Final Project Assignment by Minchol kim https://padlet.com/mkim195/Bookmarks en-us 2022-04-12 14:38:14 UTC 2022-04-23 14:41:20 UTC hello@padlet.com What is a Veteran? mkim195 https://padlet.com/mkim195/Bookmarks/wish/2140963726 Veteran means a person who served in the active military, naval, or air service and who was discharged or released under conditions other than dishonorable. ]]> 2022-04-12 14:54:29 UTC https://padlet.com/mkim195/Bookmarks/wish/2140963726 Why Nurses Need to be Aware of Military Culture when Caring Veterans? (Part. 1) mkim195 https://padlet.com/mkim195/Bookmarks/wish/2141039345 Although all discharged, injured, or ill military personnel could be eligible to receive care from a Veterans Affairs (VA) hospital, it may not be practical due to the financial burden of copayment, distance from the VA location, and limited specialty services, so many seek care in civilian hospitals across the United States. Civilian hospitals are well-equipped to provide the technical and medical care needed, but few are prepared to provide holistic care of military personnel based on their unique values, principles, beliefs, and customs. Some veterans may feel uncomfortable seeking care in these hospitals, because they do not understand the military culture.
However, nurses are expected to communicate and interact effectively with a broad range of clients with varied cultural origins and to work within their cultural context. Therefore, nurses need to understand the health concerns and challenges associated with military veterans and their families to enhance efficient care because they are frontline health care providers who can make a difference in veterans' lives. Nurses also need to understand that military cultural influence includes people beyond those who have worn a uniform. People who are directly influenced by military culture include: uniformed service members, civilian defense employees, veterans, and their families. By understanding the military culture, nurses can provide health care services to many people who are affected by the culture besides the veterans. ]]> 2022-04-12 15:40:21 UTC https://padlet.com/mkim195/Bookmarks/wish/2141039345 Homelessness and a Nursing intervention mkim195 https://padlet.com/mkim195/Bookmarks/wish/2141078548 Veterans are at greater risk for homelessness than non-veterans. One of the reasons was a dishonorable discharge. According to researchers with VA’s Salt Lake City Health Care System and National Center on Homelessness Among Veterans (NCHAV) (2021), 5.6 percent of Iraq and Afghanistan Veterans between 2001 and 2012 were discharged for misconduct, usually related to drugs and alcohols. The VA (2021) also found out that they accounted “for 28.1 percent of those who became homeless within a year of their discharge”. Dishonorable veterans lose all veterans’ benefits and are forbidden from working for the government and taking out bank loans. Without all these benefits, most of them are at high risk of being homeless. As a matter of fact, another study by the Department of Veteran Affairs, veterans without benefits are much more likely to become homeless (Ismay, 2016). Also, because they were given a dishonorable discharge, they are not eligible for either disability compensation or health care benefits. This can deteriorate their health issues because they will have hard time finding jobs and do not have any financial resource to cover their disabilities. Moreover, veterans with military sexual trauma (MST) are at high risk of homelessness. Researchers at VA’s Salt Lake City Health Care System and VA’s National Center for PTSD (2021) reported that “1.6 percent of veterans were homeless within 30days of leaving the military”, and this number more than doubled within a year and hit 9.6 percent after 5 years, which is double rate for veterans without MST. They can have physical health problems, use alcohol or drugs to escape from negative feelings, and feel unsafe, which all can hinder them from starting a new life. Fortunately, VA (2022) provides MST-related outpatient services to every VA medical center and treat them so that they can recover and find their lives.

One of nursing interventions for homelessness is that nurses provide health services and work as a team to address different needs of veterans while social workers and others help find housing. For example, VA (2021) has a homeless program called Homeless Patient Aligned Care Teams (HPACTs) that creates a collaborative homeless medical home modeling. HPACTs include a social worker, medical staff, mental health and substance use counselors, nurses, and homeless program staff. It assists homeless veterans by providing housing and social services and medical care. Social workers outreach these homeless veterans and increase their access to needed care. Medical and homeless program staff engage “veterans in intensive case management that is coordinated with community agencies for continuing care,” including food and clothing assistance, showers, laundry facilities and other services on-site (O ’Toole, 2021). Nurses provide direct nursing care with nursing assessment, implementing intervention and monitoring outcomes. They also plan and schedule community homeless outreach nursing visits in HPACT clinics. Mental health and substance use counselors treat their mental and emotional disorders and promote overall mental health. With each professional’s help in their positions, HPACT can eliminate barriers to “accessing quality health care by incorporating social detriments of health into care delivery, and to fast-track permanent housing placement” (AHRG, 2017). 


Reference:


American Homefront Project | By John Ismay. “'Bad Paper' Discharge Can Lead to Homelessness, Hopelessness.” The American Homefront Project, 17 May 2021, https://americanhomefront.wunc.org/2016-04-06/bad-paper-discharge-can-lead-to-homelessness-hopelessness.


“VA Homelessness: Homeless Patient Aligned Care Teams.” AHRQ, https://www.ahrq.gov/workingforquality/priorities-in-action/va-homelessness.html.


VA National Center on Homelessness among ... - Va.gov Home. https://www.va.gov/HOMELESS/docs/H-PACT-Program-Brief.pdf.


“Va.gov: Veterans Affairs.” MST-Related Treatment and Support | Resources for Veterans, 7 Jan. 2019, https://www.mentalhealth.va.gov/msthome/treatment.asp.


“We're Here Anytime, Day or Night - 24/7.” Homelessness, https://www.research.va.gov/topics/homelessness.cfm#research1.
]]> 2022-04-12 16:06:02 UTC https://padlet.com/mkim195/Bookmarks/wish/2141078548 Veteran Homelessness Statistics from 2010 to 2020 mkim195 https://padlet.com/mkim195/Bookmarks/wish/2141090638 Click the bullet point "Total Veterans Experiencing Homelessness" to see the number of veteran homelessness]]> 2022-04-12 16:14:44 UTC https://padlet.com/mkim195/Bookmarks/wish/2141090638 Importance of Family when Caring for an Individual Veteran mkim195 https://padlet.com/mkim195/Bookmarks/wish/2144950454 Family care is very important when caring for an individual veteran. Family can affect individual s’ health and development of well-being. Healthy family can communicate well with one another when they listen, use nonverbal messages to express feelings and care, and cooperate to solve problems. A family that collaborates to create this positive environment can achieve a healthy family through comforting and healing processed.
Moreover, family health routines are strongly related to behaviors with disease risks for patients. For instance, food consumption influences greatly on wellness or disease management. If a family does not change its dietary plan that increases risks of worsening health conditions, it will affect all members of family’s health. It will be difficult to change the individual and family health routines in a short time, but they must work together to stop the bad habits. Therefore, nurses should recognize family as the unit of care because it will help them to “understand that shared lives, resources, and identities play active roles in one another’s health or illness. Family contributes the most in patients’ recovery by playing active roles in one another’s health.

]]> 2022-04-15 14:40:15 UTC https://padlet.com/mkim195/Bookmarks/wish/2144950454 Understanding Military Culture for Mental Health and Nursing Care (Part. 2) mkim195 https://padlet.com/mkim195/Bookmarks/wish/2144962843 Military culture affects all veterans after the discharge. Understanding the influence of military culture upon health-related behaviors will help the nurse appropriately plan treatment to help the veteran.]]> 2022-04-15 14:57:23 UTC https://padlet.com/mkim195/Bookmarks/wish/2144962843 Transferring the Veteran's Education Benefits to their Dependents mkim195 https://padlet.com/mkim195/Bookmarks/wish/2144976964 If a veteran meets the qualifications above, the Department of Defense (DOD) can approve the Transfer of Entitlement, and the veteran's spouse or dependent can apply for up to 36 months of benefits.

Reference:
Transfer your post-9/11 GI bill benefits. Veterans Affairs. (n.d.). Retrieved April 23, 2022, from https://www.va.gov/education/transfer-post-9-11-gi-bill-benefits/ ]]> 2022-04-15 15:18:06 UTC https://padlet.com/mkim195/Bookmarks/wish/2144976964 The Civilian Health and Medical Program of the Department of veterans Affairs (CHAMPVA) mkim195 https://padlet.com/mkim195/Bookmarks/wish/2144981647  
VA provides health care not only veterans but also their family members. But VA health care coverage is only available for certain family members whose veterans are permanently disabled or died serving our nation. Under the Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA), VA covers most health care services and supplies that are medically and psychologically necessary. CHAMPVA is often mistaken with the Department of Defense (DOD) Tricare program that manages health care program for active and retired members and their families. Therefore, if you are to be eligible for Tricare, you can not be in CHAMPVA. They can deliver medications by mail right to your door if it is not urgent maintenance.
Beneficiaries of the CHAMPV can also receive pharmacy benefits through a local retail pharmacy in the OptumRx network. How they work is that pharmacies in the OptumRx network will collect your 25% cost share/copay along with the annual deductible and send the claim to CHAMPVA for the remaining amount
]]> 2022-04-15 15:25:05 UTC https://padlet.com/mkim195/Bookmarks/wish/2144981647 Various Veterans Programs for Health and Wellness mkim195 https://padlet.com/mkim195/Bookmarks/wish/2144998162 VA provides different programs for health and wellness to help veterans maintain their healthy body and mind.]]> 2022-04-15 15:48:17 UTC https://padlet.com/mkim195/Bookmarks/wish/2144998162 The Difficult Transition from Military to Civilian Life (Part. 1) mkim195 https://padlet.com/mkim195/Bookmarks/wish/2153114166 Various factors during transition to civilian life pose challenges for the men and women who have served in the military. ]]> 2022-04-22 04:58:53 UTC https://padlet.com/mkim195/Bookmarks/wish/2153114166 Specific factors that make some veterans have a hard or easy time readjusting to civilian life (part. 2). mkim195 https://padlet.com/mkim195/Bookmarks/wish/2153727657 Pew Research Center used a logistic regression to examine the impact on transition of 18 demographic and attitudinal variables. These 4 variables were found to demonstrate that veterans would have an easier time readjusting to civilian life, while the veterans with the other 6 variables would show a difficult re-entry experience.

Reference:
Morin, R. (2020, May 30). The difficult transition from military to civilian life. Pew Research Center's Social & Demographic Trends Project. Retrieved April 23, 2022, from https://www.pewresearch.org/social-trends/2011/12/08/the-difficult-transition-from-military-to-civilian-life/ ]]> 2022-04-22 15:05:44 UTC https://padlet.com/mkim195/Bookmarks/wish/2153727657 Personal Interview with the Veteran (Part. 3). mkim195 https://padlet.com/mkim195/Bookmarks/wish/2153816806 I interviewed my fellow veteran who served with me when we were stationed in South Korea in 2016. His transition to civilian life was not as easy as he thought. One of the reasons was that he was having difficult time adjusting to the civilian job because it was very different from the military. The civilian job was very profit-orientated while the military was family-oriented. For instance, his wife had two miscarriages after the marriage, one in the military and the other in the civilian life. When she had a miscarriage in the military life, his chain of command understood his family situation and let his battle buddy cover his place so that he can focus on taking care of his family without any penalties. But when she had a miscarriage in the civilian life, his leaders understood his situations but deducted his wages and leave days for time he was absent for taking care of his wife. He says that he still struggles, but many of military benefits like the Veteran Disability Compensation and health care, help him and his family survive and made his transition easier. He was entitled to 80% disability rating, which is worth $1,926.69 per month. VA also covered his wife’s pregnancy care, which encouraged his family to have another baby after the discharge. The GI Bill also helped him because he had been taking some courses since the last year he served in the military, which provided him a basic housing allowance with a full tuition for his college. He also said that his veteran status itself helped him transition to civilian life because he found his first job just because he was a veteran.]]> 2022-04-22 16:09:25 UTC https://padlet.com/mkim195/Bookmarks/wish/2153816806 Veteran Suicide Rises mkim195 https://padlet.com/mkim195/Bookmarks/wish/2153835648 The most interesting reason for this rising suicide rate for veteran was that veterans found an apathy for by the American public. Veterans did not feel supported, which led to mental distress and suicidal thought. Some of the other reasons are trauma and stress, difficulty reintegrating into civilian life, and economic disparity.

According to 2020 National Veteran Suicide Prevention Annual Report by U.S. Department of Veteran Affairs (2020), the rate of suicide among veterans was 32.0 per 100,000 while that of nonveterans was 17.2 per 100,000. This rate shows that the suicide rate for veterans is almost twice higher than that of the nonveterans. 

Reference:
2020 National Veteran Suicide Prevention Annual Report. (n.d.). Retrieved March 5, 2022, from https://www.mentalhealth.va.gov/docs/data-sheets/2020/2020-National-Veteran-Suicide-Prevention-Annual-Report-11-2020-508.pdf]]> 2022-04-22 16:24:14 UTC https://padlet.com/mkim195/Bookmarks/wish/2153835648 Some of Nursing Interventions for the Rising Suicide Rate mkim195 https://padlet.com/mkim195/Bookmarks/wish/2153851959 First, nurses should be aware of common assessment findings in veterans at high risk of suicidal attempts. Some of them are signs of depression, anxiety, low self-esteem, or helplessness. According to the Veteran Affairs department, they may change their behavior, such as poor performance at work and acting violently and do things to prepare for a suicide (like giving away special personal items, making a will, or seeking access to guns or pills). 
Therefore, it is important to have a thorough assessment of the patient and maintain environmental safety. Nurses can assess risk for suicide, monitor patients at risk, and document the assessments and outcomes of intervention. They should also provide a brief and concise report to other clinicians and the treatment team for the appropriate care and intervention because they should continue to develop a plan of care with the interprofessional team. When evaluating the care of outcomes, nurses continue to document suicide risk thoroughly during hospitalization. Documenting risk level during hospitalization and at discharge at key times will demonstrate how effectively nurses care veterans for their suicidal prevention.

Reference:
Veteran suicide prevention. (n.d.). Retrieved March 5, 2022, from https://www.va.gov/health-care/health-needs-conditions/mental-health/suicide-prevention/]]> 2022-04-22 16:37:14 UTC https://padlet.com/mkim195/Bookmarks/wish/2153851959 Military Sexual Trauma as a Risk Factor for Suicide Mortality mkim195 https://padlet.com/mkim195/Bookmarks/wish/2154602837 The study in this article provides important evidence for the impact of MST on the risk of suicide among veterans.]]> 2022-04-23 14:37:54 UTC https://padlet.com/mkim195/Bookmarks/wish/2154602837