Podcast Summary: "Shane Claytor - A View From Inside the VA Medical System"

Podcast Information:

• Title: Cleared Hot
• Host: Andy Stumpf
• Episode: Shane Claytor - A View From Inside the VA Medical System
• Release Date: December 16, 2024

Introduction

In this compelling episode of Cleared Hot, host Andy Stumpf welcomes Shane Claytor, a Navy corpsman, Iraq War veteran, ICU nurse, and MBA graduate. Shane offers an in-depth perspective on the Veterans Affairs (VA) medical system, drawing from his eight years of experience, including his tenure during the COVID-19 pandemic.

Shane Claytor's Background

Shane introduces himself with a diverse background:

• Military Service: Joined the Navy at 31, served as a corpsman in Iraq (2006-2007), and later became an ICU nurse.
• Education: Earned an MBA, transitioning into business consulting.
• VA Experience: Worked at six different VA hospitals over eight years, including during the height of the COVID-19 crisis.
• Current Endeavors: Consulting for veteran and disabled veteran nonprofits and developing an app to aid families in making critical healthcare decisions.

Notable Quote:
"I can speak pretty deeply about what goes on at the VA, and I will let him speak for himself as to what I saw, what I experienced."
— Andy Stumpf [00:25]

Experiences at the VA Medical System

Shane delves into his firsthand experiences within the VA system, highlighting significant challenges and systemic issues that impede effective patient care.

Challenges with DNR (Do Not Resuscitate) Orders

Shane recounts multiple instances where patients' wishes regarding DNR orders were ignored or overridden by the VA staff. He emphasizes the emotional and ethical turmoil this causes for both patients and their families.

Notable Quotes:
"He just died in a horrible way... I had dealt with that, me and my brother."
— Shane Claytor [06:44]

"I want the freedom to choose. And I think people should have that early with your loved ones."
— Shane Claytor [32:31]

Systemic Inefficiencies and Outdated Technology

Shane criticizes the VA's reliance on outdated electronic health record systems like VistA and the delayed integration of modern systems like Cerner. This technological lag results in inefficiencies, increased errors, and added stress for medical staff.

Notable Quotes:
"It's like working in DOS as a kid. It's insane."
— Shane Claytor [53:05]

"They're still using Vista... it's literally like working in DOS."
— Shane Claytor [53:55]

Abuse of FMLA and Staffing Issues

The misuse of the Family and Medical Leave Act (FMLA) by VA employees leads to chronic understaffing, placing undue pressure on dedicated nurses like Shane. This abuse exacerbates workload issues, contributing to burnout and decreased quality of patient care.

Notable Quote:
"Half your employees have FMLA, so when it's a busy day and you're getting brutalized, these guys will just call each other and go, oh, it's what? They call in, and they won't come in."
— Shane Claytor [65:55]

Management and Accountability Failures

Shane shares distressing stories of poor management within the VA, including instances of discrimination, lack of accountability, and retaliatory actions against staff who speak out. He highlights a particular case where a compassionate manager was systematically undermined, leaving patients to suffer.

Notable Quote:
"This is criminal. It's trash."
— Shane Claytor [40:52]

Impact of COVID-19 on the VA System

The COVID-19 pandemic exacerbated existing issues within the VA, revealing significant vulnerabilities in patient care and administrative response. Shane describes the chaotic environment, inadequate preparation, and the emotional toll on both patients and healthcare workers.

Notable Quotes:
"It was impossible to get good sleep because every two hours they come in and say, hey, how are you doing?"
— Shane Claytor [08:18]

"It was like a war zone. Pumps were going off all day long. We were intubating patients left and right."
— Shane Claytor [69:57]

Conclusions and Recommendations

Shane advocates for comprehensive reforms within the VA medical system, emphasizing the need for:

• Modernized Technology: Immediate upgrade of electronic health records to enhance efficiency and reduce errors.
• Stricter Accountability: Implementing robust oversight to prevent abuse of leave policies and ensure management accountability.
• Patient-Centered Care: Prioritizing patients' wishes and providing genuine support during critical healthcare decisions.
• Elimination of Bureaucratic Obstacles: Streamlining processes to facilitate timely and effective patient care.

Notable Quotes:
"You have to have standards and you have to hold people accountable and you have to be willing to shed light on the issues."
— Shane Claytor [137:22]

"The patients are the ones that suffer. It's brutal."
— Shane Claytor [134:22]

Final Thoughts

Shane Claytor's candid recounting of his experiences sheds light on the profound challenges within the VA medical system. His insights underscore the urgent need for systemic reforms to honor and effectively care for veterans. Shane's dedication to improving the system through consulting and app development reflects his ongoing commitment to making a positive impact on veteran healthcare.

Closing Quote:
"At the end of the day, the patients are the ones that suffer, and they suffer greatly."
— Shane Claytor [137:22]

Note: The timestamps provided correspond to the moments within the transcript where the quotes were made, offering listeners precise references to key points discussed during the episode.