Cleanliness is Next to Godliness

So Thank you very much
It's really nice to know
That you enjoyed the show
--Thank You Very Much,
Kaiser Chiefs
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O4 0800 Nov 09 Ranger had a lab appointment at the local VA clinic. First order of business was a urine sample, delivered through the little door in the wall, and the washing of the hands. Except for a small problem: There was no soap in the dispenser.

Not at the end of a long day, but the beginning, at the urine counter. Possibly the Department of Veterans Affairs thinks us all West Pointers, and that we never get piss on our hands. Signage everywhere exhorts us to wash our hands, but with what?

Now, the VA says they are cleaning up their act, and promise an end to screw ups like the unwashed tubing used in endoscopies and colonoscopies in VAMC clinics in Florida, Tennessee and Georgia. But no soap in the specimen room doesn't give this former trooper hope.

Everyone used to say the VA system was a crack operation. Negative further.

Shafted

I'm workin' two shifts, eatin' baloney.
Askin' myself, "Why didn't you just learn how to cook?"
--She Got the Gold Mine (I Got the Shaft),
Jerry Reed

A frog in a well shaft seeing the sky
--Chinese saying

Your highness, when I said that you are like
a stream of bat's piss,
I only mean that you shine out
like a shaft of gold when all around is dark
--Oscar Wilde, Monty Python's Flying Circus
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Does the largess of the Veterans Administration know no bounds?

Today's Miami Herald reported the VA will offer free care to vets who might have been infected in Miami hospital. Kind of a tough way to game the system.

Though a U.S. Department of Veterans Affairs letter "pledges free medical care and treatment for former patients who have tested positive for HIV or hepatitis since being exposed to endoscopic cleaning mistakes at three VA hospitals, including one in Miami," some veterans advocates say they are promising nothing that the vets would not have already received. Instead, they are advocating for disability and damage remuneration.

It was discovered in December 2008 that some endoscopes used in colonoscopies performed at VA hospitals in Miami, Murfreesboro, TN, and Augusta, GA, were only rinsed, and not sanitized between uses.

"Investigators with the inspector general's office at the VA testified at Tuesday's subcommittee hearing that fewer than half the VA facilities using endoscopes had procedures posted for cleaning them as well as documents showing staff are trained in such procedures."

"After other VA sites were notified of the problem, 16 reported they weren't following guidelines for cleaning endoscopes" (Lawmakers Slam VA in Hearing).

The VA has been held up in the past as the poster child for streamlined medical care. The medical transgressions were often committed by contract personnel from teaching hospitals in the vicinity apparently unfamiliar with the equipment sanitation protocols.

These grave errors show that the system may not be the well-oiled machine it is made out to be.