Strategies to understand and support health goals
Veterans have distinct determinants of health related to their military service and occupational exposures. With more veterans seeking care in the community, the American Nurses Association Membership Assembly recommended in June 2024 that the association pursue work to improve nursing knowledge related to the healthcare needs of veterans.
Because of the military environment and its associated stressors, veterans, compared to their civilian counterparts, have disproportionally higher rates of chronic physical health conditions, physical injuries, mental health disorders, substance use disorders, posttraumatic stress, military sexual trauma, and traumatic brain injury, according to the Membership Assembly proposal. Veterans also may have had toxic chemical and airborne exposures during their service, which can increase their likelihood of developing malignancies and chronic illnesses. Early detection and guideline-directed treatment of these conditions improve healthcare outcomes and reduce morbidity and mortality.
The country has more than 15.8 million military veterans, but only 9.1 million are enrolled in Veterans Administration healthcare (U.S. Census Bureau). Veterans represent a significant section of healthcare consumers in community settings, but their veteran status frequently goes unrecognized. Veterans experience poorer health outcomes and more chronic health comorbidities than non-veterans (Betancourt). Nurses must approach their care with sensitivity, understanding, and a commitment to creating a supportive environment. We must partner with veterans to understand their health goals.
Key strategies to provide the best care for veterans include the following:
- Create a safe space for open expression. Maintain a welcoming and nonjudgmental clinical environment in which veterans feel comfortable expressing their concerns. Veterans should feel they can speak honestly without fear of judgment.
- Ensure confidentiality. Remind veterans that healthcare discussions are private and confidential. Also review the limits of healthcare confidentiality.
- Develop rapport. Building trust and establishing rapport before asking about sensitive topics help ease anxiety and foster a sense of safety. Ask for permission before delving into the details of delicate topics. This shows respect for the veteran’s boundaries and provides them with some control in the conversation and situation.
- Validate veterans’ feelings. Acknowledge and respect the vulnerability veterans show when discussing their health concerns, especially if they’re related to mental health. Validate their experiences and emotions, and let them know that you’re there to support them. Be available when they reach out; this will build trust and rapport.
- Provide situational awareness. Explain the purpose of your healthcare questions in a de-stigmatizing manner. Let veterans know that screening questions and protocols are designed to offer personalized care, assess their risk for health conditions, and ensure access to necessary resources and support when needed.
- Instill hope. Help veterans see a path forward. Let them know that they’re not alone, they have treatment options, and that you’ll support their choices. Encourage veterans to participate in setting their health goals, and share with them evidenced-based treatment options that have helped other veterans.
By incorporating these strategies into your practice, you can create a supportive and effective environment for veterans.
Learn more about veterans’ healthcare on May 21 through a free webinar, Caring for Veterans: Best Practices for Screening (hubs.ly/Q03gsFdp0).
—Emily Bell is senior policy advisor in nursing programs at the American Nurses Association.
American Nurse Journal. 2025; 20(5). Doi: 10.51256/ANJ052532
References
Betancourt JA, Stigler Granados P, Pacheco GJ, et al. Exploring health outcomes for US veterans compared to non-veterans from 2003 to 2019. Healthcare. 2021;9(5):604. doi:10.3390/healthcare9050604
U.S. Census Bureau. Veteran status. data.census.gov/table/ACSST1Y2023.S2101?t=Veterans&g=010XX00US
Veterans Health Administration. va.gov/health/
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