STOP ABUSE OF POWER:

Sunday, November 16, 2008
Stop abuse of power
VA Medical Center Condones Racism ,retaliation and abuse of Power.

Is racism , retaliation, and abuse of power tolerated in the VA Medical healthcare system? Do you think sweat shop mentality is dead. Do you think that cover up and conspiracy is reserved for elite political realms. Do you think that Al Capone style management has been mothballed to fiction. I used to think so.
Read my true story and you be the judge, this is happening NOW.
I am a Certified Nurse Practitioner, a veteran, African American and Hispanic ethnicity. I have been a Certified Nurse Practitioner for 7 plus years and for 4 years before that a critical care RN, and +10 years as a test engineer. I have never encountered a situation like the one I am currently experiencing in all these years. I worked for the VA in 2004 as a fee for service and never had a problem during that time.
In July of 2007, I accepted a position at Wilkes Barre VA Medical Center in Pennsylvania unaware of the impact that new management at the VA would have for me. I went to work enthusiastic and hopeful. I wanted to help my fellow veterans. I was sure my dedication, hard work ethic, and experience were compatible with the VA’s mission.
I went from employment acceptance to direct patient care with no orientation or formal training as is the norm. Aside from no formal training on the facilities new policies and procedures, I received no formal training on the facilities electronic medical record system. This system is called CPRS. It is the basis for medical records , ordering and reporting. The system includes patient notes, medication orders, and labs, everything you would find in a paper medical record. The system also encompasses a tracking method for provider/clinician work output. Of course this spyware system is tied into billing. This system, as with other large software systems, has its own special quirks and annoying glitches that can make learning to work the system, especially without formal training, challenging to say the least.
I worked with an earlier revision of the system 3 years earlier at the VA but unfortunately that was two and one half years earlier. I found significant differences with the present system from what I could recall of the prior earlier version . During my learning process I discovered a software glitch/flaw inherent to the CPRS system. This flaw would delete previously entered encounter information that a mid level clinician would enter, and hence any attempt at proper billing, if the patients primary care provider happened to see the same patient later that day. this of course would generate errors to the bean counters since revenue was lost because timely encounter information was lost and private insurance companies as well as medicare would not reimburse since the encounter information was not entered or re-entered in time. The lost revenue which I was told by those that used such information as a weapon against clinicians was in the millions of dollars and was sent to Texas (or so I was told) where it was tabulated. Repeatedly being harassed by administrative gnomes that loved to make me, as well as other clinicians re-enter encounter information that we swore we had already done gets to an individual. Especially when the gnomes would leer and tell you how you are costing the system so much money because of your inept practices. I began then to investigate and search out the few technically adept wizards at the VA , those who actually understood the way CPRS worked and who had access to check how data was being entered and by whom. I found a technician who actually was trained and formally educated as a programmer, but who was relegated to serve little more than clerks with some CPRS template training because of the incestuous and inherently inflexible way supervisory positions were granted at the VA medical center. This technician whom I will call OZ was able to search my patient database with me and discovered in minutes dozens of incidents wherein my encounter information was deleted after patients I had seen in appointments were then followed by their primary care providers. Imagine my surprise when OZ told me in a matter of fact way that this in fact was a known flaw in CPRS for over 5 years! Thats right 5 years known software glitch that he had years earlier told higher management about but which had been ignored because the system was such a good spy and could be used, despite the waste in taxpayer money as a weapon to punish any clinician that wound up on the wrong side of management. CPRS is then also an electronic assassin that can gather false data on a clinicians efficiency that can be unleashed in Lord of the rings type fashion against anyone deemed an enemy of mordo( management 5th floor and higher).
This is a fact that if any manager or politician not seduced by the dark side could investigate if they could break the spell of Mordo.
Of course I told Dr XX and Dr XY and Dr XYZ about what I discovered with the help of OZ, do you think they were happy, rather the looks and reaction I received was one reserved for he who would run through the Vatican screaming he had found the body of the Christ.
I was treated like an old testament leper, from that moment on officially on the outs.
As far as I am aware, the problem has still not been resolved. That means millions of your tax dollars are being thrown away.
Soon after this time my immediate supervisor Dr XY began displaying odd behavior. There were mood swings from jovial and friendly to ill temper. This was punctuated by personal attacks directed at me. These attacks were at first rare but then became the norm. They included foul language and racial slurs.
August 2007; Dr XY proclaimed he was God and I was his slave. This proclamation became more frequent and animated. Dr XY would point his finger skyward as he called himself “the god”.
September 2007; Dr XY started referring to himself as “The Master” and I was his slave.
These attacks and proclamations at this time were only directed at me. I would repeatedly and patiently explain to Dr XY, his behavior was inappropriate and I found it offensive. Dr XY would respond by telling me I was dismissed from his presence.
October 2007; Dr XY began to occasionally utter the above proclamations in the vicinity of others.
Dr XY began to feel more emboldened. He repeatedly stated names of other high profiled doctorsXX, and XYZ in management at the VA remarking these individuals would do anything for him. Dr XY’s assumption of omnipotence was becoming apparent to other employees such as ETFS, ETSM, EKGJB. As the months progressed the verbal attacks on me became more vile. They went from you sh*t, f*ck you, and lazy b*stard, to lazy sp*c bastard, and lazy black b*stard.
I was torn. I felt shame, anger, and disgust. Then Dr XY targeted me with a work schedule that would allow me a lunch break only once a week on Friday.
I went to another doctor whom I will call Dr XX requesting a transfer explaining my reasons and stating nothing more than Dr XY’s abusive behavior, in the hope that even a cursory informal investigation would expose and correct such abuse. Unfortunately Dr XX being a close friend of Dr XY told him everything I had said in confidence.
Predictably Dr XY’s attacks increased. Now emboldened by support from Dr XX, in front of other employees Dr XY would proclaim of my proposed request for transfer. He would laugh at those times and say he would ensure I was transferred to the nursing home which according to Dr XY was no place any clinician wanted to be.
As punishment Dr XY then increased my work load even more. He would purposely schedule me to be in 2 places at the same time to make it look as if I was always late. I then found a legitimate way, despite all the obstacles Dr X put in front of me, to accomplish all my work in a timely fashion. I need to note at this point prior to accomplishing this, nurses and other support staff had to work overtime to cover my clinic time slot. Thank Dr XY for needlessly spending more of your tax dollars. When Dr XY discovered I was doing all my work and leaving on time he was furious.
Now it was about January or February 2008. In addition to the foul language and racial slurs Dr XY began telling me I had a big belly and began laughing at my religious medals saying they were “crazy”.
Around March 2008 Dr XY proclamations began to spill out and involve other employees, stating he was a god and their master, along with outbursts of cursing at them, why not he got away with it in my case.
One day I was in my office with a colleague discussing some test results. Dr XY came in and asked me a question which I answered. Dr XY then looked over at my guitar and asked me if I would like for him to break that guitar over my legs. I was too angry to respond and just looked at him. Dr XY repeated the threat. I just shook my head. Dr XY smirked and strutted out of my office. The clinician who witnessed this threat told me that she felt uncomfortable by Dr XY’s threat, I will call the clinician PASE, pase was so disturbed upon hearing Dr XY’s threat that pase filed an affadavit with the federal police on campus. NO charges were filed against Dr XY. No apology was or has been received. VA management aware of the debacle and did nothing to discipline him despite publically referring to itself as a no tolerance for violence facility, that apparently only applies to those not so well connected.
I once again complained regarding Dr XY’s behavior. In fact I was told by Dr XX in front of the local Union President that a fact finding investigation would be launched. Reprisals were immediate. I had weekend work that was scheduled and booked 13 weeks in advance and it was taken away from me with significant loss of wages.
I was removed from patient care for more than six months months despite the facilities medical bylaws that state this cannot be done to any clinician for more than thiry days.
Please note I was the one punished for daring to complain about their darling doctor.
Please note that in tune with a management that thrives on abuse of power what the bastards did was to cut off all my access to the CPRS software that way I effectively had all clinical priviledges removed without being officially reported as such my the federal governments healthcare priviledge reporting system called Vet pro. In this way the VA management could report truthfully to any lazy bastard politician that only superficially looked into my reported loss of priviledges and state it was not true since the VET pro software reported I still had privledges. I hope the reader will recall that earlier I had stated that CPRS sytem of electronic record is the only system the clinician can use to function as a clinician. If a clinician is cutoff from CPRS that clinician cannot function as a clinician. I believe the reader can get a sense that herein is a management system that is adept at using the electronic medium to manipulate truth to a machiavellian degree.
I was made to sit at a desk, enter appointments, and stuff envelopes.
I contacted the EEO office, The IG office, and my Congressman. I also provided copies of my schedules. More Reprisals Within about 2 weeks from my filing complaints, I was informed that a Nursing Board of Review was directed at me. Dr XX, Dr XY, and now the influential Dr.XYZ, as well as BossXU were seeking my dismissal.
April 2008 a sham, I was allowed to review documents in fact finding. I would have to defend and explain them at a nursing standards board, I was told by the smirking Mr. MacV of labor relations. Yet I could not get any information of the alleged events in the testimony against me, in fact everything except the charges was blocked to me only dated (many months in past) was given , Everything was blacked out. I was told by Mr.MacV this is the way Title 38 Hearings are done, I was also warned, in the presense of the local union vice president, that if I tried to investigate any of the cases I would be terminated immediately. Remember I had my CPRS privledges suspended.
My Union Representative was the local vice president, he was aware of his lack of experience with this type of hearing and requested a 1 day delay to obtain to guidance of the local president to aid me. This request was flatly denied by Mr. MacV.
Within 30 days or so with no information on my part as to specifics the hearing took place, surprisingly they ruled in my favor. It seemed that the haughty Dr.XX, Dr. XY, Dr. XYZ, and BossXU had tried to frighten me into leaving and had not counted on me fighting back. In fact to my surprise the board appeared openly dumbfounded regarding the whimsical nature of complaints and accusations against me. They were also puzzled why no fact finding investigation was ever made regarding my complaints. Keep in mind I was told by Dr.XX in the presence of the local Union President that an investigation would be launched. I was told privately by one of the board members that she was disgusted by the sham of a hearing that was held against me.
Management still has not investigated any of my charges and has not questioned even one witness whose name I provided. I made an official EEO complaint, and at an EEO informal hearing held May 2008, I told Dr. XYZ and Mr.HR Ged that a nursing Standards hearing resulted in no charge of misconduct on my part, I pleaded in front of EEO rep and all at the meeting to please launch the investigation that had been earlier promised by Dr.XX .
No investigation was forthcoming. Retaliation did continue.
I still suffer retaliation simply because I dared to complain about a hostile and degrading work environment and because instead of running I stood up for the most basic of human rights that of dignity.
I have been placed into primary care despite the fact my entire career has been in sub specialty of cardiology, without benefit of shadowing a primary care practitioner, and despite management acknowledging I had no formal training in their CPRS system or their tera term system(one used for communication). I have been given the clinic of Dr.FF who left this job after only 1 year because of the unrealistic workload.
I am given 10-14 pt load plus 15-24 daily patient callbacks, plus walk in patients plus 15-24 daily medication renewals, plus expected electronic communication between staff. In short I have been set up to FAIL.
I have used every avenue at my disposal to resolve my situation. I have sent letters to Congressman Kanjorski, Senator Spectre, regional director Mr. Mooreland, and VA system Director Dr. Peake. Nobody has as yet effectively come to my assistance, most just send a letter to the same people I have complaints against, cute huh, thereby effectively fanning the retaliation that to this day continues. This leads me to believe that Wilkes Barre VA Medical Center and the VA medical system by being complicit condones racism , retaliation, and abuse of power, and has far reaching tentacles.
If one does not address bad policy and bad behavior, in my view you are condoning it. Apparently it seems some of our politicians also condone the same by virtue of lack of action.
There has been much talk about improving the health care provided to our veterans. I say you cannot fix the veteran until you fix the system. How can a health care provider focus on the patient 100% (as they deserve), when working in a hostile and toxic environment where racism, retaliation and abuse of power is tolerated.
Take it a step further. Why not fix a well known computer system glitch that costs the VA health system millions of dollars. Those are our tax dollars. As a tax paying citizen I demand more efficient accounting of my money. Can you imagine how much more we could do for our veterans with efficiently used resources.
It comes down to one simple fact. I am a veteran. I want to provide quality, respectful health care to my fellow veterans. I want to do this in a professional and therapeutic environment. The current Wilkes Barre VA Medical Center and VA medical system by extension does not facilitate the most basic rights of human dignity, and respect how can they then be entrusted with the care of any veteran.
Therefore I am taking my concerns to the public for I have confidence that the American people will not tolerate a system they have bought and paid for that is characterized by injustice, and an AL Capone style retaliatory of management that seeks to turn back the clock to the sweat shop days of intolerance.

Sincerly
In Chains
Tonyzzz7
[email protected]