Sunday, June 13, 2010

The Proposal

The problem, of the lack of treatment for wounded soldiers, started at the Walter Reed Medical Center, so the Army came up with a solution of opening the Warrior Transition Units. In the hast of opening the Warrior Transition Unit the Army did not plan ahead for the services needed to treat the returning soldiers from Iraq and Afghanistan. Soon the Warrior Transition Unit were full of soldiers needing medical attention for physical wounds that they had received during the war that they were in. These are the easer patients to provide services for the care that they need is quite apparent. The other soldiers that are receiving care at the Warrior Transition Unit are in need of psychological care recovering form traumatic brain injuries and post traumatic stress disorder. These patients are much harder to treat because of the lack of physical injury.

After restructuring the care for the wounded the Army came up with the Triad of care system. It was better than the Walter Reed Medical Center system but still lacks the needed care for the soldiers. The Primary Care Physician would have a case load of two hundred patients to one primary care physician. The Squad Leader (a non-commissioned officer serving as the primary link to the chain of command) would have a ratio of ten soldiers of on squad leader. The Case Manager (responsible for collaborative process of assessment, planning, facilitation, and advocacy of options and services to meet the individuals health needs) would have a ratio of one case manager to twenty patients.

How can this plan work? It looks good in writing but look at the numbers this is a unrealistic amount of patients for anyone to be able to handle in a hospital setting. One Doctor, with a patient load of two-hundred patients on daily basics, how can this be acomplished? One nurse trying to take care of twenty patients, this is at least in the grasp of being able to be accomplished how long before this professional burns out and no longer cares about the people that he or she is caring for.

The biggest problem facing the Warrior Transition Unit is the lack of Primary Care Physicians if the Doctor worked every day of the month, the Doctor would have fifty-four minutes per patient. That is thirteen minutes and thirty seconds a week. These numbers reflect if the doctor is working twelve hour days and does not take a break, and has his patient come to the Doctors office. The Army needs to have more Doctors at the Warrior Transition Unit how can anybody be treated this way for anything that they would be in the hospital for. If the Army would have made the ratio one Primary Care Physician to one-hundred patients this would have given the patient forty-five minutes a week with the Doctor.

The case manager (the patients Nurse) in charge of care of the soldiers has a little more time to spend with the patient but not enough to be effective. The nurse is responsible for medication management making the patient’s appointments and general care of the soldier.

The squad leader has the best because the squad leader has only a few patient that they are in charge. The squad leader should know the most about each of the patients that they are in charge of except most of the squad leader have no or very little medical training so the squad leader is not very efficient connection between the nursing staff and Doctors.

The Warrior Transition Unit needs to increase the number of Doctors and Nurses that are responsible for the care of the soldiers, the squad leaders need more medical training, so that they can become an effective role in the recovery of the patients.

The Warrior Transition Unit have become a dumping ground for the soldiers who are being discahged from the Army. The Army is looking for a place to hide these soldiers until they can dump the wounded soldiers in the lap of the Veterans Administration medical system. Who is this helping? The Army they can discharge the soldier and not have to worry about the care that the soldier needs to receive.

Thursday, June 3, 2010

Cause and Effect

The Walter Reed Medical Center came under fire by the press and the public for the lack of treatment of the soldiers returning from the wars in Iraq and Afghanistan. So the quick fix was to create a new system of care for the soldiers. This was well received by the Army and the communities. The Warrior Transition Units were a well received at first.

After the Warrior Transition Units were running for a few years they are now getting the same scrutiny that the Walter Reed Medical Center was under fire for. Now the Army is trying to fix the same problem that existed when they first started the program. The Army is doing a better job at healing the wounded at the Warrior Transition Units and the care the soldiers receive is better than it was in the past. But the cause created an effect and the effect is causing a cause. The Army is running in a circle with the treatment of the wounded soldiers.

Tuesday, June 1, 2010

What is the Army doing at the Warrior Transition Units

The Society of the Federal Health Agencies(AMSUS) interviewed LTG Eric Schoomaker, MC., USA. In his interview we have failed to provide all the safety nets needed. LTG Schoomaker also said the Army has taken lessons and worked to transform the ways soldiers receive care. The Army has taken a lot of the lessons learned and improved the way that they care for the soldiers are being cared for at the warrior transition units.

The Chairman of the Joint Chiefs of Staff, Navy Admiral Mike Mullen is concerned that many soldiers are in too big of a hurry to their lives back to normal that they may not be telling the health care professionals all of the problems that they are experiencing. The Warrior Transition Units need to make sure that the soldiers are receiving the care for Post Traumatic Stress Disorder (PTSD) and Traumatic Brain Injury's (TBI).

General Chirarelli defended the Warrior Transition Units in an interview by the New York Times saying that they are really, really new units, and we learn everyday. Also pointing out that 80 percent who passed through the units have been satisfied. General Chiarelli added we are going to try our darnedest to get better than that, but I don't think we'll ever get up to 100 percent.

Everybody is defending the lack of care as this is a new unit and we are learning from our mistakes. As you can see from the leadership of the Military that they are working on the problems in the units and trying to fix the problems.

Friday, May 28, 2010

Warrior Transition Units Good or Bad

So through my researched I was almost ready to change my stance on the subject of the warrior transition units. but the more I researched the more I became aware of the major problems with the Warrior Transition Units. With a 20% failure rate that is pretty bad. If i went to the Doctor and was to receive a vaccines and the Doctor sad there is a 80T% chance of the shot working and the other 20% will kill you. Will you be willing to take that shot.

As i started t looking deeper in the subject and what the Army is doing it almost had me convinced that the Warrior Transition units are a good thing and not as bad as had thougth. some of the things that the Army has done to improve the quallity of care given but it is not going to solve the problems that the returning soldiers will face. with only one Doctor for every two hunderd patiens the care will not improve

Tuesday, May 25, 2010

A Messy Bureaucratic Battlefield leading to the Perfect Storm

Wow some terms that are being used in the topic of the Warrior Transition Units. Lets start with "Messy Bureaucratic Battlefield", a soldier gets medevaced from Iraq. The soldier ends up in a Warrior Transition Unit, he has no uniforms they are all still in Iraq. He has appointments to attend and functions that are mandatory for him to attend. The soldier submits the paper work to get new uniforms it get lost. The poor soldier is sent in circles trying to get it straightened out but to no avail. He has to start the process all over. What if it is his discharge paper work? It happens all the time. Or what if the soldier has had his leg amputated and gets orders to go back to the war what a paper work nightmare that is.

This has lead to the "Perfect Storm" Inconsistencies in the leadership and management of Soldiers, inadequate facilities, conflicting interpretations of laws and regulations, and a host of other factors that were not readily visible to Army leaders. One small mistake on the leadership of the soldier and the "storm" has started. A lost document, miss-communication of what the soldier is able to do or not do what is his or her duty status. This all can lead to confusion and misunderstanding the soldier being sent back to the war instead of home. The list goes on and on. How can the Army stop the storm?

Sunday, May 23, 2010

How do we stop the drugging



Along with all the other problems that I have discussed in my blog another problem is the over use of prescription drugs in the Warrior Transition Unit. The Doctors are handing out pills to the patients like they are candy. The Doctors are not spending enough time with the patients to help them.

The Doctors only spend about forty-five minutes a month with the patients. This amount of time spent with a patient is far below the amount of time that a civilian health care provider will spend with a patient with the same mental health problems. The Doctors at the Warrior Transition Units are only masking the symptoms that the returning soldiers are experiencing, the Doctors are giving large amounts of drugs to keep the men and women under control they are not fixing the problem.


I say stop using so many drugs and start treating the people and get them healthy so that they can return to a somewhat normal life.


Tuesday, May 18, 2010

Soldiers committing sucide while assigned to the Warrior Transition Units

After reading the article, Awol Fort Carson Soldier kills himself in California published by the Colorado Springs Gazette on 23 May 2009. Carlyn Ray Mitchell used deductive reasoning as to why the young soldier committed suicide. Mitchell started with the big picture of Pfc Roy Mason being missing from the Warrior Transition Unit in Fort Carson. The day after Pfc. Mason went missing officials at Fort Carson ask the public to be on the lookout for Mason and the red Cobalt he had rented.

Mitchell tells of the two tours of duty that Mason served in Iraq, from August 2004 to July 2005 and October 2006 to December 2007. That he was a fomer member of the 4th Brigade Combat Team, many of the members of this unit have been involved in homicide and suicide cases in the last couple of years.

Mason called 911 at about 1:20 P.M., told them were to find his body, and they should come quickly so the children would not see him. When authorities arrived they found him dead in the car that he had rented and the gun that he used to kill himself still in his hand.