Veterans Health Care Programs In The US
There are just over 20 million veterans living in the United States, over 9 million of these veterans are enrolled in the Veterans Affairs (VA) health care program (Veterans Health Administration, 2009). Of those 9 million, it is unknown as to how many are actually receiving care. Healthcare is provided to all service members and their families while serving active duty, this care is 100% covered by the service in which they’re signed up with. Once service members are discharged from active duty their healthcare drops off completely. Depending on their situation, they now must apply for VA healthcare. Not all veterans qualify for healthcare once discharged. There are requirements based on amount of time served, injuries obtained during service and discharge status (such as honorable, general or dishonorable discharge). Caring for a veteran, post active duty, requires knowledgeable understanding of the client. There are many factors that come into play while treating a prior service member. Many veterans have been exposed to hazardous materials and dangerous situations in which not everyone can relate to or understand. Showing compassion and understanding during this vulnerable time can make all the difference.
When caring for veterans, it is important to understand what sets this population apart from the general public. Veterans have the same health issues as the general public but also suffer from several others in which the general public could never understand. The health-related conditions that are important to know and understand while taking care of veterans are, “mental health conditions, such as suicide risk and substance use disorders; traumatic brain injury and women’s health issues; depression, pain management, reproductive health, coping with chronic general medical and psychiatric conditions, sleep problems, weight management, posttraumatic stress disorder (PTSD) and homelessness” (Weber & Clark, 2016). Many of these health issues/conditions are ones that you cannot see just by looking at a person. Conditions such as a TBI or PTSD are considered ‘invisible’, they are not easily noticeable unless you have a conversation with the service member or read about it in their chart. Another issue that could cause an obstacle for treatment is pride. Many service members do not like to ask for help or complain about what is ailing them. They also try to hide what is going on so that they’re not judged on the things going on inside their heads that would be too difficult to explain. During a study held by the Washington Post/Kaiser family Foundation, it was found that from a sample of 800 veterans, 70% felt that the general community misunderstood their experiences from service. Many of these service members have felt disconnected from civilian life due to the profound differences between civilian and military life (Oster, Candice & et al, 2017). The amount of people in this survey of service members who have felt they would be misunderstood if they sought help is just a small percent of the 20 million veterans in the United States today. How many of these service members have decided to push off being seen by a healthcare professional due to this misunderstanding?
Per the Veterans Administration website, the Veterans Health Administration (VHA) is the largest integrated health care system in the United States, providing care at 1,255 health care facilities…to over 9 million Veterans enrolled in the VA health care program (Veterans Health Administration, 2009). They state that these VHA centers provide a wide range of services as well as specialty services. The site also mentions that at every medical center, they provide a Patient Advocate. These people are highly trained professionals who are there to help resolve any apprehensions about any aspect of a service members health care experience. But do veterans feel like the VA has successfully committed to their care model? In the article, “The Meaning of Care for Veterans,” a study was performed to find out what was important to veterans in order to improve their care. The analysis proved that caring was important to the veterans with these subthemes: “(a) communicating, which included teaching and explaining, and listening, (b) following up, which included partnering or collaborating, and (c) using specialized knowledge” (Cohen, Struwe, Swore Fletcher, & Kingston, 2018, p.162). Most of those who were interviewed felt like their VA was providing most of what was important to them regarding their care. But this is just one study focusing on one VA care center. What of the other 1,254 VA facilities offering care? Are they offering the same care to the rest of the United States?
According to the 2019 National Veteran Suicide Prevention Annual Report put out by the Office of Mental Health and Suicide Prevention with the U.S. Department of Veterans Affairs, there were 6,139 U.S. veteran deaths as a result of suicide in 2017. There has been an average of over 6,000 suicides each year from 2008 to 2017 and this number continues to soar over the years. “Suicide rates among veterans who are enrolled in VHA services are noted to be affected by; economic disparities, homelessness, unemployment, level of military service-connected disability status, community connection, and personal health and well-being” (‘2019 National Veterans Suicide Prevention Annual Report’). The numbers show that for each year from 2005-2017, veterans with recent VHA use had a higher suicide rate than other veterans. However, over these years, suicide rates among veterans with recent VHA use increased at a slower rate than for other veterans. There is no all-encompassing explanation for these suicides and no single medical cause, etiology, or treatment or prevention strategy for these suicides (‘2019 National Veterans Suicide Prevention Annual Report’). Suicide continues to be a growing concern among veteran and is something the VA is working very hard towards trying to eliminate.
There are several tactics put in place by the VA in order to help healthcare workers, and particularly nurses, to better understand how to provide specialized care for veterans. The VA has come up with veteran specific questions for healthcare workers to ask veterans in order to help care for them properly. These questions are, 1. When and where did you serve? 2. What was your job while serving? 3. How has the military service affected you? (Weber & Clark, 2016). These questions provide clear guidance for evaluating a veterans health needs and guide nurses in providing the most optimal health outcomes. Being informed about veterans and their health needs should be a priority for all nurses. Learning about their needs helps enable nurses to promote desired outcomes and contribute to their overall quality of life (Weber & Clark, 2016). Nurses are at the forefront of providing care for veterans and should be armed and ready to help provide the best care possible by understanding their clients.
Overall, veterans deserve proper health care benefits and understanding. There are too many times that veterans’ health care is overlooked and misunderstood. One of the first people a veteran interacts with during a medical visit is a nurse. This first impression and interaction are going to help shape the visit. It is important for the nurse to tailor questions and methods that would make the veteran feel comfortable enough to be vulnerable in front of the health care team and ask for help. This will hopefully, in turn, result in less suicides and further health problems that get forgotten.
