University of Minnesota trains new nurses to tend to veterans

When newly minted nurse Samantha Woehrle sees a patient for something as simple as a headache, she'll know to ask if the person sitting across from her has ever been in an explosion or exposed to Agent Orange.

It may not be the usual line of questioning in the waiting room. But it makes sense if the patient is a veteran.

For the first time, the University of Minnesota School of Nursing is graduating a group of nurses skilled in tending to the health needs of the nation's veterans.

Woehrle and 19 other nurses who received their diplomas last week are specially trained to understand veterans' complex medical demands, from post-traumatic stress disorder to conditions specific to the war being fought.

They are joining the workforce at a critical time for veterans and for the Department of Veterans Affairs, one the largest health care providers in the world. In the next five years, 40 percent of the VA health care workforce will become eligible for regular retirement, with 23 percent projected to actually retire. The average age of a VA nurse is 49. At the Minneapolis facility alone, a quarter of its 936 direct care nurses are currently eligible for some form of retirement.

A recent Veterans Affairs study on its own workplace warns: "The need for workers is immense and continues to increase. Demand for the services of top health care talent has intensified as the country's population has aged and public budgets have shrunk, making it more difficult to hire and train more personnel."

But there is more to it than that.

"It's really to infuse this knowledge base in the health care professional world," said Elaine Darst, one of the co-directors of the U program. "There's a very big emphasis on learning about veterans and what the needs of veterans are."

Woehrle was one of the first students chosen for the program and admits she didn't know what to expect. But the number of opportunities offered to the VA students turned out to be far more expansive than for others in her class.

There was also more time to talk about care plans and disease processes with faculty, she said.

Now, she said she plans to apply for a position with the VA hospital. In addition, she said the training broadened her understanding.

"I have more of an appreciation for the military, because sometimes my generation can get pulled away from it," she said. "It brings us more in touch with the history of our country."

The health care needs of veterans can be more complex than those of civilians. Some health conditions might be specific to the war in which they served and worsen as vets get older.

Others, like post-traumatic stress disorder, are more common.

While the VA anticipates a slow decline in the veteran population over the next 10 years, projections show that younger vets will demand more preventive care.

Female vets, whose numbers have nearly doubled in the past decade, will require more resources for things such as mental health and reproductive care.

"The first rule on our docket is the question: 'Have you served?' If that's the case, then as a health care provider of any stripe, our next responsibility is to have some follow-up with that," said Brad Foley, co-director of the VA Nurse Academic Partnership.

But the program is designed to help the graduates provide quality care for veterans in any community health system. As many as 70 percent of veterans receive their health care outside the VA system.

Recent graduate Abiola Abu-Bakr didn't intend to focus on veterans issues when she entered the program. But after her experience, she said working in the VA will apply to whatever she does, particularly as she works toward a doctorate in public health nursing.

"If anything, it's equipped me with a mind-set," she said. "I'll still be able to use every single thing I've learned to better assess my patients."

The local collaboration began in 2013 with a $5.3 million award from the VA.

The grant allowed the university to admit its largest class of undergraduate nursing students in history, with 148 sophomores entering its bachelor's degree program, 20 more than in any previous year.

In addition to providing clinical training within the VA hospital, the school expanded curriculum to provide more simulations and data on veterans health care issues to all 362 of its undergrad nursing students. The grant also supported 10 faculty members whose work was devoted fully to the education of the students through the VA.

Participating students spent much of the last two years of their four-year bachelor's degree nursing program at the Minneapolis VA hospital, where they were offered training in multiple trauma, long-term rehabilitation, home health, telemetry, spinal cord injury, psychiatric mental health and chronic pain treatment.

The money is expected to end after four years and 100 additional students have completed the program. Once the funding ends, the nursing school and the Minneapolis VA plan to keep the program going with eight students.

Veterans don't seem to mind being the test subjects.

On their last set of rounds for the semester, junior nursing students encountered Army veteran Craig Schooler, hospitalized for pancreatitis. Schooler willingly submitted for a check of his vital signs and pronounced the care he was getting excellent.

Down the hallway, Marine veteran Marc DeLosier, admitted for heart issues, was assisted on a short walk by student Krista Kirchner and RN Stephanie Carlson.

"They're doing a great job," DeLosier pronounced. "I'd let them care for me anytime."

Mark Brunswick • 612-673-4434