Confessions Of A VA Nurse: Mending More Crushed Spirits Than Broken Bones

VA nurse TJ Wilcox Olson

For years, a young woman in the Black Hills of South Dakota would sit by the phone from midnight to noon. Around once a week, she'd get a call that would make her heart race. It was a veteran, so distraught, so panicked, so depressed, that the young woman thought he might kill himself.

TJ Wilcox-Olson, 33, (pictured above) worked in patient mental health for 3½ years in the VA Black Hills Health Care System, which serves veterans across a huge swath of the rural West, including parts of Nebraska, Wyoming and Montana. Now, she's the patient safety manager, responsible for making sure patients don't harm one another, or themselves. She also serves on the board of the Nurses Organization of Veterans Affairs.

Wilcox-Olson always knew that she wanted to be a Veterans Affairs nurse; her mother had been one for 33 years. "I saw the life it gave her," says Wilcox-Olson. Having earned a bachelor's degree in psychology before getting her nursing degree, she sees nursing as a way to heal veterans' less visible wounds. "Most people think of nurses as changing dressings," she says. "But these people have other parts broken." She works with veterans with post traumatic stress disorder and substance abuse problems, veterans who are depressed and homeless, veterans who live in the facility because they need full-time care. When it comes to the costs of war, Wilcox-Olson is on the front lines.

An unprecedented 45 percent of post-9/11 veterans are filing for disability benefits, reported The Associated Press, many of them for mental health issues. In a study of almost 300,000 Iraq and Afghanistan vets, 37 percent received a mental health diagnosis, usually post traumatic stress disorder or depression.

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While an increased awareness of mental health may be partly responsible for the uptick, Wilcox-Olson says that it also speaks to the changing nature of war. Active duty always requires servicemen to train their minds in particular ways, and "for the guys now, it's much more of a mental game." With more and more women fighting in wars, there are also far more incidences of sexual trauma.

Wilcox-Olson never refers to her patients as patients; they're always veterans. At first she was hurt when they refused to share experiences of active duty with her. "You don't know anything," some would tell her. "You're not a veteran."

"I had to learn not to take that personally," she says.

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This is part of the struggle of providing care for returning troops. When someone suffers mental health problems due to an illness, a divorce, or the death of a loved one, a nurse has at least a conceptual starting point to understand the person's trauma. But that isn't true for a VA nurse who hasn't been in battle.

"I don't know what they saw or where they're coming from, the experiences they've had," says Wilcox-Olson. "I'm not sure how to help them -- I wasn't there. I don't know what they're thinking about."

Wilcox-Olson remembers one veteran who was facing a wall, terrified, and wouldn't respond when she called his name. She shouted and shouted, but he didn't register her voice at all. When the man finally came out of it, he was shaking.

Another veteran was working in the on-site greenhouse as part of a work therapy program, but the smell of dirt triggered something in him. "That was quite eye-opening for me," she says. "The everyday things we take for granted."

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And when Wilcox-Olson was working the night shift, a veteran would call up at least every other day. Usually they were just lonely, she says. But around once a week, she'd send someone to the caller's home, to make sure the veteran didn't hurt himself.

Working in mental health has several added challenges, like the fact that many veterans are hesitant to accept her care at all. Although things have improved a lot in the last couple of decades, mental health problems still carry a stigma. That's especially true for those on active duty, who may worry that any record of mental issues could derail their career.

"I've had veterans come in and ask, 'How do I tell my kids why I'm here? Why I've been admitted to the hospital?'" Wilcox-Olson says. "It's just like any other hospital," she replies. "You came to the hospital to get help."

Despite all the trauma she sees, Wilcox-Olson doesn't sound worn down. On some tough days she'll go home to her husband, and pet the cat for comfort. But overall, she's grateful. "I'm lucky that I can leave it here at the facility before I go home," she says. And while mental health work can be frustrating -- as addicts relapse, and conditions prove complex and intractable -- it gives Wilcox-Olson that same energy of purpose that she saw in her mother.

"It's amazing," she says, "how you can really affect someone's life by caring for their mind."

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