Thursday, October 25, 2012

Veterans, PTSD, and Simple Customer Service (Wouldn't it be nice...)

It seems best to start with my husband's Facebook status from last night.  It alone will get my point across (but of course, I'll have to add my two cents :) ):

"Well I went to the VA today. For a shrink appointment but at the check in was told that my doc wasn't seeing anymore patience because she has been promoted. I never got a letter or a call. So the VA mental Heath dept. has yet again canceled my Heath care. I don't have a social worker anymore because he's to busy to care and don't show up for group meetings. Are when he's there he leaves early saying he got work to do. Now I don't even have a shrink and cant get my meds anymore. people wonder why Vets do the things they do. We can't get help from any where. We are truly alone in our fight. NO HOPE."

In the past two years, my husband... a hero with severe (VA's words) PTSD and well as Traumatic Brain Injury has been shuffled through FOUR different people to handle his psychiatric medications.  For anyone, changing doctors constantly is at the very least uncomfortable... but for a Veteran who has to really, really, *REALLY* work at developing any sort of bond, it's almost catastrophic.

We wait for months to get appointments, when we are able to get them they are often first thing in the morning (which, for those of you who don't live in our world of PTSD, TBI, and the related sleep issues, can present a monumental challenge) despite my continued pleas to make sure that he is scheduled no earlier than 11:00 am so that I, as his wife and caregiver, have the best possible chance of getting him there on a "bad" day, and then after seeing someone once or twice, without notice, explanation, or an opportunity to see the current physician a last time, we are unceremoniously swapped to someone else.

His first psychiatrist in our current VA system was actually good.  We saw her once a month.  She listened.  She didn't balk at my hubby's sarcasm and she sort of got our odd sense of humor (a coping skill we've developed over the years).  But, she was moved into the C&P department.  That time, however, we did at least get one last appointment for her to explain to my husband what was happening (an ideal move in a less than ideal circumstance).

Then, we were assigned to a psychiatrist who barely spoke English.  I don't say that to be cruel, I mention that because it meant the two times we were able to see him (one time that he forgot to even put his notes in the system and my husband was recorded as a "no show" despite the fact that we'd spent 30 minutes in his office), the conversation was almost impossible.  It consisted of me explaining what medications we had tried, including some that had caused really *BAD* reactions, and then him re-prescribing those medications.

Then, for a short time we were able to see the Nurse Practioner who does double-duty in our VA's TBI clinic and in the mental health clinic.  In many ways, this worked well because she's familiar to us (we see her quarterly in the TBI clinic), but in the State of Alabama she can't prescribe certain types of medications (including some of the hubby's sleep/anxiety stuff), so while she could help with some things, she couldn't cover everything.  She also explained that in our VA it's not "preferred" for there to be a crossover between the two clinics (the same provider seeing a patient both places), though honestly that doesn't make a lot of sense to me... especially when you're dealing with Veterans who need consistency to a greater degree than most.

So, then we got assigned to yet another psychiatrist.  This one, thankfully, was actually pretty good.  But, since our mental health clinic was short staffed by this point, it took 3 - 5 months to get appointments with her.  We had the first appointment, the next was scheduled for 8:00 am on what ended up being a horrible PTSD/TBI day and we had to cancel, that appointment was re-scheduled (almost 3 months later) for yesterday... and now we're back to the start of the story.

Honestly, in dealing with ANY hero... but especially when serving heroes with mental health problems... good old fashioned customer service should be the first order of business.  There's a lot of this scenario that can't be fixed overnight (understaffing, high turnover, etc, etc, though there are initiatives in place to hire more providers but in all honesty that may take years at best to trickle down), but simple CUSTOMER SERVICE can be fixed.

  1. If a provider is leaving or changing jobs, that provider should meet with patients at least once more to explain and if, at all possible, introduce the Veteran to the new provider.
  2. If there isn't time for a provider to meet with patients, then someone else that Veteran is familiar with should be tasked to do that job.
  3. Veterans should also be notified... not with just some computer generated form letter... but with a signed letter AND phone call explaining what is happening and what steps are being taken to ensure their continued care.
  4. When a provider leaves and a Veteran already has an appointment scheduled, that Veteran should AUTOMATICALLY be assigned to a new provider and an appointment scheduled to prevent any lapses in care.

This is basic stuff.  And, in any situation where patients are choosing to stay with or move to a different "civilian" provider or clinic, these steps are in place.  When there is a concern about patients/customers leaving, there is an emphasis automatically on customer service because it impacts the profitability of the business and the wallet of the physicians involved.  While that may not be the case in a VA setting, we should be so much MORE dedicated to going above and beyond in service to the "customers" because those customers have literally laid their lives, bodies, and minds down in service to us.

So, we do have another appointment scheduled with yet another provider... a month away... more waiting... more hoping and praying for my hero and others like him not to give up.  If we really are going to start making a dent in the growing suicide, divorce, substance abuse, death, and destruction being left in the hearts, mind, and homes impacted by combat, we have to start the places that can be changed NOW and keep working towards the long-term changes needed overall.  To put it simply, our heroes don't have years to wait for people to start getting this right.  By then, they will have lost hope in a system put in place to help them and we as caregivers will find it nearly impossible to get them to the resources they need. 

Hoping (and praying) for better,

Brannan Vines
Proud wife of an OIF Veteran
Founder of FamilyOfaVet.com - an organization dedicated to helping heroes and their loved ones survive and thrive after combat with real world info about PTSD, TBI, and Life After Combat!

 


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