In the last five weeks I have heard that phrase delivered with exasperation, anger, humor and more knowing looks than I can count. I am new to the VA and new to serving Veterans. I expected to be green. I just didn’t expect that being “inducted” into the VA would be such a loaded subject for so many people.

I didn’t always know that I wanted to work with Veterans. However, I’ve known since the fourth grade that I wanted to be a psychologist. I knew back then that I wanted to understand and help people, even when they couldn’t understand and help themselves. Easing pain – even just a little bit – one person at a time has always been my personal mission. I was working as the only psychologist in four counties of rural Kansas, focusing my work to help people with Borderline Personality Disorder. I understand emotional pain, and I believe I have a gift for seeing through it to the person locked inside.

In December, that gift brought me to Southeast Louisiana Veterans Health Care System as the new Suicide Prevention Coordinator.  Suicide has become the 10th leading cause of death for all Americans; for Veterans the risk of suicide is doubled. As Veterans come home from Iraq and Afghanistan, it seemed to me that the VA was a good place to pursue my mission of making the world a less painful place, a little bit every day. And to be truthful, when I was in the middle of a job search last year looking for new opportunities, it was the mental health providers at VA who stood out to me as the most compassionate, driven and flat-out competent folk I had the privilege of meeting. It seemed like work worth doing, alongside professionals I could admire.

VA was also the only place I interviewed that embraced my passion for social media as a way to connect providers and patients.  At this time, most mental health providers I know are avoiding Facebook, blogging and Twitter. At VA, everyone I spoke with understood the value of connecting providers, patients and their health care system using personal technology and “new media.” In mental health care we understand it is the relationship that heals, and I knew that I needed to work in a place that understood the importance of life-long patient relationships. A place that would do anything, even brave the Web 2.0 frontier in health care, to do this.

What was so clear to me, as a provider looking from the outside in, was that VA was innovating, while much of the health care community, especially mental health care, was trying to continue practicing 21st century health care using 20th century models and technology. I knew that this was a place where I could pursue my goals for the innovative use of personal technology to improve mental health. This was where the early adopters were, so this was where I needed to be.

So, of course, I wasn’t *quite* prepared to see VA from the inside. “Welcome to VA” became the standard, playful response as I sought solutions to the dozens of administrative snags a new employee will typically experience here. “Welcome to VA” was code for “See what we mean? This system is frustrating.”

What I have learned in the few weeks I have worked here is that there are two VAs inhabiting parallel universes. There is the VA that I saw from the outside: innovative, resource-rich and driven to provide truly excellent care to the Veterans who have earned it. There is also the VA that others see from the inside: bureaucratic and difficult to navigate.

And then there are the providers. When I started out writing this blog, I hoped to include some stories about the amazing providers with whom I work; I discovered that people are so modest they didn’t even want me to share their stories. These are people who usually come an hour or two early, often stay late and go the extra mile to find a new resource for a Veteran who might otherwise slip through the cracks in this system.

I asked one person, “If you won’t let me write about this story, then how will people know?” He told me, “Ask the Veterans. They know who those providers are. They are the best resource you’ll find on the VA. This is where that social media thing you keep talking about could come into play.”

So, perhaps that is the question I’m asking Veterans today. I’m new here, and I’m willing to learn. What makes a provider at the VA outstanding? How do we build strong connections with you? Connections that might save your life or save the life of a Warrior you care about? There is me, there is you and woven around us there is this “system.” How do we build a bridge over it all and connect?

Welcome to VA.

Dr. April C. Foreman is a Licensed Psychologist, serving Veterans as the Suicide Prevention Coordinator at VA’s Baton Rouge Outpatient Clinic. She has a passion for combining social media and technology with traditional counseling practices to provide state of the art mental healthcare for Veterans.

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Published on Jan. 17, 2012

Estimated reading time is 4.4 min.

Views to date: 246


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  2. rc February 21, 2012 at 12:44 pm

    Also i think that when the VA does there C/P exam for PTSD there sould be a family member or close friend present. For alot of veterans exspecially when it comes to the older vets(who knew nothing about PTSD) have held all there demons inside for so many years. They have a very hard time expressing what they endured in just one exam but im sure with the insite of a family member it would make a more correct diagnosis. Not only are the veterans suffering but so are the families. They deserve to be apart of the process.

  3. rc February 21, 2012 at 12:34 pm

    I think there needs to be an on going VA section on PTSD that someone truely responds to ALL the concerns so many have. It seems to many most are not even being replied to. How does that show trust and care when nobody repsonds back with at least some kind of response. I understand there are so many PTSD concerns but whats the point in having this site if nobody is going to respond or try to help with all these comments.

  4. Steven Jacoby February 11, 2012 at 10:17 am

    I have not yet had a good provider in mental health. I requested a new provider at least a half dozen times in the last 4 years. I have been denied. I requested a copy of my records and a list of who has been looking at my records. I discovered my primary MH Doc, was writing my medical notes in a derogatory manner . In the notes he often states his opinions about my character based on his personal bias and prejudice. He imagines events from my past and states them as fact. And his refusal to sign a duty status form resulted in over a month of AWOL and the forced resignation from my job at the VA.

    Good providers! Haven’t seen any here.

  5. will February 7, 2012 at 10:04 pm

    Welcome, Thanks for caring. Hope that caring can continue through out your career.
    First thing to help vets is for them to be seen. Being a patient of the mental health feild in the Va system, I will tell you nothing is worse than being told when you call for an appointment that you appointment is a moth and half away.
    Second, While seeing mental health patients constantly look at their diagnosis. Dont just go with what a previous doctor has diagnosis, while this may seem like a waste of time for most cases, you may catch a mis-diagnosis that may result in proper treatment.,
    Third, when you have a patient and you see them for an hour out of a month or maybe 2 hours. you dont get the whole picture. Providers should also consider talking to family memeber to hear what they see. It will give you a better picture of what is going on. I never understood why that wasnt part of the diagnosis. (Of course with the patients promision for privacy purposes.)

  6. stephen lent February 4, 2012 at 7:57 pm

    I was medically retired from Detroit VAMC C&P. Talk to Dr. Harkirat Singh, Dr Riggio, and Dr McArthur who’re excellent mental health specialists (313-576-1000) working with vets. Take a look at the website (it’s free and deals with PTSD). If you havent seen the Vetnam Veterans & Agent Orange Independent Study Course (It’s in LMS). This information isn’t even the tip of the iceberg of what I have. Aside from I’m a certified Service Officer for the DAV (volunteer), I’ve done a lot of research and have a lot more information I can provide you or any other veteran if they are interested. I can be reached through the Asst Director of the DAV Detroit Office, 313-964-6595.

  7. Mike McQueen January 31, 2012 at 3:13 pm

    Real name…you want an explanation, ask the feller I’m sending you to for the story, he’ll know.
    Justin Striger, Michael E. Debakey, psychologist.
    Draft off of him.
    He’ll more than do to take anyplace I dare!!
    Welcome to The VA.


    • Mike McQueen January 31, 2012 at 3:14 pm

      um, make that Stringer!

  8. daughter of a vet. January 26, 2012 at 12:39 pm

    Ms. Foreman,
    Thank you for your article. I hope you can make a difference for our men and women.
    I have been seeking employment and applying to the VA medical center for a while, I would love to give back to our Veterans.
    Thank you and Good Luck.

  9. B.Rebert January 24, 2012 at 4:16 am

    This is just a thought to consider…

    The trial and error method of prescribing psychiatric drugs that alters our natural chemicals is counterproductive when they are used just to alleviate symptoms. Those symptoms are what the primary care physician needs to know and see to diagnose what’s causing the brain to malfunction.

    The heart’s not working right…see a cardiologist.
    The kidneys aren’t filtering…see a nephrologist.
    The brain’s not functioning right…many times it’s medicate them, send them out the door, and assume they just have an attitude.

    The brain should be treated like the organ it is and not an attitude.
    It could be an injury (accident, etc…), an illness (infection, etc…), a disease (neurological, etc…), a birth defect (genetic, etc…), or substance abuse.
    Prolonged periods of adrenaline spikes and exhaustion cause chemical imbalances that can be treated by an endocrinologist.

    I think an outstanding provider would personally read the results of a test they order, check out and follow up on any medication they prescribe, when they ask a question they would listen to the answer and they would end the appointment on a positive and encouraging note.

    Thank you.

  10. Dana Magner, LPN January 23, 2012 at 10:56 pm

    Congratulations April on the new job. You will be a great addition to the staff there at the VA. You are missed very much by all of us in the midwest, I hope to soon be able to visit you in the Gulf and check out your new office along with enjoying the scenery of the ocean!
    Should you ever get back this way, please do let me know, your knowledge is so valuable and I miss picking your brain and working with you!
    again, Congrats on the new position and I know that they will immediately see how valuable of an asset you are at helping so many people.
    Dana Magner, LPN
    Psychiatric Nurse

  11. Andres Alvarez January 21, 2012 at 5:17 pm

    Since I’ve been in the VA’s mental health program, I’ve had a great therapist who was honest with me, a straight talking, tough, no nonsense woman who knew what and when I needed to be told things I didn’t want to hear but needed to. I used to see this therapist once a month at least, sometimes twice a month. She got transferred somewhere else and that clinic closed (cutbacks, which apparently meant sacrifice mental health).
    The next therapist I had never read my history, told me I had bipolar disorder not PTSD, and I’ve seen her 3 times in the last year.
    That kind of therapy is not what we need. You’re going to have lots of patients, clients, whatever we’re called now. Treat us like a family member so you don’t inadvertently cause undue harm and pain. Treat us like a friend that you want to see get better and better things. Treat us as patients and remember your oath. Just don’t treat us as a job, a necessity to get paid. Most of us will see through that in a heartbeat and your time will be unpleasant for everyone.
    Do good, be open to new options (EMDR, EMDRI, SGB, meds, alt. medicine). Doing something the same old way is not a good way.

    Just one Vet’s ideas. Oh, welcome to a new experience, hoping for a great experience for you.
    Andres Alvarez
    US Army, 1991-2010
    OEF 2002-03
    OIF 2004-05
    OIF 2006
    WTU Ft. Bliss 2007-09

  12. Crystal Dunkin January 20, 2012 at 4:31 pm

    Welcome to VA, Dr Foreman! I am so happy that you are asking questions of your Vets. It’s not very often that we are publicly acknowledged as a “resource”. We are indeed that! I am a Peer Support Specialist, for my Vets. I call all vets, my Vets… I genuinely care for them, as people, and appreciate all that they have done for all of us. I too am a Vet. I have the “lived experience” where you have the “clinical experience”. You need both to really make recovery, especially for Vets, work. It’s proven. If you as an individual, don’t have both, look for it and seek out those peers; incorporate them, our Vets, into your approach. (that’s my two pennies on that)

    I feel that in order for your transition to go smoothly, you tell your Vets about you. If you have military experience or not, up front. It may not seem such an important factor to someone on the outside looking in, but it is very important to most Vets. I’m not saying that just because you do or don’t have this experience, that it will hinder your success. I feel that letting the cat out of the bag, in the beginning, opens that door for open communication. I speak from my own personal experience with my Psychologist. She was new to my VAMC. She had no experience in or with the military…I asked her that right away, because I strongly felt that if she “hadn’t been there, or done that”, that should would not “get it”, or be wholly capable of helping me. I was wrong. She was more than capable, and great, as a matter of fact. If it were not for her and lack of military experience, I don’t think I would be here today. Why is that? Well, she provided me an opportunity to teach her what I knew about the military; to teach her “our language”. She was very open to that, and I feel that was such a great step in the right direction for my mental health and for our working relationship. She and I worked together for about 6 1/2 years. I needed her. She needed me, whether she knows that or not, haha. Well, I don’t see her any longer. I don’t need to, but, she is always available if I do.

    What makes an outstanding provider?
    I say, be yourself. Help encourage me to be myself. Teach me to be okay with things when they don’t go my way. Teach me patience. Teach me that it’s okay to carry all of my emotional baggage. And teach me how to carry it. Look at me when you talk to me. Look at me when I talk to you. Treat me the way you want to be treated.

    As far as making strong connections; I’ve given some pointers, but I really do like the inclusion of technology. Some of our older…

  13. ALB1982 January 20, 2012 at 2:56 pm

    since I work at the VA I would say RUN FOR THE HILLS, and run as far away as you can!!!! But since you seem like the type that stay in the fight here is what I would love to see…….

    The term “bedside manners” that is often refers to a doctor that actually care and listen to their patients is long overdue and overrated. First don’t see the patient as a down and out pitiful person that is only here to increase their VA rating or seek travel pay. Some of us could care less of our/their rating and would like to gain the proper tools to just feeling better (i.e before OEF/OIF).

    1. Don’t assume every veteran is suicidal so try not to treat each patient as though they are. (I understand that the suicide rates among veterans is on a rise but cater to those that fit that bill).
    2. Recognize every time you meet with a veteran for a appt everyday isn’t a bad day, celebrate that the Vet actually had a great day or week.
    3. Be open with your patient while we all know that there are boundaries that must be followed….who wants to talk and open up to a complete stranger?
    4. Don’t look at your patient as though their issue is a horrible disease or illness, that the provider might catch.
    5. Show yourself as being human and have the capabilities to laugh, and be warm towards a patient.
    6. Identify the patient by their first name , no Mr. or Mrs. Regardless of age you are trying to build rapport not sale them a car.
    7. STOP SAYING THANK YOU FOR SHARING, I am not sure if providers are told to say that in psychology 101 but it gets annoying!
    8. You are suppose to show compassion not let the veteran know you have compassion for them, it works better if they feel it.
    9. STOP reading lines out of the psychology books… me we can tell when something has been rehearsed.
    10. We know most of you did not deploy or wasn’t rape so saying “I cannot imagine how tough that was for you”. duh
    11. Stop staring…eye contact huge plus….. staring for the whole 50 mins AWKWARD.
    12. Fluff often it is a waste of time but sometimes it’s ok to get off track.
    13. Let US know who is in charge.
    14. Know the VA is the government…there is no such thing as change in the government “adjust” is usually what happens.
    15. No new groups without completing or fixing the current groups that often times cater to male veterans or suck.

    • stephen lent February 4, 2012 at 8:10 pm

      I’ll disagree with the comment ‘run for the hills’ (although I think it’s a tongue-in-cheek remark) as I fought the suits at John Dingall VAMC and lost (I’m still fighting for the vets, but for the most part, at least at the Detroit VAMC, the care is as good there as at the big HMOs and I use both. I could get away with helping the vets like I did (by am I giving a lousy picture of myself), but I the 4 years I worked at the VA, I received 18 customer service awards and developed an excellent working relationships with other departments all over the hospital that other employees are too ‘good’ to be bothered in doing. I’m still down there ‘pushing wheel chairs’ as a volunteer when I can.

  14. wife of a vietnam vet January 20, 2012 at 2:17 pm

    Welcome April, First i want to thank you for truely caring. I can only speak from our experience with the VA mental health system but i havent seen anything good so far. Ive said this a million times that each individual is going to be different. Example vietnam, yes PTSD to some would think is the same for the new war veterans and they are not. The biggest thing that the VA doesnt get is , vietnam vets had no clue what PTSD was , so they come home different and try to live there lifes but the problem is the life they are living isnt a normal life,but they do there best and try to move on. They have held all there emotions in for a very long time, now they are realizing that there ways of life truely arent normal at all. So they seek help with the VA and the VA docs expect them to just open up and talk(which i understand its there job to do this) but the problem is vietnam vets have a hard time opening up now , since they have lived and held this in for years. It takes a very special doc to reach inside these vietnam vets hearts and get them to express what they have held in for years and years.

    • wife of a vietnam vet January 20, 2012 at 2:33 pm

      I personally know several vietnam vets and almost all of them live there lifes differently then as i would say is normal. No i might not be a doctor but i can tell you that im 54years old and i can honestly say that not one vietnam vet i know can ever talk about what they endured while in combat(not even to there spouses) If you read some of the older vietnam PTSD blogs you will read all stories of so many vietnam vets. What amazes me the most about the VA docs in the mental health care is some of them are very cold shouldered, and a vet sees that right from the beginning, now how do you think the vietnam vet is going to open up, in there minds all there thinking is the VA didnt care back when the vietnam war was going on and they dont care now. Everyone knows that those men and women were not treated with dignity or respect, if anything they hung there heads in shame(and thats a fact) so you really have to put your self in there shoes(which im sure isnt going to be easy, if you havent lived it ) but if you truely care you will find away to reach inside there hearts and listen and help them. They have live over 38years with there heads hung down, im still trying to reach into my husbands heart to this day after many many years , so he can feel that im there for him and i do truely care but im sure in his mind he feels something else but thats because he needs help. To make our story short, the VA doc said yes my husband has PTSD but no stressors, (well duh, i wonder if just maybe he was another cold shoulder doctor ) i would respond most definetly. Well i talked my husband into seeking out a private doctor who specializes with PTSD from veterens. And it amazes me how that doctor reach right inside my husbands heart and got him to open up, but very slowly over time. Once my husband seen he truely cared what he had to say, it opened up even more. This private doctor did the same evaluation the VA doctor did and concluded he is 100% PTSD from the vietnam war and also stated each and every stressor my husband has.So we filed an appeal and sent in all the private doctors findings along with the stressors. Well one would think that would help the VA speed up the claims process, but nope its still sitting in stage one, for 1 1/2 years as if nothing has even been looked at.

      • wife of a vietnam vet January 20, 2012 at 2:53 pm

        This private doctor is currently treating my husband with a couple different meds and counseling. It been a very long and hard road in our marrage, living for years not understanding why my husbands way of life is so different then our family but at least now we know why he is what he is today. It truely hasnt gotten much easier for our family even with the meds and counseling at least not yet. Im trying so hard to except and understand why he is what he is and why i cant sleep in the same room with him because he awakes through out the night, with which i know now are his flashbacks from the war, and why he wont go with our family to the 4th of July VP fair because of all the fireworks, and why he has a hard time being around people and constently feeling on edge, and why he cant trust, love, or care.on and on… I can only hope and pray that with gods graces, he will help my husband with his PTSD and that this private doctor helps my husband heal , so we can try to live a somewhat normal life as a family. I truely hope that in your heart you can reach into all vets, who have endured so much in life. God bless you and your services to the VA. Best of luck to you.

  15. Charles T. Cauthen- Combat Vet January 20, 2012 at 1:42 pm

    Dr. Foreman, If you put a rotten apple in a barrel of apples you’ll get a barrel of rotten apples.A good apple in a barrel of rotten apples will rot too. Don’t illusion yourself, I believe that eventually you will realize that helping veterans in the DVA is just a smoke screen. If a vet calls the VA suicide hotline, why would he call the VA? For help, maybe? would he get that help? Not from the VA, you need an appointment from your VAHC primary, who’s affraid of a vet with PTSD. His function as your primary is to fill in programed computer questions for research on your demise and the debiliating progress of your diseases receive from military service. I wonder how you will feel when you diagnose a veteran with severe PTSD and the VA Regional Claims officer totally disagrees with you and denies the claim. Maybe you should think hard about trying to help vets in a system designed to destroy us. Your efforts may be discouraging being involved with such a corrupt gov. entity, that obeys no laws and answers to no one. Don’t let the VA destroy what you’ve obviously got,” compassion”.

    • Mike McQueen January 31, 2012 at 3:18 pm

      Charlie. Brother I agree with you 100% with one small rebuttle…
      Don’t she at least deserve a chance and our standing behind her? I mean how many have ever ask for your opinion whether they actuall gave a care or not?
      Semper Fi

    • Steven Jacoby February 11, 2012 at 10:26 am

      “Your efforts may be discouraging being involved with such a corrupt gov. entity, that obeys no laws and answers to no one.”

      You are right about that! The Federal Times says that Supervisors and Executive management either “don’t know the laws”, Don’t follow the laws”, or “just don’t care”

  16. Bob Eaton January 20, 2012 at 1:37 pm

    I am a 100% combat disabled vet (PTSD among others), 2 tours in Nam and since 1995 had been seeing VA mental health on a weekly 1-on-1, monthly Psych, and always at least one or 2 groups per week and a myriad of meds. To say recovery is a job is putting it mildly. I am now down to 1-on-1 2X a month with a vet center counselor. I am a peer support volunteer at the Roseburg, Or. VA RRTP Program, and an advocate of music therapy. I am at this stage in my life in large part because of the VA. I am alive and still married because of the VA. So don’t get discouraged rest assured there is hope for those of us who want it and are willing to use it.
    A few tips:
    We vets and the VA system are pretty good at burning the Docs out. This isn’t your everyday downtown Psychiatry, suicidal thoughts are the norm rather than the exception. Your going to hear some stories that go beyond the realm of imagination but are real and we relive it 24/7. Don’t judge us, listen, learn, apply. A good start would be to sit in on as many PTSD aftercare, and anger management groups as you can. Also be skeptical of all the so-called cures and healing techniques. The VA tends to use us as guinea pigs for their experimentation. We are adult human beings (even though we may not act it) and as long as you treat us that way you will eventually get our trust. Word travels fast about the different Docs in the veteran community.
    I have seen many Docs, nurses and counselors come and go most all came in with the outlook you laid out here. Many come for the resume and then leave. Always keep in mind that we are the reason you have this job. In a years time come back and tell us how the job is working out for you and tell your own success stories. Odds are you will have moved on. I hope not, good luck and stick to your convictions.

  17. OIF Veteran/VA Employee January 20, 2012 at 10:09 am

    Another case of a non-veteran being hired, who deep down only cares about government benefits and pay. There’s way too many VA employees who believe the veteran is there for them, when in fact it is the other way around. Thanks to all who never served and considers a veteran a means to a paycheck.

  18. Steve January 20, 2012 at 2:48 am

    What makes a good VA health provider? I would say, “Can Do” attitude when it comes to your patients and the VA. Based on your blog, you already possess this rare quality. Navigating the rocks and shoals over government paperwork… Good luck, you figure that one out you got my vote for President 2012.

    “You don’t manage people, you manage things. You lead people”. Admiral Grace Hopper

    You mentioned something about your local VA staff, modesty, working long hours, and don’t wish to share their stories . That really falls upon you. To initiate formal recognition of your own staff and co-workers for the commendable work being performed. This not only provides just recognition to that individual / team, but further provides visibility to the invaluable work being done. Additionally provides a retention tool to retain qualified staff, and in the end reflects on the overall effective management and leadership.

    Above is example of “help me, to help you, help me”… Everyone benefits, staff, patients, and the VA.

    Doing a Google search on your job description to get a understanding of the scope of your responsibilities. I think its honest to say as a “Suicide Prevention Coordinator”, you are on the front lines of a battlefield most Americans are vaguely aware of.

    You may decide to make the VA a career, or choose to move on to other opportunities. There are many ways to serve ones country. You will be able look back with pride of your service at the VA in providing our veterans life saving intervention and follow on care at such a critical juncture.

  19. Jason Payne January 20, 2012 at 2:06 am

    Ms. Foreman, thank you for serving my fellow Veterans.

    I would like to welcome you to the government, every agency has bureaucracy to weave through. I humbly suggest you decide early on not to get wrapped up in the system, but rather use the means you know already to connect with Vets as humans. Utilizing social media is a good start, several Veterans organizations are using social media to quickly disseminate information to members and to efficiently recruit new members and Veteran supporters alike. If you haven’t done so already go to the Iraq and Afghanistan Veterans of America website and apply for membership as a supporter. You will read blogs, emails and news alerts from the newest generation of Vets and I think being able to read what the Vets are saying to each other will give you a better insight to what you are in store for.

    Please adopt the mentality of the warriors you are going to help…don’t ever give up. Again, thanks for what you do. We need you.

    Respectfully yours,

    Jason Payne
    Veteran, USAF, OIF 2005 & OEF 2010

    P.S. I recently wrote a piece you might be interested in. Here is the link for the blog posted on January 17, 2012.

    • April Foreman January 20, 2012 at 11:03 am

      I have been to several times, and I am *impressed*. It confirmed my guess that many OEF/OIF Veterans will be social media savvy, and that this was a good medium to find and connect with this particular Veteran community.

      I am reading and processing all of these comments and the comments on Facebook.

      It seems as if there is quite a bit of material, and enough for another post. What are your thoughts?

  20. Amy January 20, 2012 at 1:08 am

    Dr. Foreman,

    If you really want to connect with vets, just be honest. Be honest with us and be honest with yourself. In general, vets are keen on seeing straight though a pile of bull.

    No matter what you ever do in your lifetime, you will never know the experience of being in the military. And, you most certainly will never know the experience of combat. I have been obtaining MH services in the VA system since 2005 and have dealt with the range of providers’ personalities. Those that feel they know-it-all upon entering a situation are the ones that prove to be the most frustrating with which to work. Those that are honest with who they are and what they know garner the most respect.

    Being new to the military culture, there are many acronyms, phrases and experiences that is common to military that you will not understand. Do not be afraid to ask questions of your clients. We prefer folks to ask rather than guess (or pretend they know) about something from the military. In fact, there are many times I have discussed military-specific knowledge with a sense of pride.

    I wish you well in your new endeavor.

  21. chris stoots January 20, 2012 at 12:35 am

    What makes a provider at the VA outstanding? How do we build strong connections with you? For just one minute (second), look the patient directly in the eyes and act like you really care what he/she is saying and that you really are listening to that individual. As opposed to taking notes on the computer or paper and continuing to talk over the patient as he/she tries to talk. And then delivering your conclusion based on what you have surmised from other Dr.’s notes and finally presenting your vaguely prepared plan for course of treatment. Which you had already decided before you met with the patient. This is nothing personal, we’ve never met. This isn’t directed at anyone specifically, though many are guilty of it. This is not to diminish the MANY good providers that I have and have had. You may be, “just what the patient ordered”. Good luck to you, and, “Welcome to the VA”.

  22. Dave Hatfield January 20, 2012 at 12:24 am

    As with anything else, many things make a great VA care provider – more than anyone could cover in a short post. From my experiences, the best VA providers know what’s going on outside the VA, and know what’s going on inside the VA, too. I suffer from Gulf War Illness (GWI), and even today there are providers in the VA who aren’t aware of the Federal laws or VA’s rules and procedures on GWI, VA’s own research results on GWI, or on the research being done outside VA on GWI. That’s really inexcusable.

    I also know it’s a challenge to be overwhelmed with veterans who need care in a system without enough providers or resources to keep up. The best providers still seem to be able to make each veteran feel like they’re getting the provider’s full attention for whatever time he or she is with that veteran.

    From my own personal experience learning and teaching leadership, I would suggest to be a great provider you should try to have some fun and joy in what you’re doing, too. What you do is important and success, even partial success, is something to celebrate, so have some fun and enjoy your ability to help some of the best people America has had to offer over the years!

    • Steven Jacoby February 11, 2012 at 11:03 am

      I am having the same problem with GWI. Did you find the Gulf War Guidelines Examination form for the doctors to use?

      I found it but have yet to get a provider who will use it.

      I am still having problems from the illness. I went to the VA 20 years ago and they told me the headaches, skin falling off, and bladder problems were my imagination. So I stopped going. I recently found out they now recognize GWI so I applied for disability and was declined because I had not gone to the VA in 15 years and needed to establish care showing symptoms throughout time.

  23. Frankie Vazquez January 19, 2012 at 11:42 pm

    What makes a provider at the VA outstanding? The challenge there is obviously things continue to change for better or worse and while our new community attempts to bridge our past we need to continue to try to improve our future therefore understanding our values, ethics, and history is where I would start looking in order to be outstanding.

    How do we build strong connections with you, connections that might save your life or save the life of a Warrior you care about? : As we settle in to our final base camp as veterans, we must adapt to our new life the difficulty in that varies from society to society, so connecting is a matter of constructing a social network. A social network much like tutoring services found in many universities and colleges where veterans may be able to express themselves cognitively and emotionally.

    There is me, there is you and woven around us there is this “system.” How do we build a bridge over it all and connect?: Hello, April Foreman the difficulty in providing treatment is found in the nature nurture of each veteran, individually as we become part of a new culture of historians with many similar and different experiences. As we settle in to our final base camp as veterans, we must adapt to our new life the difficulty in that varies from society to society. The changes a veteran experiences is dramatic, and each veteran will handle their change differently, and a good place to continue to look for what you seek is in their society. The challenge there is obviously things continue to change for better or worse and while our new community attempts to bridge our past we need to continue to try to improve our future therefore understanding our values, ethics, and history is where I would start looking in order to be outstanding.

    You can also send me a Face Book invite.

  24. Elizabeth P January 19, 2012 at 11:37 pm

    I am a woman vet. Talk to me like my service was just as important as any man who ever served. Some of my problems are in my head, but not all of them. I had a terrific PA in Mental Health for 6 straight years until he retired. I have a good social worker from the last couple of years, but sometimes she doesn’t “get” me. My PA was a crusty old Vietnam vet who knew what to say. I’m a Desert Storm vet, although I never had to go. Just talk to me. Help me with the system, or find someone whose job it is to do that. I’ve figured alot of that out on my own over the last 16 years, and I know I have to be part of my health care team, but sometimes I have to fight so hard to get what I want, need, and am entitled to.

  25. Brian Allen January 19, 2012 at 11:11 pm

    Thank you. You give a damn or you would be there. Suit up and Show up.Look them in the eye and remember they are some of the most compassionate people on earth. Be tough and don’t be easily offended. Laugh with them.
    Brian Allen grateful veteran.

  26. Bill Moore January 19, 2012 at 10:49 pm

    “What makes a provider at VA outstanding? How can they build strong connections with you? Connections that might save your life or save the life of someone you care about?”

    Work hard at avoiding becoming a ‘company man’ (in your case, ‘woman’), i.e., placing VA priorities above ‘best medical practices’ and human-to-human treatment. Avoid especially VA-trumpeting about how dedicated they are to vets, and how much they care, while simultaneously implementing policies that seem more about empire-building politics, than about giving practical, effective, supportive, easy-to-access aid to the vets and front-line, often overburdened (burned out) primary caregivers/staffs who serve them. The official line of VA communications often seems like the hollow posturing and self-serving rhetoric of politics – hardly surprising given the ‘new, improved’ VA status of cabinet-level agency (there to be used primarily for political advantage and ruling-party support arm, it sometimes seems, rather than caring for them “Who Shall Have Borne the Battle”)

  27. shane January 19, 2012 at 10:47 pm

    Please don’t act like you care about the vet’s problems but really care. As a vet being tried for PTSD i don’t believe that this is happening, I am becoming truly sour with the VA system of treatment, it seems to me that all anyone wants to do is have me take more drugs which i HATE!!!! I believe that there people in the system that care about us vets and what we have gone thru and still go thru, please don’t lose that drive.

    thank you
    Operation Desert storm vet
    OIF X4
    and too many others to count

  28. Ed January 19, 2012 at 10:43 pm

    I may not be qualified to guide you on how to help, but I might as well put in my 2¢. One thing to do is talk to the vet, not at them but to them. If you want to practice find a vet in the family and talk with them. Listen to us, we have a hard time telling what we feel and look for someone to listen Once you open the emotion door all will come out like a giant flood. Watch the vet, especially their face and eyes. My Primary Care (who just happened to be a vet herself) did just those things and recognized a cry for help. She nudge me into getting help. And that saved my life. As far as the “Other” VA goes, there are staff who know how the get thing done. Find them and bribe them, coffee, candy, or even a smile works.
    Good luck, remember your not alone.

  29. Connie Wallace January 19, 2012 at 10:21 pm

    Welcome – and thank you for asking for opinions. I am a veteran and I work at the VA. You are correct about the two sides of the VA – I think that is the first thing to realize if you want to be one of the “Great” providers the VA has. Understanding that the Veteran is often so frustrated by the bureaucratic system – before they even get to the provider – that they sometimes forget to focus on why they are there, the great care they can get, the innovations being made, and the great people inside the system. Once you show some compassion for the red tape they must go thru to get the care they need – then they can see you as the great provider you can be. As far as Mental Health – wow – what a very needed field for veterans – and I think there are 2 hurdles to overcome for many vets. You are correct we need to get past the stigma of being seen as weak if we ask for help. But I also think that many dont ask for help because they think there are people out there who are worse that need the help more, and feel embarrased to ask for help if they have not had it as bad as others they see around them. How do you reach that group? Rather than focus on just the suicide hot lines – what about those who could prevent ever letting it get that far if they got help BEFORE they felt like suicide was the only way out. What about if we offered help for how to handle the stress and the transition from one environment to another and how to handle compartmentalizing your life so that you can do the job you need to do?? Just a thought.
    I sincerely say “Welcome” and hope that others can see that you are another example of the wonderful people we have on the inside – if they could just get past the frustration of the system.

  30. Diane January 19, 2012 at 10:19 pm

    I wish you luck! You’ll need it. I’m a 100% P&T Service-Connected Vet with BPD who served during the Cold War and 1st Gulf War. Never saw combat, but had my share of adversity. The VA system is cumbersome, archaic, and just plain male-dominated and male-oriented. We female vets get what’s left after the men get help. I finally received my disability from the VA, but I get my care in the civilian world because it is more up-to-date and focused on ME, the person. And try to navigate the new online VA website!! Impossible. Without some special passcode, you can get NO information. The people at VA and DEERS are totally inept at helping, too. I am now going to a Vet Center and hopefully will get the help I’ve been searching for. I’m sure there are workers at VA who are there to help, but it seems so many have lost sight of who they are serving — those who put their lives on hold for however long in order to defend this country……we deserve (that’s all of us, men AND WOMEN!!) much better…..

  31. Rebecca Klein January 19, 2012 at 10:18 pm

    Although I am British, my father is American and proudly served in the U.S. Army from 1965-1971. I found out he has been receiving DVDs through the V.A. system and donated from a group called Maybe a mention about them within the V.A. news media would be nice. RK

  32. Jonathan Ledford January 19, 2012 at 11:07 am

    I do not know what to say. I have had PTSD for so many years I really don’t know when it started. I have wonderful people, Bob Carlin, Dr. Strickler who try to help me to no avail. I am not getting better if anything I am getting worse or just stuck in a mental hell. I am working trying to do a job helping veterans file claims but according to my boss I do lousy work and I am just no good.
    Just another sad story I hear these stories from veterans everyday. I feel so bad I don’t even know what I want anymore. I used to want to go to sleep and never wake up but now I don’t know what I want.
    Just wish I could get better.

  33. Bill Rogan January 18, 2012 at 6:05 pm

    Thank you for this opportunity. I think it is very important to understand that the care giver and the care recipient are of the same source they are all citizens of our country, one side would not be here with the other. The recent efforts by the VA are commendable and appreciated. Getting in position to receive services is sometime the challenge, it should made perfectly clear what one needs to do to become enrolled. Just put yourself in the situation of needing help “what do you do?”
    Mental help is even harder because of embarrassment and astigmatism. Society and fellow servicemen must be educated to see that many mental issues are the result of physiology rather then a flaw in thinking or personality.

    • D. Hulen January 20, 2012 at 12:45 am

      Not really sure what these previous comments are about but if you would like to now how to reach A vet. the magic word is TRUST, without it you have NOTHING, truth be known, most vets do not trust VA.

      • wife of a vietnam vet January 20, 2012 at 3:09 pm

        I totally agree with your statement about the TRUST but the question i have is , i wonder why there is no trust ? Someone doesnt just up and say i dont trust you unless you give them a reason not to trust and alot of veterans have been put through the ringer so to speak, so in there minds the VA doesnt care about them, because if they did they would listen and do the right things for all vets and they’re also feeling if they cared, why in the world does it take years and years to get what they so deserve. In the private sector of the medical field, they could never keep there license if it took them years to help someone, so right there they feel NO TRUST. Whats the answer i dont have it but i can only hope the VA try to find away to make it all work out for the best interest of the veterans. I think they have come along way with iraq and afganistan veterans, so hopefully things will continue to move in the right direction for ALL VETERANS.

  34. gene @boutdrz January 18, 2012 at 3:01 pm

    Welcome, Doc! Glad to have you here.
    You have entered into a sector of the medical/psychologicaly society that many people know nothing about.
    we do great work here. your passion to help shines through in your introduction.
    that is your biggest asset, imho. be passionate about the care you provide to our Heros.
    I am an RN at a VA Hospital in New England, and I am also a Veteran. I did not see combat, but served for many years. I suffer from BPD. I have issues that sometimes make daily life a struggle.
    But i have found a few Docs here in our system who are passionate.
    Glad to have found another.
    Feel free to shoot me an email, or look me up in Office Communicator….

    Be Well,

  35. PAUL R WHITNEY January 18, 2012 at 11:40 am






    USN , 1943-1946

  36. Jill Mohler January 18, 2012 at 11:34 am


    I would like to know the educational and credentialing information to be a VA psychologist. I am a veteran with a Bachelor’s Degree in Business and want to switch fields. Any information you could offer would be greatly appreciated.

    Thank you,

    • Tanya Boozer January 19, 2012 at 10:14 pm

      Jill, you have to have at least a Masters in Psychology to be a Psychologist at the VA. A lot of your credits will carry over though. I commend you on wanting to help fellow vets this way, we need more good psych docs that really care.

      Welcome to our family Dr April and thank you for caring. :)

    • Ginny January 20, 2012 at 10:04 pm

      Look at the patient, not the diagnosis. Listen to the patient, most of us have lived the diagnosis for a long time, no one fits the textbook ‘normal’, I know I don’t. I am a nurse, but most patients are not….speak ENGLISH. Don’t assume every patient knows medical lingo! Approach with empathy and compassion, as much as you are sick of hearing me say I am hurting, I am tired of not being treated or heard!! And since not all providers can have the exact same issues as me, don’t tell me I hurt when I do, you are not in my body and I am thankful you are not because I would not wish this on anyone!!!! Just becaue I have PTSD, don’t ASS U ME I am a hypochondriac, or a somatization disorder. I will give you respect if I receive the same in return. A disabled veteran.

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