Part of what any good health-care professional does, including an advanced-practice nurse, is know when it is time to seek help from more experienced professionals. I'm a primary care doctor. It doesn't mean I know everything. When something is beyond my competency or expertise, I seek consultation from my colleagues.
I don't believe that the problems in the VA are necessarily about money. When I look back over the problems of the VA over the past decade, this is fundamentally a system that hasn't kept up with modernization in the way that the rest of health care in the private sector has.
If there is evidence that an employee has broken the law, caused harm to veterans, or have violated the public trust, they should be terminated immediately. Instead, due to overly cumbersome and lengthy arbitrations as well as extensive bureaucratic red tape, VA has not been able to remove employees as quickly as we would have liked.
