steve cooper prostate cancer

Veteran Steven Cooper won his malpractice case against Phoenix VA for misdiagnosing his prostate cancer resulting in a $2.5 million decision.

The federal judge presiding over the case concluded Phoenix VA breached the standard of care when a nurse practitioner found abnormalities during an exam but failed to order additional testing. Veteran Steven Cooper, a 46-year-old entrepreneur, is believed to only have five years left to live.

Lawyers defending VA said the nurse practitioner did not breach the minimum standard of care in part because Cooper never complained of urinary problems. However, that nurse practitioner failed to order additional testing despite noting prostate abnormalities.

Eleven months later, another VA clinician informed Cooper he had stage IV prostate cancer.

The verdict is an interesting one because it holds VA accountable for the acts of a nurse practitioner who performed prostate examinations. It is arguable that had Cooper seen a qualified urologist straightaway, that VA would have caught the prostate cancer at a treatable stage before spreading to other parts of his body.

Hopefully, this case will send a message to VA executives that overstaffing with advanced practice nurses versus hiring doctors will not, in itself, absolve the agency of liability when it fails to provide competent medical services necessary to diagnose and treat any reasonably presented condition like prostate cancer.

Source: http://www.azcentral.com/story/news/local/phoenix/2017/03/06/arizona-man-awarded-25m-medical-lawsuit-vs-va-hospital/98829600/

123 COMMENTS

  1. Undoubtedly waiting time are being falsified. In my case after have a seed implant radiation I started to have great difficulty urinating and some times it took 5 minutes. After seeing the same practitioner in urology twice, In mid November I was told that I might have a blockage and that an appointment for scope exam would be made.but I wasn’t given a date. In February I was informed that the procedure would be on March 27. That appointment was made only after I went to the primary care doctor that referred me to radiology and told her that nothing had been done. I had no opportunity to use veterans choice because I never had an appointment date. When I finally got one after over 90 days, it was still more than 30 days away.

  2. “[Lawyers defending VA said the nurse practitioner did not breach the minimum standard of care in part because Cooper never complained of urinary problems.]”

    So, the VA once again tried to BLAME this on the VETERAN for not complaining of urinary problems? WTF VA? WTF VA?!!!!!!!!!!!!!!

    How about having proper medical personnel instead of WINGING IT you rat bastards! I personally think this Veteran was LOW-BALLED and the VA should be shown a lesson they only understand…give ALL FUTURE BONUSES FOR NEXT DECADE TO HIM AND HIS FAMILY….NOTHING LESS!!!!!!!!!!!!!!!!!

    Damn, this shit pisses me off to no end!

    • So, by the VA’s very own reasoning, a medical professional is still giving MINIMUM STANDARD OF CARE as long as the Veteran never complains about an internal ailment that you may or may not even know about let alone FEEL until it’s WAY TOO LATE? HINT VA: That’s what proper imaging and diagnostics are for…as well as Gastroenterologists and Proctologists….not a Nurse Practitioner that’s FIRST LOYALTY IS TO THE FUCKING AFGE UNION!!!!!!!!!!!!!!!!!!

      Does today’s article answer WHY we cannot and SHOULD NOT TRUST the VA for proper healthcare? The VA will ALWAYS do THE MINIMUM OR LESS. There’s no doing 110% at the VA…they take pride in that 10% metric.

      • namnibor,
        When it comes to the VHA’s nationwide, it’s all about the fucking “BONUSES”, NOT veterans healthcare!
        Until the “Vulture Culture” is replaced, don’t expect to see any changes!

    • nurse practitioner did not breach the minimum standard of care in part because Cooper never complained of urinary problems……….. I will bet he did…….they did it to me before i started using secure messaging and sending my concerns before an appointment but then they still tip toe around it and tell me thats why you get the GABAPENTIN i call it the zombie drug, they think its a cure all, mine goes in the garbage. i have other ways doing it naturally and it works and just got a copy of my blood work so i do have the proof ..just go to GOOGLE SCHOLAR and look up up your concerns some you have to pay for but there is plenty for free

      • @OLDMARINE – Gabapentin is a go to drug for the VA. Side effects of Gabapentin;

        •dizziness, drowsiness, weakness, tired feeling;
        •nausea, diarrhea, constipation;
        •blurred vision;
        •headache;
        •breast swelling;
        •dry mouth;
        •loss of balance or coordination.

        The side effects from Gabapentin were too much for me to handle, since I already deal with weakness, constipation, headache, dry mouth, and loss of balance.

        The VA has never asked me how my medications are working for me. They hardly probe using specific medical questioning techniques. Tacky and weird medical practices.

      • ANUTTERVET More common: side affects of gabapentin
        i felt worse taking the shit then not. but PC said WE decided the benefits out way the side affects. I wonder who the we was. so just add 10 more problems to my list to cure 1. TRUE FUCKING IDIOTS

        cold or flu-like symptoms
        a delusions
        dementia
        hoarseness
        lack or loss of strength
        lower back or side pain
        swelling of the hands, feet, or lower legs
        trembling or shaking

      • ANutterVet, another suse effect of Gabapentin is nightmares.

        Taking them for about 4 days was enough for me.

      • @OLDMARINE, @91Veteran – Fortunately, I stopped taking Gabapentin after one week. I didn’t like the side effects. I come across many Veterans that are prescribed this medication. I can only imagine the amount of Gabapentin on the formulary shelves. I was on 1800mg of Gabapentin per day. Other Veterans that I met, were taking as much as 3600mg a day. Like I said, the VA loves this drug. A pseudo cure all medication.

      • @ANutterVet: Your right, I can’t tell you how many times I have been scripted Gabapenton. I don’t remember the exact reason I didn’t like taking it, but I think it was two fold, one, it didn’t do shit for the pain, and I am pretty shure I didn’t like the way it acted on my mind. Don’t quote me on that tho. I am just not 100% sure, so many damn drugs over the years, I can’t remember what drug did what. Your right tho, I don’t know many veterans at all that “haven’t” been scripted Gabapenton.

      • Allow me to reiterate my VA experience with Gabapentin: Both feet from calves down to feet were swollen about 3x my shoe size, and I know because I had to at that time in my life go to food pantries and free clothing places while doing both my SSDI and VA Svc. Connected Claim and had to grab a ridiculously large clown type shoe in order to go to my VA appointment when I called complaining of the swelling 3 months-in and each time the VA tried to say it was a heart thing…I was also partially State Medicaid at the time so my private Dr. I got into no problem because…I had to go to the freaking ER because the swelling got really painful and only further slap in face because taking it for polyperipheral Neuropathy because the fucking VA did not want to go through the paperwork of at the time, off-VA Pharmacy Formulary, the drug Lyrica, which is a molecule off and expensive.

        Why is it a molecule off and close kissing cousin to gabapentin? BECAUSE the real-world medical and research found years ago a significant # of patients HAD MY DEATHLY SIDE EFFECTS….Lyrica does not do that and has less side effects…

        Know what that VA nurse/hack on the phone told me when I called about I could not wear any of my shoes because of the swelling? “You cannot enter the premises without proper footwear”…..WHAT THE FUCK VA….YOU ARE A H O S P I T A L, not a melba toast factory….or are you? Soilent Green, VA style.

        Yep, I left the VA from that experience coupled with another deathly lackadaisical approach to Infectious Disease as soon as I got Medicare….Bye Bye VA.

        I am doing advocacy for fellow Veterans also out of self-interest to be honest, I want to feel fucking SAFE and utilize the VA and CALL it “MY VA”…not some marketing happy horseshit.

        My private Dr. and Specialist told me that ANY truly trained medical professional would KNOW the classic side effects and deadly at that, gabapentin was doing to me. Her exact words she had to tell me twice, “The VA is going to kill you. You need to get away as soon as you get Medicare”. I did. I am hear writing today because as long as one Veteran is treated like shit and given shitty care because they are shitheads, I will keep advocating.
        Sorry. Rant out. (I’m not sorry one bit) 🙂

      • Exactly the same here namnibor.

        As you know because of my bitching about it, I have health insurance and could go outside for care of my service connected conditions, and have done so when needed and paid what I had to.

        As I said to my Primary care doc when she asked why I don’t just go outside for care of my service connected conditions, I said with the billions spent by this country on the VA, one would think the promise of taking care of service connected medical problems would be kept.

        What I did say was that it wasn’t my insurance agent that was deployed or injured.

        I also figure that even though I might not be the sharpest knife in the drawer, I can at least try hold them accountable for doing the right thing for veterans and to help others if I can.

        As for Gabapentin….whenever I get a prescription from my VA, every vet has to go into an enclosed booth with a pharmacist and be told what the medicine is for, how many to take and when, and what some possible side effects there may be.

        When I got the prescription for gabapentin, I had called to get a primary care appointment for a service connected shoulder injury because I had so much pain I could barely move my arm.

        A few hours later, a nurse called and said it would be a few weeks before I could even be seen, so he said I could come in and get the prescription and see if that helped. He said my pain was nerve pain. He didn’t say anything more when I naively said I would other than to take 1 before bed. He never mentioned side effects.

        I did that over 4 days, started having bad nightmares so I stopped.

        I just looked at the bottle that I still have. It contained 575 100mg pills and says take 3 times a day.

        Yeah, the VA hands out Gabapentin like the Army handed out Motrin.

      • @namnibor: That aint ranting, thats truth telling right there. You hit the nail on the head so many times I swear your were a pnuematic nailer.

      • “here”….and also do note, I have NO heart issues nor any history of such. However, as insistent as the VA hacks were that gabapentin was not the culprit and it was somehow my heart. The VA never once sent me for any heart or related studies/tests. The ER I went to sent me for same but even when in the ER as soon as I said the name “gabapentin”, they KNEW what it was or a high 99% chance that was it, coupled with heaping serving of VA incompetence…the ER’s see it all the time. Sad. Truly sad.

        If you nuked a VAMC from orbit, what would be seen remain standing like a Biblical Pillar Of Salt, the VAMC’s stockpile of gabapentin.

    • Isn’t that a nice treat Nam? Go to the VA to get disrespected, dishonored and jacked around by some fat whale wanting to play doctor, and when the incompetence is discovered and the death warrant is signed, the veteran gets the blame.

      Now, how fast will all kinds of problems arise if a veteran seeing a wanna-be doctor demands to see a real doctor instead? Including DBC flags and escorts everywhere?

      • It might prove prudent to pack a few Twinkies in your backpack when going to the VA and to easily distract the fat whale wannabe dr. in order to see a more qualified one, just toss the Twinkie out the window or a flight of stairs. 🙂

        Never underestimate the power of a Twinkie. Long shelf-life as well. 🙂

  3. The malpractice laws need to be rewritten. The VA is currently operating with impunity and even when they are caught, and put someone’s life in peril, they openly deny fault. Holding employees accountable will better serve those who receive care.

    It’s wrong to literally force us to go to the VA, receive substandard treatment, then hold nobody accountable for atrocities.

    It’s too bad this young man is going to lose his life.

    What say you Veteran Service Organizations? Crickets

  4. This article today is exactly how my “brother” – “Hangman” was misdiagnosed by the VHA in Daytona Beach, Florida. And, on 3/10/16 he “passed”! His wife said, “At the moment he stopped breathing, a smile crossed his lips!”
    At least I knew he wasn’t in any more pain!

    I’m glad, and saddened, Cooper was able to receive $2.5 million for this VHA FUCK-UP!
    Only, money is NOT worth anything, if your held hostage by a corrupt government agency. Especially one which doesn’t give a rats ass about veterans!
    Is that nurse still working there? If she is, that would be a slap onto every veterans face!
    In my opinion, the “Holman Rule” should be inacted just for her, and anyone else responsible, for the FUCK-UP of that VHA in Phoenix! Maybe receiving $1 a day for a year, might just wake that stupid bitch up!

    Rant over for now!

  5. Ben, this is a no brainer. In your article, you stated that the, “nurse practitioner failed to order additional testing despite noting prostate abnormalities.” I noticed that abnormalities is plural, meaning more than one symptom was detected in Steven Cooper. The abnormalities are the indicators that something may be wrong, and warranted further testing.

    And, when the Nurse Practitioner [NP] noticed these abnormalities, besides ordering more tests, the NP should have done a more thorough exam, and asked more detailed questions. A PCP should always engage their patients, and act like a Medical Detective. Something that I’ve found to be lacking with Primary Care Providers working in the VA Healthcare System.

    Just because a patient doesn’t complain of pain or other symptoms, doesn’t mean that something isn’t wrong. Relating to chronic pain in the back, some individuals can handle this type of pain more than others. And vice a versa. An experienced Medical Doctor [MD] would’ve known this, and would’ve taken that into consideration, but most likely would’ve asked Mr. Cooper more questions, and still have ordered further testing on our Brother from the Military.

    I did a simple nonspecific search on Google without using the word “symptoms,” and using the phrase, “is prostate cancer rising in men of America?” On my first search, the first link that came up on the first page was from “www.cancer.org” of the American Cancer Society [ACS], and the first sentence on ACS’s page was, “Other than skin cancer, prostate cancer is the most common cancer in American men.”

    The information about Prostate Cancer was not hard to find. That’s why I said that it was a no brainer that additional tests should have been performed on our Veteran. Shame on this Nurse Practitioner [NP]. Additionally, this VA NP should be terminated from the VA due to this outright negligence.

    I have been concerned ever since I entered that VA healthcare trap, due to the VA having Primary Care Providers [PCP] that are a Physician Assistant [PA], Nurse Practitioner [NP], or a Clinical Pharmacologist [CP] instead of a Medical Doctor [MD]. Even when having a Medical Physician as a PCP, I’m still concerned because the MD most likely isn’t licensed in the State where the VA Medical Center or Clinic is located in which they practice medicine.

    By the PCP being licensed in the State where they practice, this would help to remove some of the protective Federal umbrella from the VA’s PCP’s, and add a small layer of protection in favor of the
    Veterans being treated. The VA was created for the benefit of Veterans, not the AGFE employees.

    As for myself, I will continually to challenge my PCP, a Nurse Practitioner, relating to the healthcare that I receive from the VA. I won’t be surprised if my challenging isn’t misinterpreted as being violent, therefore being put on the Disruptive Behavior [DB] or the EPERS list. The universal guidelines for being put onto one of these lists are too broadly defined.

    May you, Steven Cooper, be comforted during this time in your life. We are holding you close to our hearts, and praying for you. Steven, God bless you and your family.

    • What irritates me about that comment that he did not complain, therefore the Nitwit Practitioner did not order more tests and it’s his fault is the arrogance of it.

      Its the arrogant belief that he should have known how to do her job, and should have known it was his responsibility to complain of certain symptoms to inform her.

      We all know how you could complain of a pain in your back and VA providers would ignore the complaints, along with the knife sticking out of it while asking if you smoke, drink or who pays the bills in your house.

      I take my car to a mechanic to have him fix it. I don’t tell him how it is fixed. He likely will ask questions to determine what needs to be fixed. I don’t just go in there are tell him the radio is too loud, the windows don’t roll down and the left taillight is burned out when he needs to fix the transmission.

      That kind of stupid remark about him complaining suggests every vet should go in and recite their medical symptoms for the last 5 years to see what might cause the light bulb to go on.

      WTF ever happened to her responsibility to ask questions pertinent to his symptoms?

      • @91Veteran – Right on 91. Most VA PCP’s don’t probe Veterans with questions, therefore many additional problems are being missed and overlooked. Veteran Cooper should’ve had more tests performed.

        Like grocery stores, each location has an average amount on how much each customer is spending. I wonder if the VA has an average amount per cost for each Veteran that uses VA medical services. If there is, it could be based off of gender, age, ethnicity, . . . etc.. I’ll bet the VA has some sort of numbers in their databases.

      • Also, with IBM’s Watson super computer in the mix, you *would think* the VA would be up on most current diagnostic technics and medical breakthroughs as much as the VA loves to tout they are ‘world class’…what the VA omits there is the ‘Third’ in front of ‘World Class’ medicine.
        It’s almost like the VA sent planes to African and Indian outback village outposts and used skywriting to advertise to those sitting outside their mud huts to come play doctor…oh, and do not forget about all the various Pakistani and even Afghani medical personnel, or my favorite, the Americans that decide they like to were burkas and practice Islam because it’s easier to dress…and the LAST THING these troops coming back from the current wars seeing at the VA for PTSD or worse is similar looking villagers off the boat that you cannot understand….Third Word Class Medicine, yep. Toss a bag of chicken bones on ground, ooga booga, toss some zombie dust in Vet’s face…bingo, take some gabapentin, and do the hookey pokey and turn yourself about~~~~~~~ 🙂
        Rant Out.

      • @91 Veteran: These doctors wouldn’t care even if you did recite all your symtoms. I told my pcp, that I had a terrible pain between my shoulder blades, she sends my upstairs for an exray, says I have an old broken rib. I said” I think I would remember a broken rib” she shrugged it off, and the next day I lost my life 3 times, to a major heart attack. The er cardiologist installed 2 stents, and wanted to wait a day for my heart to stabilize, and then was going to go back in and install a third stent. The va called the hospital and told them to stabilize me and that I was to get to a va heart center. The third stent was never placed. The pcp again after I told her she almost killed my said” well you don’t look like the kind of person that would have a heart attack” This after knowing my cholesterol levels. They have no remorse for their fuck ups, and could give a shit less about anyone but themsleves. They are in it for the money only. What a great gig, no responsibility and get paid almost 1/4 mil a year. Live is gooooooooooood when your a va pcp/nurse/practitioner/phama-doc/union fucking thug rat bastard fuckavetasaurplatapuss.spinkteraroundtheneckblindcocksuckeropolus.

  6. [email protected]

    all the money in the world will not return a healthy prostate

    • Providing said check for $2.5 Million does not bounce. I wonder what kind of VA f^ckery they will invent in paying that out to him and his family? Will the VA try to spread that out into payments over time and at the same time withhold his Disability Compensation? I’m sure we have not heard the last of this Veteran’s nightmare nor his family’s.

      • Actually the money is paid through the US Treasury Dept. The money doesn’t come from the VA directly. So they get off the hook there too.
        Basically in the long run, it’s the taxpayers that foot the bill.

    • @disgruntled vet,
      I bet they’ll have a hard time collecting it!
      Like namnibor says, How will VA pay for it, (paraphrasing)?

      • As Kat says, it comes from the US Treasury.

        It needs to come directly from any budget the VA plans on using for bonuses.

        If that isn’t enough, then from their art budget.

        If that isn’t enough, then from their relocation budget.

        We can keep going until the entire VA budget is zeroed out. Its time they take some responsibility for the pathetic providers they hire and protect at all costs.

        Speaking of responsibility, where the hell was this nurses supervision? Does she just see patients on her own without any oversight?

  7. OK, folks, here’s some great news and some really bad news!
    First:
    From;
    “Not Fake News”
    dated: Mar. 6, 2017 – (7:07 min. long)
    Titled:

    “BREAKING: Trump’s Obamacare Replacement Bill Is Here, Nobody Can Believe What’s NOT In It….”

    #2.)
    From;
    “Military.com/Daily News” via: “Stars and Stripes”
    dated: 6 Mar. 2017
    Titled;

    “2 Vets Win Agent Orange Exposure Case from Okinawa”

    by: Mathew M Burke and Chiyomi Sumida.
    This was great news for these two vets. Really bad news for everyone else. Read the article to understand why.

    #3.)
    From; “Military Advantage Blog”
    dated: Mar. 6, 2017
    by: Tom Philpott
    Titled;

    “VA Costs Could Balloon With ‘Choice’ Reform, New ‘Agent Orange’ Ailments”

    Again, good and bad in this article for all of us veterans!

  8. MALUM IN SE… This is what I’ve been saying all along…””The U.S. Federal Courts””are veterans only “hope””. We must come together and “fight” in courts across the country. The federal judges in this country have seen and heard the “crys'” of veterans!!! Check and re-check the laws in place for us..i.e. ‘”Class Actions”” litigations…because I can remember when veterans “”DIDN’T HAVE RIGHTS TO THE COURTS”” ….it wasn’t that long ago we were “”treated like slaves”” because the dam V.A. had “”no””one to legally get in that ass!!! Thank god that the legislators saw fit to “”change”” those laws thus giving us “”JUDICIAL REVIEW “” of the V.A….Mark my words this case may have set a “‘PRECEDENCE””in V.A. related “law”. The U.S. ATTORNEY GENERAL IS GOING TO APPEAL,if he can the decision…..because now “”would be attorneys are going to litigation everything because of the fees associated with a $2.5 million dollar case…FIGHTING IN THE U.S. FEDERAL COURTS IS IT!!!”””MALUM IN SE “”.Fight the Wrong””.

  9. I have said for many years the VA should be using Nurse Practitioners, or PA’s . The only hire these people to save money, The veteran always pays the price. I myself refuse to see medical providers that are not doctors. In fact I have been known to walk out of an appointment because I was not made aware ahead of time of the status of the treating medical personal. I would rather pay out of my pocket than to see these uneducated quacks! After all, doctors go to school for years, and they still don’t know it all,, so why are veterans expected to see shake and bakes? My life is too important for this kind of shit.

  10. Hey va, you think 2.5 m is too much? Ask his family what they think, when this veteran is no longer here because of your fucking BS. Will the nurse practitionaer get fired? Fuck no, they already gave her, her defence: “Lawyers defending VA said the nurse practitioner did not breach the minimum standard of care” The union thugery woould be proud. I bet she gets a bonus, for saving the va all that money on “further testing”. Hey Shill-kin? I bet your useless ass does shit about this, you will probably promoter the nurse/practitioner huh? You piece of garbage. President Trump, When are you gonna focus and drain this FUCKING SWAMP? How many more have to die?

  11. 03/07/2017

    Dear Benjamin Krause,

    Local TV Channel Three/Five in Phoenix reported that this Judgment was to be announced in the morning of 03/07/2017—which is false, delayed news.

    Early this week I had tried to get a hold of the Greg Patton the Attorney here in Town [disconnected] and over in CA [left a message]. Strange that the Lawyer has an answering machine—Reno never had one over in Long Beach/Lakewood [Worker Comp/CDC—Toxic Chemical Exposure case].

    It is good to see that Amy Veteran Steven Cooper got some money [not enough] for sabotaging his life. That is the reason Karlheinz Halter [Slidematic/Precision Components] did not buy the bullshit that Union Bank [Ulger] Attorneys tried to hand us in the Late 1980s, as we called it Treason [1998 Cox Report].

    Preventing Care is what the VA has created—Limiting Doctors, Limiting Nurses, Limiting workers, Limiting Procedures and Surgeries, Limiting Medicine, Limiting Visits, maximizing Waits, preventing entry into the System, refusing to listen, refusing to act, refusing to respond, refusing to be human, and creating a workplace that is hostel and unproductive and is blatantly abusive to all [including the President, the Senators, the Congressmen, the Governors, and the American Public/Taxpayers].

    And for the Contractors and Subcontractors—it has been hell to do business with the VA if you are not on their “preferred list.”

    Sounds like the “stupid people” had infiltrated our Medical System.

    What a great job they have done.

    Sincerely,

    Don Karg

      • Your brothers and sisters-in-arms have your six and our prayers. Chronic health issues seem to have a profound way of impacting the way we view things, it’s almost like a fifth dimension of thought because of a brand new perspective. Utilize all this energy to advocate and help things become better for current and future Veterans, and am so sorry for what you have and are going through. Glad you won an award and perhaps set a legal precedent in placing a boot dent in the VA’s incompetence.

        Again, you need anything, let you brothers and sisters know. Peace. And, fuck the VA. 🙂

  12. I hope you will be able to follow this Ben because I think this case will have far reaching implications, beyond just using Nurses as doctors.

    Will this cause a knee jerk reaction within the VA where every veteran will be required to have a prostate exam including females? To make it look like the VA is doing something and avoiding liability?

    Would they care since its the taxpayers paying for this with zero blowback on the VA?

    The biggest question is, will the VA cut their losses to avoid bad PR and pay this judgement? Or will they appeal this ruling for the next several years in order to avoid the floodgates opening for many more malpractice suits? The offer condolences to his widow?

    The attitude of the VA in this is typical indifference. Hmmm. The nurse met the standard of care, but the guy has Stage IV cancer after seeing that nurse.

    That suggests the standard is too low or non existent.

    I’m thinking non existent.

    • 03/07/2017

      Dear 91Veteran,

      Great response to the article—Call it what it is Hush Money.

      If it looks like a spade, call it a spade—-Karlheinz Halter always used that in his writings.

      The VA will have to deal with countless of numbers of lawsuits coming at them.

      What to expect—Ask the Aerospace Whistleblowers of the 1980s?–Well, most are dead.

      Planned, or just incidental—ask the U.S. Senators when they slammed the door shut.

      Oh, most of them are now died.

      Get the picture.

      “That suggests the standard is too low or nonexistent. I’m thinking nonexistent.”

      Phoenix VA is at the Bottom of the Barrel for a reason [Where is Sen. Flake, Sen. McCain, Rep. Sinema, Governor Ducey, Mayor Stanton?]. According to Dennis Wagner [the main investigating reporter out of 18 over at Carl Icahn’s Gannett/USA Today/ Arizona Republic] “picking low hanging fruit.” Why? It is not because it is easy to pick.

      Sincerely,

      Don Karg

  13. I’m glad they won, so far anyway. It’s another reason to stay away from the VA. I hope this does open a door that has been closed for too long. Why would Sessions fight the decision? I’m not getting the why. Wouldn’t that be going against what our President said? One thing I am sure of, there will be no apology from the VA.

    • I don’t see Sessions deciding on his own to fight or appeal this.

      I see it being appealed if a bunch of contractors, VSOs or congressmen see their gravy train being threatened.

      • Don’t forget about AFGE President David “little” Cox and his minions. The AFL-CIO and by proxy, AFGE, will spend $3Million to save $1Million, because they can and will defend an idiot dues-paying member like a rabid dog as to not have a crack punched through in legal precedent to allow further eroding of the cookie jar.

        Now, since it’s the Treasury Dept. in which such payments are made for this Veteran in today’s article, I second the proposition to take said $$$ directly away from VA’s casual high dollar spending habits and I think the interior decorating and art budget as well as VA’s Public Affairs budgets should be the first to feel the blunt force of that giant sucking sound from their cookie jars.
        As it stands, the VA will not “learn their lesson” one bit and this will repeat again and again, and already has. “This has all happened before.”–‘Battlestar Gallactica’.

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  15. That is par for the course, here are my complaints of the last year.

    Low testosterone, they will not treat because I am overweight. Number 1 side effect of low testosterone is weight gain.

    Hi protein levels in the urine, time and time again. With my malignant hypertension I have asked for kidney tests to make sure it is filtering the blood correctly with no action whatsoever.

    Again with uncontrollable blood pressure I have begged for a cardiologist since 2012. In 2012 the doctor pretty much said I had to have a heart attack to get a cardiologist. Since they wouldn’t give em a cardiologist to treat my blood pressure, they sent me to the pharmacist in Dallas to treat it. When I saw he was Pharm D I laughed and said you know I have been a nurse 30 years and not once knew a Pharmacist who could treat and diagnose an individual, without the medical rotations, internships, residency and fellowships that a qualified doctor has to go through. I walked out.

    Fast forward to the end of 2016, nuclear medicine stress test showed small to medium heart attack. Nuclear Medicine stress test did not show this in 2013. I was carried out of the VA yelling, the doctor still won’t give me a cardiologist, says it is only small to medium.

    • @nicky w savage: Don’t leave cardiac issues up to the va. Please don’t do that. As you already found out it can kill you. I also believe stress tests, and nuclear stress tests should only be given at a heart center. If a heart attack is triggered, your fucked. I understand you may not have a choice but to use the va, so do this. Once a month go to the va er and complain about chest pains. It won’t be long before your offered a cardiologist, just tell them you prefere to see a cardiologist at a va heart center. VA also lost a lawsuit, for not providing cholesteraol lowering drugs to a veteran that was known to have high cholesterol, and he died. Here is a list of other cases the va has lost:Examples start at the bottom of page 7. “http://www.tullylegal.com/forms/Guide_to_Suing_the_Department_of_Veterans_Affairs.pdf”
      I am not preaching here nicky, actually I am quite pissed off at how they treated you. This is just my way of dealing with that anger.

  16. This article is sad and there is probably hundreds maybe thousands of Veterans who have been treated like this or worse. For a payment of a life the va gets off easy per their normal standards. I guess i am happy for the dear Veteran for winning, but he should have not gone thru any of this incompetence in the first place!!! Here is your payment for incompetence that we fought you every step on the way of this horrible experience of your life.

    It is not enough!!!! A life is worth saving and the va just does not understand this. Early detection is your best chance of fighting disease or cancer. The va does not want to even deliver that standard of care. They stole this man’s life and God knows what he has been suffering and will continue to suffer. Cancer is not any easy death!!!

    I will think positive for this Veteran and for all other Veterans. I pray for justice for this dear Veteran to continue and that his cancer disappears and for healing of his body. I pray that God hears the voices of Veterans who are suffering and continue to suffer at the hands of these va monsters. I pray for God’s intervention and justice begins now for many who suffer. Vengeance is mine and i will repay sayeth the Lord.

    • @ANutterVet: That is : fuckavetasaurplatapuss.spinkteraroundtheneckblindcocksuckeropolus
      Definition: A va practitoner/nurse that resembles a platypus, but has it’s head stuck up it’s ass and got it’s head stuck up it’s ass by being a blind cocksucker and blames the vet for it’s circumstance and fucks said vet over.
      Use in a sentence: While showing my va pcp the knife that accidentally got stuck in my back, the fuckavetasaurplatapuss.spinkteraroundtheneckblindcocksuckeropolus, decided to send me for an endoscopy just for the hell of it, and since my pecker was never injured while in the service or anywhere else, I was billed for the entire ordeal, there by fucking over yet another vet.

      Bens blog dictionary page 23: fuckavetasaurplatapuss.spinkteraroundtheneckblindcocksuckeropolus

      • @cj – I had to teach my PCP how many 4 hour segments were in a 24 hour period. After the schooling, my meds were renewed, plus instead of prescribing me a muscle relaxant, I was given more pain medication. WTF. I not only have to watch the overall medical care that I receive, I have to show my PCP how many tabs that I take per day [when the PCP writes the script], and then they are so uptight about pain medications, yet they prescribe me more for what is called breakthrough pain. These people live in a totally different world.

        How are you doing tonight? Are you still having digestive problems?

        I have a pen pal friend in whom I never met, he is also an Obamamite, and we have had our share of political disagreements. But, we try very hard to work through the different beliefs in the issues. We have had many disagreements, and have fought like cats and dogs. Anyway, he has a good partial solution pertaining to undocumented illegal immigrants.

        He stated that the Fed Government should require all employees to verify if a prospective employee is legal or not. If they are illegal, they are supposed to turn them in. There is some merit to this, but it seems like it is a good idea. Especially if ICE has a special site or hotline so that employers can directly contact them.

        But here is the liberal slant, he said that this process should not apply to those in the produce industry [pickers and such]. Besides working in restaurants, farming is where most of the illegals are working. My friend said the he was concerned about stabilizing produce and other food prices. What do you think?

        I don’t know how long that I’ll be on tonight. For some reason, I’ve started to get easily tired after 12 midnight.

  17. Shill-kin doing a bang up job, wasn’t it he who started this whole nurse/practitioner pharma/doc in the first place? and didn’t he testify that he would get rid of people like that? Well Shill-kin? When can we expect your resignation? After all it was YOUR policy that murdered this poor veteran.

    • @cj – You’re asking Skull Skin to admit to a wrong doing. Only way for this to happen is if Skull Skin is recorded or via emails. His phones should be tapped.

      • @cj – I’ll be searching for some supplements. Hopefully I’ll get a notification from Outlook. I’ll check back on the blog in a couple of minutes.

  18. @ANutterVet: I am still having trouble, I am on the max dose of meds for reflux, I use a 1/2 tsp of baking soda in about a cup of water to control breakthough pain.

  19. @ANutterVet: It is a terrible thing another veteran is going to die a horrible death due to the va’s incompetence. What is even more horrible is that not a single person will be held accountable.

    How are you tonight?

    • @cj – I know, that’s the VA for you, no solid accountability. I hope Cooper gets his the money. Its only a token. He deserves more.

      cj, I’m getting tired of no consistency, only that the VA can change their minds all the time. Its tiring. I’m still unsatisfied with everything.

      • @ANutterVet: I don’t blame you, I mean come on…………how many people in this entire world can say, they had to expain how many hours are in a day and how many pills that would mean a script should be made out for to their doctor? Not many, that I can tell you for sure.

  20. @ANutterVet: Actually it feels like I am having a heart attack, and also sometimes after I eat, I swear if feel like the food fell from a 20 story building and hit the bottom of my stomach. I know there is something wrong, but I can’t force a doctor to do their job. I am in the process of finding another gi doctor.

      • @ cj, you feeling that bad now? You think it could be an ulcer? Saw my pcp yesterday in private sector she said i was the sickest person she saw all day my flu turned bad now on high antibiotics, prednisone, and cough syrup. Been too sick lately. Tired of it. Sounds like you are getting tired of it too. You need to get some help buddy, get a referral and testing.

      • @Ex va: This isn’t new, it’s been going on for a long time, I usually get scoped once a year, Have had a bravo unit inserted. They just can’t figure it out yet. The first scope they ever did, was at the va, I woke up durring it and heard one of the interns say “Oh my God, is that a tumor” then I reached out and grabbed a nurses leg and out I went, They told my I had stomach varicies, Then the next scope they were gone. Every doctor, even my cardiologist says, that’s impossible, stomach varicies just don’t disapear or go away. So, I have no clue what they saw,or what it was,or what’s going on inside.

      • @cj – They were probably scoping someone else and got the both of you mixed up. I just had a brainstorm. If I have to have any procedure done and it requires me to be put out, I would like my wife to be there in the room. I know, I know, I’m asking for too much. Excuse me for thinking on how to protect myself from these unaccountable reprobate dingbats. I’m going off at 1:30am. Too tired. Very long day today. Up early, PT, consult with PCP.

      • @ANutterVet: I hear ya, You sleep well, and as always, God Bless you and your family. Will talk soon. Goodnight.

      • @cj, @Ex va – Ok, you both have a good night. My head is bobbing over top the keyboard. Good night, and God bless you both and your families. Ex va, keep an eye on your condition. Both of you have been dealing with your med issues for quite a long time. I’m very concerned about the both of you. Don’t fool with these conditions. Good night.

  21. @ANutterVet: No bleeding. I am thinking either the meds are eating away at my insides or there is something growing that souldn’t be there.

    • @ cj, sorry your feeling so bad. You need to get looked at. I hate going to doctor appointments, mine wondered why i waited so long. Don’t wait too long cj.

    • @cj – Sounds very unusual with what is happening with your stomach. Try not to wait long in getting this checked out ok? I don’t like what I’m hearing. At least, there is no blood in your system, that’s a good sign. I’m concerned due to the way that you describe what is going on. Were you able to use any of the links that I sent to you? I’ve been up since 5am and I have finga slippage.

    • @cj, @ ANutterVet, glad to see you both tonight. I catch any virus, then it turns bacteria, then i need antibiotics, if it is an ulcer they can treat it with antibiotics too. I hope it is an easy fix for you cj.

      • @Ex va, @ANutterVet: Yes it is an unusuall thing going on, but I am diligent, and will get to the heart of the matter soon.

      • @cj, i am glad you are being diligent. Probably the meds, i have been on so many who knows what happens long term. You been thru the mill cj. You too ANutterVet. I hope things get better. If Veterans keep winning, its gotta change. I believe in a higher power and he doesn’t like the innocent slaughtered. He gets angry about it. The va may have to pay in a way their not going to want to do.

      • @Ex va: I don’t feel as tho I have been through the mill so to speak. You and Nutter sure have been. For me? It is just things that naturally occur from getting older. I don’t even complain about it all, cause I am so use to it all that it doesn’t slow me down or anything like that. I only have two battles left to win against the government, then I don’t really care what happens to my health.

      • @cj, @ANutterVet, don’t mean to sound preachy tonight talking about God. Sometimes, i get emotional about things, this article got to me tonight i am happy he won just sad about what he is going thru. I am sick so probably more sensitive than normal.

      • @Ex va: I didn’t think you sounded preachy….. I think what you said was good practice. Your right about alot of things Ex va, miracles do happen, I have seen things that couldn’t be explained any other way.

      • @cj, i know what you mean about battles. I do have a good feeling about you and ANutterVets battles. I believe you both will win yours eventually. You both have the evidence and intelligence and God on your side. I said God again. Lol.

      • Ex va: You can say God as many times as you want. Yes I will never give up, and, I have won every single time. What I can’t stand is the amount of time these damn people eat up in delaying the inevitable outcome. I have been fighting them since 78.

      • @Ex va – Preach on! You don’t have to excuse yourself. We all need to be reminded that there are no limits when it comes to God. Your fine Ex va. Now, I’m going to hit the hay.

      • @cj, that speaks a lot about your character fighting them since 78. Speaks about their lack of character. I pray you get all the back pay owed and more if allowed and should be!

  22. @ ANutterVet, i didn’t it isn’t in lungs its upper respiratory. My throat closing off oxygen was low. It is starting to break up. I will get an x-ray if i don’t start doing better next few days. I was lucky to walk down the hall I was so dizzy and weak. I just wanted to get scripts and get out of there. Lol. Thanks for reminding me about an x-ray.

    • @Ex va: LOL I know what you mean, when your not feeling well, you just want to get the heck out of where ever your at. Sux being around people when you feel so badly.

      • @cj, i thought i was going to pass out a couple of times, couldn’t breath. BP was up too. Pain bad. Trust this doctor. I have been going to this doctor about 10 years. Your and ANutterVets comments was hilarious. I swear you say exactly what i think sometimes. ANutterVet too.

      • @Ex va: yes it is very good to have a doc you can trust. LOL yeah we can get into some funny talks at times. I think everyone here has made up new words out of frustration to decribe the damn idiots that work at the va.

        I read Bens next post. I don’t know what to make of it. I think that one is a little over my head. i will have to wait for other people to comment before I can tell what it is all about.

      • @cj, Ben’s new post is just what you expect crime! I think you have to have a criminal mind to understand the va or experience it like we Veterans have done. I worked with other Veterans at the va and some of them didn’t like it but they went along with the majority of it. I logged and did my duty and filed complaints, didn’t change much. Too damn corrupted. And they target the complaintant.

      • @cj, sorry, your upset and angry, i know how that frustration feels. People need to know what is going on and they are beginning to see the truth because Veterans are speaking out about it. That in human history is usually the beginning of change. This is a long overdue. It exists because it is being discussed. If no one was talking then we would really be screwed. That is why this blog gives me some hope.

      • @Ex va: Don’t be sorry Ex va, I am just a hot headed Italian is all. You sleep well and goodnight. Will talk soon.

  23. @Ex va: Personally I think they denied the TBI claim, because they know exactly what kind of battle that is going to trigger, when it is rulled im my favor. They know how fucked they are going to be when that happens.

    • @cj, when you win this, you be proud because you are winning this for the fight you stood in and for others who no longer can fight. You remember you fought and won. I hope you get the peace you deserve with this too.

      • @Ex va: I don’t think I will ever be at peace. This battle has consumed my entire life. So even when I win, in reality, I lost, because I let it take my life away.

      • @cj, HELL NO! You are going to win this and then you will. Get the peace! I can’t explain why we go thru hell on this earth and the ones most deserving of hell seem to squeak by it. You have nothing to regret or be ashamed of because you stood up to these jerk offs. You have your life ahead of you, i know it doesn’t feel good at times, but feelings can deceive anyone. These battles mean something and if you didn’t fight then you could say they took part of your life away. You chose because something in you said this is wrong so you fight. That is what we do, we endure and will fight the wrong.

  24. @cj, i am going to sign off. Thought a lot of my past with the va and hope i don’t have nightmares. Good talking to you guys this evening. I like your art for the va, it still cracks me up. Lol. Take care and God Bless.

  25. You should all write to your congressmen and women to not allow the unsupervised independent practice of nurse practitioners and nurse anesthetists in the VA system. They are currently fighting for independence and our veterans deserve more, they deserve to be treated by physicians like everybody else.

  26. Figure its about time to chime in here. As a veteran who has received care at the VA long before I was a VA provider, all I can say is some seriously misinformed stuff being thrown around here.

    Yes, there are horror stories about the VA. Yes, access can be bad. BUT, I have seen just as many horrific things in the private sector. The biggest difference is publicity. I can honestly say that Veteran VA providers care more about Vets than any non-vet provider in the civilian sector ever will. Can the VA do better? Yes, and I, as a patient and provider, believe it will be better in time. So many things the average person does not see behind the scenes.

    As for NPs. Seriously, its not like we (yes, I am also an NP) went down to Wal-Mart and picked up a license while shopping for chips. Most have at least a Masters Degree, and many, such as myself have that 9 years of college and doctoral degree. Given over a decade of experience in multiple settings and over 50,000+ patient encounters (in non-VA healthcare alone), having supervised medical residents (yes, MD and DO), we aren’t just a bunch of unqualified quacks that make stuff up as we go. I have had NP/PA providers in my health that have taken better care of me than physicians. Are one better than the other? It really depends on the person and experience. You can find crappy physicians everywhere too.

    • I agree veteran providers would likely be better, and I agree NPs can provide better care than some quack doctor who has no other choice than to work for the VA or retire.

      I also agree publicity can be a factor.

      Where I disagree strongly, and what makes publicity a factor is accountability.

      When a VA provider commits malpractice and is not held accountable, it results in bad publicity, whereas in a private hospital where there is accountability with real teeth, the entire health care organization does not line up behind a bad provider to protect them. A private hospital likes to keep mistakes private for a reason, both legal and cut down on lawsuits.

      The VA simply ignores the problem, moves the problem somewhere else, or promotes the problem causing even more damage.

      The VA without any accountability at any level often leaves veterans with little choice other than publicity.

      Until the VA changes and brings accountability, there will continue to be bad publicity.

      As a veteran, you certainly understand the importance of accountability, and what happens in even the smallest unit when there is a complete absence of it.

      If you want to reduce the bad publicity, then hold your fellow employees accountable for their actions.

      • @91Veteran – Sorry 91. I can’t buy into Veteran and NP Providers message. Been misled for a long time. Kind of smelly.

      • I don’t disagree ANutterVet, it is kinda smelly, but I figure being a fellow veteran, I would given him/her the benefit of the doubt.

        I give that benefit knowing full well that I have been screwed by fellow veterans working for the VA. One is an Air Force vet that works as head PR flunky for my VA, and the other was a Navy vet who had worked as a patient advocate.

        At least, that was her title. She was as worthless as tits on a boar, lied to my face and refused to do her job in any manner.

        I gave both a chance, but will never again.

    • @Veteran and NP Provider, @91Veteran – I kind of smell a little trolling here, but this Veteran will add some sense to the mix of confusion.

      I totally disagree. I too have been around the block in the life science field. Sir, to tell you the truth, you post your comment under an article about a Veteran’s misfortune in trusting the VA. Then you make no mention of having any compassion towards Veteran Stevin Cooper, or to his family. Right there tells me the lack in your judgement. At least you could have said something in his support.

      You also make no mention of the changes that is going to happen in the VA. Shootz, your leaders can’t even figure out what is happening with the Choice Program. The VA healthcare system needs to be dramatically reformed and reorganized. Its that simple. You also make no mention of the Veterans lives that are at stake, and how valuable Veterans are. Shame on you. This also reveals your limitations, foresight, and understanding from a Hippocratic Oath point of view.

      You said, “I can honestly say that Veteran VA providers care more about Vets than any non-vet provider in the civilian sector ever will.” Sir, this is a far stretch. You can do better than this. Many VA providers act like robots, don’t trust their patients, and they don’t even want to converse with you. Many don’t even know how to express themselves, let alone practice good medicine.

      There are more problems in the VA besides scheduling and wait time issues. Many providers don’t even probe patients with medical questions. My experience is that they cut the script and don’t even ask how the medicine is working for the patient. And, if you ask for a medication that you know works for you, you must likely will be labeled as a drug seeker.

      There are also issues with cheap generic medications in which the VA doesn’t want to address. Some generics don’t even work as well as others. Who is responsible for that? I find that most VA providers will not even speak out about the things that need to be changed in the VA healthcare system. Like you, you don’t post your name, the facility you work at, or anything that can identify you. I say this, because you speak mostly well of the VA so you should have no worries about retaliation from your superiors.

      There are many other things that I and others could submit, but not one VA Administrator has come into this blog, and said, “I care about Veterans, and I want to know where we are missing the mark. Not one.” Propaganda.

      • @ ANutterVet, TRUTH! The providers are too well taken care of to ever speak out against their colleagues negligence!!! The providers are criminals that are never held accountable for Veterans deaths!

      • @Ex va – I get tired of hearing the bullshit. Too many Veterans lives are at stake. Thanks Brother.

      • @ANutterVet: Amen brother. Also, Veteran and NP Provider. Don’t give me your shit about a non va provider not caring as much as a va provider. Listen up dummy, my private provider has two sons, both are US Marines, one has a TBI, you wanna bet she cares way the hell more than you, or any non english speaking va provider does? And tell me, Veteran and NP Provider. exactly how many liquified remains have ever been found in a private sector hospital? or in Russia for that matter. I’ll give you a hint ZEROOOOOOOOOO. For all we know YOU could be that Veteran and NP Provider, who didn’t follow up with,Veteran Stevin Cooper. Or maybe, your one of those quacks, as we call them, that deny veterans service connections for a nice bonus. Don’t come on this blog, and start preaching to us about the level of care we have recieved, without FIRST apologizing for your quack colleagues. Care to address the family members of veterans, who have died waiting for help? There are plenty that visit Bens blog. I can’t think of a single private sector individual, that has died waiting for help, from a private sector provider, that wasn’t from some form of experimental program. How many private sector providers have been caught hiding a deceased veterans body in a shower? Yeah, that’s right, only you guys care about veteran, like nobody elses business. I call BS. And just for the record? Careing about a veteran, never saved a veterans life. Didn’t you get that memo in med school? What saves a veterans life is expedient and proper medical care. Not how much one cares about a veteran. I am damn sure the undertaker cares about veterans just as much, after all, you never know do you? that said undertaker just might have sons and daughters of his/her own, serving on the battlefield as we speak. When you can stick your neck out, and testifiy against one of your fucked up, useless peice of shit colleagues, that cares more about your precious union, then they do veterans, then we will except you with open arms, and stand by your side to boot. Until then…………………piss off…………..and as always……..thank you for your service.

    • Seriously, its not like we (yes, I am also an NP) went down to Wal-Mart and picked up a license while shopping for chips. ……COULD OF FOOLED ME

    • One can be an overeducated dangerous idiot and still be of no use to truly giving great medical care to Veterans when that AFGE condescending attitude is dished-out at the VA and it’s systemic. I do NOT get such shitty attitude or care in the private sector using Medicare last 7 years. I also have not been re-infected by C-DIFF or MRSA in those years using private healthcare….the VA did that to me a few times that landed me 7 times in hospital (private/Medicaid at time), and more.

      The private sector has that VA Kryptonite called real accountability with ramifications and teeth. The AFGE collectively protect their flock…even if one of them kills a Veteran via blunt force trauma in his hospital bed…no, we do not feel safe and I think I smell some swamp gas bubbles or rotten cabbage.

  27. I retired 8 years ago, and a priority for me was to make sure I get the best possible insurance just so I don’t have to step one food in any VA Hospital. We should disable, and issue PPO to all retired VETS and Med disabled. I’ve seen first hand with my father(s), and uncles how the VA treated them.

  28. As far as bragging about a masters and doctorate in nursing, neither of these make you even half as qualified as a physician. Majority of credits obtained during these programs aren’t even clinically or medically relevant, see below. While I agree in the current health care environment there is definitely a need for midlevel providers (NPs, CRNAs, etc) and many are very good at what they do, they can’t replace physicians.

    Fall I (13 credits, Semester 1)
    Context of Healthcare for Advanced Nursing Practice (3)
    Biostatistics for Evidence-Based Practice (3)
    Advanced Pathophysiology/Physiology (4)
    Human Growth and Development (1)
    Advanced Nursing Health Policy (2)
    Spring I (12 credits, Semester 2)
    The Research Process and Its Application to Evidence-Based Practice (3)
    Clinical Pharmacology (4)
    Advanced Health Assessment and Measurement (3)
    Organization and Systems Leadership (2)
    Summer I (10 credits, Semester 3)
    Health Promotion and Risk Reduction Across the Lifespan (2)
    Diagnostics Skills and Procedures for APN (2)
    Health Supervision (2)
    Clinical Reasoning I (2)
    Problem Identification (1)
    DNP Practicum (1, 56cl)
    Fall II (10 credits, Semester 4)
    Philosophical, Theoretical & Ethical Basis of ANP (3)
    Nursing Inquiry for EBP (2)
    Clinical Reasoning II (2)
    Clinical Practicum I (3cr, 168cl)
    Spring II (10 credits, Semester 5)
    Translating Evidence into Practice (3)
    Clinical Reasoning III (2)
    Clinical Practicum II (3cr, 168 cl)
    Project Development (1)
    DNP Practicum (1, 56cl)
    Summer II (7 credits, Semester 6)
    Analysis and Evaluation of Individual & Population Health (3)
    Clinical Reasoning IV (2)
    Clinical Practicum III (2, 112cl)
    Fall III (11 credits, Semester 7)
    Health Information Systems and Patient Care Technology (2)
    Health Economics and Finance (3)
    Clinical Reasoning V (2)
    Clinical Practicum IV (2, 112cl)
    Project Implementation (1)
    DNP Practicum (1, 56cl)
    Spring III (8 credits, Semester 8)
    Clinical Data Management (2)
    Clinical Practicum V (4, 224cl)
    Project Evaluation (1)
    DNP Practicum (1, 56cl)

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