Although only 0.4% of the United States population are actively serving in the Armed Forces, the U.S. Department of Veterans Affairs (VA) estimates that roughly 7.3% of the population are veterans, making veteran care a major issue in the national healthcare schema.
According to the VA Office of Public Health, veterans are more susceptible to certain diseases or conditions because of their service or deployment location than members of the civilian population. Some of these conditions include traumatic brain injury obtained in combat as a result of explosives, radiation exposure related disease linked to ionizing radiation exposure during qualifying military service, and the undiagnosed, unexplained illnesses popularly called “Gulf War syndrome.” Beyond these, many service members have issues of mental health, including post-traumatic stress disorder.
As nurses know, treating patients requires going beyond understanding various diagnoses and treatments; communication is a key factor in patient care, and when it comes to veteran and active-service members, properly understanding the issues military personnel face can make all the difference in their healthcare experience.
Maria Rahming, a Master’s Entry to Nursing Practice (MENP) alumna and retired Navy veteran, believes in the importance of nurses not only recognizing the specific needs of veterans, but in acting as the front-facing aspect of care within the hospital. According to Rahming, it was her positive experiences with nurses that helped shape her decision to enter the profession. “Many times, it was the nurses who set the tone for the operating room, who were advocates for their patients at the bedside on an inpatient unit when a need wasn’t fully met, and they were there to help further explain situations or decisions.”
Stacy Gates, a current MENP student and veteran of the Army National Guard, notes the many challenges of caring for veterans, especially in recognizing mental health wellness. “Something I think we as providers need to keep in mind is that as a service member, you are conditioned to ignore a lot of discomfort, physical and especially emotional. It takes a keen eye to recognize issues related to the mental and emotional health of veterans, and these issues can have a huge impact on their physical care.”
“Many veterans have to deal with or have dealt with situations not commonly seen with traditional employees in the community,” says Rahming, echoing the importance of recognizing service member-specific needs. “Many have been in combat and suffer from wounds or loss of limbs, while others, who may not have physical scars, may suffer from post-traumatic stress disorder, depression, the loss of comrades, or even the lack of being able to see their family on a daily basis because they’ve been deployed to a distant location. Nurses have to be able to be sensitive to these circumstances.”
Steven Lisowski, a current MENP student and Marine, adds that “as a nurse you have to be aware of a pre-disposition of that kind of behavior, whether it’s minimizing pain, addiction, or suicide: you have to investigate deeper with a veteran than an average citizen.” As a student at the Rosalind Franklin site, Lisowski has attended a number of clinical rotations at Captain James A. Lovell Federal Health Care Center (Lovell FHCC), a VA hospital. According to Lisowski, attending clinical at a VA hospital “helps in understanding priorities, communication skills, and challenges that tend to circle around veterans and especially active military.”
Currently, the School of Nursing has three active clinical rotations at Lovell FHCC, all mental health rotations. Students also frequently attend rotations in Med/Surg, Critical Care, and for internship experiences. Lovell FHCC is unique in that it is not only a VA hospital, but a care center for active military members as well. Students who attend clinical at Lovell are able to get hands-on experience working with active military members along with veterans, something that both students and instructors find invaluable when learning how to assess and administer care.
Mark Bisbee, a current DePaul clinical instructor at Lovell FHCC and Navy veteran, speaks highly of DePaul’s clinical rotations within the VA, not only in terms of veteran care, but of the advanced education students receive. “DePaul is ahead of the curve in that many DePaul students get an opportunity to work within the VA. The VA is cutting edge when it comes to medication assessment and charting. They were the first to do barcode administration. By and large, patients are very happy with the care.”
Speaking about the benefits of being able to attend two clinicals at Lovell FHCC while a student, Rahming says, “Being able to learn about and participate in the special health care considerations that veterans and, in some cases, their family members, needed was a great eye-opener for me.”
As issues regarding healthcare change, so too must education change to meet these needs. “Serving your country is one of the highest forms of service we can do,” Lisowski says. “Moving forward, healthcare goals need to be reflective.”
Even though veteran and active duty service members make up a small portion of the overall population, their healthcare needs are no less important, research understanding veteran issues is no less needed, and the benefits for nursing students to have a hands-on experience in veteran care during their educational tenure is no less informative than the variety of other health care needs and services nurses provide.
“Service members in many ways are no different than the rest of the population. We are a microcosm of the United States, with all of its complexities, and suffer from many of the same physical, mental, and emotional ailments,” Gates says. “In other ways, we exist as a unique culture, based on the shared experience of service in the United States Armed Forces, and must often navigate those lifelong consequences.” Of the similarities between the profession of nursing and serving in the Armed Forces, Gates adds, “Both allow you to work as a part of a team to problem-solve and serve your community.”