause after a lack of standardized operating procedures.  Every mid-level supervisor, trainer, manager, director, etc. titled individual at the VA should be embarrassed when told their staff is untrained; but, it appears these same leaders do not care!

The Duty of AmericansHow can a person draw the conclusions that the VA appears to not care about improvement, or that the lack of caring is rampant across the entire VA structure; look no further than the site visit VA-OIG inspection report of the Department of Veterans Affairs – Veterans Benefits Administration (VBA).  The deputy undersecretary for field operations expected regional office managers to be aware of issues raised in other regional office site visit reports, but there was no written policy for addressing frequently identified errors.  So, the mid-level regional office managers must be told to investigate internal websites to gather lessons learned and apply those lessons in their regional offices.  What an incredibly inept excuse; shameful conduct by a senior leader, and how much worse does this attitude become as it filters down to the troops?  The behavior that claims a new policy is needed to improve performance is utterly bereft of logic and demonstrates the lackadaisical attitude being discussed.  Then these same leaders wonder why their staff is disengaged, disconnected, and distrusting of leadership; unbelievable!

One of the first lessons I learned in becoming a business professional was, “If you have to write your ethics down, you have already lost.”  The VA policies on ethics, ethical conduct, and ethical behavior are voluminous, trying to cover every detail, every loophole, every issue, and mostly the VA-OIG reports on ethical breaches reflect individual poor judgment at best, and designed incompetence at worst.  Yet, still, the VA tries to implement ethics without a source, moral behavior without a purpose, and the individual employee is left with plenty of excuses for not behaving in a properly ethical manner.  This is the topic of another article; but it must be made clear here and now, ethical lapses continue to abound at the VA.  From the nurse not giving drugs to patients and selling the drugs on the street, to hospital directors not disclosing what appears to be a conflict of interest, the VA remains afloat on a sea of ethical violations.

The remaining reports in August reflected an investigation that the VA-OIG was unable to substantiate due to a lack of reports filed in a timely and proper manner.  More designed incompetence on the part of the VA.  Also included in these final reports were more repetitions of issues discussed where staff training was the root cause for ethical violations, failure to properly perform duties as hired, and staff training was the problem with adherence and compliance issues.

The disconnect is obvious, and the direction forward is clear.  Hospital Directors, write the standard operating procedures, using the resources of how the work is performed currently as the baseline.  Then begin correcting and amending the written procedures over the following year to improve performance to a written standard.  Once the written standard is completed, e.g. the baseline, begin training of staff.  You cannot measure individual performance without standards, and standards cannot be followed without written operating procedures for conducting business.

Behavior-Change© Copyright 2020 – M. Dave Salisbury

The author holds no claims for the art used herein, the pictures were obtained in the public domain, and the intellectual property belongs to those who created the pictures.

All rights reserved.  For copies, reprints, or sharing, please contact through LinkedIn:

https://www.linkedin.com/in/davesalisbury/

July Updates: OIG Reports That Should SHAME the VA!

Survived the VALate last week, I received a call from the Chief of police at the Phoenix VA Medical Center.  In July, I had been arrested for not wearing a mask.  By late August, I had figured the Phoenix VA Medical Center Director was going to just “forget me” and hope I go away, then the call comes in.  The Chief of police begins by stating, “I do not know why I am calling you, but I was requested to call and see what I can do to help.”

This response of the chiefs can be viewed two ways, he honestly does not know and needs to be updated, or he is using this as a conversation starter and does know.  I choose to see the best in people and gave the chief the benefit of the doubt.  I explained the situation, the multiple different stories regarding “VA Policy on Mask Wearing,” my multiple visits where I was not hassled about not wearing a mask, the confusion with the face shield, and the behavior of his officers in trying to implement poor policy.  To which the chief replied, I cannot help here and will return this issue to the director’s office where I had initially filed the complaint.

I do not blame the VA Police for arresting me.  They are tools of policy, as I have discussed previously and you can review here.  The police in my situation are stuck in the middle between a ridiculously inept hospital director, and the need to enforce the policies which issue forth.  At the beginning of COVID-19 hysteria, the director received a memo from the Department of Veterans Affairs (VA) regarding how to handle COVID-19.  The director did not adapt the policy to the local hospital, placing patients at risk who wears a mask in Phoenix summer conditions; nor, did the director include the ability for individual adaptation to individual patient health concerns, SAIL Metrics.  Thus, the VA Police are stuck, they cannot allow exceptions, they cannot allow for individual accommodations, and this places more burden upon the veterans seeking and requiring care at the Phoenix VA Medical Center and clinics.

The VA provides the rating of VA’s and the following website: Why not the best VA which will easily explain in a numeric format the indicators of problems with each VA.  What I find interesting is how many times the worst VA hospitals find themselves on the Department of Veterans Affairs – Office of Inspector General (VA-OIG) for egregious breaches of common sense, customer service, and common decency.  The Phoenix VA Medical Center is in VISN 22, and knowing the various hospitals intimately in VISN 22, the only conclusion possible in reviewing the data is that the 8 different hospitals in VISN 22 are in a dead heat race to the bottom, and the Albuquerque NM VA Medical Center is the best of the worst.

Carl T. HaydenThe VA-OIG conducted a healthcare inspection at the Atlanta VA Health Care System (VAHCS) in Decatur, Georgia, and found they had a backlog of open community care consults, and the OIG found deficiencies in processing, scheduling, and timeliness of these consults. Important to note, the contributory factors included but were not limited to, inconsistent scheduling processes, inconsistent oversight, and deficiencies with third-party administrator scheduling oversight, shortages of scheduling staff, and lack of training and supervision for scheduling staff. The facility did not consistently meet facility process requirements for scheduling audits and lacked a process to identify consults that were missing documentation after administrative closure.  While the Decatur VAHCS should be praised for not having any critical patient concerns due to the scheduling failures, this appears to be more luck on the patient’s part, than efficiency on the scheduling staff part.

The VA-OIG conducted a healthcare inspection at the Nashville VA Medical Center in Tennessee to evaluate alleged deficiencies in cardiac telemetry monitoring services including policies, staffing, and communication.  The facility should be praised for its progress in fixing deficiencies without the recommendations of the VA-OIG investigatory team.  The facility leaders also deserve praise for their attention to details, improvements in communication, and other facility improvements made since Feb 2019.  The last time this facility made the VA-OIG inspection report, the investigation was not pretty and their improvement needs to be praised; while more progress is needed, congratulations on the progress made.

Speaking of providing praise where praise is due, the VA-OIG conducted a comprehensive healthcare inspection of the Kansas City VA Medical Center (VAMC) and multiple outpatient clinics in Kansas and Missouri.  While this VAMC and outpatient clinics still have significant growth in improving SAIL metrics, they have progressed and growth is happening.  I send my regards, and sincere congratulations on the progress made.  I also wish them the best in continuing to improve.  This VAMC has a long road to recovering, but I know with patience, improved organizational design, and better staff training, they can get where they need to be.

ProblemsImagine you’re a patient, or worse a family member escorting the patient, with suicidal ideation, and you hear the doctor say, “the patient can go shoot themselves. I do not care,”  How would you feel about the 12-hour stay in the Emergency Room, after seeing seven different providers who did not read the notes, complete adequate patient handoff between the ER and outpatient mental health, which also includes deficiencies in the hand-off processes, and providers’ failure to read the outpatient psychiatrist’s notes, which led to a compromised understanding of the patient’s medical needs and a failure to enact the outpatient psychiatrist’s recommended treatment plan.  Completing six-days later in the veteran taking their life.  This exact scenario should NEVER have occurred but did at the Washington DC VA Medical Center.  Now, the physician making that detestable comment had previously made similar comments about other patients; crickets from leadership.  The ER physician making this incredibly obtuse statement has a history of making “inappropriate comments” about patients in the ER, and this has been known to leadership since Feb 2019.  No action, no investigation, no remediation, and now we have a dead veteran because the representative of the VA had the gall to say, “the patient can go shoot themselves. I do not care.”

I-CareWhen any veteran dies by their own hand, it is a tragedy.  But, when the VA has any responsibility in that veteran committing suicide, heads should roll, individual people should be held accountable, and in this case, especially, criminal proceedings should commence!  I worked in the VA ER, I know what the providers, nurses, and other staff providing patient interactions say.  I have reported several inappropriate comments that the patients heard to no avail, no recourse, and no action by hospital leadership.  I know, intimately, the political chicanery that occurs at the VA, and I can tell you, this IS a pet issue with me, and I am unapologetic in calling for criminal charges on these providers who are abusing veterans and their families!

Leadership CartoonThe VA-OIG inspected the VA Illiana Health Care System (VAHCS) and multiple outpatient clinics in Illinois.  The VA-OIG also inspected the William S. Middleton Memorial Veterans Hospital and multiple outpatient clinics in Illinois and Wisconsin.  I have been in both and I can say unequivocally, more progress is needed and the leadership desperately needs to improve professionalism among staff, improve patient safety from the bureaucrats not providing care, staff competencies, and staff training.  All of which were among deficiencies mentioned by the VA-OIG.  There is great potential in these VAHCS’ for achieving greatness, but the bureaucrats need deep cleaned, and removed!

What continues to astound me is the replication of excuses and issues between VAMC’s and VAHCS’ when these comprehensive healthcare inspections are conducted.  On average, I can expect 3-5 comprehensive healthcare inspection results from VA-OIG per week in my email box.  Yet, the same exact issues and excuses are used time after time, location after location.  Those VAMC’s and VAHCS’ who are failing know they are failing, and the lack of care witnessed by the inaction of the hospital leadership infuriates this veteran.  Leaving me asking, “Who will care enough to demand change and cease allowing these tepid and weak excuses to be allowed?”  Are the elected officials even looking at the repetitive nature of the issues and asking follow-up questions, demanding answers, or even bothered by failures in comprehensive healthcare inspections?

I have not personally visited or been a patient in the following VAMC; however, the stories I hear from my friends and colleagues tell me the VA-OIG might have missed a few indicators of problems in this inspection and bought the excuses for designed incompetence.  The VA-OIG conducted a review at the Ioannis A. Lougaris VA Medical Center in Reno, Nevada. The review proactively identified and evaluated declining performance metrics that could affect the quality of care and patient safety.  The staff blamed the falling metrics on “losing focus, staff pay, other change initiatives, inefficient processes, which all contributed to performance deficits.  These are standard excuses for designed incompetence and I refuse to accept these conclusions by the VA-OIG.  Will the Ioannis A. Lougaris VA Medical Center in Reno, Nevada be the next Phoenix, AZ VAMC to kill a couple hundred veterans before these excuses are no longer accepted?

VA SealThe behavior of the VA as recorded in these VA-OIG investigations and inspections continues to reveal significant problems with staff, where the staff has designed processes and procedures to allow a ready excuse for any problems that arise and continues to prove that a veteran takes their life in their hands when visiting the VA.  These actions must cease forthwith.  There is no excuse for the behavior investigated and reported.

© Copyright 2020 – M. Dave Salisbury

The author holds no claims for the art used herein, the pictures were obtained in the public domain, and the intellectual property belongs to those who created the pictures.

All rights reserved.  For copies, reprints, or sharing, please contact through LinkedIn:

https://www.linkedin.com/in/davesalisbury/