Morality, the Vaccine to Envy

Angry Wet ChickenIn reading the news today, under the heading of “equity,” we find masturbation taught to first graders, hardcore porn taught to high schoolers, and San Francisco, CA., sliding into lawlessness and chaos.  Honestly, I felt my mind trying to explode; yet, life must go on.  In several previous posts, I have described how equity is a mask for envy.  For example, sexual grooming of the innocent comes from people envious of the innocent.  The district attorney in San Francisco is envious and uses his envy to gain power and lord that power over those who elected him.

The Church of JESUS CHRIST of Latter-Day Saints, in their book of scripture The Doctrine and Covenants, Section 121, verse 39, has an applicable declaration.

We have learned by sad experience that it is the nature and disposition of almost all men, as soon as they get a little authority, as they suppose, they will immediately begin to exercise unrighteous dominion” [emphasis mine].

Detective 2For those interested, “unrighteous dominion” is considered to be oppression, pride, vain ambitions, and a host of other contention-increasing actions designed to stay in “power” where the exercise of authority can be abused.  For example, the district attorney and staff in San Francisco were informed by those who elected the DA to power that the crime and the lawlessness in the city were hurting them. The DA and staff are reported to have claimed those raising concerns were racist.  The governmental leaders in San Francisco consider themselves as having authority. Yet, they refuse to acknowledge that their “authority” comes from the governed and was granted through the electoral process and can be taken back.  Hence the verse quoted is an excellent description of what is being witnessed today at every level of government.

Various sources define morality; in fact, morality has been considered a philosophical debate, and much is written on this topic.  For this reason, the definition of morality is as follows:

Morality is the differentiation of intentions, decisions, and actions between those that are distinguished as proper and those that are improper. Morality can be a body of standards or principles derived from a code of conduct from a particular philosophy, religion or culture, or it can derive from a standard that a person believes should be universal.”

I am not here to dictate what is and is not moral between you, your conscience, and your supreme being worshiped.  However, I will emphasize that America was founded upon the morals of Judeo-Christian theology, and these morals have been a solid anchor in the chaotic push and pull of beliefs and morals across time.  I mention this because that definition of morality opens the doors for people to insist that sexually grooming young children is morally acceptable because they believe that sexual grooming should be universal.  Planned Parenthood, GLAAD, and several other groups believe that sexual grooming and stealing the innocence of youth is required because they personally envy children their innocence.

ModestyBelieve it or not, sex is NEVER free; there will always be consequences.  The 1960s sexual revolution has done more harm globally than any other revolution or clash of arms in history, bringing us back to the topic rather forcefully; morality is the only vaccine to envy.  But, who decides the morality of a nation, a state, a country, or a city?  The electorate as a collective voice selects the morality of that area.  The electorate decides the laws through the ballot box in a representative government.  In a non-representative government, the king, monarch, dictator, etc., dictate the morality of the population, which is one reason why old countries have histories where immorality was rampant as the people followed the examples of the leaders, not the leader’s words.  Want a history lesson in morality and how people copy a leader’s morality, look no further than King Henry VIII of England.

Social Justice Warrior 3Circling back again to how morality is the vaccine for envy, provided the morals involved in supporting morality are selected carefully and exemplified by leaders.  In the discussion on morality, philosophers question if there are absolutes?  Absolute right and absolute wrong, or are morals a gray area where time and social pressure keep everything gray?  Depending upon your appetite and your ability to control your appetites tends to set your moral convictions.

5 Illegal Drugs That Doctors Once Prescribed As Miracle CuresFor example, Playboy and Hustler have made billions of dollars selling sexually explicit content to the masses.  Some participate in pornography; others refuse pornography.  Those who choose to imbibe in pornography live a fantasy life where no woman will ever be good enough to meet the pictures witnessed and the lurid content from the magazines selling appetite suppression.  Both sides of the morality issue will complain they deserve attention and should be free to express their rights.  Both are using the same tool, envy, to make their moral stand become a legal standard.

Who wins and who loses?  Why?  These questions get to the heart of the problem and identify why morality is a vaccine for envy.  Morality, where all men (including women) are equal, would see the chains of pornography and set a moral standard to limit the content to adult audiences.  But, every 10-year old knows a friend whose dad has a subscription and has seen a Playboy or Hustler magazine.  Is this a failure of the law or moral codes; no, it is a failure of parents and parenting.  Yet, society will consider this a social problem. The K-12 educators will become involved in peddling worse to your children, all because of curiosity, failed parenting, envy, all of which stem from moral problems and morality breakdowns in social systems.

Exclamation MarkAs a kid, I remember the fierce debates over convenience stores being allowed to sell adult content, video stores carrying adult movies, and the continued fight over how much is too much in an R-rated, PG-13 rated, and G-rated movies.  Why were these fights and debates occurring; the lude and loose morality of the 1960s perverted sex into being “free,” and morality took a back seat to legal freedoms without accountability and responsibility.  Consider the gargantuan awards against cigarette manufacturers; why were these awards so high, poor moral choices, envy, and a refusal to accept that the daily choice of smoking 5-45 cigarettes is going to cost you your health as a consequence.

Sure, medical professionals peddled smoking as a curative; but they also peddled mercury, heroin, cocaine, and a ton of other chemicals and poisons, and those companies never got in trouble.  So why were cigarette manufacturers singled out; envy and a lack of morality where consequences are accepted for personal behaviors.  Nobody twisted arms and forced anyone to smoke.  Yet, the cigarette manufacturers have been forced to pay for advertising to prevent smoking, smoking cessation classes, and a host of other programs by legal mandate, for the moral failures of people in society.Are You Sure Grandpa Never Took Heroin? You May Be Surprised | BoredomBash

Is the connection clear?  Envy breeds bad case law, which enables poor moral choices without consequences.  Except, the consequences for personal choices cannot ever be escaped!  Therein lay the issue and the answer.  I do not care what moral code you choose to follow, provided that moral code does not infringe upon another person’s rights and liberties; believe who, what, and where you will.  Just understand that your moral code comes with consequences that others should never have to pay for.

Knowledge Check!Equality in the world, since the 1960s, has been a mask for envy.  Through the power of envy, people have become discontent, disabled, and disconnected from morality and the consequences of immoral behaviors.  America stands on a tipping point where envy is concerned, and if we, the citizens who can understand, cannot persuade, educate, and correct this trend line, disaster looms large!  We must recognize that the path of envy, in all its nicer sounding, feel-good imitations, is part of the problem we face!  Yes, I believe in liberty, freedom, the inalienable rights of man.  But freedom, liberty, and the rights of man are not government benefits to be doled out at the whims of bureaucrats.  It is not more government we need when morality is threatened by envy, but less!

© 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.

NO MORE BS: Memorial Day 2021 – Are you sure this is “proper” remembering?

Knowledge Check!It is no secret that the Department of Veterans Affairs (VA) is a sick and twisted organization.  It is no secret that the Department of Veterans Affairs – Office of Inspector General (VA-OIG) tries to recommend how the VA should be operating in accordance with currently established procedures, methods, and policies for the benefit of the veteran community.  It is no secret that I continue to write about the VA in the hopes of sparking interest in communities and obtaining more fair, honest, transparent, and humane treatment for veterans by the Government agency tasked with caring for veterans.

On this Memorial Day, as you sit down to barbecue, family, friends, sports, I would ask that you take a moment and consider if this were how you would like to be remembered?  Are the actions described proper for remembering those who sacrificed and came home?  Are these actions, which are adding to veteran funerals, an appropriate way for veterans to be leaving this world?  If the answer is no, I ask for your help changing the Federal Government by electing people who will scrutinize the government more stringently and demand change in all government agencies.  If you deem this behavior acceptable, please leave a comment detailing why you think so.  I want to hear your thoughts.Image - Eagle & Flag

From a VA-OIG report published on Wednesday 26 May 2021, we find the following announcement:

Phillip Hill, a former VA program analyst, was sentenced to 46 months in prison for stealing personal information from veterans and VA employees while employed at the Central Arkansas Veterans Healthcare System. The investigation revealed that Hill contacted another individual and attempted to sell personal identifying information to a buyer for approximately $100,000.”

Now, I am thrilled this guy was caught.  I am glad he will do time behind bars.  Yet, why did Assistant US Attorney Jana Harris allow a plea deal?  Where are the VA supervisors who should have been monitoring this employee’s work and behavior?  What are the details of the deal?  The VA continues to have nothing but IT/IS security, and these problems are decades old.  Still, the elected representatives allow the criminal behavior to exist until the criminal is caught, and then the elected representative’s crow about cleaning the swamp.  Is this how you correctly remember veterans, their sacrifice, and their memories?VA 3

I suppose the following VA-OIG report, released 27 May 2021, should begin with congratulations.  The Department of Veteran Affairs – Veterans Benefits Administration (VBA) mostly processed monetary proceeds records accurately.  However, the following continues to astound and amaze me:

Service and pension center staff do not have timeliness measures for proceeds incorporated in their performance standards. Setting a timeliness standard would help encourage the closing of these proceeds. The OIG also found that ineffective monitoring contributed to delays in handling proceeds. The Debt Management Center had only limited internal monitoring but instituted new practices for monitoring proceeds in February 2020, shortly after this audit began” [emphasis mine].VA 3

Why are government employees not held to a productivity and quality standard?  Being a veteran with regular concerns involving the VBA, I cannot help but wonder why quality and productivity are not required?  As an industrial and organizational psychologist, the first step in improving responsiveness to customers is to increase productivity and implement quality measures.  I know the Federal Government’s legislative branch, e.g., Congress, has insisted on developing quality measures.  Yet, the same tired excuses built upon designed incompetence are allowed to survive, and all the VA-OIG can do is issue more recommendations.  Consider something; proceeds include payments to dead veterans.  How much financial hardship occurs at the passing of a loved one?  How much more difficult can that death become when months down the road, money spent is suddenly being demanded back because some incompetent bureaucrat failed to do their job in a timely manner?

QuestionIs this properly honoring and remembering the veterans and their sacrifice?  Is this behavior acceptable in your workplace?  Why do we allow this behavior from government workers?

While never having been a patient at the Chillicothe VAMC in Ohio, I have friends who are patients.  The stories they tell about care there would shock and amaze many.  What infuriates me, the VA-OIG just published their report of a comprehensive inspection of this VAMC, and the results are as tragic as a veteran’s death!  The information was released to the public on 27 May 2021.  Never forget, the Chillicothe VAMC in Ohio was recently investigated for improper cleaning and sterilization procedures, as well as employee monitoring for compliance for medically reusable equipment, which for this case refers to endoscopes.  With this fact in mind, let us review the comprehensive inspection report.

Limitations on findings:

      • The VA-OIG held interviews and reviewed clinical and administrative processes related to specific areas of focus that affect patient outcomes. Although the VA-OIG reviewed a broad spectrum of processes, the sheer complexity of VA medical facilities limits inspectors’ ability to assess all areas of clinical risk” [emphasis mine].

VA 3The statement provided here is pretty standard and represents the first limitation to the scope of the investigation; complexity limits inspector ability.  Yet, who made the VAMC so complex, the VA.  Who has allowed the complexity to grow as designed incompetence, the VA? Why is the VA allowed to cheat their inspector general through complex operations which limit inspector ability and increase patient risk?

The Focus of Inspection (Investigation Scope):

      • The VA-OIG team looks at leadership and organizational risks, and at the time of the inspection, focused on the following additional areas:

WhyLong have I wondered why the second item in the comprehensive inspection is “Quality, Safety, and Value.”  When the VA continues to present the bare minimum of quality, disregards patient safety, and due to complexity, offers less value than a broken wrench to a mechanic, but I digress.

Finding One:  The VA-OIG issues 12 recommendations to the leadership team, and “selected results showed respondents were generally favorable the national VHA results.”  I have been accused of being cynical, which generally is wrong.  However, when I see words like “selected results” in an investigation into patient care and concerns, I have to ask, “How hard did the VA-OIG have to dig to find favorable results?”VA 3

Finding Two:  Strategic Analytics for Improvement and Learning (SAIL) represents a value model to help define performance expectations within VA.  This is the standard language for comprehensive inspections.  “In individual interviews, the executive leadership team members were able to speak in-depth about actions taken during the previous 12 months to maintain or improve organizational performance, employee satisfaction, or patient experiences.”  If we accept this as a true statement.  How was an employee able to fake documents, fail to clean reusable equipment properly, and repeatedly get away with this abysmal behavior at this VA?

VA 3Finding Three:  Under Quality, Safety, and Value, we find the following tidbit:

The VA-OIG noted concerns with protected peer reviews, utilization management, and root cause analyses.”

Essentially meaning there are problems with whistleblowers, privacy protection, retaliation against whistleblowers, proper utilization of policies and procedures, and the leadership could not find a problem using root cause analysis if their lives depended upon it.  The source for my interpretation of the VA-OIG results arrives from the following:

VHA Directive 1117, Utilization Management Program, 8 October 2020. Utilization management involves the assessment of the “appropriateness, medical necessity, and the efficiency of health care services, according to evidence-based criteria” [emphasis in the original report].

I have to ask the VA-OIG whether these findings were before or after the employee who endangered patient lives through improper cleaning and sterilization of reusable medical equipment were discovered?

VA 3Finding Four:  Under medication management, we find the following:

The VA-OIG team observed compliance with many elements of expected performance, including pain screening, aberrant behavior risk assessment, and documented justification for concurrent therapy with benzodiazepines. However, the VA-OIG identified opportunities for improvement with urine drug testing, informed consent, patient follow-up after therapy initiation, and quality measure monitoring” [emphasis mine].

VaccineIf you read any of the comprehensive inspection reports, you will see this is a common and recurring theme at the VA.  Some of the medication policies are being followed, but the same problem with drug testing, informed consent, patient follow-up, and quality measuring monitoring always remain a problem.  It is almost as if the SAIL learning matrices do not even exist as a quality improvement tool.

Finding Five:  Under High-Risk Processes, the VA-OIG report claims the following:

The medical center met the requirements for quality assurance monitoring and monthly continuing education. However, the VA-OIG identified deficiencies with standard operating procedures, an airflow directional device, and staff training and competency” [emphasis mine].

Are the SAIL metrics even accurate?  Where is the value in the “monthly training and monitoring if there are issues in following standard operating procedures, problems in staff training, as well as staff competency?  Do you get it?  The training sucks at the VA, and the SAIL metrics do nothing to fix the problem, address the deficiencies, or even improve competency?  The same question arises here, from quality, safety, and value; how was an employee able to successfully pencil-whip the paperwork while not doing their job in properly cleaning and sterilizing reusable medical equipment?  Where are the SAIL documents that should have identified a problem?  Where are the SAIL metrics in aiding in finding root causes for derelict employees?VA 3

Honestly, do you, the taxpayer, consider the Department of Veterans Affairs, which covers the Veterans Health Administration (VHA), the Veterans Benefits Administration (VBA), and the National Cemeteries adequate to remember the veteran correctly?  Do you, the taxpayer find value in the leadership and investigative arms of the VA to correct and improve performance?  Do you, the taxpayer find that the VA employees are doing their level best to honor, remember, and pass on the legacy of veterans?

Image - Eagle & FlagOn this Memorial Day weekend, please consider the data in this and the other VA-OIG reports regularly relayed on this blog, and ask yourself, are you doing enough to help veterans?  I love Memorial Day, and I love my country, but America has some serious problems, and only when the electorate awakens to the issues can real change begin to be implemented.  We, the veteran community, need you!  We need your voice as we struggle against the incessant attacks from the VA.  We need your votes for the elected representative’s intent on scrutinizing the government and demanding action.  We need you!  Please help us!

© 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.

NO MORE BS: Assimilation: A Plea to All Immigrants and Americans!

American Flag Etiquette (Care and Display Guidelines)America continues to open its doors to a large group of new immigrants from countries worldwide, but especially from war-torn and ravaged lands.  Welcome; I am glad you are here!  A Mayor of London previously came to America and derided, denigrated, and demeaned America for asking immigrants to assimilate.  Yes, America will ask you to assimilate; yes, this request includes those legal and illegal immigrants; yes, assimilation is hard, but the effort is worth it.

What is Assimilation?

Assimilation is only taking the best of your old culture, ideals, values, and beliefs and adding them to the best America has to offer.  America is not a perfect country; we ask for your help to improve our country by adding the best of your experiences to our best experiences and building America into a greater nation.  Why does America ask you to assimilate, even though it is hard; the answer lies in the principles of unity, responsibility, and achieving the “American Dream.”

What is the “American Dream?”

A composite illustration with text and the headline “What Is the American Dream Today?” Including an illustration of the Statue of Liberty with buildings in her hand with the text: “Acceptance of government protection of free enterprise.” An illustration of two cities across an ocean with the text: “Belief that other nations should replicate America’s development.” An illustration of storefronts with the text “Faith in a free market economy.” An illustration of a cloud of information with the text: “Promotion of free flow of information and culture.” Illustration of money flowing between two sets of hands with the text: “Support for free trade agreements and foreign direct investment.”The “American Dream” is to realize freedom, all the benefits of liberty, shouldering all the responsibilities of freedom, and achieving these freedoms through work, education, and self-discovery.  Many Americans need to be reminded that the “American Dream” has nothing to do with acquiring stuff.  The “American Dream” has nothing to do with spending money, although great freedoms are found in earning money and spending that money according to your desires.  The “American Dream” has nothing to do with purchasing a home, even though owning property is a cherished freedom.  The “American Dream” is realizing freedom in all its glory and all of its reality.

The “American Dream” means failure, struggle, hard work, loss, gain, understanding value, and so much more.  The “American Dream” has tragedy and heartache, misery, and the ultimate joy of achievement.  Some of the hardest struggles in understanding the “American Dream” are found in sending loved ones marching to war and not seeing those same loved ones marching back home, and it is the “American Dream.”  Understanding and embracing freedom, to see the best and worst of humanity and realize that freedom through a constitutional republic is still the best form of government available, even through all the imperfections.  The “American Dream” means unifying around a single standard.

What is the single standard to rally around?

The US Constitution and the American Flag are the standards to rally around.  Does rallying around this standard mean suddenly easy street, riches, and smooth sailing; absolutely not!  Rallying around this standard means unifying, dropping the labels, the hyphenations, the separations, and realizing that we are better together than we are separate.  Again, the “American Dream” is all about understanding freedom in all its glory, majesty, and terribleness.

21 Things You May Not Know About the U.S. Constitution | Mental FlossThe principles of unity are many, but also very few.  Unity is all about choice; having a choice is all about freedom.  Freedom is all about shouldering the consequences of making choices to become more unified or less unified; simple and complex, easy and difficult.  Unity is not a paradox; unity is a learned principle.  Consider the young child. Being a child is challenging, learning a language, culture, basic education standards, and growing.  The same is true for immigrants.  Many come here and are overwhelmed.  Like children, simply asking for help becomes a great challenge, and many times that challenge is because immigrants do not realize that support is available and merely requires asking for help.  Hence, the responsibility is all on you, not everyone else; this means the consequences for asking or not asking are also all on you; this is freedom.

The principles of unity are found in a common language and based upon the “Rule of Law.”  America is the only country on earth where you can keep your tongue, and the national language, American English, can be a second or non-primary language.  Yet, the choice to learn American English has consequences, and those consequences come with a cost.  Learning American English is hard, requires work, and will not make sense until time and experience are added to learning.  Not learning American English is harder and restricts freedoms:  the ability to enjoy all America has to offer and forces you to forever remain outside America’s embrace.

Like language, the “Rule of Law” has consequences that allow more freedom or constricts freedom, all based upon your individual choices and how you evaluate the consequences.  For example, break the law in coming to America, and you are not welcome even though many politicians will say differently to abuse and use you.  Come to America legally, and you are expected to assimilate to become a citizen.  Come here temporarily, as, on a visa, we will expect you to adhere to the “Rule of Law” and eventually return to your original country.  Fail to return to your original homeland, and you are here illegally, which has consequences.

Should English Be the Official Language of the U.S.?The principles of unity include understanding, learning, and choosing to plot your own path.  No one is going to run your life for you.  Choosing to run your own life requires learning, understanding value, and shouldering the consequences of good or ill choices.  In America, you can choose to be homeless, and this is perfectly acceptable.  You can choose to chase money; acquiring great riches is possible and completely acceptable in America.  Acquire those funds legally, and America rewards them greatly.  Acquire those funds illegally, and eventually, American Justice will prevail, and those funds will be lost in a very public trial.  Again, we see unity combined with choices, leading to coming together under the same standard and enjoying positive consequences or refusing to come together under the standard and enjoying negative consequences.

Andragogy - LEARNThe principles of responsibility go hand in hand with the principles of unity—many of the principles of unity overlap with responsibility principles.  For example, fail to rally under the US Constitution’s standard, break the law, and watch how quickly the consequence leads to being forced to shoulder the responsibility to yield to unify affects you personally with the full weight and scorn of the American people.  Do illegal actions, and you may sometimes not get caught and punished.  Eventually, all of society will know how deplorable you are, and justice gets served in myriad different ways.

Consider dishonest politicians.  Sometimes they do not get caught and exposed to the harsh reality of the American justice system.  Still, they lose all the respect of voters, lose their title, and remain outcasts and pariahs in American society through the media retelling their stories, through a loss of income, and American society continually chastising them for their misdeeds.  American culture can be very harsh for those choosing not to assimilate because the refusal to assimilate means a refusal to unify under a single standard, which requires everyone to do their part to make America better.

ToolsMaking America better is not a job that can be neglected, evaded, shirked, forgotten, ignored, or refused.  America is all about working together.  Work requires sacrifice, learning, and correctly using freedoms to achieve more freedoms.  Working together requires a common language; the common language signifies a common bond amongst those striving to achieve freedoms as a symbol of desiring more freedoms.  Please, take the best you have, add it to the best America offers, and assimilate into America.  Unify with us in a beautiful patchwork quilt of diversity and togetherness.

Diversity should never be sacrificed for unity, and unity must never be sacrificed for diversity and individuality.  It takes both diversity and unity to make America.  It requires sacrifice and responsibility to make America.  It requires a willing mind and open heart to achieve freedom and understand that more freedom is possible with assimilation than without assimilation.  The choice is yours, and the consequences are yours, choose carefully.

© 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.

Realities and Uncertainties – The Paradigm at the VA

I-CareThe Department of Veterans Affairs – Office of Inspector General (VA-OIG) reports they are returning to a more regular schedule of release for the inspection reports with the Department of Veterans Affairs (VA) recovering from COVID-19.  Congratulations are in order, to the VA, as they begin returning to normal operations and procedures.  The reality is that standard operating procedures (SOP) are regularly missing at the VA, this absence causes uncertainty, and forms the crux of this report. A question for the VA-OIG, “How can you assess employee competency without SOPs?”  To the VA VISN leaders, “How can your directors and supervisors, conduct employee evaluations without written SOPs?”  The short answer is you cannot!

Congratulations are in order, for the Marion VA Medical Center (VAMC) in Illinois.  The Marion VAMC experienced a “comprehensive healthcare inspection” and were generally praised for the excellent work being conducted, the happiness of the patients, and the overall condition of the facilities.  While there were recommendations made by the VA-OIG (29 in 8 different areas), the overall report was satisfactory, and this is mentionable.  Hence, my heartfelt congratulations for your success in this inspection.

VA SealThe Marion VAMC VA-OIG report raises a common theme, and this is a reality the VA appears to be incapable of addressing training and two-directional communication.  From the hospital director to the patient-facing staff, training always appears as a significant issue in VA operations.  Having experienced the training provided by the VA for employees, and as an adult educator, I know the uselessness of the training program and have several suggestions.  Perhaps the problem would be best addressed if more evidence was provided of a systemic failure in training employees at the VA.

In 2017 Congress mandated a change in research operations for the VA, specifically where canine research was concerned.

The OIG found VHA conducted eight studies without the former or current Secretary’s direct approval, resulting in the unauthorized use of $393,606 in appropriated funds.VA continued research using canines after the passage of the funding restrictions, in part, because VHA executives perceived that then VA Secretary David Shulkin had approved the continuation of the studies before his departure.”

The cause of the problem, the VA-OIG discovered was, “Unclear communication, inadequate recordkeeping, and failure to ensure approval decisions were accurately recorded and verified all contributing to VHA’s noncompliance.”  The researchers and executives relied upon two leading causes for not following regulations, designed incompetence, and a lack of training through clear and concise communications.

Congress mandated the documentation to assure approval was obtained before research commenced; yet, the researchers and administrative staff collectively failed to do their jobs and were able to hide behind the bureaucracy they established to excuse their poor behavior.  Loopholes for designed incompetence and lack of training need closed; but, two incidents do not clearly illustrate the reality of the problem.

ProblemsThe VA Southern Nevada Healthcare System in North Las Vegas, in response to a referral from the U.S. Office of Special Counsel (OSC), was investigated by the VA-OIG after a community healthcare worker was attacked.  The VA-OIG findings are appalling, but the reasons for the problem are worse.

The OIG determined that facility managers failed to timely respond after the social worker reported an assault during a home visit and did not address the social worker’s health needs after the assault. The social worker’s supervisor failed to immediately report the incident to the community and VA police. The facility’s policies lacked specific guidance regarding employee emotional and mental health injuries. Further, the OIG substantiated that the social worker was not informed by a supervisor of a homicidal threat, occurring subsequent to the assault, until two weeks after facility leaders became aware of the threat.”

The facility leaders knew there was a problem, yet did nothing before or after the event, that could have cost this healthcare worker their life!  VA-OIG recommendations boil down to a need for clear communication and staff training.  The recommendations highlighted another issue entirely that forms the reality and creates uncertainty at the VA, communication is not a two-directional opportunity to share information.  Single directional communication is useless, and those leaders supporting the bureaucracy to only allow communication to flow in, need immediate removal from the VA.  During my time at the VA as an employee on the front-lines, facing patients, I regularly experienced the lack of communication, and this issue is systemic to the entire VA as witnessed and observed at VA Medical Centers across the United States.

The Nevada incident is deplorable, reprehensible, and the potential for loss of life cannot be overlooked by VA leadership in Washington, at the VISN, or at the Medical Center any longer!  The problems of communication cannot explain this incident, and failure for training cannot excuse this behavior!  Since the OSC initiated the complaint, I am left to wonder, did the employee reporting this incident get fired and needed to appeal to the OSC for remediation?  I ask because the knee-jerk reaction to problems at the VA is to fire the person reporting the issue, as previously observed and personally experienced, and as described to Congressional representatives during televised hearings.  A more thorough investigation into causation needs to be concluded and reported to Congress for this incident reeks of politics and CYA.

Leadership CartoonThe Harry S. Truman Memorial Veterans’ Hospital in Columbia, Missouri, and multiple outpatient clinics was recently provided a comprehensive healthcare inspection, and the leadership team provided 14 recommendations in 7 different areas for improvement.  While congratulations are in order, for the patient scores, the employee scores, and the overall conditions discovered.  Yet, again staff competency, e.g., training and communication, remain critical articles requiring targeted improvement.  Is the pattern emerging discernable; in Nevada, an employee is assaulted and training and communication are blamed, comprehensive healthcare inspections are conducted in three different geographic areas and the same causation factors discovered; training and communication are systemically failing at the VA.  But, the evidence continues.

The John J. Pershing VA Medical Center in Poplar Bluff, Missouri, recently underwent a comprehensive healthcare inspection.  The VA-OIG issued 17 recommendations in 6 fundamental areas, including staff competency assessments, e.g., training and communication, as well as the inadequate written standard operating procedures.  When discussing designed incompetence, the first step to correcting this problem is writing down the standards, operating methods, and procedures.  Then the medical center leaders can begin training to those standards.  Barring written instructions and published standards, employees are left to ask, “What is my job? and “How do I perform my job to a standard?”

The Oscar G. Johnson VA medical center, and multiple outpatient clinics in Michigan and Wisconsin recently underwent a comprehensive healthcare inspection, 11 recommendations in 3 critical areas.  As did the Tomah VA Medical Center and multiple outpatient clinics in Wisconsin, 4 recommendations in 3 crucial areas.  Both facilities are to be congratulated for their continual improvement and their success during the inspections.  In case you were wondering, staff competency assessments, e.g. training and communication, are vital findings and variables in improving further for both facilities.

The VA has what it calls “S.A.I.L” metrics that form the core standard for performance.  S.A.I.L. stands for Strategic Analytic (sic) for Improvement and Learning.  Learning is a critical component in how the facility is measured and yet remains a constant theme in the struggles for improvement.  Thus, not only is two-directional communication a systemic failure, but so is the poor training results found on all the comprehensive healthcare inspections performed by the VA-OIG.  Poor communication almost cost a healthcare worker their life, and staff training was a key component for recovering from this incident in Nevada.  How can the VA consistently fail at two-directional communication and training, designed incompetence?  Those in charge require an excuse for not doing their jobs, and the most common excuse provided is a lack of training and poor communication.

I-CareIt is time for these petulant and puerile excuses to be banished and extinguished.  The following are suggestions to beginning to address the problems.

  1. Easy listening is a musical style, not an action in communication.  By this, it is meant that the VA needs to stop faking active listening and engage reflective listening.  Reflective listening requires reaching a mutual understanding and is critical to two-directional communications.  In the world of technology, not responding to email, not responding to text messages, and untimely responses to staff communication are inexcusable on the part of the leaders.
  2. Staff training remains a core concept, but before staff can be properly and adequately trained, standards for performance, operational guidelines, and procedural actions must be clearly written down. The first question I asked upon hire was, “Where are the SOPs for this position?”  I was told, “Do not mention SOPs as the director hates them and prefers to work without them.”  Do you know why that director preferred to work at the VA without SOPs because she used it as an excuse to get out of trouble, to fire those she deemed trouble makers, and to escape with her pension and cushy job to another VA medical center?  A repeatable pattern for poor leaders to spread their infamy.  Shame on the VA Leaders for promoting this director to a level beyond her incompetence.  Worse, shame on you for creating an environment where many like her have excelled and done damage to the VA reputation, mission, and patients, including killing them while they awaited care.
  3. From the VA Secretary to the front-line patient-facing employee, cease accepting excuses. The private sector cannot hide behind immunity from litigation and act in a more responsible manner.  Thus, the VA needs to benchmark what private hospitals do where staff training and SOP’s are concerned.  Benchmark from the best and the worst hospitals for an average, then implement that average as the standard.  One thing discovered in writing SOPs for the NMVAMC, the committee for approving SOPs, and the process for writing SOPs were so convoluted and time-intensive that the SOP was outdated by the time it could be implemented.  Shame on you VA leadership for creating this environment!
  4. Training should be an extension of an organizational effort and university. The VA is not properly training the next generation of leaders; thus, the problems multiply and exponentially grow from generation to generation.  Launch the VA Learning University concept, staff that university with adult educators, and allow lessons learned from the university to trickle into operational excellence.
  5. Form an independent tiger team in the VA Secretary’s Office who has the authority to travel anywhere in the VA System to conduct investigations with the ability to enact change and demand obeisance. The Nevada incident was a failure of leadership and needs a thorough reporting and cleansing of the bad actors who allowed that situation to occur.  Worse, in my travels, I have heard many similar stories.  I heard of a patient getting their ear chopped off when a veteran assaulted another veteran after becoming irate at waiting times in the VA ER.  I have heard and witnessed multiple incidents of furniture being thrown, employees being assaulted, employees harassing and assaulting patients, staff property trashed, and so much more.  These incidents need direct intervention and investigation by a party not affiliated with that affected VAMC and the leadership’s political policies.

Carl T. Hayden04 October 2016, the VA-OIG released a report on dead veterans after the comprehensive investigation into the Carl T. Hayden VAMC in Phoenix, Arizona.  The same event occurred in 2014, at the same hospital, with the same causes and the same conclusions.  The core causes for the dead veterans, no written procedures, poor to no training, and reprehensible communication practices.  The Phoenix VAMC went out of their way to fire all the employees who reported problems at the Phoenix VAMC before the veterans began dying in 2014, I can only speculate that the same occurred in 2016.  Staff was frightened in 2014; they are demoralized in 2020.  Nothing has changed at the Carl T. Hayden VAMC in Phoenix, Arizona, after two successive hospital directors, if anything the problems have worsened.  The problems worsened because leadership failed to act, failed to write down SOPs, failed to communicate, and failed to train.  The hospital directors since 2014 have been appointed from the same pool of candidates who created dead veterans in the first place, and that is a central failure of the VA Secretary and Congressionally elected representatives’ failure to act!

How many more veterans or staff must die before the VA is willing to act?

© 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/

Plasticization of Words and the American Political Left – Shifting the Paradigm

Non Sequitur - Plasticity of LanguageI love words; I was taught from a young age three invaluable lessons:

  1. Speak the King’s English with exactness.
  2. Correctly pronounce and enunciate your words.
  3. If you do not know what a word means, and misuse it, you are wrong and must correct your mistake immediately.

Growing up, these rules were inviolable.  You could use any word you knew the definition of; but, you had better pronounce that word, enunciate, and be able to defend yourself when asked.  Since 1990, I have become detested with two things the American Political Left has chosen to do that is atrocious and worthy of the vilest condemnation, racism, and the plasticization of words.

As a student of history, the American Political Left has, from the inception of political parties, been telling lies to hide political skullduggery and shenanigans, to obfuscate issues, and derail issues.  The plasticization of words has shamed many a person, has cast doubts that have ruined elections, and been exercised tirelessly to tear America apart.

Pentagon BureaucracyConsider a term oft used to describe the political left, “Social-Justice Warriors.”  Long have I asked my political left-leaning colleagues what this term means, how it applies, and the veracity of the term as a description of societal action.  Breaking down the term, we find three definitions taken from Dictionary.com:

Social: Adjective – relating to society and its organization; Noun – informal social gathering

Justice: Noun – just behavior or treatment; administration of law or authority

Warrior: Noun – an experienced soldier or fighter

Social Justice WarriorThus, to extrapolate meaning from the definitions, one would conclude a social justice warrior is “a person in society, looking for the social administration of law, who has experience fighting for the proper administration of law.”  Yet, the definition from the dictionary for this term is 180-degrees different and is termed derogatory, “a person who expresses or promotes socially progressive views.”  Those rioting and looting in the streets got there because a social justice warrior enraged the community on an issue that is racist, one-sided, and emotionally driven.  Lest it is forgotten, the term being applied to the people driven by emotion to launch protests that become mob violence is derogatory in nature, critically disrespectful of the person calling themselves a social justice warrior.  But, the social justice warrior carries this title as if it were a compliment and a badge of the highest esteem.

Thus, language is plasticized to confuse, interfere, and claim moral superiority, while at the same time damaging the basic fiber of America, destroying small businesses, and ruining commerce.  In reviewing the historical records of riots in America, the term social justice warrior appears to have cropped up as a neutral or possibly positive term in the 1990s, but by 2011 the term had gained its derogatory connotations with the rise of social media.  Many victims of social justice warriors claim they have been “thought policed,” “word policed,” attacked for not being appropriately centered on progressive politics.  The social justice warrior is often extremely biased, self-aggrandizing, sanctimonious, but first, last, and always puerilely unreasonable!

Social Just Warriors 5A recent attack by a social justice warrior regarded the inability of poor black people to have government-issued photo ID, and that without that photo ID, the poor black person would be disenfranchised in exercising voting rights.  My response was that holding any person down by race was racist, and the social just warrior preceded to become unhinged.  Let us be clear, anytime a person’s race is the sole reason that person, or group of people, cannot take part in something, is racism, and the person espousing that opinionated garbage is racist.

In fourth grade, shortly after the Christmas Break, Governor Anderson Elementary School, Belfast Maine.  The teacher is Mrs. Ohlund, I am repeating fourth grade because I was accused of being socially unprepared for fifth grade.  I express doubts about Martin Luther King and a negative opinion regarding “Black History Month.”  Then I am falsely accused, for the first of many times, of being racist.  I lost three recesses, had to write a paper by way of apology, and was forced to spend the rest of “Black History Month” not participating in the events planned and scheduled.

Social Justice Warriors 4From that day to this, I have been attacked for not seeing race, not being sensitive to the race of others, and refusing to allow a person’s race to be an excuse for poor performance, bad language, and infantile public and private behavior.  I remain unapologetic; I am not a racist!  I hold myself to the highest standards publicly and privately as my first obligation to society.  Without regard to race, color, creed, etc. I hold others to the same standards.  I am willing to teach and remain willing to learn as my second obligation to society.

Senior Chief Cloud (DCCS) gave me a tongue lashing in the US Navy because I could not understand the verbal interlocution of a second-class petty officer.  The second-class petty officer used “Ebonics,” while on duty as a form of speech, and I had no idea what he was saying.  Off-duty, this same second-class petty officer spoke differently and I was able to understand him, just fine.  I was accused of being racist, disrespectful, and obstinate for not understanding the intentional speech patterns of a higher-ranking person.

Social Justice Warrior 2I quickly learned that if any other race of person employed “Ebonics” they were told to speak properly, but there was a pass for black people.  When I pointed out this was racism, I was sent up on charges for being disrespectful to see the Commanding Officer.  In the US Army, I was the only white person in my squad in S. Korea.  I was never invited to squad parties, social get-togethers, or allowed into training.  I asked why I was being excluded and was told it was because the squad leader did not understand white people.  The command structure supported the exclusion, and I was left without support as a new soldier in the US Army.

When white people treat black people in a manner that segregates, separates, or allows lower standards based upon race, this is considered racism, and rightly so.  Yet, when black people reflect the exact same behaviors, the socially progressive elements in America rush to defend this behavior, and it is still racism.  The term racism sees no colors, understands no race, and cannot distinguish between people.  The term racism has been plasticized and forced into seeing colors and races, but only when directed in one direction towards black people; and, this is wrong!

In S. Korea, I met some of the most amazing people, gifted, talented, intellectually brilliant.  In S. Korea, I never felt I was a foreigner; the people accepted my small gestures to learn the language and were very kind.  Yet, in South Chicago, South Detroit, Bakersfield, Palisades, and other traditionally black neighborhoods, I am a foreigner, and the people not only treated me like scum on their blocks but insisted I did not belong.  How is it, I can feel more welcome in a foreign country, than on American soil, simply because of my race; this is racism!  The same is true when I visited Bahrain, and the Rock of Gibraltar, highly integrated societies, where I was the foreigner but was never treated as a foreigner or an outsider.  But, travel to Jersey City, Burlington, or Baychester and I was told to wear armor because I was going to be shot.  As a point of interest, Bruce Willis has this same problem in the movie Die Hard 3, and Hollywood treated that overt racism as a movie plot; this is wrong!

Social Justice Warrior 3In the name of racial equality, America has been taught since the early 1980s that words create problems, and some words cannot be used by “white people.”  This behavior is inherently racist and spreads the problems of race, not improving racial relationships.  During President Obama’s reign, America learned that peanut butter and jelly sandwiches are racist.  Fluffernutter sandwiches are racist.  But, this is not so, they are sandwiches, food, and delicious.  Yet, through plasticization and a social justice warrior, suddenly, a staple of millions of people is now “off-limits” and cannot be consumed.  My local sandwich shop had to stop selling a peanut butter honey spread on bagels as a sandwich option because the owners feared being picketed.

It is time for Americans to stand together against the tyranny of plastic words.  Terms see no race, color, creed, and can do nothing but form expressions in communicating ideas.  People see colors, race, creeds, handicaps, and more, words do not.  The plastic words employed by the political left need to be called out every single time a new term arises, and the following are some suggestions for reducing plastic words.

  1. Get to know words and their definitions. It is okay to look up new words and use them in daily vocabulary.  It is okay to have a vocabulary to fall upon to describe, detail, and inform your communication.
  2. When in doubt, ask for clear definitions for terms. If this is the second or more instance, compare definitions from previous explanations, and every time the definitions do not match the intent, call that person out.
  3. Insist upon pronunciation and proper annunciation of words. The English language is beautiful when properly used, and the proper usage of language improves the world.  Be the speaker that makes flowers bloom in another person’s mind through language.
  4. Swearing, cursing, and vile imprecations do nothing but degrade the speaker and lower the speaker’s intelligence. Insist that speakers improve their language usage before speaking as a sign of respect.  I show my respect to you by guarding my tongue, you show your appreciation and respect to me by guarding your tongue, and communication advances both of us.
  5. Plastic words are a social disease and a tool of weak and untested minds. Remember, emotional outbursts are not tolerated by parents from children, and are even less tolerated by adults towards other adults.  Teenagers should be able to get away with back-talking and emotional hyperbole, why do we allow these same outbursts from adults?

Words DefinedImproving communication is all about knowing and using language succinctly and precisely, and then supporting proper social behaviors through courage and tenacity.  There is no reason the grocery store, the restaurant, and other social and community gatherings should be an atmosphere of foul deprecations, excuses for small minds to emotionally lose control, or for adults to imitate the worst childish behaviors.  Standards promote freedom, and the US Republic is all about personal freedom through responsibility and accountability for one’s self.

© 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/