ennifer S. is an Army veteran of Operation Freedom. Since returning home Jennifer has suffered from recurrent headaches ringing in her ears difficulty focusing and dizziness. In addition soon after returning home she began to experience moments of panic when in open spaces flashbacks reliving the blast and the death of fellow soldiers feelings of emotional numbness and depression and being easily startled. She was placed on medical leave and diagnosed with Post Traumatic Stress Disorder (PTSD) and is currently being seen by a psychiatrist at the VA hospital. Her husband understands the concept of PTSD but is unprepared to handle his wifes deteriorating condition.
Recently Jennifer was seen at the local urgent care center for recurrent headaches complaints of shortness of breath and chest pain. Her husband informed the urgent care nurse that for the past four weeks his wife has been unable to care for the children remains in bed complaining of headaches and is very jumpy.
The nurse refers Jennifer to a Public Health Nurse from the Veterans Affairs Center realizing that returning veterans with PTSD and their families face an array of challenges with implications for the veterans their partners and their children.
Key elements of the nurses assessment are as follows:
Jennifer is 33 year old woman who enlisted in ROTC in college where she majored in Journalism. Upon graduation she obtained a position in the Army as public affairs broadcast specialist. Her first assignment was at a base in upstate New York but three years ago she was relocated to the St. Louis Missouri area. Jennifer has been with the same partner for 14 years and they have 2 children ages 6 and 13. Cameron is 10 years old and entering middle school and Zeta is 6 years old and in kindergarten. Jennifer and her wife Sara married two years ago when same sex marriages became legal. Sara works as a civil engineer in the St Louis area. Both Jennifer and Sara come from large families who reside in the Boston area. Jennifers family is Portuguese and Saras is Irish Catholic. While Jennifer was deployed her mother moved in with Sara and the girls to provide additional support and child care.
One year ago Jennifer was deployed to Afghanistan on a six month assignment to report on the events of the war: she thought she had a safe assignment. While working on a story in the field an Improvised Explosive Device (IED) exploded near her: two soldiers and 4 citizens were killed including one child. Although she was unhurt she was unable to sleep after this event. Upon returning stateside she began experiencing vivid nightmares sleeplessness survivor guilt and depression. She was recently diagnosed with PTSD and is attempting to find a support group and counseling. Unfortunately she has found that treatment for female veterans is limited and the family continues to struggle.
Answer these questions:
1. Describe the health disparities present in this family and the impact PTSD has had on Jennifer herself as well as her family and community.
2. Discuss a current state and federal legislation program which addresses returning veterans health issues.
3. Describe the political advocacy role community/public health nurses have in addressing veterans health disparities.
For Reference use: Stanhope M. & Lancaster J. (2014). Public health nursing: Population-centered health care in the community (8th Ed.).
Chapter 27: Family development and family nursing assessment
Chapter 28: Family Health Risks
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