National Nurses United

PTSD 10/11/06 1:11 AM Page 21 Freedom veteran, who fought more than two years to access proper they start having symptoms later, they're charged a co-pay." Knowledgeable nurses can play a major role in recognition of the PTSD treatment after being denied by the VA. And the more psychologically damaged the soldiers, the higher disorder. "We do a lot of referring. Knowing the diagnostic scales are the tab. Aside from the costs of care associated with adverse mental important," Berg said, adding that it's very helpful for vets suffering health outcomes, PTSD's effect on the central nervous system can from symptoms to hear a nurse say, "'It's not just you. You're not compromise general health as well, increasing a patient's vulnerabili- going crazy. It may be PTSD." In addition to just the experience of ty to hypertension and atherosclerotic heart disease, thyroid dys- combat, Berg reports that many returning soldiers have suffered amputations—the literal loss of a part of themselves—that further function, immunologic disorders and infection, and chronic pain. Besides medical problems, PTSD exacts social costs as well. While contribute to disruption of self. "It's challenging, I know. But nurses should step forward and say vets make up about 13 percent of American males, they constitute an estimated one-third of all homeless men in the U.S. This year, the VA what they're seeing," added Berg, who greatly admires many of her will have resources to serve 100,000 of the anticipated half-million seasoned colleagues, like RN Charles Kaimain, who have been working with PTSD patients for many years, and written articles about homeless vets. Nearly half of all male Vietnam War veterans diagnosed with their work. Berg's own comments to the press have not come without cost to herself and her career. Early PTSD have been arrested or served jail this year, she was investigated for time at least once, while more than a "sedition" by the VA, after writing a third served time more than once, the letter to the editor of her local paper as adjustment survey showed. Of those, a VA nurse, criticizing the Bush 11.5 percent have been convicted of a administration's handling of the Hurfelony. ricane Katrina aftermath, and the Iraq For Ralph Stewart, the story told by War. Her computer was confiscated, these figures is a familiar one. Followand she was reported to the FBI. ing his return from Vietnam, the CaliThis summer she received an apolfornia resident spent years in the penal ogy from a VA administrator, and, system for drug use and petty violence. —ralph stewart, veteran notably, the VA itself has of late come Eventually, after a diagnosis of PTSD, to some of the same conclusions as counseling, and group therapy, Stewart's symptoms stabilized and he returned to college and a semblance Berg, recently announcing that a staggering 35 percent of Iraq War of normal life. But, says the former GI, too many psychically injured veterans have already sought treatment for emotional problems. A national debate is brewing about just such announcements, soldiers have not. "A lot of friends who fought with me really sank after Vietnam," he said. "No one could explain what was happening with critics saying such figures are inflated. They assert that the system gives returning vets a major incentive to claim combat-related to them. Nothing like that to make you feel alone." Even in cases where medical and social support is available, psychological injury by rewarding them with higher benefits, a conshame about their condition often hinders psychologically-hit veter- troversy not unlike the welfare rights battles of the Reagan and Clinans from getting help. Compounded with fear of how a PTSD diagno- ton eras. The clamor has led to a major ongoing VA review of PTSD sis would hurt military standing or future employment, many diagnosis, treatment, and compensation. As a result, the benefits of soldiers simply never seek treatment. According to a 2004 New Eng- aging vets from previous wars have been threatened and, in many land Journal of Medicine report, just 23 to 40 percent of U.S. vets at cases, their pride offended. "I didn't ask for that check," one Vietnam veteran told a PBS Newrisk for PTSD sought professional help for their condition. "Many are mistrustful," said RN Laura Berg. "They're just not sHour reporter. "If you want to jump in my head and live how I live, coming in. They feel, 'The government lied to me about what we I'll give you the check, and I'll go back to the coal mines and make my were getting into, why would I go to the government for my health- $60,000 a year. If I could sleep. If I could get along with people and care?'" Instead, the Albuquerque VA's PTSD team hears about trou- not get wild and crazy." As returning PTSD-affected soldiers and refugees face their bled young vets from other sources, she says. "We have grandmothers and mothers calling from as far as 400 miles away saying, 'Please help ghosts, RNs across the country will be involved in their struggle to regain their lives. The upside, says Berg, is that this time around, my son. He's not the way he used to be.'" For the many GIs who don't have relatives calling, it may be left to there's more public information available and more understanding RNs and other primary care workers to track them down, as evi- about PTSD than after the Vietnam War. As a result, more patients denced by the national VA website's current bulletin entitled "Help who need it are seeking help. "As nurses, we can help families," she said. "We can help them stay for Veterans with PTSD." Written by the National Center for PTSD, it lists signs and symptoms by which the disorder can be recognized, together, and keep people in the workforce. If we're able to, we're not going to lose quite the generation we did in Vietnam." ■ and resources for vets who may suffer from it. For vets, early recognition is important, both for most effective treatment and for their financial solvency. "Vets have only a year of Caitlin Fischer is a San Francisco Bay Area writer, research historian, and free healthcare after returning here," Berg said. "If they return with instructional assistant at Berkeley City College. Diana Reiss is a physician PTSD and are connected with services during that year, it will be cov- assistant and an associate of the Center for Investigative Reporting, and has ered thereafter. But if they don't come in during that first year and written for Salon, Hippocrates, and other publications. "A lot of friends who fought with me really sank after Vietnam. No one could explain what was happening to them. Nothing like that to make you feel alone." OCTOBER 2006 W W W. C A L N U R S E S . O R G REGISTERED NURSE 21

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