Thursday, May 4, 2017

Healthcare Inspection—Environment of Care and Other Quality Concerns, Cincinnati VA Medical Center, Cincinnati, Ohio - Veterans Affairs Office of Inspector General (OIG) in Washington. D.C., United States for Thursday, 4 May 2017

Healthcare Inspection—Environment of Care and Other Quality Concerns, Cincinnati VA Medical Center, Cincinnati, Ohio - Veterans Affairs Office of Inspector General (OIG) in Washington. D.C., United States for Thursday, 4 May 2017

Healthcare Inspection—Environment of Care and Other Quality Concerns, Cincinnati VA Medical Center, Cincinnati, Ohio
OIG conducted an inspection at the request of Senator Sherrod Brown to assess allegations concerning the environment of care, emergency airway management (EAM) of patients, and clinical practice by a former Acting Chief of Staff at the Cincinnati VA Medical Center (facility), Cincinnati, OH. We were asked to determine whether: Clean and dirty materials were stored together in the same location after an OIG 2015 recommendation to store clean and dirty materials separately; Reduced availability of EAM providers may have led to a “close call” [delayed intubation of a patient]; Deficiencies regarding the former Acting Chief of Staff’s professional clinical practice had been identified by the facility during peer reviews or Ongoing Professional Practice Evaluations. We substantiated that clean and dirty patient care equipment items were stored together in the Community Living Center following closure of an OIG recommendation made during a review of the facility in October 2014 (CAP Review of the Cincinnati VA Medical Center, Cincinnati, Ohio, Report No. 14-04215-99, February 4, 2015). We did not substantiate a reduction in availability of facility providers for EAM or a delay in the intubation of a patient. We did not substantiate reported deficiencies in the clinical practice of the former Acting Chief of Staff. We recommended that the facility Director ensure that clean and dirty patient care equipment items are stored separately in the Community Living Center, that managers monitor compliance, and that monitors include shower litters and wheelchairs as specific items.
All other inquiries can be directed to vaoig.reportsstaff@va.gov.
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The many ways being a military nurse ‘keeps you on your toes’ for Thursday, 4 May 2017 from Military Health System in Washington, D.C. United States


The many ways being a military nurse ‘keeps you on your toes’
Army Maj. Lani Pineda will never forget the day she helped her flight medic evacuate a young girl who had been hurt by an improvised explosive device in Afghanistan. Seeing how bad the injuries were, they knew they needed to get her to a hospital quickly. The child saw the distraught look on the flight medic’s face as he hovered over her. Despite her own pain, the young girl reached up and placed her hand on his face to comfort him. There, in the middle of a war zone, Pineda witnessed a gesture of pure compassion that she never imagined she’d see.

The many ways being a military nurse ‘keeps you on your toes’
Maj. Lani Pineda, an Army nurse in the Washington, D.C. area, shares insight into her experience as a critical care nurse in Afghanistan in 2013. There, she helped transport wounded warriors from the point of injury to the hospital. (Courtesy photo from Maj. Lani Pineda) bBy: Military Health System Communications Office
Army Maj. Lani Pineda will never forget the day she helped her flight medic evacuate a young girl who had been hurt by an improvised explosive device in Afghanistan. Seeing how bad the injuries were, they knew they needed to get her to a hospital quickly. The child saw the distraught look on the flight medic’s face as he hovered over her. Despite her own pain, the young girl reached up and placed her hand on his face to comfort him. There, in the middle of a war zone, Pineda witnessed a gesture of pure compassion that she never imagined she’d see.
“It was really emotional to see this tiny girl who had gotten hit, and she was an innocent person in the war,” said Pineda. “My flight medic later told me his daughter was about her age, and so it was hard for him to witness that. Just going through those kinds of things makes you appreciate what you have.”
Pineda, like many military nurses, wasn’t just a caregiver in that moment; she was also a counselor to her fellow soldier. Military nurses are part of a versatile group of well-trained and well-educated professional leaders who take care of the people around them, both at home and on the front lines. During National Nurses Week, the Military Health System is highlighting the diverse places our nurses serve.
“Being a nurse in the military is ever-changing and you have to be willing to adapt at all times,” said Army Capt. Christine Kampas, a brigade combat team nurse who served as the lead medical adviser at a regional hospital in southern Afghanistan. “It keeps you on your toes.”
While deployed in Afghanistan, Kampas oversaw supplies, equipment, and patient-transfer logistics. She also helped with medical training and advised a colonel in charge of 27 Afghan National Army clinics. The experience taught her a lot about herself – how she responds to the unexpected, teaches, and learns – and gave her opportunities she wouldn’t have had outside the military, she said.
“Be open-minded and ready for different experiences and challenges you wouldn’t necessarily think you would have as a nurse, because you’re not just a nurse,” said Kampas, who will take over as Company Commander for the medical company of the 3rd Brigade Combat Team, 101st Airborne Division. “You’re a soldier, too.”
Pineda got her start in the Air Force and is now a nurse in the Washington, D.C. area. She never expected to continue in the military beyond the four-year obligation she incurred through Air Force ROTC – let alone join the Army. But after working with wounded warriors in Germany, she decided to stay. While in Iraq a few years later, she watched Army helicopters bring in injured service members. She decided she wanted to be part of that mission and transitioned in 2012. A year later, she deployed to Afghanistan where she worked as a critical care nurse attached to a medical evacuation unit. Her job was to transport wounded warriors from the point of injury to the hospital.
“I learned more as a nurse in nine-and-a-half months with my flight medics than I did in nine-and-a-half years as a nurse in a hospital back home,” said Pineda. While it’s unusual for a nurse to participate in pre-hospital medical evacuation, the experience showed her what critical care is truly like and what the flight medics go through, she said.
Pineda’s leadership instincts kicked into full gear one day as she landed at a small base near the front lines in Afghanistan. She and her flight medic had prepared to evacuate six injured service members. But as they got there, they realized the heads-up they received beforehand had a typo: 60 injured warfighters streamed in – all urgently needing care. Despite the glitch, they pulled the mission off successfully with the help of Navy corpsmen.
“It was definitely a team effort,” said Pineda. “The feeling of knowing there are people on the team that are depending on you forces you to put your own fears aside and dig deep.”
Army Capt. Martina Taylor-Campbell, a nurse with almost 20 years of experience on active duty, said many people don’t realize nurses do more than treat patients. Taylor-Campbell began her active duty career as a field artillery surveyor, but shifted her focus within a few years. She entered Army Medical’s Enlisted Commissioning Program for her nursing degree in 2003 and commissioned three years later. In 2015, she deployed to Afghanistan where she commanded a brigade combat medical company. She trained medics for combat zone operations, oversaw treatment for more than 3,000 people, participated in planning sessions, and helped her troops overcome the adversity they faced.
“As a nurse, when you get to go down range, you really understand what military medicine is all about,” said Taylor-Campbell, who is about to start her doctorate in nursing at the Uniformed Services University of the Health Sciences.
Looking back, Pineda said she believes that going through such varied experiences on the battlefield and back home have enriched her career as a nurse in the Military Health System.
“It really makes you appreciate the opportunities you have,” said Pineda. “I’m proud I can serve in that capacity with my troops.”
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Medal of Honor recipient credits military medicine for helping him save lives on, off battlefield
A man who courageously fought the enemy on the battlefield and received the Medal of Honor for his gallantry has a new fight: erasing shame from those seeking help after a tragedy.
“I want to help remove the stigma associated with post-traumatic stress, which is really an instinctive, reflective response of the body and mind to recall a traumatic event in order to avoid repeating it,” said retired Army Staff Sgt. Ty Carter. “You’re supposed to feel upset after a trauma. I want people to understand that they can heal from this.”
Medal of Honor recipient credits military medicine for helping him save lives on, off battlefield
Ty Carter courageously fought the enemy on the battlefield and received the Medal of Honor for his gallantry. Now he has a new fight: erasing shame from those seeking help after a tragedy. (Courtesy photo)
Military Health System Communications Office

A man who courageously fought the enemy on the battlefield and received the Medal of Honor for his gallantry has a new fight: erasing shame from those seeking help after a tragedy.
“I want to help remove the stigma associated with post-traumatic stress, which is really an instinctive, reflective response of the body and mind to recall a traumatic event in order to avoid repeating it,” said retired Army Staff Sgt. Ty Carter. “You’re supposed to feel upset after a trauma. I want people to understand that they can heal from this.”
Carter has his own experience with trauma and the stress that follows. The morning of Oct. 9, 2009, started like many of the others he experienced halfway into a yearlong deployment to Afghanistan. A firefight with the Taliban became the wake-up call for Carter and his comrades at a small outpost in Nuristan province. He volunteered to resupply the shooting positions on the outskirts of the base and wound up getting caught in a fight that lasted hours and cost the lives of eight of his fellow soldiers, with many more wounded. If not for the actions of Carter, it could have been worse. “I made a whole bunch of stupid decisions that helped a whole lot of people out,” he admitted.
Those he helped and their families back home might not agree that any of Carter’s decisions were “stupid.” Among the choices made that day was going back for another soldier injured during the fight, risking his own life as the bullets whizzed by his head and nursing his own wounds from a rocket-propelled grenade that exploded nearby. He gave first aid that extended his colleague’s life, if only for a little longer.
“I tied a tourniquet on his leg, because most of his ankle and calf were missing on one side,” said Carter, also patching up his wounded comrade’s multiple bullet wounds before eventually getting him back to an aid station. “While Sgt. Bradley Larson provided cover fire, I carried Spec. Stephon Mace up a hill [under fire the entire time] to get him back.”
Together, still under attack, Larson and Carter carried Mace 100 yards the rest of the way to the aid station. While their wounded comrade would die on the operating table, it didn’t lessen Carter’s instinct to save a fellow soldier.
“When you see someone wearing your same uniform, fighting to defend you, hurting and in pain, it’s like you’re looking at one of your own kids,” said Carter. “And you’re going to do everything you can to help and protect. He was part of my family, and I knew how to help.”
Carter credited his first aid training learned in the Boy Scouts, as well as what he learned during a previous military stint as a Marine, and Army training about saving the lives of those injured in combat.
“Every time I went through the combat lifesaver class, I took it extremely seriously, and when it came down to making it happen, I just made it happen,” he said.
Nearly eight years after the firefight and four years after receiving the Medal of Honor, Carter has a bigger purpose: educating fellow service members, as well as civilian police and first responders, on getting the help needed.
“I would tell leadership, doctors, and fellow service members to keep an open mind,” he said. “I’m trying to give them the information they need to improve their quality of life so they can learn to cope with their trauma.”
On Thursday, May 4, 2017, Carter will be among those recognized at the Heroes of Military Medicine dinner in Washington, D.C., receiving the Ambassador Award. He appreciates the honor and wants to use the event to communicate how advances in military medicine dealing with post-traumatic stress are helping others. In addition, he’s heartened by how leadership now encourages troops to seek help and not feel weak for asking for assistance.
“Bravado has been killing us,” said Carter. “Now we have a better understanding of what’s really happening; we have a better ability to take care of our own.”
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U.S. Department of Veterans Affairs CMV - News Update
U.S. Department of Veterans Affairs in Washington, D.C., United States for Wednesday, 3 May 2017


In Case You Missed It: The Center for Minority Veterans is sharing recent news stories that may be of interest to minority Veterans, service members, and their supporters on a weekly basis.
[Podcast] #28: Skye Marshall – Air Force Veteran, Actor
Skye talks with us about serving in the Air Force, following her dreams to Hollywood, working with Al Pacino, and more.
#VeteranOfTheDay Anthony L. Johnson
We honor your serivce, Anthony!
Air Force Veteran, table tennis champ set to compete at National Veterans Golden Age Games
Veteran Garfield Adams won five base championships in table tennis during his 22-year military career. At the Games he will compete in table tennis, badminton, 100-meter run and powerwalk.
#VeteranOfTheDay Walter James Dexter
We honor your service, Walter!
Keep updated & let us know how we're doing.
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How to stay the course for good mental health
Military Health System in Washington, D.C., United States for Wednesday, 3 May 2017



How to stay the course for good mental health
Seeking help and committing to treatment for a mental health challenge is one of the best investments you can make. Yet treatment is rarely quick or simple. It demands your time, energy and attention, which can be draining or discouraging.
If you feel treatment isn’t helping, you may consider giving up on medication or therapy, or even decide that you don’t need them at all. But before you throw in the towel, consider these facts about mental health treatment.
How to stay the course for good mental health
Many mental health conditions require treatment and won’t go away on their own. Putting off or dropping out of treatment could cause symptoms to get worse and impact many areas of your life. (U.S. Army photo)by: Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury
Seeking help and committing to treatment for a mental health challenge is one of the best investments you can make. Yet treatment is rarely quick or simple. It demands your time, energy and attention, which can be draining or discouraging.
If you feel treatment isn’t helping, you may consider giving up on medication or therapy, or even decide that you don’t need them at all. But before you throw in the towel, consider these facts about mental health treatment.
Your Condition May Require Medical Help
Many mental health conditions require treatment and won’t go away on their own. Putting off or dropping out of treatment could cause symptoms to get worse and impact many areas of your life.
“Service members are much more likely to preserve their careers if they resolve problems early, before symptoms increase to a point that they impact their jobs,” said Navy Capt. (Dr.) Carrie Kennedy, director of the Deployment Health Clinical Center. “When service members put off treatment or drop out before the symptoms have resolved, they put their careers at risk.”
Depending on your condition, therapy can take as many as 10-12 sessions before you notice improvements. Similarly, it may take some time for your health care provider to find a treatment plan to best address your needs.
You Have Many Treatment Options
There are many options when it comes to mental health treatment. If one method is not working for you, your provider can suggest alternatives.
“Service members, at times, do not feel comfortable asking their mental health providers about certain types of treatment, or telling the provider that they prefer therapy to medications or vice versa, or asking to try something else,” said Kennedy, who holds a doctorate in clinical psychology. “However, when service members work with their providers to get treatment that fits more with their own personal goals and personality style, they often find treatment to be a better experience. Service members should be encouraged to ask questions and to speak up about their treatment.”
Your Recovery Requires Commitment
As with any successful investment, you must actively participate in the process to receive the most impact. To experience the benefits of recovery, you need to stay involved with your treatment. See your provider regularly, complete therapy homework and take medications as prescribed.
Remember, there are no quick fixes when it comes to your mental health. Treatment takes as long as it takes. Consider your recovery process as a long-term project that requires your commitment to succeed.
You are not Alone
Hear from other service members who sought mental health care and get the latest information on treatments from the Real Warriors Campaign. To find mental health resources in your area, reach out to the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury Outreach Center. You can contact them 24/7 by phone at 1-866-966-1020, or via email
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