With the number of veterans in the U.S. currently at 16.2 million, it’s a good bet that emergency departments will see veterans at some point. EDs certainly service the over-65 population, which currently stands at about 56 million people. Given the large numbers of these two patient populations, even with some overlap between them, ED nurses should be prepared to treat veterans, geriatric patients or people who are part of both groups.
Ashley Lunkenheimer, RN, CEN, NE-BC
About half of all veterans are enrolled in the government-run Veterans Health Administration, which provides medical care for individuals who served in the military. The VA has 111 EDs and 33 urgent care clinics nationwide. However, veterans don’t exclusively rely on the VA for medical care. “Our veterans choose care in all ERs, not just VAs,” said Ashley Lunkenheimer, RN, CEN, NE-BC, chief nurse executive at the Veterans Health Administration in Washington DC, who will co-lead the session “Caring for the Geriatric Veteran” from 12:45-1:15 p.m. Pacific time on Sept. in Titian 2201.
The session will explore some of the special considerations when caring for geriatric patients and veterans, who often have higher rates of certain conditions than the general population. They are more likely to suffer from balance issues and have an increased risk of falls, for example. In the case of veterans, the fallout from serving in combat may include hearing loss and tinnitus; head and brain injuries; shrapnel wounds; orthopedic injuries from lifting and carrying; and mental health disorders, including post-traumatic stress disorder, depression, anxiety, substance abuse and suicidal thoughts.
It’s important for ED nurses to be sensitive to environmental triggers when treating these patients. “The emergency department is not a calm place to be,” Lunkenheimer pointed out, referencing the noise, bright lights and potentially chaotic atmosphere that may trigger individuals who have served during wartime. “[They need] just a little extra support.”
Benjamin Thelen, MSN, RN, CNML
The first step for ED nurses is simply to be aware of the unique vulnerabilities of geriatric patients and veterans. After that, nurses can take concrete steps when presented with these patients. For instance, they should aim to offer one-on-one care, focusing their full attention on the patient and allowing the patient to explain their situation with no distractions. If several providers need to see the patient, it’s better to do a team assessment than to make the patient go from one provider to the next, as having to repeat the story of why they’re seeking treatment can be frustrating.
ED nurses also need to have an awareness of any cultural or social norms when dealing with geriatric patients and veterans, and understand the most effective way to talk with them, said session co-leader Benjamin Thelen, MSN, RN, CNML, a nurse manager at the Milwaukee VA Medical Center. Sensitivity to the unique difficulties that patients may have experienced leads to a better experience for them and can impact their outcomes. “It allows us to be more effective in the way we treat these folks,” Thelen stated.