By Sylvia Foley, AJN senior editor

Photo (c) Associated Press

Photo (c) Associated Press

“The war tried to kill us in the spring,” says John Bartle, the narrator of The Yellow Birds, Kevin Powers’s acclaimed novel about two U.S. soldiers serving in Iraq. “I know now that everything that will ever matter in my life began then.” The same might be said by many war veterans. The effects of military service, especially on veterans’ health, vary greatly and can be lasting. And with most veterans seeking care through non-VA channels, it’s imperative that civilian nurses have some knowledge of the health issues veterans face.

In this month’s CE, “Enhancing Veteran-Centered Care: A Guide for Nurses in Non-VA Settings,” authors Barbara Johnson and colleagues describe a wide range of veterans’ health concerns and provide guidance for civilian nurses caring for these patients.

Overview: There are currently 22.5 million living U.S. military veterans, and this number is expected to increase dramatically as military personnel return from Iraq and Afghanistan. Although honorably discharged veterans may qualify for health care through the U.S. Department of Veterans Affairs (VA), only about 25% of all veterans take advantage of this benefit; a majority seek services in non-VA settings. It’s imperative for nurses in all civilian care settings to understand the impact that military service has on veterans’ health.

This article provides an overview of veterans’ unique health care issues, focusing particularly on traumatic brain injury, polytrauma, hazardous exposures, chronic pain, posttraumatic stress disorder, military sexual trauma, substance use disorders, suicide, and homelessness. Evidence-based assessment tools and treatment guidelines for these health issues are discussed.

A resource table provides telephone numbers and Web sites offering tools, educational materials, and veteran services. A second table provides detailed veteran-centered health assessment and screening questions.

Johnson and colleagues also discuss the roles of military culture and “veteran identity,” which continue to affect veterans even after they have transitioned back to civilian life. The authors conclude with three general suggestions:

  • Ask every adult patient whether she or he has served in the military.
  • If the answer is yes, take time to listen to the patient’s story.
  • Incorporate the patient’s military experiences and health concerns into the medical record.

To learn more, read the article, which is free online, and listen to our podcast with the lead author. If you’ve cared for veterans, please consider sharing your experiences with us in the comments.