Earlier this month, Hospital of the University of Pennsylvania (HUP) Nursing Grand Rounds hosted “From War to Home: Through the Veteran’s Lens.”
Nurses are indeed on the front lines of transitions to civilian life for many of our nation’s veterans, and those braving wintry conditions to Stemmler Hall were treated to an intimate look at military life through Photovoice, a program sharing photos and words of those who served in Iraq and Afghanistan. Through those personal stories and research from Gala True, PhD, assistant professor of medicine, attendees increased their military cultural competency and enhanced their ability to provide patient- centered care for veterans.
True challenged the audience early, asking them to reflect on the care they provide to these patients.
“If you are a nurse or physician, why would you care if your patient is a veteran,” asked True. “How can you connect on a human level with the issues facing veterans”?
There are many reasons why nurses should care about whether their patient was in the military.
“There are a lot of experiences that veterans have, even during basic training, that are relevant to their physical and mental health,” says True. “If they’ve deployed, those could come more to the forefront.”
In addition, veterans may have access to benefits and services that they are unaware of. As the health care provider, nurses can inform their patients about what is available.
True noted that there are more than 20 million veterans in the United States today, and many of them listen to their health providers.
“Only about half of those separated from military service are accessing care through the VA,” said True. “Most veterans are using at least some community services.”
True gave the nurses some questions that are useful in starting a dialogue with patients and inquiring about their military health history. Through this conversation, nurses can more effectively determine the effects of that background on the patient, and sometimes, how it may also affects their loved ones.
Many obstacles stand in the way of creating that dialogue, but the conversation is vital to reveal underlying conditions that may otherwise go unnoticed.
“Some veterans who are struggling with PTSD or mental health issues still try to keep up appearances,” explained True, as she went over one veteran’s photo showing him shaving and sporting a “high and tight” haircut as a way of putting on a brave face and tough exterior.
“When healthcare providers see veterans, sometimes they don’t see that maybe they’re in trouble, depressed, or in pain because that person is still trying to keep appearances together.”
Whether it’s mental health issues, housing issues, or physical health concerns, each case is a unique opportunity for a provider to see if there is an underlying condition.
One of those veterans is Drew Bendler, a former staff sergeant in the U.S. Army, who shared his military experience as a plea for more personalized care.
Bendler served in the U.S. Army from 1984-87 and re-enlisted in the Army after 9/11/01 as a staff sergeant in the NJ National Guard from 2004 to 2013. He served a combat tour in Iraq, where he provided security for the House of Wisdom, an initiative focused on utilizing the Qur’an to advance peace between Sunnis and Shi’as.
“After serving 13 months in Baghdad, I was in denial that I had any problems,” said Bendler. “Things over there were to the point where you had other things to worry about, you didn’t think about how you were going to eat, what the weather was going to be like, you just wanted to survive and make sure your battle buddies survive.”
After his duty, at first Bendler used alcohol to cope with trauma from his military service. Living in a veterans home for 90 days, Bendler says he still has some bad days, but experiences far more good days and is still progressing.
Bendler recently graduated from Penn’s Veterans Upward Bound program, a federally funded program that prepares eligible veterans for college. Bendler tutors and mentors others in the program and plans to enroll at Penn in May on the way to reaching his dreaming of being an elementary school teacher.
“I want to see health care providers push veterans in the right direction to get help like I did,” says Bendler.
One of the best ways to achieve this, adds Bendler, is through educating health providers to have the tools to help veterans who may be in denial about what they need.
Whether in the classroom or in events like these, True agrees that education is an integral step forward.
“Knowing about your patient’s military background and what it means to them promotes a stronger patient provider alliance and ultimately helps you to provide more effective clinical care.”