Just found out this week - 3 intakes + 19 follow-up appointments + one open day for walk-ins + 4 hours for meetings and training requirement/week. No group is required; however, it is encouraged to start a group if interested. Now I feel horrible when I look at some of the long-term patients in their eyes with the thought of considering leaving in the back of my head.
I gathered the courage to send an email to HR with an ultimatum after receiving a tentative offer. My supervisor followed up with HR and demanded an answer before the end of the business day. HR finally responded with some movements. It is hopeful, but still uncertain. Keeping my fingers crossed. 🙂
This is my opinion. At my current clinic it feels we are barely doing true PCMHI. We’re the walk-in clinic, which happens to receive referrals from the PACTs.
I have some colleagues who are part of one of the test sites and from the bits I've heard, that would be an understatement lol
What's not wrong with it...delays, overbudget, safety concerns, training issues...the usual.
www.beckershospitalreview.com
What's not wrong with it...delays, overbudget, safety concerns, training issues...the usual.
Lawmakers raise concerns over VA rollout of Cerner health records system to Ohio facility - FedScoop
VA halts beleaguered Cerner EHR project through 2021 to try to right the $16B ship
The Department of Veterans Affairs scrapped the rollout schedule for its new medical records system for at least six months to overhaul training and fix governance and management problems, recogniz | The VA scrapped the rollout schedule for its new medical records system for at least six months...www.fiercehealthcare.com
VA's $16B Cerner rollout: Go-live delay, leadership change & 14 more things to know for 2021 - Becker's Hospital Review | Healthcare News & Analysis
The Department of Veterans Affairs said in July that it was pausing its EHR rollout with Cerner for the rest of the year while it reevaluates the cost of the launch, its training program and more.
That was the exact phrase I was going to single out to say--is that even a legitimate collection of words?
You know what the really funny thing is? Even though that phrase is a perfectly-crafted bit of bureaucratic gobbledygook that, essentially, is them 'casting a spell' on their audience (they think) in order to attempt to fool them into believing that they are actually going to be accountable in the future (we all know that is not true).........I know exactly what they are (falsely) promising. It's the same thing they have failed to do (already) even prior to any kind of 'new' EHR rollout: get feedback from the providers (the end-users) about the inefficiencies, headaches, dead-ends, redundancies, and various other self-injury-inducing aspects of our daily workload and documentation systems so that we can smooth out the corners and make life manageable for providers. I have always said that we need to hire a few human factors psychologists to assess and give feedback on the entire system. But if they have NEVER done any of this before, why would I think they would do it now? They seem inclined to drop all kinds of wonderful speech in front of Congress and the TV cameras. I'll believe it when I see it.
Is this a thankless job? yes
Haha! I appreciate the honesty.
As demanding as full-time clinical work can be at the VA...I find the demands of clinical practice far more tolerable than dealing with just about everything and everyone else in that system. At least the identified clients have a bona fide excuse for their crazy and a formal treatment plan.
I'm not sure I'd recommend the DBC as the best thing to get involved in as your first extra activity at VA, unless disruptive behavior is an interest or area of expertise.
Good advice. You don't want to be all 'gung ho' with idealistic visions of serving the noble mission shoulder-to-shoulder among a "Band of Brothers (or Sisters)" only to discover--too late-- that you're playing out a dysfunctional and political "Game of (Potty-) Thrones." Of course, which HBO Series predominates at your VA may vary with the personalities and people involved. Best to get a sense on the casting before signing on to play a role in the series.
Right. And replace 'pieces of flair' with political feel-good slogans and hashtags in your email signature.
We should get some honest ones:
That sounds awkward and would make me feel uncomfortable during the transition. Glad that things worked out for you 🙂
Hi Shiori - I have some thoughts about this. Even as a POC, I think cultural humility is extremely important because as you know experiences across groups and even within group members are never the same. More importantly, their perceptions of those experience can differ. So I use the opportunity to express this awareness, and my understanding of intersectionality, and then emphasize my work collaborating with the patient to formulate an individualized case conceptualization in order to provide personalized care for everyone's unique needs. I discuss listening with an open ear and my efforts to not make any assumptions about a person, their experience and perspectives based on my understanding of their histories. So I think balancing this humility/curious/individualized approach with your ability to validate minority stress and build strong alliances could be an effective approach (if it feels right to you).
I should have mentioned that the current chair of the DBC was a previous mentor I have a good relationship with and enjoyed working with, and I also have a background in DBT, so I didn't just close my eyes and pick the first committee I pointed to and was like, "That's it! The Disruptive Behavior Committee is THE ONE."
To add to this, I typically respond by saying that “POC” is a broad category, and we all have different experiences based on ethnic identity (including within racial categories) as well as things you mentioned like location, or other aspects of identity like gender and sexual orientation. I’m used to being requested by clients initiating therapy, and we tend to speak about similarities and differences between us. Even if we have the same racial and ethnic identity, gender, age/generation, and where we grew up play a huge part in our values. We may actually be worlds apart.
Not as awkward as when the employees I was onboarding/training found out I was leaving. Just a part of life. I was there for several months after the offer and tried to leave everyone in a good place. My boss understood as it was more money for less work.
Ugh, you have nothing to apologize for. I am truly sorry for "white-splaining" talking about diversity to you. I read back your original comment and see that you didn't actually ask for any advice and were more reflecting on the discomfort. That was my mistake. Still learning.
No need to apologize, I understood what you meant! It’s a tough situation to navigate professionally.
I fumbled the diversity questions in many interviews until post-doc. It made me very uncomfortable in trying too hard to provide an answer that was not going to make the interviewer and/or the interview panel uncomfortable. With great effort and internal struggle, my answers were often superficial and performative as if they were scripted (they were not. I was just trying not to say the wrong thing). During a meeting in my post-doc training year, the training committee solicited feedback from us about how to enhance their interview process for the upcoming year cohorts of interns and post-docs. I finally gathered enough courage to gracefully verbalize my situational discomfort as a clinician of color when answering diversity questions during interviews. I respectfully shared a perspective from my minority status. I pointed out that when these interview questions were formulated from a majority position, it puts clinicians of color in an awkward position as our perceptions of diversity differ and depend upon where we stand in our subgroup or intersection of subgroups. I also suggested the training committee to read the Location of Self, which I attached here. I regretted that I should have taken the risk to share my insight sooner as my feedback was well received by the committee.
This is interesting. I also get weirded out by that talk. I think, for me, when people talk about "the meaning of life" I always go to social connection. My research was also in socioemotional functioning. So I find myself drawn to working with those who struggle with social alienation, disconnection, and emotion dysregulation...so, Veterans. Lol
Interesting. It's been said that, "The logical conclusion to intersectionality is individuality; the individual is the ultimate minority."
Yes, I've been on both ends now too and have gotten to give feedback both as a trainee and an interviewer that "standardized" questions often miss the mark and make nervous interviewees work harder to actually convey their expertise and answer the actual intended question. It's like RVUs and grids. It works for some people well enough, but it's terrible for others. It's also frustrating to be asked these same questions by literally the same people who ask for my feedback in the first place because 1) it was scary to share feedback with people who evaluate me and 2) they didn't use the feedback anyway. The VA is slow and cumbersome, but we've been venting for 28 pages for a reason.
Sometimes, it makes me wonder if people contribute to this forum could be my colleagues and supervisors. Would we interact with each other transparently? Thanks to Fan_of_Meehl for starting this space for venting and honest discussions.
Wow, awesome post. I feel like I get 1000x more out of a single, heartfelt relation of an individual's experience in this area than I get out of 1000 PowerPoints, lectures, or book chapters. Thank you for putting this out there.
