Barrier between veterans, clinicians persists

BUFFALO, N.Y. – New research, which surveyed nursing and social work graduate students, found that future clinicians are not taught about military culture in the classroom and are often ill-prepped to treat veterans and their families.

The study, “On Working with Veterans: What Social Work and Nursing Students Need to Know,” was led by Susan Bruce, clinical associate professor in the University at Buffalo School of Nursing, and Lisa Butler, associate professor in the UB School of Social Work. The research was published in the Journal of Military and Veteran Health.

The research is a part of a larger study, in which veterans and military families were also surveyed, that aims to better prepare nurses and social workers to treat veterans.

“In health care, you need to understand the person sitting in front of you,” says Bruce, also coordinator of the UB Adult Gerontology Nurse Practitioner Program. “Just like children and pregnant women, veterans and their families have now become a vulnerable population and we need to understand what their culture is.”

The research found that clinicians and veterans were often unable to form a relationship because students had difficulties relating to or understanding their experiences. Even when a student had a military background, rapport was not improved, unless both experienced combat.

Other challenges included a limited amount of time given to treat each patient, which for some of the students amounted to just 15 minutes, and a limited list of medications they could prescribe under Department of Veterans Affairs (VA) health plans.

Because only 30 percent of eligible veterans seek care at VA clinics, says Bruce, many students are likely to encounter veterans in primary care settings, community clinics and hospitals.

The need for better training is also heightened by the vast number of the more than 2.6 million American soldiers returning from the Iraq War and war in Afghanistan.

In addition to physical care, returning soldiers often need psychological treatment.

According to the VA, one in five veterans who served in Iraq return with post-traumatic stress disorder (PTSD). Symptoms can range from difficulty sleeping to the inability to be near fireworks due to the sounds of fireworks exploding, says Bruce.

However, not all soldiers return with PTSD, she adds, and other veterans may have trouble adjusting to civilian life, or experience grief over the loss of a lifestyle or a friend.

“My father told me ‘no daughter of mine will ever go into the armed services,’ and I never understood why until I watched war videos and heard the stories,” says Bruce, whose father served in the World War II. “He didn’t want to expose his kids to the things he went through. PTSD isn’t something you give them a pill for and it’s better. It has to be worked out over time.”

The researchers will use the study results to design clinical training programs that incorporate an explanation of military culture, such as acronyms, the functions of different branches and the experiences soldiers go through.