Name
Capella University
NURS FPX6026
Instructor’s name
September 30th, 2024
Analysis of Position Papers for Vulnerable Population
Increased instances of post-traumatic stress disorder (PTSD) among the veteran community prompt difficulty accessing treatment and further elevate healthcare disparities within the American healthcare system. PTSD is experienced by 12-23% of veterans who have served in war zones and causes drastic disruptions to their family life, work, and overall health. Overall, society needs to put appropriate measures for pre-deployment and post-deployment treatment for these veterans as a mark of appreciation (Conejero et al, 2023). This population, especially community-dwelling elderly veterans, are often unwilling to report trauma-related symptoms and may even have historically unexpressed symptoms that may become exacerbated or manifest over time.
When PTSD symptoms show up in elderly veterans, they are likely to be accompanied by other mental and physical illnesses such as dementia. PTSD can be worsened by age factors, which present clinicians with specific merits that need to be approached in a specific method. Healthcare providers need to address these complexities using agewise interventions, but deciding which treatment methods would work best continues to present challenges (Jo et al., 2023). Comorbid SUD investing veterans with PTSD with a rate of 26-52%, complicates treatment, as clinicians may avoid utilizing EB therapies and respecting therapeutic response due to risks.
The management of these challenges calls for interdisciplinary practice. A myriad of healthcare professionals involved in the patient’s care including mental healthcare providers should integrate to provide effective and person-centered care to veterans (Conejero et al., 2023). To mitigate the disparity and improve the results for posttraumatic stress disorder veterans, the healthcare organizations trying to expand and improve the availability of psychiatric care, increase the healthcare insurance density, and work together in a unified approach. This approach is crucial to sorting the quality of care that these veterans are supposed to receive for their services.
Position of PTSD Based on the Healthcare Outcomes
PTSD as one of the known mental disorders diagnosed in veterans is associated with either direct or indirect experiences of trauma. These are intrusive memories of the traumatic event, nightmares, sleep disturbances, and avoidance of any settings that relate the person to the event. PTSD criteria do not change about the nature of the event that led to the development of the condition (James et al., 2019). PTSD greatly affects people and their society, and studies reveal that it has a strong correlation with suicidal attempts, including controlling for depression and anxiety. Those diagnosed with PTSD also have other problems including interpersonal problems, family problems, and economic problems plus other diseases that have physical and psychological aspects.
Post-traumatic stress disorder is an area that affects veterans and other service members with high risks where 23% of participants in either OIF or OEF received treatment for PTSD (Krause et al., 2021). The sequela associated with PTSD such as alcohol dependence, marital difficulties, and depression exert considerable stress on both the patient and his or her relatives. To address these complexities the Veterans Health Administration has come up with treatment protocols from research that would enhance the situation of the veterans. Organized healthcare institutions work hard to ensure that proper evidence-based interventions are availed for the management of PTSD to get veterans their lives back.
Carl Alomar is the best example of how such veterans have to combat PTSD daily. After developing a fracture of his foot due to an incendiary device during the Iraq Invasion in 2007, he was given Oxycodone for pain management (Li et al., 2023). However, it made him a workaholic who lost his job, married, and finally compounded his problem to that of taking illicit drugs. Although using a plethora of services provided by the Veterans Administration where he can attend rehabilitation programs Carl remains unfulfilled and fails to come to terms with his illness.
The Role of Interprofessional Team in the Management of PTSD
The staff or the specialty team that will address PTSD is made up of different healthcare professionals such as the nurse, psychologist, and therapists within the mental health section. All members provide crucial support in the goal of hospitalizing patients with mental illnesses, including PTSD, and then provide support to ensure that they adjust to a more stable life after they are discharged (Liu et al., 2021). Because of the likelihood of the disorder, especially in military veterans, the care plan may require some changes according to the level of trauma in the patient. While practicing clinicians in this study reported prescribing medication, they also noted doing so as a function of PTSD severity.
Psychiatric nurses in return dispense these medications and also help in the coordination of the daily care of the patients. Physicians consult with psychiatrists in matters of identification of PTSD and suggestions of appropriate treatment depending on the patient. Interdisciplinary team members also engage in the development of patient-specific care plans for regular treatment conferences rather than applying generalized PTSD procedure schema for each patient based on the type of trauma they experienced (Mäki et al., 2022). This way of the organization of the team’s work enables giving the necessary amount of attention to a person, being ready to support or cure him/her, and considering the degree of the disorder. However, the interdisciplinary team involved encounters several difficulties that could act as barriers to the adoption of these complex care procedures. For example, when employed in a professional environment, psychologists and clinical psychologists may face difficulties in integrated cooperation concerning the diagnostics and medications for patients with different levels of PTSD manifestations. Furthermore, some team members may resist change, thus impeding or halting the implementation of alterations that would improve PTSD patients’ care.
The Evidence and the Position to Support a Team’s Approach to Quality Outcomes
A multi-sectoral approach is essential in resolving Carl Alomar’s opioid addiction problem. Carl narrated how substance use has almost plagued him and his family, adding that he has always been absent from work. His efforts to withdraw from opioids got him hospitalized, a scenario that could have proved fatal, this is since many opioid addicts (Mäki et al., 2022). Another treatment that is usually employed during the treatment of veterans with opioid addiction and on a team basis is cognitive behavioral therapy abbreviated as CBT. CBT can be described as a process of identifying the relationships between different cognition emotions and actions. It plays an important role in anxiety caused by substance use and provides skills for the enhancement of mood and expression.
The second method employed by the interdisciplinary team to tackle the opioid addiction problem is known as Contingency Management Therapy. CMT encourages patients to stay obedient, for instance, they will be rewarded for not using drugs. Research has shown that CMT is a very efficient approach to ensuring patient abstinence during opioid dependence treatment (Ramachandran et al., 2023). A combination of CBT and CMT could help Carl later in the process of his recovery drastically. Specificity of care involves drawing up a plan of treatment for such a client and integrating the details of a client’s PTSD and history of trauma to be taken by his mental health team for the care of Carl.
This mechanism which is patient-enduring and grounded on evidence not only helps Carl but could also inspire other people there who make up healthcare teams (Taylor et al., 2021). When Carl’s interdisciplinary team performs this collaborative treatment, likely, that other healthcare staff will also apply the same method to PTSD patients with substance use disorders. This model of care could be shared between different healthcare institutions because they all want to provide the best care they can for their patients to produce good results for veterans like Carl.
The Evidence and Position Contrary to the Team’s Approach to Quality Outcomes
Some of the caregivers may not want to change the ways of handling PTSD because it is complex, while others may be willing to apply the new strategy. Such resistance is primarily due to treatment protocols provided in the DSM-5 by the American Psychiatric Association, which may discourage some clinicians from applying new paradigms of management (Liu et al., 2021). Moreover, the new approach would be slightly more complicated than the traditional method and it therefore may be a challenge to some of its users.
Studies have shown that the use of Enhanced Telephone Monitoring abbreviated as ETM does boost health outcomes for patients who are shifting from their hospitalization to outpatient services. In a controlled study of veterans with SUD, ending telephone counseling after a three- to six-month period marked noteworthy improvements (James et al., 2019). Anticipated federal legislation to support programs battling opioid use include; The Veterans Health Administration using Medically Assisted Therapy (MAT). MAT blends counseling with drugs such as tramadol, suboxone, and naloxone that seek to rebalance the body’s chemicals, curtail drug cravings, and support normal operations in the body.
The other viable strategy within the continuum of care is a specialized community healthcare outcomes model. This strategy eliminates the congestion of specialized care by adding telemonitoring to how providers train, counsel, and manage prescription opioids for misuse (Li et al., 2023). Together with these components, this model provides fundamental counseling and pharmacotherapy to people who have restricted options in seeking medicine. This explains why a veteran like Carl Alomar requires a one-stop center that can address PTSD coupled with opioid use disorder at the same place.
NURS FPX 6026 Assessment 1 Conclusion
According to estimates, over two billion people suffer from chronic pain, and the problem runs rampant within the military population where shame and co-morbidities such as PTSD, stress, and anxiety make it even worse. It also looks into the disturbing new elevation of opioid use disorders among veterans, stressing the requirement of a proper treatment model (Jo et al., 2023). Some of the issues addressed are the relationship between powerful opioids with different interdisciplinary teams and the need for interprofessional care enhancement. In taking care of the service members some of the objectives include encouraging shared appreciation that mental disorders are not evidence of personal weakness, ensuring that adequate treatment is offered to the ex-combatants in the rural areas, and adopting of treatment plans utilizing different staff from different disciplines.
NURS FPX 6026 Assessment 1 References
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Jo, S., Kurt, Ş., Mayer, K., Pituch, K. A., Simpson, V., Skibiski, J., Takagi, E., & Reifsnider, E. (2023). Compassion fatigue and COVID-19: A global view from nurses. Worldviews on Evidence-Based Nursing, 20(2), 116–125. https://doi.org/10.1111/wvn.12641
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Liu, Y., Zhang, L., Guo, N., & Jiang, H. (2021). Postpartum depression and postpartum post-traumatic stress disorder: prevalence and associated factors. BMC Psychiatry, 21(1), 487. https://doi.org/10.1186/s12888-021-03432-7
Mäki, M., Kaakinen, P., & Pölkki, T. (2022). Interprofessional Collaboration in the Context of Pain Management in Neonatal Intensive Care: A Cross-Sectional Survey. Pain Management Nursing: Official journal of the American Society of Pain Management Nurses, 23(6), 759–766. https://doi.org/10.1016/j.pmn.2022.08.006
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Taylor Miller, P. G., Sinclair, M., Gillen, P., McCullough, J. E. M., Miller, P. W., Farrell, D. P., Slater, P. F., Shapiro, E., & Klaus, P. (2021). Early psychological interventions for prevention and treatment of post-traumatic stress disorder (PTSD) and post-traumatic stress symptoms in post-partum women: A systematic review and meta-analysis. PloS one, 16(11), e0258170. https://doi.org/10.1371/journal.pone.0258170
