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

Aims And Objectives: To identify how civilian nurses are caring for military veterans following mandatory continuing education on veterans' mental health needs and to describe challenges nurses are facing in provision of that care.

Background: Veterans and military personnel experience mental health conditions at a high rate and are increasingly receiving care in civilian healthcare facilities. Nonmilitary providers may not be prepared to address this population's challenging needs. Military culture may influence the presentation of mental health conditions; thus, critical assessment points by nonmilitary medical personnel may be missed. Education is touted internationally as a means to address deficits, but research is lacking to support that statement.

Methods: Adhering to research reporting guidelines, 115 of a proposed 322 civilian nurses in a tertiary hospital volunteered to complete a one-time online survey that contained quantitative and demographic questions. Forty of 115 nurses went on to complete the qualitative query. Descriptive statistics summarised quantitative results, and constant comparative analysis was applied to qualitative responses for theme identification.

Results: The study was stopped early due to reports of violence from veterans upon nurses. Results showed continuing education did not change documentation of military status. Following mandatory continuing education, civilian nurses continued to describe uncertainty in how to adapt care, on how to interact with veterans and in how to deal with violence.

Conclusion: The status of care to veterans remains insufficient, but nurses are asking critical questions on how to update practice. Additional support and research in the clinical setting is needed to promote a safe caring environment.

Relevance To Clinical Practice: 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.