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Opportunities for impact by Nurses within DoD system

Opportunities for impact by Nurses within DoD system. Fort Stewart, GA. CDR Cindy L. Butler, RN, BSN, MBA. 19 DEC 2013. UNCLASSIFIED. Background. Fort Stewart, GA Home of the 3 rd Infantry Division consisting of three Combat Brigades, a Sustainment Brigade and multiple tenant Units

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Opportunities for impact by Nurses within DoD system

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  1. Opportunities for impactby Nurses within DoD system Fort Stewart, GA CDR Cindy L. Butler, RN, BSN, MBA 19 DEC 2013 UNCLASSIFIED

  2. Background • Fort Stewart, GA • Home of the 3rd Infantry Division consisting of three Combat Brigades, a Sustainment Brigade and multiple tenant Units • High operational tempo with multiple ongoing deployments and redeployments • High volume, high acuity behavioral health needs • 20,000 + Soldiers

  3. Behavioral Health Clinics • Multiple clinics and services offered at FSGA including the following: • Community Behavioral Health • North TMC Behavioral Health Clinic • Soldier Resiliency Center • Warrior Restoration Center • Social Work Service • Tuttle Behavioral Health Clinic • Inpatient hospitalization for acute stabilization

  4. Behavioral Health Services • Individual Therapy • Marital Therapy • Group Counseling or Education • Psychotropic Medication Management • Psychological Assessment • Outreach & Prevention Services • Case Management • Referrals for Ancillary Services • Administrative (non-discretionary / Chapter / school) evaluations • Consultation & unit needs assessment / coordination • Limited In-patient services (short-term stabilization) • Command Directed Evaluations (Emergent or Non-Emergent) • Social Work Service • Warrior Resiliency Center IOP Program (medical referral only)

  5. Nursing Roles within FSGA system • High Risk Nurse Case Manager • Chief, Division Behavioral Health Clinic • Embedded Behavioral Health Program Lead • Psychiatric Nurse

  6. High Risk Nurse Case Manager12/2009 through 02/2010 • Developed Division SOP for High Risk Case Management Program • Provided direct therapeutic support and case management services to Soldiers deemed High Risk • Safety assessments between established therapy appointments • Monitoring and encouraging treatment compliance • Collaborated with Soldiers’ multidisciplinary providers (Psychiatrists, Social Workers, Psychologists, Psychology Technicians) • Collaborated with Commands, Military Family Life Consultants, Chaplains and other providers/clinics to ensure integrative approach to management of HR Soldiers • Since inception, program has offered support and improved communication between BH and Command groups to enhance Soldier safety of hundreds of Soldiers.

  7. Chief, Division Behavioral Health Clinic03/2010 through 10/2012 • Directly supervised more than 30 interdisciplinary staff assigned to the Soldier Resiliency Center, the Soldier Readiness Reprocessing Center, and the Welcome Center • Initiated the Embedded Behavioral Health (EBH) team model, aligning three teams in support of the 1st, 2nd & 4th Combat teams • Embedded Behavioral Health model developed at Fort Carson, CO and pushed out through Army • Helped improve relationships and communication with Command to enhance Soldier safety • Decreased off-post referrals and inpatient hospitalizations • Faster dispositions • 13-member teams are assigned to specific Brigades with a credentialed provider assigned to each Battalion • Teams to be embedded within Brigade footprint; 4th BDE Team already embedded within the Troop Medical Clinic

  8. Chief, Division Behavioral Health Clinic03/2010 through 10/2012 • Improved access to care by more than three weeks for medication management appointments by building Tele-behavioral health clinic from ground up in cooperation with Warrior Restoration Program and Southern Regional Medical Command • Solved critical space deficits by gaining funding approval for three new clinics (currently out for bids, construction to start in JAN) • Oversight of process for BH Providers meeting flights returning from theater on the tarmac if they have Soldiers who have been designated as “red (high risk)” • Educating Unit Commanders and 1st Sergeants concerning behavioral health resources, stigma, and how to access care for their Soldiers (individualized orientation sessions) • Assisting with Unit Needs Behavioral Health Assessments

  9. Psychiatric Nurse, EBH Program Lead11/2012 through present • Performs intake assessments, staffing with credentialed providers. • Provide case management services to designated Soldier population • Serves as the liaison between MTF, installation/garrison/DPW, SRMC, and the MEDCOM EBH Program Management Office • Maintain oversight of staffing and facilities issues concerning EBH teams • Manages assigned projects and analyzes programs for Chief of Department of Behavioral Medicine • Collaborating with Clinic Chiefs to develop standardized suicide risk assessment tool for department • Writing ER referral SOP • Collaborating with NCMs to develop Off-Post Referral Case Management Program

  10. Conclusion • Behavioral health needs among active duty Soldiers have proven to be high. • Suicide rate within Army is exceedingly high and has been reported in the news. • Nurses within the DoD system can make an impact at both the grass roots level and on a broader level.

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