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Post Traumatic Stress Disorder (PTSD) Positive Interactions With Veterans with PTSD Purpose for Educational Teaching Unit This educational instruction unit will: Become a basic class offered during the orientation of all new employees. Also be included in the competencies that all employees who interact with veterans with PTSD will be required to renew yearly. Enhance the current staff communication skills needed in successful interactions with veterans with PTSD. Improve interaction with and cooperation from veterans who have PTSD. Objectives of Teaching Unit To define PTSD. To identify potential causes for poor interactions and communication to develop between staff members and veterans with PTSD. Present an opportunity for role-playing between staff members to facilitate effective communication between staff members and the veteran with PTSD. To encourage behaviors on the part of the staff members which will be reflected in positive interactions between staff members and veterans with PTSD. Incidence of PTSD PTSD is experienced by 9% of the general population. The veteran population has a much greater chance of experiencing PTSD. At least 30% of the still living veterans who served in Vietnam are diagnosed with PTSD.(Dieperink et al., 2005) Causes for PTSD An experience of violence. Experiencing traumatic events such as death of another, serious physical harms, or the threat of either. Experiencing feelings of intense fear, helplessness, or horror. Man-made disasters such as a bombing. Natural disasters such as a hurricane. Reactions to stress Feelings of stress after trauma are normal. With PTSD, symptoms are more severe and last longer and can affect relationships, employment, and other parts of life. Trauma Exposure Associated with: Dysregulation of the neuroendocrine, neurotransmitter, and autonomic and central nervous systems, which can cause considerable harm to health. Common responses of avoidance symptomatology of PTSD reduce the chance that people affected will seek medical help. Those with PTSD may also have restricted social networks and social isolation (Lee, 1997). Symptoms of PTSD The emotional numbing symptoms of PTSD lead to withdrawal and difficulties in expressing emotion (Riggs, Byrne, Weathers, & Litz, 1998). Veterans with PTSD will leave a facility without treatment, rather than to have confrontational interactions where they feel neglected and uncared about. A veteran with PTSD may find it very difficult to leave his or her home to come to an appointment. The person with PTSD is intuitive, quick to react, and will often have severe amounts of anxiety about all things and has little resource to deal with stressors of any nature. Patients with PTSD often express difficulties with concentration, attention and memory (Neylan et al., 2004). Symptoms continued…. Have sleepless nights or trouble falling asleep. Poor emotional ties, which leads to social isolation. Trouble dealing with stress. Increased response to stressors. Increased “flight or fight” reactions Poor employment history. Have difficulty in controlling painful memories. Relive the traumatic event. Avoid situations that remind him or her of the traumatic event. Irritability. Symptoms continued… Hyper-vigilant and feel keyed up. Experiencing depression. Feeling numb. Fear for personal safety and the safety of others. Feelings of guilt, self-blame, and shame (Iraq War Clinician Guide: National Center for PTSD Fact Sheet, 2004). How to Positively Interact with Veterans with PTSD Introduce yourself and have a positive attitude, explain what is going to happen if the veteran is there for a procedure. Make eye contact. Be formal unless given permission to be informal. Use a quite tone of voice and speak while looking at the veteran (many have hearing deficits). Positive Tools for Interactions Use the patient’s name, he or she is not a task or case. Let the veteran know that you appreciate the situation that he or she finds him or herself in. Listen carefully and make sure you understand. Acknowledge and express concern. More Positive Interactive Tools Listen, clarify, use common language, avoid using rules as reasons to not help. “What have you heard?” is a good question to ask. Offer respect. Appreciate what the veteran has gone through and will be going through. Offer choices when making appointments, try to coordinate all appointments on the same day. Positive Influences Look for the patient’s strengths. Welcome concerns and complaints. Do not hurry. Remain calm. The veteran is always right. References Dieperink, M., Erbes, C., Laskela, J., Kaloupek, D., Farrer, M.K., Fisher, L., & Wolf, E. (2005). Comparison of treatment for post-traumatic stress disorder among three departments of veterans affairs medical centers. Military Medicine (170), 305-308. Lee, L. (1997). Social support, reciprocity, and well-being. Journal of Social Psychology (137), 618-628. References Iraq War Clinician Guide, 2nd edition (2004). War-zone-related stress reactions: What families need to know. A National Center for PTSD Fact Sheet. Walter Reed Army Medical Center. Neylan, T., Lenoci, M., Rothlind, J., Metzler, T., Schuff, N., Du, A., Franklin, K., Weiss, D., Weiner, M. & Marmar, C. (2004). Attention, learning, and memory in posttraumatic stress disorder. Journal of Traumatic Stress 17 (1), 4146. Riggs, D., Byrne, C., Weathers, F. & Litz, B. (1998). The quality of intimate relationships of male Vietnam veterans: Problems associated with posttraumatic stress disorder. Journal of Traumatic Stress 11, 87-101.