Let’s Talk About the VA – The Insanity Must Cease!

I-CareWhen the Department of Veterans Affairs (VA) does something good, I praise them.  The VA recently had a good report come from the Department of Veterans Affairs – Office of Inspector General (VA-OIG), apparently there was progress made in improving performance once policies were written down, training of employees occurred, and over time there has been an improvement, however small and seemingly insignificant.  I offer my sincerest congratulations on making progress and change on this issue.

Carl T. HaydenHowever, I will castigate and deride all abuses of veterans, myself included.  At the Phoenix VA Medical Center, the Carl T. Hayden VA Hospital remains a hotbed of bureaucrats on a power trip weekend from Dante’s first ring.  The abuses at this hospital continue and the leadership needs to be corrected!

For those who do not remember, the Carl T. Hayden VA Hospital in Phoenix, AZ used to be an award-winning hospital, a pillar of good performance, and an example of how VA Hospitals could be run.  Then, the director was changed, the hospital staff changed, awards stopped coming, and veterans started dying.  Leading to the fiasco of dead veterans on paper waiting lists, during Pres. Obama’s reign.  CNN reported on April 30, 2014, that at least 40 United States Armed Forces veterans died while waiting for care at the Phoenix, Arizona, Veterans Health Administration facilities.

On 29 June 2020, I reported to the VA ER sick and in desperate need of assistance.  The assistance was refused because I cannot physically wear a mask.  In my medical records, it is noted that I suffer from shortness of breath and any mask exasperates this problem.  In direct violation of Federal Law that commands all emergency rooms to see whoever walks in, the ER staff refused me service due to the “Mask Policy” as part of their “Covid-19 response.”  No options, no exceptions, no excuses, I as the patient could either endanger my health or find a different hospital ER.

The Emergency Medical Treatment and Labor Act (EMTALA; 1986) is a federal law that requires anyone coming to an emergency department to be stabilized and treated, regardless of their insurance status or ability to pay.  EMATALA also dictates that no person can be refused treatment in any Emergency Room.  The EMTALA is not new and is part of the training from day one for all staff at the VA.  For ER staff, this is the golden ticket and special care is taken to ensure this law is followed to the letter; rather, this law is supposed to be the premier standard from which good health care policy is built for emergency rooms.  Except, the Carl T. Hayden VA Hospital in Phoenix, AZ., and the Raymond G. Murphy VA Hospital in Albuquerque, NM., both appear to be the exception to EMTALA, by order of the staff bureaucrats, who are supported in their illegal and nefarious behavior by the hospital administration collectively, and the hospital leadership specifically.

Raymmond G. MurphyI have written previously of the patient abuse I witnessed, and reported, at the Raymond G. Murphy VA Hospital, in Albuquerque, NM.  I have written about the patients turned away by nurses and other staff because these staff members refused to follow the law.  I reported the risks and problems being run by refusing patients in the ER, and this all fell on deaf ears.  Well, I will not stop raising this illegal practice as a major concern for the hospital leadership all the way to Secretary Wilkie and the elected officials in Congress who refuse to act to improve the toxic culture found in the VA.

You, the bureaucrats in the VA cannot break the law with impunity and your actions are leading to major patient safety concerns, increased hospital operating costs, and putting real people in real harm!  I spent more than an hour in the VA Parking lot trying to calm my breathing down to safely operate a motor vehicle, so as to drive to a different hospital emergency room, where I was treated without ever having to deal with the mask issue.  While in the VA Parking lot, I was attended to by three Federal Police Officers who were willing to try and get me seen at the ER but were stuck trying to force the “Mask Policy,” regardless of my physical inability to wear a mask without causing additional harm and injury.  The Federal Officers were called because the ER staff reported a violent and non-responsive patient had just left the building.  I was both responsive and never violent in the ER.  Regardless of the fact that I was extremely short of breath, unable to walk, and unable to be seen at the VA.  When the officers found me in the parking lot, I could barely breathe and was so weak from lack of oxygen that I was graying out in vision and other major issues; thus, how the ER staff can say I was violent and non-responsive is beyond my comprehension.

The behavior of the ER Staff at the Carl T. Hayden VA Hospital in Phoenix is beyond the pale and bordering on obscene, as well as illegal!  Where is the accountability?  Where is the patient advocate?  Where is the Administrator on Duty who has the power to demand corrective action?  Where is the rightful opposition; well, I know where the rightful opposition is, it is buried with the dead veterans, who died awaiting care at the hands of the VA!

VA SealWhere is the patient advocate in this problem; well, that night after being refused care I reported the problem to the patient advocates office via secure message, and the following morning, the patient advocate replies that “It is VA policy to mandate all people wear masks if they desire treatment.”  Not caring about the federal laws governing ER visits, not even bothering to mention that the treatment by the staff as reported was ludicrous and vile, and not even to bother to ask if I was seen elsewhere.  Just a brief, less than 100-word, statement telling me my concerns for my safety and health are not important and policy must come first.  The perfect bureaucrat, with the most detestable response it has been my displeasure to experience since the last time I visited the DMV.

I am sorry but everyone is required to wear a mask at the VA Facility. I understand you may have shortness of breath but you can wear a mask and undo one side every couple of minutes. This is for your safety and the others around you.

T. C. M. [Name Shortened for Privacy]
Patient Advocate

Will someone please explain how this can occur?  Will an elected official please demand a behavior change at the VA, and remain interested long enough to facilitate the solutions Sec. Wilkie needs to effect change?  How many veterans will have to die needlessly at the hands of the VA before the elected officials decide that veterans’ lives matter and the VA is taking our lives?

I get it, there are a lot of problems in America, and more in the world.  But, the US House of Representatives, instead of passing a budget, which they are statutorily mandated to do, is writing letters, and meddling in Israel’s business.  If the US House has the time to meddle and jump down every rabbit hole on the political landscape, they must have time to assist the veterans and improve the VA.  If the US Senate has the time to meddle, postulate, and pander, then they have the time to review the plethora of VA-OIG reports and begin assisting the VA Secretary in correcting the problems in the VA.

The saga continued this over the first two days of July and forms the bitter cherry on top of the crap sundae the VA is trying to serve the veterans.  I received a call from my primary care provider’s nurse who has the attitude of supreme petty authoritarian to a lesser subject, reminding me several times that the mask policy was political, trying to blame all hospitals in the region of implementing a similar policy (which is fake), and then trying to excuse himself by claiming he was just a messenger and not involved in the policy implementation.  Concluding the call, with the temerity to tell me that I was in the wrong to not follow VA policy.  The patient advocate had the effrontery of sending a message to me stating that I should have asked for a full-face shield instead of a mask.  Seeing as no face shields were offered as a workaround, seeing as the policy enforcers demanding only a mask as the single viable and allowed option, and seeing as I spent more than an hour while in extreme pain trying to be seen to no avail, none of that mattered, the patient was at fault, per the patient advocate.

LinkedIn VA ImageMy cherub-like demeanor has taken a bloody beating over this incident.  Worse, my health has suffered tremendously and I have had to question myself and my advocacy of the VA.  The behavior of the bureaucrats and petty authoritarians of the VA at the Carl T. Hayden VA Hospital in Phoenix, AZ is detestable, and I can only conclude and wonder if I am having these problems, what are less outspoken and less knowledgeable veterans suffering?  I will not be the quiet little mouse in the corner where my safety and the safety of other veterans are being endangered by the politics and illegal actions of Federal Employees.  The policy is wrong and needs immediate revision before more veterans die at the hands of the VA!I-Care

© 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/

As the Department of Veterans Affairs Goes, So Does America – A Warning!

I-CareWould the honorable elected representatives please answer the following question: “Are the veterans of America’s armed services the next ‘Tuskegee Syphilis Study?’”

While we await this answer, here is why the question is raised.  The Department of Veterans Affairs – Office of Inspector General (VA-OIG) just posted their investigation results of the Critical Care Unit Staffing and Quality of Care Deficiencies at the Charlie Norwood VA Medical Center in Augusta, Georgia, and the results remind me of the game musical chairs and the disaster caused by the Tuskegee Syphilis StudyTuskegee Syphilis StudyMusical chairs because the VA-OIG was unable to ascertain direct harm because of record screw-ups, gross mismanagement, and a detestable and despicable perception of the patient.  The Tuskegee Syphilis Study because real harm to real people was caused, and the leadership did not care enough to fix the problems without an official investigation.

More on the Tuskegee Syphilis Study – History can be viewed in the link.

The VA-OIG report begins with the following:

“Critical Care Unit Staffing and Quality of Care Deficiencies at the Charlie Norwood VA Medical Center (VAMC) in Augusta, Georgia discusses significant patient safety issues including events related to noncompliance with pressure injury policy, intensive care unit cardiac monitoring, and sitter availability for high-risk patients.”

Pressure Injuries
Bedsores/Pressure Injury Progression

But concludes with the following:

“Publication is warranted so that other facility leaders and healthcare practitioners can be made aware of OIG-identified problems applicable to their own facility.”

Leading me to ask, of the VA-OIG, is this warning to proactively fix, or retroactively hide the nefariousness of poor management and dead patients?

Pressure injuries are exceedingly painful, can become deadly very quickly, and leave scarring and pain.  Pressure injuries are the nice term for bed sores, which are caused by critically ill patients who are already unable to move and circulate blood properly to the skin.  Thus, the tissue dies, a sore develops, then the skin breaks, and by this time that patient who is already in trouble, is now in danger of death.

Pressure Injuries - Example
Bedsore

Bedsores, pressure injuries, are serious conditions; yet, the Charlie Norwood VAMC has record-keeping problems, staffing issues, and without outside impetus refrained from fixing the problems.  All reminiscent of the “Tuskegee Syphilis Study.”

Hence the articles originating question, “Are the US Military Veterans the next ‘Tuskegee Syphilis Study?’”

If so, I refuse, and those leaders who think this conduct is allowable need to be held personally responsible for the harm they are causing.  If the answer is no, why are so many VA-OIG reports of leadership and management’s nefarious deeds being allowed until the VA-OIG comes knocking?  Even after the VA-OIG investigates, is anything being done?  Are people being held accountable?  The leadership issues are repeated, and while those repeats might not be an exact match from VAMC to VAMC, the leadership problems are real, glaring, and real people are dying!

America was shocked and angry when the whistle and plug were finally pulled on the Tuskegee Syphilis Study, and rightfully so.

Tuskegee-Patient
Syphilis wounds

Yet, it appears that the VA learned nothing from the history of Tuskegee except to keep playing musical chairs on responsibility, paperwork, and hiding the evidence from accountability.

America, your medical system, which before President Obama was the best in the world, is now on the same train of failure the VA Medical System is on.  Are you paying attention to the harm caused to veterans?  Do you want the same?  I do not!

America, to correct the problems at the Department of Veterans Affairs, and to reduce the costs to the taxpayers, as well as beginning to correct the damage done to your health care, the following is needed immediately.

  1. Legislation needs to be written and passed repealing ObamaCare.  Every single mandate, every single costly item, and sunder forever this socialism experiment.  The answers to the rising costs of medical care, including dental and vision, are not to be found in increasing the size of an already bloated government.
  2. Legislation needs urgent action to provide Secretary Wilkie the powers of any other CEO to clean the Department of Veterans Affairs. The leadership between the veteran facing employee and the Secretary’s office needs to be culled, and the only way to do this is through legislation.
  3. Demand accountability. The VA-OIG reports these issues constantly, the findings need to be on the news and be topics of conversation.  No longer should a bureaucrat be able to shift responsibility, harm patients, and keep their comfortable jobs and benefits.  Real harm to real people is being caused by the medical system paid for by your tax dollars, demand more!

Understand the following principle, know it well, and let us begin processing the reversal of this trend.  Charles Reich (1964) wrote a Yale Law Journal article describing “New Property.”  The new property Reich discusses is you and me, and how we are used by bureaucrats like property to be abused, harmed, and mistreated, all through the largess of the government we pay for.  Like a wheelbarrow or a hammer, we are the fodder upon which the bureaucrat steals money from one person to pay another person through government benefits, all to the enrichment and personal satisfaction of the bureaucrat.

Government Largess 2The actions of the nameless and faceless bureaucrat are unconstitutional, but allowed in the name of “government action.”  Every time you hear the government is acting on your behalf, it means that the power of the people has been stolen, and will be doled back to the taxpayer in infinitesimal amounts, while the bureaucrat keeps getting fatter.  Think Reich (1964) is wrong, here are some examples.

  • The government went to war against poverty, the poor have become poorer, poverty’s blight has spread, but the government offices “fighting” poverty are fat with people and taxpayer dollars.
  • The government went to war against drugs, the only winner so far has been the government.  The drug infestation has only gotten worse, and now states have begun selling harmful and illicit drugs for the tax money.
  • The government got into student loans, to “make the lending field fairer.” Students were harmed, colleges and universities tripled, or more, their tuitions, and students are saddled with increasing levels of debt.  But, the government officers in charge are living high on the debt and interest.
  • The government allowed labor unions to represent government workers, now the taxpayer is abused, treated like scum, taxes went up, but responsibility and accountability under the “Rule of law,” that all citizens are expected to live by, have all but disappeared for government workers.  Ever tried getting adjudication or remediation from a government worker?Government Largess 4
  • The government and some private citizens decided black health needed improvement. Planned Parenthood and the Tuskegee Syphilis Study are but two of the disasters that hit the black communities and have destroyed their community’s legacy, honor, and power, all for government largess, and the lining of private pockets.

Choose to stop being the property of the government; the US Constitution declares the government works for us, and we control them, not the other way around!

© 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/

 

Relieve the Suffering – I-CARE: Shifting the VA Paradigms

I-CareDuring my tenure as a medical support assistant (MSA) in the emergency room of the Albuquerque, NM VA Hospital, I took a class being offered on the new direction the VA customer service was going to embody called I-CARE.  I-CARE became my objective, as a customer service professional. As a dual-service/service-connected disabled veteran, I saw the abuses prevalent in the VA Hospital and wanted to change myself and provide mentoring to my co-workers in adapting I-CARE principles into their daily efforts.  Unfortunately, because of labor union interference, leadership failures, and supervisor efforts to counter I-CARE implementation, my efforts were discounted, denigrated, and derided until I was discharged from VA employment.  But, I-CARE remains a part of my commitment, my professional outlook, and personal commitment to customer service was forever changed by implementing the principles of I-CARE.

Leadership CartoonI write harshly about the crimes of the VA because I-CARE and deeply desire to see the VA bureaucracy changed, to witness the adoption of I-CARE into the daily efforts of every VA employee, and to see the VA leadership teams develop policies and procedures that will benefit the veterans, and relieve the suffering of veterans, their spouses and children, and live the VA mission of bearing up those who have born the pains of battle.

ProblemsI have seen veterans blithely refused prompt care because of the frequency that veteran had been seen, the lifestyle choices of that veteran, or simply because a charge nurse or doctor did not like the politics of the veteran as displayed by their clothing.  I have seen illegal actions taken to turn people away from care at a VA Hospital Emergency room by VA Police officers, charge nurses, and other nursing staff, and been powerless to stop these crimes because the hospital leadership refused to act, and became hostile to the employee’s reporting the problems.  I have witnessed leaders delete emails reporting problems as those emails were proof and evidence of crimes cannot be allowed to remain at the VA.  I-CARE about these issues; I report these problems, but because I-CARE I also provide solutions, easy fixes that could be applied and adapted for the relief of suffering and reduction of risk to the hospital.  My reports all were ignored while an employee, from the team leader to the director of Hospital Administration Services (HAS), to the hospital director’s suite, all sorts of deaf ears and crickets were in attendance.  I reported issues to the Veterans Integrated Service Network (VISN) which is a geographic group of VA Medical Centers under common leadership; also, to no avail, crickets, and deaf ears.

I-CareYet, I-CARE; still, I-CARE drives me and motivates me to see change occur at the VA.  To right the wrongs, and rebuild the VA.  One of my early leaders at the NM VA Hospital said something very prescient, “If a civilian hospital did half-the things the VA Hospitals get away with, they (the civilian hospital) would have been shut down and the leaders imprisoned.”  Having witnessed a year of crimes personally, seeing the inability for change to occur due to leadership, watching talent wasted, and monitoring the revolving door of employees in the VA, I concur with that statement.  The leader who spoke had 25-years of civilian hospital administration experience, before coming to the VA, and the VA would only hire this well-educated, highly experienced person as a GS-7, an entry-level employee.

Image - Eagle & FlagIn the coming days and months, I will continue to write about the VA.  Using personal experience, patient experiences related to or personally witnessed, and the Department of Veterans Affairs – Office of Inspector General investigation reports, as the reasons for the solutions I propose.  I-CARE, enough to stand as a witness that the VA in its current form cannot, and should not, be allowed to thrive any longer.  Change must come to the Department of Veterans Affairs (VA), including to the Veterans Health Administration (VHA; hospitals and clinics), the Veterans Benefits Administration (VBA; compensation and pension claims), and the National Cemeteries.  Thus, I witness my commitment to I-CARE and 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/

The Department of Veterans Affairs: The Liars and Thieves Edition

I-CareIn December 2019, I witnessed an employee of the Department of Veterans Affairs, Hospital Administration, create rules to inconvenience a veteran, lie to a veteran, obfuscate, and generally mock a veteran.  The incident included the employee threatening the veteran with throwing away documentation, the primary care provider needed because the veteran was not mailing the forms to the doctor as the employee demanded of the veteran.  The veteran must travel and thought dropping off the forms would be acceptable; until he met this employee.  23 January 2020, I was the veteran being lied to, and my “cherub-like demeanor” evaporated faster than dew in a July sun.  For the December incident, I signed my name to a letter going to the Hospital Director Andrew M. Welch, written by the abused veteran, and testified that I witnessed the treatment this veteran received.  To the best of my knowledge, no action was taken by the hospital leadership where this employee is concerned, I asked.  A copy of this article will be sent to hospital leadership.  If any additional information comes available on this issue, I will write an addendum and update this article.

23 January 2020, 1505-1510, I went to my primary care provider’s clinic at the Albuquerque, New Mexico VA Hospital.  I had another appointment, was early, and went to ask why I am receiving letters claiming the primary care clinic is “having difficulty” contacting me.  The employee is titled “Advanced MSA,” which means they are a Medical Support Assistant who has been promoted.  For my other appointment, I have received two text messages, one automated call, and three appointment emails.  For my next appointment, 24 January 2020, I have received two text messages, one automated call, and three emails.  For my appointment in December 2019, I received two text messages, one automated call, and three emails.  I regularly receive calls from other clinics in the VA Hospital.  My cellphone has voicemail, and the voicemail is regularly checked and responses made.  Yet, the MSA claims, “I have tried calling you, and you do not have voicemail.”  I checked my recent calls, and showed the MSA where I had not received any calls from the VA on the days indicated, and asked why I can receive all these other calls from the VA, including the text messages, but only his calls are not showing up.  The MSA then became intransigent, resolute, and adamant, raised his voice, and told me our conversation was done.  After observing the ways and means of this VA employee over the course of many months previously, I wonder, “how many other veterans are not being contacted in a timely manner, while this person lies, cheats, and steals?”

Quality of FindingsUnfortunately, this is the standard, not the exception for the MSA’s in the HAS (Hospital Administration Services) Department, led by Maritza Pittore, at the Albuquerque VA Hospital.  I have witnessed multiple MSA’s committing HIPAA violations through record diving, gossiping about veteran patients, acting rudely, ignoring veteran patients and their families to complete conversations, and refusing to do their jobs.  As a point of fact, one assistant director one told me, “if what the VA does was replicated by a non-government hospital, they would be closed down and sued.”  While employed from June 2018 thru June 2019, I brought this to the attention of the leadership, including multiple emails and voice conversations with Maritza Pittore, Sonja Brown, and several other high-ranking leaders and their assistants, all to no avail.  I have had nursing staff tell me confidentially that they cannot do anything where the MSA’s are concerned because “it’s none of their business and outside their job duties.”  Yet, the VA continues to proclaim the MSA, the Nurse, and the doctor, along with the patient, are a “healthcare team.”  Upon being discharged, without cause, reason, or justification, I brought this information to the OIG, my congressional and senate representatives, among many others, all to no avail.  The level of customer service, especially at this VA Hospital, is far below the pale because the leadership refuses to engage and set standards for customer service, with enforced penalties. I-CareMore to the point, the employees mimic the customer service they receive from the leadership team.  Thus, even though the Federal VA Office has launched “I-Care” as a customer service improvement initiative, the customer service in this hospital continues to fall and will continue to fail until the leadership exemplifies the standards of customer service expected.

As a dedicated customer service professional, I have offered multiple solutions to the continuing problems veteran patients experience in the Albuquerque VA Hospital at the hands of the MSA’s and other front-line customer-facing staff; but the suggestions all continue to fall upon deaf ears.  I do not paint all the MSA’s and staff as liars, thieves, and cheaters, because there are some great people working at this VA Hospital.  Unfortunately, the rotten apples far exceed the good workers by multiple factors and powers, to the shame of the leadership team who continues to ignore the problem, deleting emails, and generally lying when placed on the spot about the problems.

An example of this occurred recently where a member of the staff of a congressional representative asked about communications sent from an employee to the Director of VISN 18, with carbon copies being sent to Maritza Pittore HAS Director, Ruben Foster MSA Supervisor, and Sonja Brown Associate Director of the Hospital.  None of those emails “magically” exist when asked for, and the verbal conversation included outright lies, misdirection, and complete fallacies.

Since the VA-Office of Inspector General (VA-OIG) continues to appear disinterested, I can only ask, “what does a person do to see action taken to correct the problems, right the abuses, and bring responsibility and accountability to the employees of the Federal Government?”  President Trump is providing great leadership, VA Secretary Wilkie is doing a good job and needs more help, but the elected officials in the House and Senate refuse to do their job, and the middle management of the VA is entrenched, obtuse, and inflexible.  The US Media treats veterans’ issues as a punchline to a bad joke.  Still, the problem worsens; still, the abusers maliciously treat people abhorrently; and still, those placed in leadership positions stall, obfuscate, and hinder.

My treatment at the VA Hospital in Albuquerque includes being physically assaulted by an employee, my medical records perused by, and then gossiped across at least four separate clinics, and still that MSA remains employed.  In fact, this employee was promoted for her “good work and dedication to helping veterans.”  I am sick and tired of the poor treatment, the harassment, and the vindictiveness served to veterans of all types, sizes, and colors, at the hands of petty bureaucrats as they visit the Department of Veterans Affairs.  The Albuquerque VA Hospital is one of the most egregious examples of bad behavior and nepotism in the country and it is past time the leadership was replaced and the assaults and crimes brought into the sunshine for some “sunshine disinfectant.”

cropped-snow-leopard.jpgUpdate to this article, 10 May 2020: By the first week in April 2020, the Advanced MSA in the clinic was moved to a less customer-facing post and a new MSA hired.  The quality of that individual was never experienced due to relocating.  The supervisor of the MSA was not very interested in correcting the problems and that showed when I visited with them while trying to obtain an appointment that the Advanced MSA refused to schedule.  Change must come to the VA!

© 2020 M. Dave Salisbury

All Rights Reserved

The images used herein were obtained in the public domain; this author holds no copyright to the images displayed.

Desperate Changes Need at the VA – A Letter to the President

President of the United States
Attn: The Honorable Donald Trump
1600 Pennsylvania Ave NW
Washington, DC 20500

10 May 2020

Dave Salisbury
1947 Edith Blvd SE
Albuquerque, NM 87102

Subject: The Department of Veterans Affairs

Dear Mr. President,

Please forgive my presumptuousness in writing to you directly.  I have made several attempts at raising the issues contained herein at lower levels, to no avail.  As the Chief Executive Officer of the United States of America, I come to you as the person of last resort.  The Department of Veterans Affairs (VA), especially Healthcare and Benefits departments are sick, and in desperate need of urgent corrective action.

  1. The VA-OIG has documented multiple times when claims have been improperly been decided, where training was lacking, leadership failed, and the veteran suffered.  Yet, never in the VA-OIG report is a discussion on correcting the past decisions.  The process for a veteran to have a previous decision, more often than not improperly decided by the VA, is to produce new material evidence, and wait interminably for the VA to decide they need to act.  This single issue is a leadership failure of enormous proportions, that Congress refuses to act upon; thus, the leadership failure begins and ends with the House of Representatives and the Senate refusing to do the jobs they were elected to complete.
  2. While the following is specific to the New Mexico VA Healthcare System (NMVAHCS), the problem is rampant throughout the entire VA healthcare system. I witnessed, 11 December 2019, a VA employee tell a veteran that they would not submit paperwork for the veteran, to the doctor, in the clinic unless the paperwork was “processed correctly.”  Meaning that the veteran took an envelope, placed the VA forms inside the envelope, and then mailed that paperwork to the VA Hospital.  The veteran lives a significant distance to the hospital and was trying to do in person what had failed through the USPS, this was made clear to the VA Employee.  The employee went as far as to claim, “If that form is placed on my desk, I will throw it away because it is not being presented to the doctor in a manner acceptable to the employee.”  Never have I witnessed such blatantly disrespectful behavior by a bureaucrat.  In true bureaucrat fashion, he created rules to thwart, obfuscate, and dodge work; unfortunately, this is standard practice with the majority of employees in customer-facing positions in the VA.  The leadership failure, the protected status of termed (beyond first-year) employees at the VA, and the dearth of customer service skills are all aspects to the core problem the VA is terminally suffering from, bureaucratism.
  3. From June 2018 to June 2019 (5-days short of completing my first year) I was an employee of the NMVAHCS, working in the Emergency Room as a Medical Support Assistant (MSA). I was discharged through lies, deceit, and under the auspices of Quid Pro Quo, where my termination was required for two others to be promoted.  While employed, I regularly reported to the leadership team my supervisor, the HAS director, the hospital director, the VISN 21 director, and the VA-OIG problems like HIPAA violations, a physical attack by a senior MSA on my person, fraud, waste, and abuse, as well as potential solutions to improve the ER operations.  All to silence and platitudes from the leadership team.  Did you know there is a loophole in the whistleblower protections if you are under term employment, (1, 2, or 3 years term) you have no whistle-blower protections, and if your job is lost, you have no whistle-blower protections?  The abusers have worked out many angles to protect the dregs of society while allowing malfeasance and misfeasance to proliferate in government employment.  Please allow me to elaborate upon the specific issues witnessed:
  • A 14-year old is being treated in the ER. A 16-year old is turned away.  The difference, the triage nurse who decided who gets seen and who gets bumped because the NMVAHCS cannot treat children.  When asked what age is considered a “child” under the hospital policy, no answer in 12-months of regularly asking.  I saw several times when this repeated, the most egregious was a new military spouse, 17 years old, denied treatment at the ER that services the Air Force Base next door due to being “too young” per the triage nurse.  By the way, under Federal Law, this is illegal for an ER to do; yet, this was regular practice while employed.
  • A health technician supporting ER patient care comes out of the ER and begins to harangue a patient currently being seen, expressing comments that made clear the health technician knew intimate details of that patients’ chart, past care received at the NMVAHCS and other VA Hospitals across the southwester US, and treatment received. Under HIPAA this behavior is illegal, as well as being immoral, unethical, and plain wrong.  Yet, HIPAA is regularly broken by MSA’s, Health Technicians, and other care providers in this VA Hospital.  Every time these HIPAA violations were brought to the attention of the HAS Director, excuses, platitudes, and professional brush-off occurred, including the deletion of emails reporting these problems.  On more than one occasion, the HIPAA violator was promoted to “treat” the problem.  When these issues were brought to the attention of the VISN 21 Director, the problem was pushed back onto the assistant hospital director in NM for further consideration.  When complained of to Congressional Representatives, lame excuses were generated by the Assistant Hospital Director and the HAS Director and accepted by the Congressional Representatives staff.  HIPAA Abuse continues unabated!
  • Homeless veterans regularly received substandard treatment when compared to other veterans. I saw nurses bad-mouth, scream, and yell at homeless patients.  I saw a homeless patient with a broken leg, get delayed treatment for more than four hours because the duty nurse was tired of treating this particular patient and didn’t believe the veteran had broken his leg after a fall.  I saw nurses put patients into treatment rooms and left for anywhere between 45-120 minutes because the shift was changing and the nursing staff did not want to treat another patient before their shifts ended.  The nurses stood outside the patient’s door, joking, carrying on, and gossiping while the patient listened and waited to be seen.  Every time these issues were raised the lamest excuses came from leadership, platitudes, and pie-crust promises were delivered.  I reported these issues and more via both verbal and email, to no avail; yet, when a member of Congress’ staff contacted the hospital, there is no email proof that the leadership was ever made aware of these problems.  If these are examples of “World-Class Care” being delivered to veterans, I shudder to consider what poor service would include.
  • The NMVAHCS has a reputation for killing the employment of term employees all the way up to their last day under the term. For example, a house-cleaner employee, a good worker, well-liked by the staff where she cleaned, got into a disagreement with her supervisor and was terminated at lunch on her 364th day of employment in a 365-day probationary term.  Her supervisor did not need a reason to discharge her and used their disagreement to end her employment.  By the way, the employee was in the right, and the supervisor made the needed changes after discharging the employee.  An MSA male employee, hard worker, came in on his 361st day of term and was terminated, no reason, no excuse, no justification, simply told to scrape his employment parking sticker and leave.  This pattern has repeated so often, that the veteran employment counselor at workforce connections warned me to not accept employment with the VA due to the NMVAHCS’ reputation for ruining people.

The NMVAHCS is one dead veteran from becoming the next Phoenix VA Hospital incident.  I am not without hope, but it will take the House and the Senate to enact the type of change needed in the VA to truly see significant and lasting change.  Towards this end, I suggest the following:

  1. Draft legislation, one a single sheet of paper canceling the collective bargaining agreement (CBA) of all Federal Government Labor Unions immediately, and forever sundering the death grip the labor unions have on policies and procedures that protect the criminal and steal valuable resources from government coffers through direct and indirect means and methods. The cost of labor unions in government is astronomical and removing this single cost will open funds in Federal Budgets that are desperately needed.  I know this is a political hot potato, and I know the impeachment farce continues to be a mental and physical drain.  But, as the German Philosopher has said, “The hard is good.”
  2. Draft on a separate sheet of paper, new legislation giving the Secretary of the VA plenipotentiary power, the likes enjoyed by every CEO in the private sector, to enact change. You have a good VA Secretary, but the staff is a hodgepodge of weak-kneed political cronies that should have been retired years ago!  This legislation also would allow for a cleaning of house at the VA, realigning the entire organization, placing the power to positively affect veteran lives into the hands of the PACT team and out of the hands of the bureaucrats.
  3. Place power into the hands of a roving IG team to have benefit claims immediately reviewed after a lapse in the procedure is discovered. Meaning that the veteran’s claim affected by bad decision-making by the VA is immediately checked by the VA-OIG instead of waiting around in record purgatory for new and material evidence.  Another VA-OIG team should be put to work reviewing past claims where the VA was caught, and getting this backlog cleared out.  The appeals process for benefits claims needs a complete overhaul.  While this legislation and action might require more than a single sheet of paper to enact, it is the right thing to do.
  4. The Mission Act was a good first step, but the entrenched bureaucrats are hindering and hampering the roll-out for personal gain, e.g. retirement. Encourage Congress to take up the legislation proposed, insisting that nothing else is added to these bills to protect the veracity and simplify the approval process.

I appreciate the work you do.  I especially appreciate your classy wife, your well-behaved and intelligent children, and the gains made in “Making America Great Again.”  I know the proposals are difficult; but I also know if we do not attempt the impossible, we can never know the realization of the legacy left to each American by those who have sacrificed before and leave a legacy of hope for our children’s children.  Thank you for your sacrifice and service.

Sincerely,

M. Dave Salisbury

© 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 Leadership Statement – Shifting the Political Paradigm for a Better America

As a leader, three basic principles drive leadership:  freedom, agency, and learning (Robinson, 1999; Rao, 2013; Tucker, 2001; and Ulrich, 2008).  Three inviolate laws are also present, these inviolate laws are: respect, engagement, and preparation; these laws are guided by the principles of freedom, agency, and learning.  Hand-in-hand, these three principles of leadership and the three inviolate laws govern society.  Image - MSM HandledWe are learning by sad experience that many, especially on college campuses and in professional sports arenas, consider respect to be a one-direction demand, where accountability is not enforced and where the hooligans and terrorists of thought, demand and punctuate their demands with violence. A person, who tries to curtail the thoughts of others with physical, verbal, or emotional abuse, has crossed the line into thought terrorism, and their voice is reduced to nothing, even though mainstream media (MSM) outlets provide these people a soapbox to reach a larger audience.  A person, who demands respect to flow to them and refuses to give respect to others, is abusing verbally and emotionally those they refuse to respect.

Leaders, who embrace the freedoms of their followers, allow them full possession of their individual freedoms, encourage them to employ individual agency, and allow them to be guided by a thirst for learning (Broskowski, 1984; Ekanayake, 2004; and Hoppe, 2006).  Image - John Wayne QuoteThe engaged learner prepares fully in a constant cycle of learn and teach and needs to be supported in this cycle in order to remain a learner preparing to teach and a teacher preparing to learn.  The leader has responsibility for teaching correct principles and embracing the need for the learner to govern himself or herself.  Thoughts and beliefs, opinions, and personal preferences cannot and should not be litigated, forced, or coerced.  Those, who choose to act in a manner not conducive to a quiet and orderly discussion, diminish themselves, harm themselves, and place themselves outside civilization, like the rabid dogs of the west.  The proper response by civilization for those placing themselves in this category, rabid dogs or wolves, remains the same:  permanent separation and removal.

The successful leader is morally obligated to embrace loyal opposition found in those being led and to take and give counsel and guidance to improve plans, implement ideas, and garner the individual buy-in from free agents ensuring integrity, responsibility, and accountability are not lost or forgotten.  The leader is a teacher and a teacher is a leader.  The cycle for learning and teaching does not become lost or less significant as rank is increased.  The inverse occurs. The greater the rank the higher the responsibility to remain engaged in the learning/teaching cycle (Kumle and Kelly, 2006; Maehr and Braskamp, 1986; Nibley, 1987).

Imperative to those with greater authority are the requirements to oversee those to whom authority has been delegated.  Image - Quote Poltics is DirtyWhen those possessing delegated authority use that authority to denigrate, deride, and destroy, that authority needs to be publically stripped, and the individual forced to make amends concurrent with the laws of the land and the expectations of society.  We have come to a point in the laws of America where those with money and powerful political connections (Anthony Weiner) can receive pitiful punishments for dangerous crimes, and those without powerful political friends and money receive far harsher sentences for crimes committed, where standard sentence guidelines include some portion of all of the following: 5-10 years in prison, registering as a sex offender, and fines starting at $50,000 (Lorang, McNiel, & Binder, 2016).

Consider the IRS Scandal, the VA Scandals, and the continuing news cycles where politicians make promises and renege on those promises before the ink is dry on the election result forms.  The staffs to whom authority has been delegated are being allowed to run rampant, and those selected to be leaders are doing nothing to curtail the abuse of power being inflicted upon the population (Perez, 2015).

America, President Trump is a leader, whereas many of the House and Senate are less than the poorest managers ever vested with delegated authority.  Consider Senators McCain, Feingold, and Collins, where Obamacare is concerned, they campaigned on repealing Obamacare, and they continue to actively thwart the legislative process for personal gain (Prokop, 2015).  Leaders, regardless of their field of endeavor and political environment, act, work, and their actions are logically tied to their work.  While one might disagree with the actions based upon personal opinion, the actions taken signify their leadership.  Managers, do not act, are not tied to their actions, and never are held accountable; whereas, the leader and their actions are inseparable.  Hence, while McCain, Feingold, and Collins, among others, will thwart the needs of America for personal gain, Trump will be held accountable for their inaction.  Image - Terrorism DefinedThe same is true for the inaction and legal quandary Obama created at the IRS and the VA, managers performed tasks that were incongruent with the law, were not held accountable, thus the president remains culpable.

Consider how many times “deals” have to be made just to get common sense, helpful, and proper legislation out of committee and in front of the current sitting president.  In real life, “deals” would be considered bribery, collusion, inducements, kickbacks, and blackmail; yet, the citizens accept these legislative maneuvers in the hopes of improving America through legislation.  We are told as children that politics is a dirty business; it has become a dirty business, because those in power and those with delegated power have refused to honor, sustain, and support the laws of the land, the expectations of the citizens they purport to represent, and the illegal use of tax money to conduct these bribes is reprehensible at best.

Currently, the solution remains in the hands of the voters re: stop electing the same old names over and over again.  Why have Senators McCain and Collins become so powerful; tenure in the Senate, McCain since 1981 to present and Murkowski since 2002, and Collins since 1996, they have been living off the public taxpayer for too long!  I am not advocating term limits.  I am advocating an informed and motivated electorate willing to be the leaders they wish to see in office, and holding those in power accountable for the power that has been delegated from “We the People” to those who temporarily hold elected office.  I am advocating for voters to make the election box more important than the TV box, the cubicle box, or the social media box.

I am advocating for the return of a highly charged and logically powered electorate to take back the reins of power from those currently in office, especially those who have continually proven they cannot handle our authority.  For example, Senator Collins has continually proven a weak link by taking positions anathema to her voters, but lacking a viable alternative, her voters return her to power every six-years.  In fact, having lived in her district, I know for a fact there are many of her voters who despise Senator Collins, and hold their nose and vote for her anyway.  Having lived in Senator McCain’s district, the same is said of him when voting every six years, no viable alternative, send the same old name back to power.

Much noise has been made about professional sports players and the refusal to stand for the Anthem and the American Flag.  Under the three principles of leadership and the three inviolate laws, these players do not deserve the jobs they hold, let alone a position of respect.  The reason is simple.  The flag covers all.  Standing for the flag means respect for all, honor for all, and will, regardless of the other person, stand for America as the last bastion of liberty, freedom, and a republican form of government.  The liberties demanded to allow you to sit are the same liberties you are rejecting every time you sit for the anthem and flag ceremony.  All kneeling sports players and flag burners should answer this question: “When you are in trouble, do you want American police, firefighters, EMT’s, and or the American Military personnel to help you?”  If so, why would you contemplate sitting when standing for the flag symbolizes you will help others and sitting proclaims you will not help others.  Since you will not help others, as signified by burning the flag and kneeling or sitting out the national anthem, where should help come from?

I cannot stress enough leadership is needed. Image - Eagle & Flag Leadership begins with those who selected their leaders demanding an accounting for the authority delegated to them.  Use the principles of leadership mentioned and the inviolate laws to correct yourself, your family, and then demand from society the same.  When we do this as a nation standing for liberty, we will succeed, and those naysayers and whiffle-whafflers will be held in eternal contempt because of their actions against us, the citizens of this Republic, the United States of America!

 

© 2017 M. Dave Salisbury

All Rights Reserved

The images used herein were obtained in the public domain, this author holds no copyright to the images displayed.

 

 

 

References

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Dandira, M. (2012). Dysfunctional leadership: Organizational cancer. Business Strategy Series, 13(4), 187-192. doi: http://dx.doi.org/10.1108/17515631211246267

Ekanayake, S. (2004). Agency theory, national culture and management control systems. Journal of American Academy of Business, Cambridge, 4(1), 49-54. Retrieved from http://search.proquest.com/docview/222857814?accountid=35812

Hoppe, M. (2006). Active listening improves your ability to listen and lead. Greensboro, N.C.: Center for Creative Leadership.

Kumle, J., & Kelly, N. J. (2006). Leadership vs. management. SuperVision, 67(8), 11-13. Retrieved from http://search.proquest.com/docview/195598300?accountid=458

Lorang, M. R., McNiel, D. E., & Binder, R. L. (2016). Minors and sexting: Legal implications. Journal of the American Academy of Psychiatry and the Law, 44(1), 73-81.

Maehr, M. L. and Braskamp, L. A. (1986) The motivation factor: A theory of personal investment. Lexington Press, Lexington, MA.

Nibley, H. (1987). Management vs. leadership. Executive Excellence, 4(12), 9. Retrieved from http://search.proquest.com/docview/204630361?accountid=458

Perez, E. (2015, October 23). First on CNN: DOJ closes IRS investigation with no charges. CNN – Politics. Retrieved from http://www.cnn.com/2015/10/23/politics/lois-lerner-no-charges-doj-tea-party/index.html

Prokop, A. (2015, September 25). The GOP can’t quit Obamacare repeal because of their donors. VOX. Retrieved from https://www.vox.com/policy-and-politics/2017/9/25/16339336/graham-cassidy-republican-donors

Rao, M. S. (2013). Soft leadership: a new direction to leadership. Industrial and Commercial Training, 45(3), 143-149. doi: 10.1108/00197851311320559

Robinson, G. (1999). Leadership vs management. The British Journal of Administrative Management, 20-21. Retrieved from http://search.proquest.com/docview/224620071?accountid=458

Tucker, R. (2001). Innovation: The new core competency. Strategy & Leadership, 29(1), 11-14.

Ulrich, D., Smallwood, N., & Sweetman, K. (2008). The leadership code: Five rules to lead by. Boston, MA: Harvard Business Review Press.