Orlando VA Celebrates Their Successes

The Orlando VA has been on their journey for over three years in a variety of ways. What I find interesting is the scoring I see in some of the “culture change surveys/artifact tools.” I don’t think the artifacts of culture change do them justice because as they create new ways to do things and do institute culture change as they understand it, it isn’t necessarily measured in the survey/artifact tools; because they are creating the mindset, the ways, the process of culture change that have meaning for their community. The tangible symbols aren’t necessarily available. They work at the process and have a focus on that rather than the cosmetic, for their culture change. What their chief nurse was eloquent in pointing out was that the cosmetic doesn’t sustain, unless the mindset is there…

Do they have issues? Well, heck yes. Are they human? Well, yeah – that’s why there are issues – proof that indeed where there are human beings there are issues! But given issues, speed bumps along the process of cultural transformation, challenges and barriers, comes the willingness to challenge themselves and the process itself, and grow as individuals and as a team. Is there anything else more important? Because it is never about me as a consultant, the VISN heads and their directives, or the VA system; it will always be about the people who make up the VA community itself.

What they show is a true transformational foundation related to their willingness to do the self examination, face the barriers that come up, resolve conflict; discuss the emotional impact of change. In the ways they listen to each other and the residents, in the questions they ask each other, and in the dialogue they create, a true foundation is created for affirming person centered experiences.

Cultural transformation doesn’t require “tasks” to be met (the focus some choose to have to create markers of “proof” of culture change) or perfection to be attained. It asks only to open the door to possibilities of person centered care for those who live and work in a community. Being human means being messy – accepting every individual comes to culture change in their own way in their own time, or not at all: culture change is a mindset and this defines each community’s journey…because it is THEIR own journey, created by those who live and work in that community.

The ripple effect – open the door to possibilities – and by simple virtue of that – things take shape. Maybe not the way expected, but in a way that happens. Change is inevitable – growth is optional; what you visualize today you either achieve or don’t but it creates movement one way or another. The Orlando VA has many successes to celebrate.

A female veteran was sitting in the dining room in a wheelchair with a staff person and another veteran, a man wearing a baseball cap adorned with many medals and pins. She called me over and told me, “When they bring me in here I ask to sit with the man with the red hat, because he represents my country, and that represents my God.” She went on to tell me she had been a staff educator at a VA hospital “back in the day,” and I could tell as she told me stories that those times remained important to her and I really liked that the staff encouraged her to share that sense of self and celebrate what that represented to her about her own identity (though I have a sneaking suspicion they had heard many of those stories before).

I was also humbled on this visit because I had a staff member who is one of the community’s biggest culture change supporters, suggest to me that the staff be asked what they felt would be the most effective next educational component!! Oh my! Didn’t that make the best sense? Here I was asking the leadership to decide the next educational step, and they were putting it back in the hands of the people who were the most actively impacted! And I had just done an educational piece on EMPOWERMENT!!! Oh my! It was time for me to re-listen to myself!!! Grasshopper had now surpassed the Teacher! Thank goodness! Because that is the point: define for yourself the journey, define for yourself the most effective steps, identify the barriers/challenges, the successes, parameters, expectations, and goals from the vision and mission as you created it.

Choose your next steps and use the resources at hand. Embrace the process! I loved it! Yes, I share my recommendations as I see what I see in the community, but I also am aware that this is not my journey. I just get to share a portion of it: for that I appreciate the Orlando VA. I will be a better educator because of that. And I also know that the daily life experience for the residents and staff will be better and more life affirming because of this process that they are making come to life. And isn’t that, really, the point?

-- Rhea L. Schneiders, Associate Educator/Consultant, IfCE