VA Mental Health Provider Venting / Problem-solving / Peer Support Thread

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iliketohelppeople said:
you can definitely set up a script to automate that (though I can imagine the VA wouldn't like that for several reasons).
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Lol I remember once being told at New Employee Orientation that charging a phone via USB to a workstation basically amounted to launching a cyberattack on the VA network.
 
WisNeuro said:
May favorite part of this ongoing thread is that it consistently reminds of the many reasons I'm glad to be out of the VA 🙂
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Indeed. Although to be fair RE: micromanaging bosses specifically, we know they aren't unique to VA. But VA may have a disproportionately high number of them.
 
AcronymAllergy said:
Indeed. Although to be fair RE: micromanaging bosses specifically, we know they aren't unique to VA. But VA may have a disproportionately high number of them.
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True. There were bureaucratic issues at my old hospital job, but they at least let me manage my clinic schedule however I saw fit. My new boss is pretty flexible, but he's something of a stickler for tracking finances 🙂
 
cara susanna said:
They want us to reduce phone visits and they said that they'll be tracking them. And, yeah, I've just been documenting Veteran preference. Some of my patients don't want to come in because they don't want to wear a mask, so that works.
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My VA no longer has phone sessions as an option in cprs. I had a vvc visit scheduled and the patient wanted to do phone, so I had to cancel the visit and encounter my 40 min session as a phone call note.
 
psychrat said:
My VA no longer has phone sessions as an option in cprs. I had a vvc visit scheduled and the patient wanted to do phone, so I had to cancel the visit and encounter my 40 min session as a phone call note.
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Do they not have telephone clinics for you guys? National had pushed providers having access to a telephone, vvc, and F2F clinic to complete notes. I know there was an issue with not billing the telephone clinics and so there has been a push away from those, but I am surprised there is no other way to document this.
 
Sanman said:
Do they not have telephone clinics for you guys? National had pushed providers having access to a telephone, vvc, and F2F clinic to complete notes. I know there was an issue with not billing the telephone clinics and so there has been a push away from those, but I am surprised there is no other way to document this.
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no, we only have vvc and face to face clinics
 
summerbabe said:
Many/all supervisors and I think all remote employees are issued a VA iphone with Teams on it so as long as you fiddle with your phone every once in a while, your light should stay green. I am remote and if I have a down period, I’ll do stuff around the house which is a great decompressor for me but I make sure that I am ridiculously reachable (eg., all notifications on highest volume, phone in pocket/hand at all times).

There is also a setting on Teams to indicate how much time elapses before you go yellow. I believe the default is 5 mins but can be bumped up and am not sure if this is permission locked or not (I was able to change mine). If you want to change yours and can’t figure out how, feel free to DM me and I’ll poke around and see if I remember how.
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Talking about fiddling with your phone/mouse to 'make the light stay green' reminds me of a description of my job as a VA psychologist to a colleague I once made in frustration...I feel like my job duties basically involve mindlessly pushing levers/buttons all day long to turn off lights so as to avoid electric shock.
 
Fan_of_Meehl said:
Talking about fiddling with your phone/mouse to 'make the light stay green' reminds me of a description of my job as a VA psychologist to a colleague I once made in frustration...I feel like my job duties basically involve mindlessly pushing levers/buttons all day long to turn off lights so as to avoid electric shock.
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I'm pretty sure you just described most jobs in the Western world. You should read David Graeber's Bullsh*t Jobs. The duct taper and taskmaster categories might ring familiar.
 
WisNeuro said:
May favorite part of this ongoing thread is that it consistently reminds of the many reasons I'm glad to be out of the VA 🙂
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Sanman said:
I'm pretty sure you just described most jobs in the Western world. You should read David Graeber's Bullsh*t Jobs. The duct taper and taskmaster categories might ring familiar.
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Yea, but the looking for green vs yellow is just out of control, right? I mean, come on???
 

Yea, but the looking for green vs yellow is just out of control, right? I mean, come on???
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I'm not saying it isn't. However, this is not a national policy. It is middle managers being ridiculous, which can happen anywhere. No one checks my teams at all or has time to do so. Hell, look at the fights at private investment banks right now. Jamie Dimon wants all his employees back in the office now, delta variant be damned. Goldman Sachs has promised to better enforce it's Saturday rule...that's right, their work/life balance is they only have to work 6 days/wk now. There are a lot of dumb jobs and dumb rules everywhere. Save your pennies and keep an F U fund for these moments.
 
Sanman said:
It is middle managers being ridiculous, which can happen anywhere.
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Yup! I'm super fortunate to have found generally really good administrative leadership (big picture versus meaningless details) and have felt supported to do my clinical work in a number of ways in my new position, which is majorly contributing to my work satisfaction. Whereas those same managers at my last position played a major role in my starting to look for VA jobs elsewhere.
 
Yeah, I haven't heard anything like that at my site. Although I actually decided not to pursue telework because I don't want to be under increased scrutiny.
 
It's come up already a lot for me. I'm recommending validating oneself/allowing to feel feelings, while also looking at thoughts about the situation and its meaning. I also am recommending keeping an eye on rumination and limiting media exposure if necessary, and staying behaviorally engaged. Talking to supportive people about it is also a good idea.

The national PTSD people have been sending out some suggestions (most along these lines, it seems) already, too.
 
Mercury in Taurus said:
I had to talk to my supervisor, who works remotely, the other day. Teams messaged her first thing in the morning and waited for 3 hours with no response. I ended up having to call her on the phone and it did not sound like she was home or near her computer. Her light stayed solid green the entire time. Is there a way to keep the light green without having to sit in front of the computer? 🤔
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Get a watch with a second hand. Pick up your mouse and place that watch under the optical reader thing. Boom, movement every second. Go about your day / no show life.
 
CheetahGirl said:
What's everyone's thoughts on the Afghanistan pullout? How should we be thinking of this in context of our OEF/OIF/OND Veterans? Not too concerned with political blame here, just curious about our Veterans and current Servicemembers' perspectives and our support for them.
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Which issue, specifically? I'd imagine the most relevant would be Vets who served there, who are now questioning why we were there in the first place if nothing got accomplished? May be a good spot for some ACT principles.
 
WisNeuro said:
Which issue, specifically? I'd imagine the most relevant would be Vets who served there, who are now questioning why we were there in the first place if nothing got accomplished? May be a good spot for some ACT principles.
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I haven't had it brought up by any of my patients yet, but yep, the bolded and related questions are primarily what the emails and suggested talking points have focused on. And in prior-era veterans, especially Vietnam, it potentially bringing similar thoughts/feelings back to the surface again.
 
AcronymAllergy said:
I haven't had it brought up by any of my patients yet, but yep, the bolded and related questions are primarily what the emails and suggested talking points have focused on. And in prior-era veterans, especially Vietnam, it potentially bringing similar thoughts/feelings back to the surface again.
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I don't really deal with any of OEF/OIF/OND guys (too young), but my Vietnam folks have been plagued by similar issues for a long time. Particularly those that suffer with chronic PTSD and are trying to understand why they endured all of their suffering. I imagine recent events are going to trigger a lot of feelings in many people and the partisan mudslinging never helps such things.
 
WisNeuro said:
Which issue, specifically?
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Just...why were we there? Was it in vain?

I do like the perspectives of military leaders saying 'if there's a win or lose perspective, we won [of course] because we staved off stateside terror for 20-years.' (Well, international terror...stateside. We have our own homegrown version, right here, too.) That's one optimistic spin without present demoralization.
 
Hi everyone! I just relocated to a rural VA for a G-12 job. We have the nicest people work here; however, things move at the pace much slower than what I am used. After being on station for a week, I still cannot access to CPRS. I am getting referrals and ready to see patients and need CPRS access to document encounters. When I followed up with the admin assistant, she deferred me to the local IT. When I contacted local IT, IT deferred my follow up to the admin person who is to follow up with HR. When I mentioned to my supervisor about the slow transition progress and that there are referrals waiting to be seen. I was told that things take time, and enjoy my temporary downtime.

This is very small VA and everyone knows everyone. I don't know the relationships among the employees and I don't want risk being perceived as pushy or demanding. In theory, I can document encounters as Late Entry when I get access to CPRS. Not sure what are the ethical concerns and other unforeseen risks? What if something happens to the patients that should have been documented timely and I am unable to do so? Should I not see any patients until I have access to CPRS? Any thoughts what will be my wisest and most responsible move(s) without disturbing the peaceful workplace vibes? Thank you!
 
Mercury in Taurus said:
Hi everyone! I just relocated to a rural VA for a G-12 job. We have the nicest people work here; however, things move at the pace much slower than what I am used. After being on station for a week, I still cannot access to CPRS. I am getting referrals and ready to see patients and need CPRS access to document encounters. When I followed up with the admin assistant, she deferred me to the local IT. When I contacted local IT, IT deferred my follow up to the admin person who is to follow up with HR. When I mentioned to my supervisor about the slow transition progress and that there are referrals waiting to be seen. I was told that things take time, and enjoy my temporary downtime.

This is very small VA and everyone knows everyone. I don't know the relationships among the employees and I don't want risk being perceived as pushy or demanding. In theory, I can document encounters as Late Entry when I get access to CPRS. Not sure what are the ethical concerns and other unforeseen risks? What if something happens to the patients that should have been documented timely and I am unable to do so? Should I not see any patients until I have access to CPRS? Any thoughts what will be my wisest and most responsible move(s) without disturbing the peaceful workplace vibes? Thank you!
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Personally, I would refuse to see patients until I had full access to CPRS. Just archive all of your emails in which you tried to get this resolved.
 
Mercury in Taurus said:
Hi everyone! I just relocated to a rural VA for a G-12 job. We have the nicest people work here; however, things move at the pace much slower than what I am used. After being on station for a week, I still cannot access to CPRS. I am getting referrals and ready to see patients and need CPRS access to document encounters. When I followed up with the admin assistant, she deferred me to the local IT. When I contacted local IT, IT deferred my follow up to the admin person who is to follow up with HR. When I mentioned to my supervisor about the slow transition progress and that there are referrals waiting to be seen. I was told that things take time, and enjoy my temporary downtime.

This is very small VA and everyone knows everyone. I don't know the relationships among the employees and I don't want risk being perceived as pushy or demanding. In theory, I can document encounters as Late Entry when I get access to CPRS. Not sure what are the ethical concerns and other unforeseen risks? What if something happens to the patients that should have been documented timely and I am unable to do so? Should I not see any patients until I have access to CPRS? Any thoughts what will be my wisest and most responsible move(s) without disturbing the peaceful workplace vibes? Thank you!
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If you aren't seeing patients, it's probably okay. If you're seeing patients, it is not okay. I've seen people file patient safety reports over IT issues that interfere with clinical work to this extent.
 
Mercury in Taurus said:
Hi everyone! I just relocated to a rural VA for a G-12 job. We have the nicest people work here; however, things move at the pace much slower than what I am used. After being on station for a week, I still cannot access to CPRS. I am getting referrals and ready to see patients and need CPRS access to document encounters. When I followed up with the admin assistant, she deferred me to the local IT. When I contacted local IT, IT deferred my follow up to the admin person who is to follow up with HR. When I mentioned to my supervisor about the slow transition progress and that there are referrals waiting to be seen. I was told that things take time, and enjoy my temporary downtime.

This is very small VA and everyone knows everyone. I don't know the relationships among the employees and I don't want risk being perceived as pushy or demanding. In theory, I can document encounters as Late Entry when I get access to CPRS. Not sure what are the ethical concerns and other unforeseen risks? What if something happens to the patients that should have been documented timely and I am unable to do so? Should I not see any patients until I have access to CPRS? Any thoughts what will be my wisest and most responsible move(s) without disturbing the peaceful workplace vibes? Thank you!
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IMO, seeing a patient without access to CPRS, being unable to review a history or chart is serious problem. If the patient is having suicidal ideation a delay in documentation becomes a serious safety issue. My suggestion, enjoy the downtime, communicate to your supervisor what you have done to attempt to get computer access, and ask about next steps. Draw a hard line in the sand at seeing any patients prior to having all of your equipment and access setup. Let your supervisor sort out the administrative issues and the decisions about how you should proceed. That is what they are there to do. You are new and this is not on you.
 
Mercury in Taurus said:
After being on station for a week, I still cannot access to CPRS. I am getting referrals and ready to see patients and need CPRS access to document encounters.
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In every VA role I have had (intern, postdoc, 2 staff positions), I did not see any patients until I had CPRS access. Are you getting pressure to start seeing patients or is it wanting to get going since you’ve officially started and are drawing a paycheck?
Mercury in Taurus said:
When I mentioned to my supervisor about the slow transition progress and that there are referrals waiting to be seen. I was told that things take time, and enjoy my temporary downtime.
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Follow his or her advice! This seems par for the course at smaller and more rural VAs. Not sure if you trained in a metro but people are more likely to take hour long lunches (when patients are not scheduled) and there’s generally less pressure because smaller VAs are more under the radar. Observe the local culture and follow the lead of the folks who have been at it a while. Good luck!
 
Agree with the above: don't see patients without access to CPRS, and maintain emails showing your attempts to get the situation resolved. There are multiple moving parts to getting someone the correct type of chart access, so it's not unusual for it to take over a week. But if your supervisor can actually pin down who's supposed to do what and where the current delay is, that might help if things aren't resolved in another week.
 
summerbabe said:
In every VA role I have had (intern, postdoc, 2 staff positions), I did not see any patients until I had CPRS access. Are you getting pressure to start seeing patients or is it wanting to get going since you’ve officially started and are drawing a paycheck?

Follow his or her advice! This seems par for the course at smaller and more rural VAs. Not sure if you trained in a metro but people are more likely to take hour long lunches (when patients are not scheduled) and there’s generally less pressure because smaller VAs are more under the radar. Observe the local culture and follow the lead of the folks who have been at it a while. Good luck!
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This is true - I work at a smaller VA clinic in a more rural setting, and all new providers don't see patients for two weeks. It's pretty great, actually.
 
Thanks everyone! Just got a new docking station and a laptop. Able to setup my work station. Progress is made, slowly but surely. Taking all your advices and redirecting my energy to check off 40 some TMS courses that all of the sudden appeared under my Learning. Maybe I will take a hike in the woods here on our beautiful park-like campus.

Also, I have noticed hour-long lunch here. People would go off campus and eat at local restaurants. I had thought that I would be fired for doing that sort of things. This is a huge adjustment; in many good ways. 🙂
 
Mercury in Taurus said:
Also, I have noticed hour-long lunch here. People would go off campus and eat at local restaurants. I had thought that I would be fired for doing that sort of things. This is a huge adjustment; in many good ways.
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From my VA experiences, there tend to be more longer tenured staff at smaller/more rural VAs, in part because people are more able to do normal human things like eat lunch with colleagues. Always helps when there’s a more defined population of veterans to serve, versus metros that are experiencing major population growth and new veterans are always popping out of the woodwork. Enjoy the job and remember the saying ‘If you’ve been at one VA, you’ve been at one VA’.

Also lol for getting fired from a VA MH role. I’m sure it happens but I’ve seen plenty of people be really, really, really bad at their jobs and they just keep showing back up for work so short of physically assaulting a veteran or something wild like that, your job security is pretty great (even if your leadership is just itching for you to be done).
 
summerbabe said:
From my VA experiences, there tend to be more longer tenured staff at smaller/more rural VAs, in part because people are more able to do normal human things like eat lunch with colleagues. Always helps when there’s a more defined population of veterans to serve, versus metros that are experiencing major population growth and new veterans are always popping out of the woodwork. Enjoy the job and remember the saying ‘If you’ve been at one VA, you’ve been at one VA’.

Also lol for getting fired from a VA MH role. I’m sure it happens but I’ve seen plenty of people be really, really, really bad at their jobs and they just keep showing back up for work so short of physically assaulting a veteran or something wild like that, your job security is pretty great (even if your leadership is just itching for you to be done).
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hahahaha when I worked for the VA I knew of people doing amazingly awful things and not getting fired. It was honestly one of the factors that made me leave. It's hard in the private sector, too, but the VA is incredible. I think you have to burn the place down. Do not worry about getting fired.
 
cara susanna said:
I know people who have gotten fired from the VA.
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I honestly don't know if I can think of anyone who's gotten fired. I know of multiple folks who've been strongly encouraged to transfer to other areas or clinics, or to leave VA entirely, and I know of a few licensing board complaints that providers have levied or at least discussed pursuing against former colleagues, but not sure if I know anyone who's legitimately been terminated.
 
I've seen it with a provider who was sleeping with a patient, and a provider who was using a a personal phone to text a patient (not personal stuff, outreach trying to get the person to schedule)
 
cara susanna said:
I've seen it with a provider who was sleeping with a patient, and a provider who was using a a personal phone to text a patient (not personal stuff, outreach trying to get the person to schedule)
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I'm actually a bit surprised by the second scenario resulting in termination. I understand the substantial privacy and information security implications, but I guess I would've thought that to be the type of thing that would result in an FPPE, unless there were previous issues or a persistent pattern of misuse despite clear understanding that the actions would be impermissible..
 
AcronymAllergy said:
I'm actually a bit surprised by the second scenario resulting in termination. I understand the substantial privacy and information security implications, but I guess I would've thought that to be the type of thing that would result in an FPPE, unless there were previous issues or a persistent pattern of misuse despite clear understanding that the actions would be impermissible..
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Yes, we were all surprised by that one.
 
WisNeuro said:
I've only ever seen it happen with a nurse who was sleeping with inpatients. Never seen a psychologist fired. Sure it happens, just rarely.
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But what were the nurse's customer service ratings like? You know the section where in annual rating where your boss asks you if you have ever gone above and beyond your job duties to help a veteran...
 
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Sanman said:
But what were the nurse's customer service ratings like? You the section where in annual rating where your bodd asks you if you have ever gone above and beyond your job duties to help a veteran...
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A whole new spin on "performance-based" employee awards. I wonder if they "exceeded expectations."
 
I have not been with the VA long enough to see anyone getting fired. In private sectors, when people reach above a certain level, they don't get fired. Even in at-will states, they are usually "given an opportunity to resign." I have seen some very good people given opportunities to resign after pissing off the wrong person or messing up with their budget. In a cooperate owned and operated facility, a good colleague of mine was walked out of the building by the VP after being told to sign a pre-drafted resignation letter. He was a dedicated department head with good performance review. The only wrong move he made was sending an email about a matter that required the VP's attention, and he capitalized THANK YOU at the end of email followed by !!!. It was perceived by the VP that as if the department head was yelling at him and being rude. Prior to that, they did not have a positive relationship to begin with.
In the VA system, I am guessing they can find ways to make people transfer or resign since firing process is so time and energy consuming.
 
Mercury in Taurus said:
In the VA system, I am guessing they can find ways to make people transfer or resign since firing process is so time and energy consuming.
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Not unless they want to bring down the wrath of the union. As most of us can attest having worked in the VA, we've all likely seen many instances in which someone should have been fired, and we almost never see an instance (aside from Cara's example) where someone was likely fired without a great reason. In Cara's example, though, the one thing that the VA does view quite stringently is infosec. It's a bad PR look when that gets out.
 
Mercury in Taurus said:
I have not been with the VA long enough to see anyone getting fired. In private sectors, when people reach above a certain level, they don't get fired. Even in at-will states, they are usually "given an opportunity to resign." I have seen some very good people given opportunities to resign after pissing off the wrong person or messing up with their budget. In a cooperate owned and operated facility, a good colleague of mine was walked out of the building by the VP after being told to sign a pre-drafted resignation letter. He was a dedicated department head with good performance review. The only wrong move he made was sending an email about a matter that required the VP's attention, and he capitalized THANK YOU at the end of email followed by !!!. It was perceived by the VP that as if the department head was yelling at him and being rude. Prior to that, they did not have a positive relationship to begin with.
In the VA system, I am guessing they can find ways to make people transfer or resign since firing process is so time and energy consuming.
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This is almost universally what I've seen. The folks co-workers have been most certain should be fired were either: A) transferred to a different service or facility; B) asked to leave/resign; or C) promoted.
 
WisNeuro said:
Not unless they want to bring down the wrath of the union. As most of us can attest having worked in the VA, we've all likely seen many instances in which someone should have been fired, and we almost never see an instance (aside from Cara's example) where someone was likely fired without a great reason. In Cara's example, though, the one thing that the VA does view quite stringently is infosec. It's a bad PR look when that gets out.
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Our union is known for being... not great, locally, so that may be related.
 
cara susanna said:
I've seen it with a provider who was sleeping with a patient, and a provider who was using a a personal phone to text a patient (not personal stuff, outreach trying to get the person to schedule)
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Wow! I used my personal phone when working remotely with a Google voice number.
 
psychrat said:
Wow! I used my personal phone when working remotely with a Google voice number.
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I know with the pandemic, they were approving this, at least for a period of time. I would hope the person cara referenced didn't get fired for this during COVID-19. Also, there's the possible issue of texting PHI, which is a big no-no.
 
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