Introduction
Registered nurses are deeply involved in advocating for the patient’s needs and healthcare quality at the clinical facilities. As RNs are required to interact with patients, RNs’ contribution to the establishment of care services for vulnerable populations is especially valuable (Swan et al., 2019). Currently, veterans undergoing opioid treatment for PTSD are vulnerable to the development of negative health consequences due to the lack of financially accessible programs and quality psychological aid. With opioid dependence frequently manifested in this population, it is essential to assess their needs and determine how nursing personnel could advocate for health care improvement. The current presentation focuses on the mentioned individuals’ health care needs, resources, and economic standing, describing pertinent issues in medical assistance provision and suggesting how RNs could promote this population’s well-being.
Registered Nurses’ Role in Healthcare Delivery
RNs in Health Care Provision
Registered nurses (RNs) occupy one of the most significant roles in healthcare provision, attending to the needs of numerous patients and offering the necessary healthcare services in medical institutions. RNs’ duties encompass many responsibilities and are essential for the patients’ rehabilitation (Swan et al., 2019). Assessing the clients’ statuses, implementing medical treatment, monitoring the individuals’ health and adherence to therapy, and collaborating with other physicians are the most vital activities performed by RNs (Swan et al., 2019). Fulfilling these duties is not only essential for ensuring high-quality care but also for properly identifying and addressing the patient’s needs in the healthcare setting.
Veterans Undergoing Opioid Treatment
The recent increase in opioid epidemic rates created significant concerns for veterans diagnosed with Posttraumatic Stress Disorder (PTSD). As veterans have high rates of chronic pain caused by combat experiences compared to any other population group, they are frequently prescribed opioid pain relievers as a treatment method (Hudson et al., 2017). However, such exposure leads to opioid dependence and can result in substance use disorders (SUDs) and numerous health impairments (Hudson et al., 2017). As such, veterans with opioid dependence due to PTSD are recognized as a vulnerable population.
Vulnerable Population: Veterans in Opioid Treatment
Veterans’ Health Care Need
The health care need for this population is to prevent the negative impact of opioids on the welfare of the affected individuals. Although some alternative forms of treatment that can be implemented to replace opioids have been suggested, such options remain mostly unavailable to veterans due to a lack of health care coverage, increased costs, and economic and social disparities caused by their vulnerable position (Essien et al., 2020). Therefore, providing medicines that are safer to use during PTSD treatment and have minimal negative consequences can improve the welfare of veterans with PTSD, addressing the identified healthcare need.
Even though numerous research studies have reported the positive impact of psychotherapy on PTSD treatment and opioid dependence rehabilitation, only a small amount of healthcare initiatives for this population include counseling. Psychological aid, such as counseling sessions, psychotherapy, or group therapy, are typically given the status of paid services or are located only in major medical institutions (Hester, 2017). Although some policies addressed the need for psychotherapy and psychological counseling, their availability remains scarce (Hester, 2017). Thus, it is essential to improve the therapy possibilities for veterans with opioid dependence and PTSD, resolving the existing economic, social, and ethical concerns.
Available Resources
Currently, healthcare policies and opioid treatment programs are the resources provided for veterans. As such, the Opioid Safety Initiative is implemented by the Department of Veterans Affairs (VA), addressing SUDs via preventative, educational, treatment, and therapeutic interventions (Albright et al., 2018). Another similar program was introduced by the Veteran Health Administration, which allows veteran populations to apply for medical insurance and receive necessary services. Nevertheless, the number of possible options remains low (Hester, 2017). In addition, these initiatives do not directly address the underlying problem, namely PTSD and its effects on veterans’ welfare.
The Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act of 2018 and the Affordable Care Act (ACA) have also been utilized to mitigate issues connected to opioid dependence. SUPPORT was designed to address opioid-induced SUDs in the general public, as well as monitor and control the prescription of opioids (Albright et al., 2018). On the other hand, ACA provides funding and guidelines for the timely diagnosis of opioid disorders. Nevertheless, these programs are not directly aimed at veterans and cannot fully address their needs.
Economic priorities, challenges, and issues
Economic Priorities
Economically, veterans require additional support that could help them secure the necessary medications and therapy without struggling for other resources, such as living arrangements, food, and daily needs. Opioid treatment is typically prescribed to alleviate physical pain, but it has numerous negative consequences, such as anxiety and dependence, and does not always eliminate physical pain (Hester, 2017). In these conditions, productive employment becomes impossible, and economic resources become scarce (Albright et al., 2018). Therefore, veterans remain economically dependent on state policies and programs that provide treatment for PTSD, both medical and psychological.
Economic Challenges
A crucial challenge the veteran population encounters is the necessity to return to everyday life, such as searching for employment or resuming education. However, veterans are an extremely vulnerable population due to the impact of military experiences on their mental and physical health; numerous veterans encounter difficulties when attempting to find an occupation or continue learning (Albright et al., 2018). PTSD often prevents them from being able to complete their working assignments or even everyday tasks, which leads to rejection from employers and educational institutions (Albright et al., 2018). Thus, large numbers of veterans must rely on alternative sources of income, which is rarely efficient and tremendously decreases their financial status.
Economic Issues
A pertinent economic issue is connected to the rehabilitation process, which requires tremendous effort and access to psychological therapy. Securing access to counseling remains strenuous for the discussed population, as most available programs focus on opioid dependency or PTSD from a physiological but not mental perspective (Hester, 2017). As such, veterans are forced to seek alternate options to mitigate the psychological issues of PTSD and opioid dependencies, such as community centers or social services-offered counseling (Doran et al., 2017). Nonetheless, the quality of such therapy remains tremendously low, while other opportunities are typically costly or not covered by medical insurance (Doran et al., 2017). Thus, gaining psychological support is a critical economic issue for veterans under opioid treatment.
Ethical, Social, Professional, and Legal Complications
Ethical Issues
Providers and Insurers
Healthcare providers and insurers must address several ethical issues when offering treatment to veterans with opioid dependence. First of all, it is essential to determine which veteran populations which be provided with the benefits and how the distribution of such options will be justified (Etingen et al., 2019). For providers, it is critical to distinguish between the specific types of services and their provision free of charge, on a discount, or paid-only; insurers, on the other hand, are to identify the types of services included in particular coverage (Etingen et al., 2019).
Policymakers
Another ethical complication refers to public policymakers and organizations involved in healthcare activities for this population. As such, public policymakers have a responsibility to create programs that adhere to the needs of veterans from various communities and of diverse financial and social standing (Duhaney, 2020). For instance, veterans from ethnic minorities or underprivileged families can often be neglected due to the lack of presentation, which results in lower healthcare quality and medical services availability (Duhaney, 2020). Nonetheless, the interests of underrepresented veteran populations are frequently becoming neglected, and policymakers should properly mitigate such complications to maintain ethicality.
Organizations
Organizations providing treatment to veterans with opioid dependence have a different scope of responsibilities and ethical problems to address. For example, such companies must remain inclusive, supporting all veteran individuals negatively impacted by opioid therapy; however, as the resources are limited, the executives are forced to prioritize specific populations while maintaining ethicality (Duhaney, 2020). Another difficulty is sustaining a high quality of care, which requires promoting ethical behavior and respect toward patients. Therefore, adhering to ethical codes of conduct appears crucial for all organizations offering health care options to veterans.
Societal Issues
Providers and Insurers
In addition to standards of ethics, the named institutions are expected to overcome the societal issues linked to the provision of care to military personnel with opioid dependence. For example, such social factors as food insecurity, level of criminal activity in the veterans’ regions of residence, and transportation options tremendously influence the activities of providers, insurers, policymakers, and veteran organizations (Albright et al., 2018). For providers, these elements are necessary to analyze when introducing new treatment options and medical services or establishing a new office; for insurers, such information is needed to design insurance plans and their costs.
Policymakers and Organizations
The social complications present a substantial threat to policymakers and veteran organizations when designing new programs and introducing new services. As such, policymakers must rely on information about social disparities, available transportation, access to social and medical services, and the overall quality of life in a given community to design relevant initiatives (Swan et al., 2019). However, as veteran communities are tremendously diverse, creating a policy that adheres to the needs of all veterans can prove exceptionally strenuous. As for veteran organizations, the low socioeconomic status of veterans’ cremains be a major area of concern, as it limits the population’s options for receiving high-quality care.
Professional Issues
Providers and Insurers
From a professional perspective, healthcare providers, insurers, and veteran organizations should create equal opportunities for veterans from various communities to receive the necessary medical services. Nevertheless, for healthcare providers, the lack of state funding and employee shortages are the main complications that prevent these clinical institutions from offering the necessary service quality (Etingen et al., 2019). This issue is also highly relevant for insurers, which base their insurance plans on statistical information about the available numbers of professionals and the standards of provided health care (Etingen et al., 2019). For veteran organizations, such complications typically result in the provision of low-quality assistance and veteran support and can lead to reduced welfare of the veteran populations.
Policymakers
On the other hand, public policymakers are expected to offer the veteran populations the necessary professional care while also accounting for the available resources and professionals needed to fulfill the created programs. Nonetheless, with the majority of clinical institutions becoming united to create hospital conglomerates, accessibility of professional care diminishes, and accounting for the veteran populations in remote regions becomes especially challenging (Etingen et al., 2019). In addition, given the rising costs of health care and the focus on the individual rather than social needs, establishing beneficial policies is strenuous for policymakers.
Legal-System Issues
Providers and Insurers
The legal concerns connected to providing adequate treatment for veterans suffering from PTSD and opioid dependence are the requirements to identify the veteran’s status and the complications related to prescription medicines. Legally, providers, insurers, and veteran organizations are required to establish the veteran status of the patient and their eligibility to receive specific services before offering medical help (Finlay et al., 2020). While from a legal perspective, this demand is necessary to prevent the abuse of the medical system, in reality, such prerequisites delay the provision of health care services and subsequently diminish the veteran population’s welfare.
Policymakers
For public policymakers, the legal concerns are typically connected to federal and state laws regulating clinical services’ distribution. Establishing a unified veteran healthcare system has been highlighted as an advantageous resolution that could address the issues connected to access inequality, state healthcare differences, and program management (Etingen et al., 2019). However, considering that legal requirements can differ significantly in various states, creating and conducting such an initiative is highly challenging. Thus, clinical programs and services remain highly distinct in different states, further promoting healthcare inequality.
Nurses as Advocates for Veterans Undergoing Opioid Therapy
Advocating for Better Healthcare
Nurses could indeed advocate for the improvement of health care delivery for this population. Considering that the provided medical services are highly dependent on the given community members’ needs, nursing personnel could argue for including alternative treatment pathways in the health care providers’ services (Hobson & Curtis, 2017). Prescribing alternative medication and offering non-opioid PTSD therapy is still considered less beneficial in most hospitals despite the endorsement from government agencies (Hobson & Curtis, 2017). Therefore, registered nurses and other personnel could delegate this information to physicians and other healthcare providers, enhancing access to alternative treatment options.
Another opportunity is to focus the attention of policymakers and veteran organizations on the issues caused by opioid dependence. As nursing personnel frequently encounters the consequences of opioid therapy, these observations should be recorded and published, with the health care insurers and government agencies being the primary addressees (Hobson & Curtis, 2017). Given that these entities are responsible for the introduction of treatment plans and nationwide programs, the nurses’ concerns could enhance these organizations’ knowledge of veterans’ struggles. In addition, this endeavor could promote the reduction of opioid prescriptions on a federal level.
Conclusion
To conclude, it is evident that veteran individuals undergoing opioid treatment to counter PTSD symptoms are a high-risk population in the US, which requires significant attention from medical providers, insurers, policymakers, and veteran organizations. Although non-opioid medications and counseling have been suggested as prominent resolution pathways, the lack of these options’ inclusion into medical institution services and insurance packages remains a critical issue. The nursing personnel could contribute to addressing this complication by advocating the needs of this population and promoting healthcare delivery improvements, as well as emphasizing the negative effects of opioids.
References
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