Walden NURS 6050 Week 8 Discussion

Initial post question

In considering the needs of those military members and their families after returning from combat it is easy to determine the obvious. The impact of injuries, whether physical or not, has a potential for a far more negative outcome than what seems at first glance. Two of the most obvious injuries often seen with returning Veterans are Post Traumatic Stress Disorder, and musculoskeletal injury with chronic pain. The latter is said to be the most common health concern with those soldiers returning from deployments post 9-11 (Spelman et al.). Traumatic brain injury and post-concussive disorder are also noted as the “signature injuries of current conflicts”. Regardless, all three health issues are significant and they also share several of the same symptoms. Walden NURS 6050 Week 8 Discussion

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Due to the stigma associated with accessing mental health resources such as counseling, activities, and even vocational rehab services at times, many military veterans do not access these services outside of the VA. Furthermore, it was interesting to discover that military actions profoundly impacting outcomes into civilian institutions after “prompt removal of problematic wounded soldiers” (Seamone, et al., 2014) has become a trend. Without going into detail about processes of discharge status in the military, attention has been drawn to this very issue resulting in loss of eligibility VA services for thousands. According to Seamone, VA services, more specifically the health care coverage itself, is likely one of the most important health needs of returning veterans and families.  Lack of health care resulting in further devastating exacerbating and chronic symptoms including domestic violence and intergenerational transmission of mental illnesses can alter a family in devastating ways.

According to O’MahoneyPaquin, author of “Social Justice Advocacy in Nursing: What is it?”,  the social justice advocacy model could be employed as a perfect tool here. In advocating to challenge such a reality we as nurses must make assessments in the upstream approach relating to discharges from the military. In researching this briefly, I found that the military has discharged soldiers who have difficulty and/or suffer from the new onset of mental health disorders resulting from service i.e. PTSD, anger problems, anxiety, and misconduct. Self-confidence, self-worth, ability to find and secure a job and risk for depression and suicide become significant factors to many of the veterans who have been to battle or around it (Allen et al., 2013). And, with further investigations, it is clear that the military often criminalizes these behaviors resulting in discharge rather than addressing the mental health needs prior to discharge (Allen et al., 2013).

For the military, this is a much more expedient resolution to problematic military personnel than lengthy treatment. Here is where advocating for mental health assessments, diagnosing, and implementing treatment such as medication and therapy before any discharge from the military can occur. The collection of evidence based-data from the downstream end, where ED visits and jail-house nursing can provide critical information regarding veterans, both honorably and dishonorably discharged. This is part of our evidence and ammunition. Calling on our comrades including organizations, nurse-leaders, nursing researchers, educators, and front line nurses to play a role in addressing our state and federal government roles in caring for our veterans suffering from both physical and mental illnesses during, and post-discharge. NURS 6050 Week 8 Discussion

Nurses have a responsibility to not only care for and advocate for the patients we see as front line nurses, but to also advocate for those we do not see every day. Veterans serve our country whether during wartime or not. In the very least, their health care should be part of the benefits package until the end of life…Hmmm, another advocacy project to think about?

References

Allen, P. E., Armstrong, M. L., Conard, P. L., Saladiner, J. E., & Hamilton, M. J. (2013). Veterans’ health care considerations for today’s nursing curricula. Journal of Nursing Education, 52(11), 634-640. doi:http://dx.doi.org/10.3928/01484834-20131017-01

Bakameier, B. (2008)”Upstream nursing practice and research. Applied nursing research, 21(1), 5052.

Seamone, E. R., McGuire, J., Sreenivasan, S., Clark, S., Smee, D., & Dow, D. (2014). Moving upstream: Why rehabilitative justice in military discharge proceedings serves a public health interest.         American Journal of Public Health, 104(10), 1805-11. Retrieved from http://search.proquest.com.ezp.waldenulibrary.org/docview/1564433185?accountid=14872

Spelman, J. F., Hunt, S. C., Seal, K. H., &Burgo-black, A. (2012). Post deployment care for returning combat veterans. Journal of General Internal Medicine, 27(9), 1200-9. doi:http://dx.doi.org/10.1007/s11606-012-2061-1

Social Justice Advocacy in Nursing: What Is It? How Do We Get There?. (2011). Creative Nursing, 17(2), 63-67. doi:10.1891/1078-4535.17.2.63. NURS 6050 Week 8 Discussion