Manning the main switchboard for the Central Texas Veterans Health Care System requires skills akin to a symphony conductor. Beginning in 2006, Marlon Askew, who spent 15 years in the armed forces and saw combat in Desert Storm, worked as the system’s central teleoperator and then supervisor, connecting thousands of veterans who call each day to the system’s Temple and Waco hospitals; its six clinics in Brownwood, College Station, Cedar Park, Palestine, and La Grange; and myriad medical, dental, surgical, psychiatric, and rehabilitation units. 

But in 2024 and 2025, Askew told the Texas Observer that backlogs started to overwhelm the system. He had just five employees under him, and some veterans were waiting an entire day to reach clinic representatives. Before he retired in May, he said some veterans became so frustrated that they threatened to kill themselves or Askew and his coworkers. As a U.S. Department of Veterans Affairs (VA) patient himself, Askew said he’s also seeing delays in getting appointments: A few years ago, he got surgery within a month of being diagnosed with throat cancer; recently, he had to wait more than two months just to get an MRI for another medical problem.

Askew attributes the current slowdown at least partly to the Trump administration’s decision to shrink the VA workforce—a move he says is hitting the many VA workers who are veterans themselves doubly hard. Another teleoperator left at the same time he did, leaving only four to man the switchboard; the VA then eliminated its nightshift, routing late night calls to an already busy emergency room. “You say you’re going to take care of us when you’re not taking care of us,” Askew said of Trump. “You’re hurting us.”

Texas has more than 830,000 veterans enrolled in the VA healthcare system, the most of any state. Some 34,000 employees work at VA outpatient and inpatient care sites across the state, and in the Central Texas VA healthcare system 45 percent of workers previously served in the military themselves, according to officials with the public-sector union the American Federation of Government Employees (AFGE).

During the Biden administration, the federal government began efforts under the PACT Act to increase staffing and expand the veteran healthcare system. But this process was suspended this year when the Trump administration froze hiring. On March 4, as part of larger efforts by the Department of Government Efficiency (DOGE) to shrink the federal workforce, the VA issued a memo detailing plans to revert to its 2019 staffing level of around 400,000 employees,meaning some 83,000 jobs would be slashed. At that time, White House counselor Alina Habba said some veterans were “not fit” for federal jobs. By early July, the VA dialed back its projected reduction to just 30,000 positions—to be achieved through “the federal hiring freeze, deferred resignations, retirements and normal attrition”—by the end of this fiscal year, though Askew and others still say the cuts are taking a toll. 

Jessica Jacobsen, a VA spokesperson based in Dallas, reiterated that July announcement in an email to the Observer, writing that “Due to voluntary departures, [the VA] won’t be conducting a large-scale reduction in force.” Jacobsen said that, other than a “small number” of probationary employees in February, “No other VA employees have been terminated based upon any actions associated with any reduction in force or reorganization.” She also added, “About 350,000 mission-critical VA employees are exempt from the hiring freeze.” 

Jacobsen disputed Askew’s allegations about call wait times, saying the “VA’s speed of response is virtually unchanged” even though “the number of calls received by our main switchboard increased.” Jacobsen told the Observer that the vacancies in the Central Texas VA main switchboard are in the process of being filled.

David Peña, a 50-year-old VA worker, was born into a military family, with five uncles, two cousins and a brother who served in the armed forces. Peña entered the Army right out of high school, spending most of his nine years of service in a rapid deployment unit based in Germany. In 2002, he was discharged with a back injury that, later in life, left him unable to run or walk for more than 200 yards. “My kids don’t know me running down the street with them, or racing with them, so it kind of robbed them of that,” Peña told the Observer. 

Still, he considers himself lucky. Friends he’s served with have developed cancer or heart disease. Others took their lives when they left the service and felt they “lost their purpose,” he said. Peña wanted to assist other veterans, so he started working as a medical technician at the Austin VA outpatient clinic in 2012. “I think it’s my duty, because I look at them as my brothers.” 

Peña sees about 60 patients a day, and despite the workload, he tries to understand each one as a veteran with “their own story.” But he says it’s becoming increasingly challenging—worker morale dropped after his department lost two supervisors this year. 

In the last six months, as Elon Musk and his DOGE painted a picture of federal workers as lazy bureaucrats, Peña said patients have been more hostile, “Trying to rile you up, calling you lazy, or calling you this or that,” criticism from “whatever news media they see.” Peña has been seeing a VA mental health practitioner to cope with past and present stressors, but he now says he has to wait six months (compared to three months last year) for an appointment. He compared what’s happening at the VA to a flawed repair. “It’s like patchwork, “ he said. “You try to cut holes in the wall, and eventually, the dam’s gonna break.” 

Jacobsen, the Dallas-based VA spokesperson, said average wait times for established mental health patients were the same this year compared to last year while waits had actually shortened for new patients. 

The Trump administration has publicly promised “to provide better care to our veterans,” but Karen Rowland, a veteran and VA nurse told the Observer, “I’m not seeing that.” Rowland served in the military from 1998 to 2004. She started working as a nurse at the Temple hospital’s mental health rehabilitation center for low-income veterans during the COVID-19 pandemic in October 2020. She said her working conditions are even worse now than during that difficult time.

As a night-shift charge nurse, on any given evening she and a team of five other nurses have to attend to 80 to 90 mostly homeless veterans suffering from post-traumatic stress disorder and substance abuse, communicate with law enforcement, and deescalate conflicts. At the start of the year, Rowland said the unit had 40 nurses for all shifts, including registered and licensed vocational nurses. But since January, five nurses have left because managers have been “coming down hard” on workers, Rowland said. Instead of hiring new nurses, Rowland said the hospital transferred nurses in from other units, resulting in fewer staffed beds in the medical surgical unit. “We are helping less veterans than before COVID,” Rowland said. 

With just two nurse practitioners and one psychiatrist working inside the mental health rehabilitation center, she said it’s difficult to attend to new patients within 48 hours of admission. Some wait a week or more to be seen by those providers, Rowland said. “A lot of veterans come in and feel like they’re not getting the care that they need. So they leave.” 

Jacobsen disputed these claims: “Domiciliary [mental health rehabilitation] patients are seen timely [sic],” and “each patient is assessed within 24 hours of arrival.” She added that the VA is currently recruiting nurses to fill vacant positions and said that the Temple hospital reduced staffed beds in the medical surgical unit “due to low patient occupancy rates, not because of any staffing issues.”

Even though Rowland herself suffered a military-related injury, she said she opts to use her husband’s health insurance because she “sees how [veterans are] being treated, how they fall through the cracks, or how everybody is just overworked, burned out.” Others don’t have that option.

In the end, Rowland said workers like her end up dealing with guilt on top of stress. “What can we do but apologize and just keep trying harder? Even though we’re trying, it’s like we’re spinning in our wheels,” she said. “So everybody’s feeling it, from the nurses to the providers to the psychiatrists to the nurse practitioners to the veterans.”