It’s very disconcerting to see young men and women as seriously injured as many of them are. Not only the physical wounds but the mental health issues—the amount of PTSD and TBI is incredible. That part was a surprise to me—I had no idea how prevalent it was. I think the majority of our patients have PTSD. Not everyone’s is severe, but all of them have some kind of adjustment. They have been affected by the war, especially when you’ve been deployed two or three or four times.
I have two female Marines who are veterans. Lots of female veterans who are not receiving care they deserve, not because the care’s not there, but because they are more reserved about asking for it. They handle stress differently. I’m actively looking for more female veterans to work with.
I was blessed with a really great career as a Navy nurse. I was stationed in California, Virginia, Naples, Pensacola, Guam, and San Diego, doing different kinds of nursing. I looked at the technology side of nursing for a while, working with nursing informatics, which allowed me to work from home while my kids were young. Then after they were in high school I was looking for a full-time job and found this. I knew about the Society but never knew they had visiting nurses.
As a nurse we tend to be a jack of all trades. You are an educator, nurturer, coach, and counselor. A lot of what we do as a nurse is listen. When you’ve been a nurse for a while, there’s a sixth sense. You watch the body language. If they’re agitated or have anxiety, it may not come out in words. You learn to read patients as you become experienced. You help them identify what they’re feeling and what’s going on. When they have traumatic brain injuries, it’s difficult for them to hold on to much. It’s difficult for them to remember what you’ve discussed or their appointments.
Often what we do is hook them up with the right resource, such as getting them into a program you know of at the VA. Then actually getting them to the VA, or going to the appointment with them. The VA wants to deliver good care but it’s a big system. When a patient has a difficult time remembering what appointment he or she has, it doesn’t take much to overwhelm them. We work closely with the families, and we talk with the primary care managers about side affects of their medication. We may say, “This is affecting their quality of life. What are alternatives?” because the patient can’t or won’t say that. We look at complimentary modes, like acupuncture that can help with chronic pain. It’s rare for one of my patients not to have chronic pain. In California medical marijuana is commonly used, which is legal.
I listen a lot. I don’t judge. You’re an adult, you get to choose how you behave. They get to know you, start listening to your suggestions, maybe become open to listening to others. You tell them the pros and cons of a decision and they are much more compliant than if you go in and tell them “This is what you have to do.”
I look at the family as a patient too. I need to keep them as healthy as possible and get resources for them to help them get care for the veteran. A lot of nurses work a lot with wives. Sometimes a veteran has no interest but his wife does. Eventually the veteran might see improvement and benefits of the program.