Care of veterans in a non‐veteran health administration hospital: What is the status of nursing practice after continuing education?

Maiocco, Gina; Stroupe, Lya; Rhoades, Anthea; Vance, Billie S.

doi:10.1111/jocn.14641

Cited by 8 publications

(7 citation statements)

References 20 publications

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“…Mentioning basic facts and statistics or providing minimal context in two sentences or less limits students' ability to competently care for this population. Thus, this review lends credence to assertions that nurses do not have the KSAs needed to care for veterans effectively (Bonzanto et al, 2019;Elliott, 2018;Maiocco et al, 2018;Mohler & Sankey-Deemer, 2017;Vest et al, 2019). Until nursing textbooks improve the quantity and quality of military/veteran content, faculty must make deliberate efforts to address and enhance prelicensure nursing education and achieve the necessary veteran care competencies.…”

Section: Discussionmentioning

confidence: 80%

“…Nurses practicing in every care setting encounter veterans from all age cohorts, various war eras, and health issues unique to military service. A growing body of evidence suggests that nurses may lack the essential knowledge, skills, or attitudes (KSAs) necessary to provide culturally sensitive veteran-centered care (Bonzanto et al, 2019; Elliott, 2018; Maiocco et al, 2018; Mohler & Sankey-Deemer, 2017; Vest et al, 2019). Among those nurses currently practicing, it is unknown how many have had exposure to or education on the health care needs of military service members, veterans, and/or their families.…”

Section: Introductionmentioning

confidence: 99%

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Veteran Competencies in Nursing Textbooks: Implications for Educators

2021

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The aim of this study was to examine the adequacy of military/veteran-related content in nursing textbooks used in prelicensure programs. BACKGROUND With increased numbers of veterans receiving care in civilian settings, nurses may lack essential knowledge, skills, and attitudes outlined in competencies required to provide culturally sensitive veteran-centered care. One explanation for this may be inadequate preparation during prelicensure nursing education. METHOD A quantitative, descriptive study guided the analysis and rating of 32 key words in 24 textbooks across eight content areas. RESULTS Key words were included in most textbooks but frequently not connected to military service or veterans. The key word with the highest mean rating was posttraumatic stress disorder; the highest rated content area was psychiatric/mental health. CONCLUSION With limited textbook resources, nurse faculty must engage in deliberate efforts to include veteran content in nursing curricula. As competency-based education trends evolve, these findings are relevant and should be considered in curricular design and revision.KEY WORDS Cultural Competency -Military Personnel -Nursing Education -Nursing Education Research -Veterans V eteran-centered health care is an ongoing public health concern in the United States, resulting from nearly two decades of deployments to Iraq, Afghanistan, and other less publicized locations. Over 18 million people in the United States are military veterans (US Department of Veterans Affairs [VA], 2019), constituting about 7.6 percent of the population (Schultz, 2017). Historically, military service members who sustained serious physical injury during war often did not survive, so their long-term care needs were not as apparent as they are for post-9/11 veterans (Baker, 2014;Geiling et al., 2012). With the passing of the VA MISSION Act in 2018, more veterans will seek care in their communities, outside VA hospitals and clinics (US Department of VA, 2019). Nurses and health care providers must be prepared to meet their needs. BACKGROUNDNurses practicing in every care setting encounter veterans from all age cohorts, various war eras, and health issues unique to military service. A growing body of evidence suggests that nurses may lack the essential knowledge, skills, or attitudes (KSAs) necessary to provide culturally sensitive veteran-centered care (

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Section: Discussionmentioning

confidence: 80%

Section: Introductionmentioning

confidence: 99%

Veteran Competencies in Nursing Textbooks: Implications for Educators

2021

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“…In non-VHA, civilian settings, there is a concerning lack of consistent inquiry into military service history. 17,23,39,40 In 1 study, fewer than 57% of nurse practitioners, physicians, and physician assistant participants (n = 102) screened patients for military service. 16 Screening all persons for history of military service helps promote a sense of value or worthiness in women veterans who may perceive themselves as " .…”

Section: Discussionmentioning

confidence: 99%

“…Civilian providers have reported only a moderate level of knowledge about military culture, military health risks, treatment for veterans’ medical conditions, or referral and consultation services available from the VHA 16. In addition, civilian providers report discomfort in discussing health-related exposures and associated risks experienced by veterans while in the military or during deployment(s) 17. In fact, many civilian providers do not routinely screen their clients for a history of military service and/or deployment 18.…”

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confidence: 99%

Women Veterans’ Descriptions of Interactions With Civilian Health Care Providers

Vance

Carpenter

2024

Advances in Nursing Science

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Women veterans often obtain care for unique gender-and military-related health issues from civilian health care settings. There is a gap in the literature surrounding woman veterans' perspectives about the care they receive. The purpose of this study was to apply the Interaction Model of Client Health Behavior framework to study the patient-provider interaction described by women veterans. A qualitative descriptive methodology, using directed content analysis, was employed. Six themes were identified. Consistent screening, provider knowledge about service roles and experiences of women veterans, and familiarity with military-related health conditions support holistic care. Further research in this area is warranted.

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“…Two years post implementation of the law, a study was conducted to evaluate the status of veteran care in a non-VHA hospital by nurses who had completed the mandatory continuing education requirement. Researchers found documentation of military status did not improve and nurses remained uncertain on how to adapt care, how to interact with veterans, and how to deal with violence (Maiocco, Stroupe, et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

Readiness of Non-Veteran Health Administration Advanced Practice Registered Nurses to Care for Those Who Have Served: A Multimethod Descriptive Study

Maiocco

Vance

DiChiacchio

2020

Policy, Politics, & Nursing Practice

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Federal, state, and educational policy, as well as public and professional initiatives, should influence how care is delivered to veterans from non-Veteran Health Administration (VHA) advanced practice registered nurses (APRNs) located in civilian health care facilities. Due to the MISSION Act, more veterans are receiving care outside the VHA, but little is known about the readiness of APRNs to address the needs of this population. This mixed-methods study describes the perceptions of 340 non-VHA APRNs concerning practice, clinical needs, and challenges they face while delivering care to veterans. Survey results show only 8% of APRNs consistently asked about military service; less than 1% asked if the patient has a family member with military history; and only 25% applied research by inquiring into military history when patients presented with conditions like chronic pain, interpersonal violence, or insomnia. Technology use via mobile application was minimally reported (<1%). “Missing in Action,” the overarching theme from qualitative data, included three subthemes: (a) absence facilitated collaboration with VHA, (b) concerns regarding personal competency in the care of the military person, and (c) lack of recognition of the significance of the need to know about military status. Practice implications proffered include implementation of mandatory inquiry into military service and enactment of APRN veteran-centric nursing competencies. Education actions involve updating graduate nursing programs to include veteran health content and increased policy awareness. Future research should encompass replication of this study in specific APRN roles and consist of ongoing evaluation of veteran care by the civilian sector as the MISSION Act is implemented.

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Care of veterans in a non‐veteran health administration hospital: What is the status of nursing practice after continuing education?

Abstract: Continuing education alone may not advance care of the veteran. A multipronged approach to include mandatory documentation of military status and coaching of providers by those experienced with the military way of life may be used to augment staff preparedness.

Cited by 8 publications

References 20 publications

Veteran Competencies in Nursing Textbooks: Implications for Educators

Veteran Competencies in Nursing Textbooks: Implications for Educators

Women Veterans’ Descriptions of Interactions With Civilian Health Care Providers

Readiness of Non-Veteran Health Administration Advanced Practice Registered Nurses to Care for Those Who Have Served: A Multimethod Descriptive Study

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