Flexible Workspaces – Alternative Work Options

Bobblehead DollAfter my service-connected injuries went crazy in 2010 and my nerves decided I needed to be a “bobblehead doll,” I quickly realized there was a need for alternatives to commuting to an office every day and working as a traditional employee.  However, alternatives to conventional employment continue to be few and far between, primarily due to the IRS in America.  2020 saw a breakout in other options to the traditional employment paradigm, and I would like to continue this discussion to generate more alternatives to conventional employment.

Olmstead and Smith (1989) wrote what I consider to be the quintessential and sentinel book on alternatives to traditional employment, “Creating a Flexible Workspace: How to Select and Manage Alternative Work Options.”  Flexibility in the workplace is not just a Human Resources (HR) duty but is helped by having HR people with imaginations and who are empowered to be creative to keep good employees.  Flexibility is not merely limited to a wide variety of work schedules which can be offered optionally.  Flexibility in the workspace also includes on and off-site employment, and cross-training, as key fundamentals in empowering employees and driving workplace flexibility programs.  But flexibility always begins with the realization that flexibility is a two-directional relationship between employer and employee and a means for enhancing the talents, skills, and abilities already hired as part of a dedicated appreciative inquiry desire to innovate.

Appreciative InquiryQuestion

Appreciative inquiry is a growth mechanism that states that they already have enough of what a business organization needs, provided they listen to their employees.  Appreciative inquiry and common sense tell leaders who want to know and change their organization how and where to begin.  Appreciative inquiry-based leadership is 6-continuous steps that start small and cycle to larger problems as momentum for excellence permeates through an organization.  But the first step, just like in defeating a disabling addiction, is admitting there is a problem.

The six operational steps of appreciative inquiry:

      1. Admit there is a problem and commit to change.
      2. Define the problem.
      3. Discover the variables and stay focused on the positive.
      4. Dream BIG!
      5. Design the future and outline the steps to that future.
      6. Destiny, create the destination you desire.

Follow the instructions on a shampoo bottle, “Wash, Rinse, Repeat.”  The appreciative inquiry model can be scaled, repeated, implemented into small or large teams, and produce motivated members who then become the force to building change.  Allow yourself and your team to learn, this takes time, but through building motivation for excellence, time can be captured to perform.

Call Center Agent - FemaleFlexibility and Viability – Not just Terms, but Lifestyles

Flexibility in an organization is understood as accepting change and positively using that change to grow and develop more flexibility.  Viability in an organization is where the continuing effectiveness of flexibility generates new growth markets and creates the organization’s potential to flex to meet the growth areas.  Flexibility and viability are interlinked and interwoven ideas that every employee should be conscious of and striving to enhance personally as part of their brand.

Andragogy - The PuzzleErroneously called “Employee Engagement,” flexibility and viability are the continued efforts of all employees to participate in the business’ success.  Appreciative inquiry is the sum of the efforts to flex and be viable in competition with other businesses, recognizing that the answers to your current problems are always found in listening to employees.  Please note, you can think your business is flexible enough, but when the winds of change blow, will your business collapse or grow?

For example, as a consultant and subject matter expert, I was called into a manufacturing company to improve flexibility.  The company had been around for more than 100-years, and the owners, a family business, figured they were pretty flexible.  From day one, though, it was apparent the business had stagnated, and there was no flexibility or viability left in the organization.  When the 2008 market recession occurred, the company lost 5 of its 6 operating shifts and barely survived by draining all remaining liquidity to stay afloat.  The company has limped along ever since, to the amazement of everyone who has worked at this facility.

GearsHence, one must understand the principles of viability, flexibility, and appreciative inquiry as a lifestyle of daily choices where the leadership is engaged in and listening to employees.  Failure to listen remains the number one reason businesses, and governments fail.  Who should governments be listening to; average citizens, not statisticians, not special interest groups, not lawyers and political cronies, the people who voted them into power.  Who should businesses be listening to; their employees, not customers, not vendors, not shareholders, all of whom need to have a voice, but the front-line employee has answers.

Realities versus Fiction

Having worked with many a small businessperson across the continental US, the smaller a business understands the need to listen to employees, but the bigger a company becomes, the less desire they have to listen to anyone, let alone employees.  This is a reality.quote-mans-inhumanity

The fiction is the proclamation that the customer should be listened to, the shareholders know what the business needs, or the vendors have essential information for the company.  While all have a seat at the table, the front-line employees remain a wealth of information generally untapped, unused, and depressingly denied the ability to help.  As a consultant, I spend most of my time listening to the employees, then presenting their ideas to management.  I have never claimed another employee’s ideas as mine and never will.  Yet, I know too many consultants whose ethical and professional brands might be slightly less demanding than my behavior standards.  This also is reality, watch the ethics of a consultant; if they waiver, there is duplicity nearby!

Creating Flexibility in the Workplace

As an industrial and organizational psychologist, I affirm in a language most somber that no single tool will be a “magic bullet” for fixing employee concerns and building flexibility and viability.  Holistic solutions are not just a current “buzzword,” but an actual truth.  The solutions must grow from an apt quote from Captain Jack Sparrow:

“The only rules that really matter are these: what a man can do and what a man can’t do. For instance, you can accept that your father was a pirate and a good man, or you can’t. But pirate is in your blood, boy, so you’ll have to square with that someday. And me, for example, I can let you drown, but I can’t bring this ship into Tortuga all by me onesies, savvy? So, can you sail under the command of a pirate, or can you not” [emphasis mine]?

People ProcessesWhat can your company do, and what can your company not do?  Between these two extremes are a lot of different possibilities, opportunities, and areas for exploration.  For example, as a call center, can you home shore your agents?  Maybe the technology is there, but are the legal questions regarding data security and safety open to home shoring?  What about contingent employment, where you use knowledge vendors to fill in during peak times, thus allowing your call center to flex off and not have to work overtime so much?  Would your call center do well with phased retirement, partial retirement, or voluntary reduced work time programs?

Each of these options builds flexibility and viability, but they come with consequences, and the valuation of those consequences should include input from the front-line employees.  For example, a call center I am familiar with used to have stepped departments, where a rep could learn the basics, then promote into the next higher step.

3-direectional-balanceExcept, the model was broken by HR, and the depth of available personnel dried up.  Thus, the call center went to a universal agent model, where all agents were expected to know all the different departments and steps and act accordingly.  The universal model was sold as a cost-saving measure.  The employees did not like the new model as all the business processes were built on the old stepped agent model.  The universal model failed, the company could not afford to return to the stepped model, and knowledge was walking out the door at an exceeding pace.

The answer was to listen to the front-line employees, but it took more than five years and ten different consulting firms and technology firms to reach this point.  But the cost of lost potential sales and lost business knowledge is still hindering this company from a full recovery.  Why; because the change that broke the company has never been fixed, just plastered over, and the universal agent approach destroyed organizational trust between employees and the employer.  Decisions have consequences, and if you do not know what your company can do, you do not know what your company cannot do; especially, if you refuse to listen to the front-line employees.I'm not listening - boring :: Funny :: MyNiceProfile.com

What will your employees do?  What are your employees already capable of doing if provided the opportunity?  Where is the focus in your company, customers, vendors, shareholders, or employees?  Why?  Who of your employees can you absolutely trust to accomplish a task?  How do you know that employee is trustworthy?  What makes that employee happy to return to work every day?Michael Shurtleff quote: Listening is not merely hearing, it is receiving the message...

When you listen to your employees, honestly and openly communicate with them, and know the why to share the why your employees can work marvels you could not believe possible.  If you desire flexibility and viability in your company, build it!  One employee at a time using imagination, honest communication, and build organizational trust.  You will be surprised at how often the answer to improving your company doesn’t have a dollar sign but a living person and a debt of gratitude.

Reference

Olmsted, B., & Smith, S. (1989). Creating a flexible workplace: How to select and manage alternative work options. American Management Association (AMACOM).

© 2021 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.

The Proper and Improper Role of Government – Chapter 5: Socialism, Communism, Capitalism, and Envy

Bird of PreyAs a kid, the USSR loomed as an ever-present force that could at anytime wipe America off the map with a pre-emptive nuclear strike.  Of course, America would retaliate with nuclear weapons, and this would create MAD or “mutually assured destruction.”  People understood MAD was bad, but the communists among us were more insidious about portraying communism.  The news media showed bread lines, soap lines, and the bitter pictures of enslavement under communism.  Thus, socialism was the way to go, and the communists were selling socialism as the better way to government.

Except, socialism is communism light, and when the socialists run out of other people’s money, communism takes over.  All because under capitalism, the results of one’s choices and consequences are harsh and cannot be hidden. Those preaching socialism and communism were envious of the capitalists who achieved and wanted what others possessed but without the hard work required to obtain benefits.

One other reality is critical to understanding the role of socialism; there is an axiom that states something like, “today’s students are tomorrow’s government policymakers.”  This is precisely what has happened; the students of the 1960s are now setters of government policy, holding onto the reigns of power through sheer willpower, to see America die before they do.  Socialism has been taught in the classrooms of government-mandated schools since the early 1900s to purposefully bring down the liberty and freedoms of the citizens of every representative government, out of envy for those in power in communist countries.  Refusing to believe that under communism, less than .01% are powerful, rich, and mighty, whereas everyone else suffers, grovels, and struggles!Plato 3

Socialism, Communism, and Capitalism – Detailed for understanding.

What is communism?  Webster relates that communism is “A system of government in which the state plans and controls the economy and a single, often authoritarian party holds power, claiming to make progress toward a higher social order in which the people equally share all goods.”  Except, everywhere communism has been tried, one-party rule leads to sycophants and ideologues ruling and taking what they want, while everyone else suffers, held in power by hired guns.  Cuba was an incredible island nation, then Fidel Castro came along, and now Cuba is a cesspool of suffering, misery, and stagnation.  Venezuela used to be the crown jewel of South America; now, it is a war zone, a catastrophe, and a pit of wasted potential.  Czarist Russia was no picnic, but it was much greater than the vulture of communism that feasted on the body of Czarist Russia while it poisoned the world.  China before communism was enlightened, capable, able, and has joined the ranks of failed communist planning and operations.Plato 2

What is socialism?  Socialism is defined in Webster as “Any of [the] various theories or systems of social organization in which the means of producing and distributing goods is owned collectively or by a centralized government that often plans and controls the economy.”  As well as, “The stage in Marxist-Leninist theory intermediate between capitalism and communism, in which the means of production are collectively owned, but an utterly classless society has not yet been achieved.”  Is the connection clear as to why socialism is referred to as “communism light?”

One last point about socialism, “legislation intended to improve the condition of the working-man. Among the measures include the insurance of workmen against accident, sickness, and old age, and the establishment of cooperative associations under state protection.”  Envy of other countries having benefits has caused legislation that never should have happened in America and many other representative governments due to costs, loss of liberty and freedom, and the destruction of fundamental processes in the “Rule of Law.”  How expensive has unemployment insurance been in non-monetary costs?  Jobs have been lost forever, the expense of hiring has pushed jobs out of America, the expense has reduced wages of those lucky enough to be hired, but the growth of government and the millstone of bureaucrats has cost more than money, we have lost liberty, freedom, and potential.The Duty of Americans

What is capitalism?  The common definition of capitalism in Webster states capitalism is “An economic system in which the means of production and distribution are privately or corporately owned, and development occurs through the accumulation and reinvestment of profits gained in a free market.”  Webster’s dictionary has come under the same influence of plastic words and liberal ideology.  Webster also defines capitalism as “The concentration or massing of capital in the hands of a few; also, the power or influence of large or combined capital.”  Do a few condense capital; yes, no doubt.  Except, when there is less government, and people keep their envy to themselves, capitalism brings the most freedom to the most people better than any other form of government attempted in human history.  So, while capitalism has its faults, which are legion, capitalism is not the problem as it embraces private property ownership.  Private property ownership is freedom from government oppression!Patriotism

Please note, it is entirely acceptable to reach a level of financial comfort, look around, see suffering, and want to aid in the relief of suffering.  This is a good thing and expected in a capitalistic system.  Those paying for the relief of suffering are not government officials hired through forced taxation.  In a socialized system, the money is stolen, legally, through forced taxation, then handed freely to those suffering, with several cuts made for wages and benefits of the workers doling out other people’s money.  In a communist system, political leaders get fat and enjoy all the benefits, while everyone else suffers without relief.  Yet, too many people would see you in a communist system and suffer, for there is no envy.  If you believe that, I have a gravity-resistant bridge to the moon for you to buy.

Envy

Social Justice Warriors 4Envy has been one of the seven deadliest sins for a reason; it breeds violence and discontent.  Webster shines a light on envy describing it this way, “A feeling of discontent and resentment aroused by and in conjunction with desire for the possessions or qualities of another.”  Fear is disgust and envy paired for the weak to overcome the powerful.  The disease of envy includes admiration, jealousy, discontent, disbelief, lies, and a host of emotions that overwhelm a person’s mind to the point where they become irrational and hostile.  Another resource claims envy (from Latin invidia) is an emotion that occurs when a person lacks another’s superior quality, achievement, or possession and either desire it or wishes that the other lacked it. Aristotle defined envy as pain at the sight of another’s good fortune, stirred by “those who have what we ought to have.”

While academics continue to split hairs between jealousy and envy and strive to create more distinctions, what has been described regarding envy is sufficient for my purposes.  The purpose of discussing envy is to aid in clearing the confusion surrounding envious people who have a modicum of power, as they perceive it, and then abuse that power for their own benefit.  For example, Trump Derangement Syndrom (TDS) was already a disease long before President Trump left the private sector for the political arena.  TDS remains rooted in envious people acting violently, abusing power, and acting unethically and immorally because of the envy they feel for President Trump’s success.Social Justice Warrior 3

Consider Speaker Pelosi (D), who ripped her copy of President Trump’s State of the Union speech up in front of cameras.  She was jealous; her pride was hurt, and she felt envious and lacked a weapon to harm the president, so she acted immaturely and disrespected the sitting president.  All this because, at heart, Speaker Pelosi (D) is nothing but a shallow and useless person, stuck in Congress and hating every minute of her tenure there because she could not obtain a higher office.  She is envious of the Americans she despises and works 24/7/365 to destroy America, all because of her envy of other people’s success.

Social justice warriors, including President Obama, are full of envy and do everything they can to obtain revenge for self-inflicted wrongs.  Envious people hate consequences for the choices they make.  Envious people turn to drugs, alcohol, and other forms of self-medication, which in turn makes their self-loathing and self-hate worse.  Then, these same envious people curse the success of others while demanding that someone else pay for the help they need to overcome their self-inflicted consequences.Social Justice Warrior 2

I recently talked to a gentleman who was severely upset that democrats stole the 2020 elections, stuffing ballot boxes, allowing illegal immigration, and a host of other crimes that occur for votes.  While I can understand his distress, he was envious of a political party for their success at suborning American Law.  He left the conversation mad because he could not understand the role of envy in himself and what he was observing in others.  Worse, the belief that justice and mercy are alive keeps him from acting to help change the situation, shift the paradigm, and improve the problems he mentioned to a solution.  Envy captures the mind, placing shades and shutters over logic while unlocking emotion, many times without the person realizing what is occurring until that mind is chained in the captivity of envy.

IronyThere is a reason why envy is a deadly sin in both the Old Testament and the New Testament, mentioned in all the ancient books as a problem, and continues to infect people who refuse to learn.  Unbridled emotions are captivity, not freedom!  There is danger in the extremes of everything.  Envy is in the extremes and imitates a minimal issue to capture the mind and control the person.  Consider this, capitalism is the best, and envious people implement socialism to chain capitalism while rooting for communism to come in a takeover, thinking they will be better off and the “rich will finally pay their fair share.”  Reality is always disappointing for envious people, and the result will be that everyone detests them when their plans come to fruition.

© 2021 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.

Monk and Mental Health

Tony Shalhoub played the defective detective in the police drama “Monk” from 2002 to 2009.  Monk is obsessive-compulsive and has a list of 312 prioritized fears and phobias.  But, as the main character, everyone is expected to see and find his mental health challenges somewhat humorous.  However, I like the show Monk for another reason, all the other mental health issues swimming around Monk that nobody understands or even recognizes due to Monk’s fears and phobias being so over the top.monk tv show cast - Google Search | Monk tv show, Mr monk

Monk started a mental health conversation in America, reflecting that even those with mental health issues can be productive members of society if given a chance.  For example, Captain Stottlemeyer, for the majority of the show’s run, has anger issues, and yet he is considered capable and competent as a Police Captain.  Lieutenant Disher struggles with his identity as a person and his value to the organization.  The supporting character’s mental health problems create the drama.  Monk provides comedy and allows the supporting characters to be accepted for their mental health issues, which is essential in this discussion.

TV Reviews - TV Liveblogging: Some Episode Of Monk - KittysneezesSharona struggled with being a mother, her boss was driving her crazy, and her mental health issues stemmed from both her boss and her nursing responsibility.  Sharona plays a problematic role; does she provide nursing care for Monk or provide living assistance as a counselor?  Concluding that stress can be a mental health issue when taken to extremes.  Natalie Teager struggled with loneliness and a desire to be her own person outside of her family.  Both mental health challenges that many people struggle with silently.  Other supporting characters had substance abuse issues stemming from mental health concerns and personal choices, thus Monk’s subtlety and genius.

When Sharona, his nurse, leaves the show, Natalie Teager provides a lesson on mental health, the difference between coddling and helping a person with mental health problems.  Sharona, for all her care and concern, never saw Monk as capable without assistance.  Natalie Teager saw Monk as competent but needing some assistance.  The difference is subtle but very real.  Monk’s behaviors and mental health problems lessen when Natalie Teager enters the show, and the story becomes richer.

Perception vs. Reality in Care Support

Image result for monk tv show cast | Monk tv show, Mr monk, Adrian monkAre you weak to admit you have a mental health problem?  Per society, not as much anymore.  Per yourself, who knows.  Perception versus reality is critical in the person with mental health concerns and in the care-providing staff surrounding that person.  Now, I suffer from PTSD, Anxiety, and Depression, as mental health concerns; but, I thank God for my support (spouse) and those characters in my life that provide the drama, while my mental health provides the comedy.  Not a single person who knows of my mental health struggles has ever treated me capable without assistance, and this makes all the difference in how I approach the world.

The pattern of admitting the mental health challenges, coping with those challenges, and the consequences of those challenges have been made bearable because my supporters never waiver from the foundation that I am capable but occasionally need assistance.  Monk taught me that it was okay to have mental health issues, to see those issues in others, and a pattern of living and approaching others with mental health issues.  The perceptions of the supporting people become a reality in the mental health challenges of the person suffering.

Monk (S1/F12) im TV Programm: 22:35 - 08.11. - Universal ChannelIt is not easy supporting someone with mental health issues, and while mental health sufferers get the attention, Monk taught the world that the mental health of the family and friends is as important to the cure as well as the problem in mental health patients.  Consider the two different approaches of the psychiatrists on Monk, but never forget two other principles in mental health, change is hard, and change is beneficial.

Change and Mental Health

Monk was stuck in a rut, and a change in the insurance policies spurs Monk to change.  As the show develops, change is witnessed as beneficial and challenging.  When Sharona left, Monk experienced quite a shock; the different care styles provided by nurses spurred complex and healthy changes in Monk. Differences in approaches by the psychiatrists produced more changes and spurred growth in Monk and the other supporting characters.  Hence, as a mental health patient and as a care provider, another pattern is produced: am I looking for changes?  Am I open to helping others engage in change?  Do I embrace both the light and dark of change?

Pin by Smeesmii R on MONK | Monk tv show, Mr monk, Detective monkAdaptation is the only constant in life.  We adapt to the people around us, the social environments, the emotions, and the influences of peers, employers, family, and so much more.  Yet, we often try to control everything to prevent change, even though every new day brings change.  Monk showed he could not handle change, mainly because he and his brother had never been taught to handle change.

Patterns in Family Rearing – Mental Health Challenges

As a kid, I was told that I would never amount to anything since I was raised in poverty and abuse.  I had teachers who made this comment often enough that I got mad!  Nobody was going to curtail my abilities and shoehorn my potential.  Their reasoning was the research that showed those in poverty as children stay in poverty as adults.  That abuse is generational, and that abuse will always influence those raised in abuse to perpetuate abuse to the next generation.

Monk (TV Series 2002-2009) - Posters — The Movie Database (TMDb)Monk showed me differently, proved that individual choices could change preset patterns, and end captivity.  Sure, Jack Junior and Ambrose are typical examples of the generational nature of abuse, leading to mental health issues.  But, Monk overcame, chose, and in choosing and sticking with his choices, he endured and conquered.  Monk overcame even with his mental health challenges, not because of, or as an excuse, but with his mental health challenges as a companion.

While it is true how a child is reared, does dictate how that child will approach the world as an adult.   Individual agency, moral choice, and the choice and consequence cycles also play fundamental roles in that person’s life.  Thus, one cannot, and should not, place blame upon how one was raised for the failures in one’s life; this position negates the agency inherent in each person, and shifting the responsibility of choices is not healthy mental health practices.  More lessons learned from Monk about how to face the world, even if you might not have had the best family environment as a child.

Did you notice that when Jack Junior makes his appearance, Adrian (Monk) has changed enough to know not to gratify and indulge his step-brother in his poor decisions?  Despite the differences in mental health problems, Ambrose, Monk’s other brother, was also not pampered, although he was given special care.  Cementing the theme that people with mental health problems are capable, have potential, and need only the opportunity to show who they are and what they can become, just like everyone else.

I am not my handicap

I have disabilities; disabilities do not have me.  I am not my handicap!  Monk taught me this lesson in spades.  When Monk gets his badge back, he realizes he has learned this lesson as well as learning what his abilities as a disabled person are.  Another subtle theme in Monk worthy of exploration.  Adrian Monk was not “Obsessive-Compulsive, Mentally health challenged, Adrian Monk.”  Adrian Monk was Adrian Monk who lived with obsessive compulsion, fears, and phobias.  The distinction is subtle but essential to living with mental health challenges as a companion, not a ruler!

I am forever grateful for the lessons learned and still being learned from Monk!  I encourage you who read this to ponder the themes herein; change is beneficial and hard, but critical; family and family life is not your life; you are not your handicap or illness.  These themes and more can help open your eyes and mind to new possibilities, freeing you from your captivity of mental health challenges, but only if you choose to open your eyes and mind.

Finally, remember your support staff.  Have you thanked them lately for their support, care, and kindness?  If not, start there, express gratitude to and for the care received from those who live with you, work with you and desire your success.  Never forget, on your bad days, your support staff is still there trying to help, and they need support too.

© 2021 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.

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

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