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Obama, Biden stress PTSD to nurses

America's first and second ladies made a show here Wednesday of enlisting the nation's three million nurses in their Joining Forces program to improve services for soldiers and their families.

At the University of Pennsylvania's Irvine Auditorium, Michelle Obama and Jill Biden thanked 150 nursing organizations and 450 nursing schools for pledging to train current and future nurses to treat soldiers with post-traumatic stress disorder, traumatic brain injury, post-deployment depression, and other visible and invisible wounds of war.

"This is truly amazing what you're doing," Obama told the crowd of about 1,100 nurses, nursing students, nursing organization leaders, deans of nursing schools, and a few soldiers. Two rows of nursing students and National Guard troops in camouflage were arranged on risers to serve as a backdrop for Obama and Biden. They stood in place for an hour before the event and another half hour during the speeches.

Afaf Meleis, dean of Penn's nursing school told Obama and Biden that nurses were in a good position to help veterans at every level of the health-care system. "You have come to the right partners," she said.

"Nurses tend to attend to the whole person, mentally, emotionally, and physically."

When soldiers come home, they don't always bring their medical and emotional problems to facilities that specialize in caring for veterans. Instead, they go to the same doctors' offices, clinics, and hospitals that treat everyone else. Nurses everywhere need to know how to help.

"Our military families deserve the very best efforts of each of us," Biden said.

Obama said that more than 44,000 troops have suffered at least moderate brain injuries since 2000. One in six soldiers has had PTSD and similar numbers report depression after they get home. These emotional problems are "natural, normal human responses to the violence of war," she said.

Speaking to the soldiers in the crowd, she said, "No matter what you're going through, America will be there for you and your families. That's what this is about."

Almost 50 nurse training programs in Pennsylvania and 16 in New Jersey have signed on to participate in Joining Forces, which this week celebrated its first anniversary. The effort contains no new federal money but encourages marshal caregivers to focus on veterans' needs. The American Association of Colleges of Nursing has created a free webinar to support the initiative. The American Psychiatric Nurses Association has a web portal devoted to information about PTSD and traumatic brain injury.

Karen Daley, president of the American Nurses Association, said education about PTSD or brain injury has previously been part of more specialized nurse training. This initiative will make learning about the signs and symptoms of these problems a standard part of nurse training. Organizations will also use the "digital age" to spread information about physical and mental war wounds.

"It's a pretty innovative approach to need that's going to be prevalent in our community," she said after the event.

Nursing groups began talking with Joining Forces in December. "This is an initiative that people immediately responded to," Daley said.

In January, 135 medical schools made a similar commitment to Joining Forces. They said they would establish a network to share research and information about PTSD and TBI.

Meleis said that Penn, which is home to many nurse researchers, would focus on the science of treating returning soldiers and their families. Penn already has nurses studying PTSD and brain injury, the needs of female soldiers, pain management in the military, emotional responses to physical injuries, and end-of life care for veterans. Researchers there have developed a computer game, Mission Reintegration, that helps soldiers recognize emotional warning signs and adjust to civilian life.

Staff Sergeant Jessica Noble, a member of the Pennsylvania Air National Guard who stood patiently behind Obama and Biden, said her minor role in the event was worth her time. She got to shake the first lady's hand when the event ended.

A nurse who also does medical work for the guard, Noble said she likes the idea of spreading knowledge about the special problems of veterans. Many soldiers return to areas where there are few other veterans around. "It's just amazing," she said of the initiative.

As for the handshake, she joked that she wouldn't be washing her hand. "But then," she added, "I wouldn't be a very good nurse."


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