‘Do It Yourself, White Boy!’ Life at the VA

 

Gil C / Shutterstock.comAnother lifetime ago, those five words were spoken to me in a VA hospital in New Orleans. Another typical civil service, morbidly obese nurse biding her time until retirement. The patient was a WW1 vet (who’d been gassed, etc.) and he needed to have his bladder catheterized. I wrote the order that was countersigned by a resident but it didn’t happen.

A few hours later I returned. I asked about it and was told,”Do it yourself, white boy!” So I did, although I fumbled my way through the procedure since his 90-year-old prostate was the size of Delaware. He’d been hurting for hours while this lady did her very minimal job as well as her nails.

Now let’s go to an actual VA doc who, when he resigned after a couple of years, was told by his boss that he was the worst employee ever. Funny thing, that doc was as bright, compassionate and motivated as any I’ve ever met. But being the “worst” actually meant he busted his bottom and refused to give in to the slothy culture which permeates ALL civil service life. Holding a meeting and resolving to eventually do something positive but never doing it was the norm. This “worst employee ever” could not deal with the rampant laziness and dysfunction. Having spent plenty of time in four VA hospitals, I can say this is epidemic.

In the private world we bust our buns. Time is money and we have promises to keep, with miles to go before we sleep.

In the civil service world, you kill your work time until the shift is over, doing the minimum and never rocking the boat. The patient life units are all just statistics anyway, right? They fought for our freedom but the basketball playoffs are on tonight, so just wait in line, buddy, and shut up.

We are headed to a single-payer system eventually, albeit run through cronyist insurance agents who are in bed with bribed politicians. As Obamacare fails, this eventual system will emerge, populated by clock-punching robots without compassion or motivation. Does anybody even remotely think civil service hospitals for ALL will be anything better than our VA’s?

There are 62 comments.

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  1. Member

    974339_10201259070517284_1691671967_nWell said, Jay, as always. Getting poked and prodded by Big Government will not be fun.

    • #1
    • June 2, 2014 at 12:51 pm
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  2. Member

    Having dealt with a corporatist personal-care structure in a variety of settings in an earlier life, I say: “Not a snowball’s chance, Doc!” (Unless *you’re* running it, of course.)

    • #2
    • June 2, 2014 at 1:06 pm
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  3. Inactive
    DocJay Post author

    Nanda Panjandrum:

    Having dealt with a corporatist personal-care structure in a variety of settings in an earlier life, I say: “Not a snowball’s chance, Doc!” (Unless *you’re* running it, of course.)

     Do I get to put a wood chipper out front or maybe just be allowed to fire lousy employees?

    • #3
    • June 2, 2014 at 1:09 pm
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  4. Contributor

    “Do it yourself white boy” How transphobic. How was she to know you self-identified as male?

    • #4
    • June 2, 2014 at 1:17 pm
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  5. Member

    DocJay:

    Nanda Panjandrum:

    Having dealt with a corporatist personal-care structure in a variety of settings in an earlier life, I say: “Not a snowball’s chance, Doc!” (Unless *you’re* running it, of course.)

    Do I get to put a wood chipper out front or maybe just be allowed to fire lousy employees?

     Doc, a bright, shiny wood chipper *and* firing all of the lousy employees…Enjoy!

    • #5
    • June 2, 2014 at 1:31 pm
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  6. Member

    Great post, Doc.

    Was speaking with a friend from Massachusetts last night. He said he sensed that the anger about what’s been happening in the last several years is palpable, that the Dems are about to be tossed out on their collective ears and that the midterms could be another blowout like 2010. The VA scandal and now the building outrage on social media about the exchange of an Army deserter for the Taliban’s most heinous monsters – who apparently slit the throats of hundreds of Iraqis in full-view of their families — are further signs he may be right. Maybe the Democrats are still waiting to pour more gasoline on their own fire. Here’s hoping.

    • #6
    • June 2, 2014 at 1:51 pm
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  7. Member

    DocJay: Does anybody even remotely think civil service hospitals for ALL will be anything better than our VA’s?

     No, and you would think that the Republicans would be making some hay out of this. But of course, they’ve neglected the veterans for all these years, too. It’s just not a group that will ever draw much water in Washington.

    • #7
    • June 2, 2014 at 2:00 pm
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  8. Inactive

    Every VA hospital I’ve ever been to has had an inordinate number of armed guards or police wandering around. The only reason I was ever able to figure was that the wait times so long, the service so shoddy, and the staff so rude, that only the ubiquitous presence of armed guards staves off patient rage.

    Never mind that, at best, every time I’ve been a patient there I’m treated as if I were a homeless substance abuser. For the record, I’m neither of those things, and don’t look like one either.

    • #8
    • June 2, 2014 at 2:08 pm
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  9. Inactive
    DocJay Post author

    Frank Soto:

    “Do it yourself white boy” How transphobic. How was she to know you self-identified as male?

     Maybe the codpiece?

    • #9
    • June 2, 2014 at 2:10 pm
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  10. Inactive
    DocJay Post author

    Salamandyr:

    Every VA hospital I’ve ever been to has had an inordinate number of armed guards or police wandering around. The only reason I was ever able to figure was that the wait times so long, the service so shoddy, and the staff so rude, that only the ubiquitous presence of armed guards staves off patient rage.

    Never mind that, at best, every time I’ve been a patient there I’m treated as if I were a homeless substance abuser. For the record, I’m neither of those things, and don’t look like one either.

     Sorry you’ve been crapped on. It’s a darn shame.

    • #10
    • June 2, 2014 at 2:12 pm
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  11. Inactive
    DocJay Post author

    Brian Watt:

    Great post, Doc.

    Was speaking with a friend from Massachusetts last night. He said he sensed that the anger about what’s been happening in the last several years is palpable, that the Dems are about to be tossed out on their collective ears and that the midterms could be another blowout like 2010. The VA scandal and now the building outrage on social media about the exchange of an Army deserter for the Taliban’s most heinous monsters – who apparently slit the throats of hundreds of Iraqis in full-view of their families — are further signs he may be right. Maybe the Democrats are still waiting to pour more gasoline on their own fire. Here’s hoping.

     Oh I’m pretty sure Obama could eat a live baby on camera and rape the mom without any negative media coverage. Or rape the dad, I’m not sure about his preferences.

    • #11
    • June 2, 2014 at 2:14 pm
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  12. Member

    DocJay:

    Brian Watt:

    Great post, Doc.

    Was speaking with a friend from Massachusetts last night. He said he sensed that the anger about what’s been happening in the last several years is palpable, that the Dems are about to be tossed out on their collective ears and that the midterms could be another blowout like 2010. The VA scandal and now the building outrage on social media about the exchange of an Army deserter for the Taliban’s most heinous monsters – who apparently slit the throats of hundreds of Iraqis in full-view of their families — are further signs he may be right. Maybe the Democrats are still waiting to pour more gasoline on their own fire. Here’s hoping.

    Oh I’m pretty sure Obama could eat a live baby on camera and rape the mom without any negative media coverage. Or rape the dad, I’m not sure about his preferences.

     Whatever you do, don’t hold back. :-)

    • #12
    • June 2, 2014 at 2:42 pm
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  13. Inactive

    DocJay:

     

    Oh I’m pretty sure Obama could eat a live baby on camera and rape the mom without any negative media coverage. Or rape the dad, I’m not sure about his preferences.

    If Obama recanted his position on “you didn’t build that!” and converted to free market principles, THEN the media would turn on him.

    • #13
    • June 2, 2014 at 2:54 pm
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  14. Inactive

    Unless there is a reform that allows crappy civil “servants” to be actually fired, or gives vets a voucher so they can choose where they go, anything else will be nothing more than window dressing.

    • #14
    • June 2, 2014 at 3:49 pm
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  15. Inactive
    DocJay Post author

    Nick Stuart:

    Unless there is a reform that allows crappy civil “servants” to be actually fired, or gives vets a voucher so they can choose where they go, anything else will be nothing more than window dressing.

     Neither will happen. Both should.

    • #15
    • June 2, 2014 at 3:54 pm
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  16. Member

    An orthopaedist I know, with lots of VA exposure during training, said the VA was like a large welfare to work program for people in healthcare –that none of them would be employable anywhere but a VA hospital. Unionization ensures their ongoing employment rather than job performance. I myself have not been in a VA since residency but certainly then, the whole system was held together by the labor of non employees (med students and residents rotating through) as DocJay aptly described.

    • #16
    • June 2, 2014 at 3:57 pm
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  17. Inactive
    DocJay Post author

    I was in an airport a couple days ago with a bunch of old Marines. Many had these hats on with medals, like purple hearts kind of medals. These are the Vietnam vets our country crapped on once. I find crapping on them this way just abhorrent and it really bothers me to no end. Give them Medicare, they earned it!

    • #17
    • June 2, 2014 at 4:46 pm
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  18. Inactive
    mm

    the VA is legendary among doctors in training for its dysfunction- vitals signs were charted on patients who had obviously been dead for hours etc

    • #18
    • June 2, 2014 at 5:14 pm
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  19. Inactive

    When I interned in Geriatrics at a VA, we had family members mark the patients diapers before they left. When they returned the next day, they patient had not been changed. I watched nurses swear and curse out the family tell them they were wrong and they would regret “making the staff look bad.” I evaluated cancer patients who were delirious from pain because they weren’t given pain medicine–or the dosages were changed to be low and ineffective.

    It’s a system that manages to chew up and spit out just about anyone who is hard working and effective. There were pockets of good care, but they were few and far between.

    • #19
    • June 2, 2014 at 5:43 pm
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  20. Coolidge

    Does anybody even remotely think civil service hospitals for ALL will be anything better than our VA’s?”

    DocJay,

    C’mon, Doc. “Better” isn’t the point. These are progressives. The priority is equalized care, not better care. That, and the creation of an entrenched, unionized health care workforce reliably generous to the campaigns of progressive politicians.

    • #20
    • June 2, 2014 at 5:56 pm
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  21. Member

    I worked at a couple of VAs in the midwest during my training. Most of the staff I worked with were genuinely nice people, mostly midwestern country folks. But they didn’t move with any alacrity. They put in the minimum effort, politely. There was one husband/wife duo of xray techs that were stellar — knowledgable, efficient, etc. They knew what you wanted done before you did. I wondered why they were wasting their time at the VA, but they were former military and dedicated to the serving the vets. 

    Any large organization of people has all-stars, a bunch of average folks and dregs that are, for some reason, un-fireable. Government seems to collect few all-stars, lots of average clockpunchers and huge heaping loads of un-fireable dregs who, unfortunately, set the pace and the tone of the whole facility. 

    On the bright side, the cafeteria always had good gravy.

    • #21
    • June 2, 2014 at 6:04 pm
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  22. Inactive

    I hope everyone caught this piece  in the Wall Street Journal. It somehow does a better job than most of us can of explaining what every doctor in American knows about the VA system (including why we’ve all been through VA hospitals at one time or another). It really needs to be made clear that this is a consistent problem, and a direct function of a single-payer government-run system, rather than a short-term crisis related to temporary bad management. Firing people at the top is a silly and pointless empty gesture.

    • #22
    • June 2, 2014 at 6:14 pm
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  23. Coolidge

    Jason Rudert: No, and you would think that the Republicans would be making some hay out of this. But of course, they’ve neglected the veterans for all these years, too.

    True, up to a point.

    Headline from The American Spectator piece by David Catron: Photo Found Showing Bush on Grassy Knoll. In other news, Dubya’s responsible for VA scandal.

    Seems that Nancy Pelosi’s blaming Bush for the VA, so the author thought he’d go all the way and blame him for shooting JFK.

    Actually, O’s in deep water. Even the Dems, as noted above, have had it – as well as O-friendly media outlets who now are telling the truth. The Daily Beast lambasted him for his neglect of the VA. The piece also highlighted the conditions under O compared to Bush. “The ranks of veterans waiting more than a year for their benefits grew from 11,000 in 2009… to 245,000,” a 2000% plus increase. Under Bush? Average waiting time “fell by more than a third” even with an increase of 320,000 Iraq and Afghanistan veterans filing.

    • #23
    • June 2, 2014 at 6:40 pm
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  24. Coolidge

    I’m back to my assumption that Obama’s not evil or mean-spirited, but just stupid. Immature, and stupid.

    I go back and forth on this. Sometimes I think he’s purposefully doing these things because he wants to “transform” America. Sometimes I just think he’s flat-out dumber than a box of hammers.

    Barry’s never had the privilege of being treated like a second-class citizen, regardless of his race – because he’s never had to resort to gov’t “help” for his most basic of needs. If he did, if he lived in subsidized housing, ate cheese blocks for lunch, watched a sister or a brother do without dinner while he ate the only can of beans – then he might understand things a little better. Maybe he’d be different.

    But that ship has long sailed. It’s hard to see the world through other peoples’ eyes when you’re holding up a mirror in front of your mediocre face.

    • #24
    • June 2, 2014 at 6:43 pm
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  25. Member

    I know someone who worked in civil service. He clocked out at 5:00 every day and was on the golf course by 4:00. Sort of reminds you of the The One “serving” in the Oval.

    Don’t worry about him, though. He’s comfortably retired on your dime.

    • #25
    • June 2, 2014 at 7:16 pm
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  26. Member

    Just checking in. Where do I sign up to be on the waiting list for the waiting list which will allow me to comment on this post?

    • #26
    • June 2, 2014 at 8:00 pm
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  27. Inactive
    DocJay Post author

    Notice the Rico docs chiming in with universal agreement about a lazy culture at the VA. That’s not all folks there but it is what the system is. Sad. Human lives deserve more respect, especially those who served.

    • #27
    • June 2, 2014 at 8:27 pm
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  28. Inactive

    DocJay:

    Nanda Panjandrum:

    Having dealt with a corporatist personal-care structure in a variety of settings in an earlier life, I say: “Not a snowball’s chance, Doc!” (Unless *you’re* running it, of course.)

    Do I get to put a wood chipper out front or maybe just be allowed to fire lousy employees?

    Do both. “Fire” them out of a big mortar so they land in the wood chipper. 

    • #28
    • June 2, 2014 at 9:43 pm
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  29. Inactive

    Chris Campion: I’m back to my assumption that Obama’s not evil or mean-spirited, but just stupid. Immature, and stupid.

     Evil, mean-spirited, stupid, and immature are not mutually exclusive. Why assume the Dear Leader can’t be all of the above? 

    • #29
    • June 2, 2014 at 9:49 pm
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  30. Inactive

    Doc what you are describing is England’s NHS. The horror stories of sadistic nurses and health aides particularly in geriatric wards are horrifying. Elderly patients with little mobility have starved and/or dehydrated to death because no one would bother to assist them. They remain soiled leading to bed sores etc. It is widely known that if family members don’t maintain a constant prescence their elderly kin will probably get worse or die.

    • #30
    • June 2, 2014 at 10:08 pm
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