Abstract
Over the years a lot of veterans return back from active duty with so many war experiences, disease conditions wounds and bruises from the war. They are often faced with many challenges reintegrating back into the society.
This paper looks at common disease conditions requiring nursing care in the veteran population, how the nursing process even though complimentary can significantly improve on the final outcome of the patients. This is with a particular focus on Post-Traumatic Stress Disorder (PTSD) as one of the major causes of the mental health conditions. It looks at what resources are available to allow for a seamless transition to quality healthcare during their civilian life.
The Veteran Population
Possible concerns requiring nursing care among Veterans.
The Possible patient concerns requiring nursing care among the veteran population are very numerous. These can range from problems that were acquired specifically as a direct consequence of the war and those that are not due to the war. Those that are not acquired as a direct consequence of the war can be due to exacerbation of pre-existing conditions before the war or those that were newly acquired either due to genetic predisposition or other causes. I will base my discussion mainly on those problems that are acquired as a direct consequence of the war. These can be categorized as follows:
Mental Health Disturbances: The top one being PTSD. Patients with PTSD often report nightmares, flashbacks, some loss of memory, emotional disturbances like guilt of being alive, anger and rage to the point of being homicidal. They may have difficulty maintaining normal relationships especially with spouse or live partners; they often have thought disturbances, they may avoid social events and have difficulty going to sleep. They are at a high risk of developing Dementia according to Maureen Salamon ( 2010) if adequate care is not taken. Others include Depression, Anxiety, Psychosis and so on.
Traumatic brain Injury (TBI): Patients with TBI can have cognitive problems like memory disturbances, decrease attention span, language problems, apathy, inability to “turn out” erroneous stimuli and reduced efficiency of information processing. They may have central nervous system problems like headache, dizziness and blurred vision. Psychological problems: like deep depression, anxiety, irritability and psychosis to name a few.
Exposure to Chemicals: some nerve agents can be used which can lead to seizure disorders, heart conditions requiring follow up and nursing care.
Other problems include things like Urologic Problems, Hearing Problems due to noise and vibration exposure, Certain cancers, rare Infectious disease such as Brucellosis and Leishmaniasis all to name a few. All these will require follow up with nurses in various disciplines such Psychiatry, Urology, Wound Care, Infectious Disease and so on.
Health care needs in context in context with psychosocial implications affecting veterans with PTSD
Some of the health needs are the following:
Because of the neurologic disturbances they acquire as a result of the changes in their Amydala and Hippocampus, they are prone to emotional disturbance such anxiety, fear, rage and inability to make decisions. They often find it difficult to easily integrate back into the society or connect with their families and children, so they may need to undergo cognitive therapy
Because of the Neurochemical changes such as increased in sympathetic and endocrine hormonal discharge. They often experience an increase in energy surge, prolonged hyper alertness, hyper vigilance, insomnia, and and so on. They may find it difficult to maintain close relationships with people, family and friends. This can place a huge burden to the family and therefore may need to undergo extensive behavioral and or Eye Movement Desensitization and Reprocessing therapies.
For Flashbacks, they may need prolonged exposure therapy. They may suffer from depression showing some affective symptoms such as sadness, lassitude, subjective feeling of distress, deterioration in personal hygiene and so on such that people may not want to be around them. So they will need to undergo psychotherapy with or without some antidepressant medications. Because some of the antidepressant can cause sedations as side effect, that can take care of their insomnia at the same time.
- Bridges to recovery 2018 https://www.bridgestorecovery.com/post-traumatic-stress-disorder/
- Web MD 2005 – 2008 https://www.webmd.com/mental-health/what-are-treatments-for-posttraumatic-stress-disorder#2
- How the Nursing Process is Complimentary when delivering healthcare to the veteran population with PTSD
All health care systems strive to provide effective and safe interventions to improve or maintain the health of their patients, including prevention efforts. In this report the term effective is used to mean that a specific posttraumatic stress disorder (PTSD) service or program results in a better outcome for the veteran compared with other services or programs, including no service or program. The term safe means that the risk of harm is acceptable and well characterized. Although the effectiveness of many PTSD treatments is well established, a specific treatment might not be equally effective in all people, nor is any treatment necessarily appropriate for all patients for all presentations of PTSD or at every point along its course.
The Nursing Process provdes guidelines and recommendations on the best practices for the treatment of PTSD on the basis of reviews of scientific evidence and expert consensus. State-of-the-science guidelines assess the strength of the evidence, the manner in which evidence was collected and evaluated, and the populations to which it pertains. Implementation strategies, such as reminders in the medical record and decision support tools, can help ensure that nurses adhere to the guideline
Resources available to facilitate seamless transition to quality healthcare for patients with PTSD
There are multiple resources available for veteran’s to facilitate seamless transitions to civil life no matter what they may be experiencing; there are resources and support systems to help whether they are looking for clinical care, counseling, assistance with benefits, or something else. For instance in crises situations, the following are available; NVF Lifeline for Vets, resources like VA Suicide Hotline, National Suicide Hotline, Stop Soldier Suicide.
There are resources and benefits for general services through the State Veterans Service Offices VA E-benefits for housing, Disability Compensation, VA Health Care, Education Benefits, Pension Benefits, and Vocational Rehabilitation and Employment.
Resources to manage their benefits like; Manage Benefits Compensation Claim Status, Personal Contact and Direct Deposit, VA Payment History, VA Letters Certificate of Eligibility for Home Loan, and the Supporting Document Upload for Claims.
Resources to manage their health like VA Medical Records, VA Prescription Refills, VA Medical Appointment Scheduling. Hearing Aid Batteries and Prosthetic Socks, VA Medical Provider Messaging, DoD TRICARE® Health Insurance, VA National Resource Directory and the Veteran Navigator Facebook (Los Angeles)
For Social Support like; Team Red, White, and Blue Team Rubicon, American Legions, Next Step Service Dogs, National Veterans Legal Services Program to empowers veterans facing the challenge of adjusting to life at home to find new missions
For transportation and any specific question or situation not addressed by the above resources they can call the Lifeline for Vets at 888-777-4443 or use any of the social media such as Twitter, Facebook31w, LinkedIn and Google
References
- National Academy of Science (2014) https://www.ncbi.nlm.nih.gov/books/NB
- National Academy of Science (2014) https://www.ncbi.nlm.nih.gov/books/NB
