Ensuring the best care for today's injured soldiers.
January 7, 2009
Taking care of soldiers recovering from wounds, injuries or illness is a job with special challenges and rewards. A new training course is helping people with these special jobs prepare to make a positive impact on the lives of those who have sacrificed much in service to the nation.
"It's not how to fire a weapon or drive a tank; it's a different kind of mission," said Sherri A. Emerich, program director of the Warrior Transition Unit (WTU) staff training program at the U.S. Army Medical Department (AMEDD) Center and School, Fort Sam Houston, TX.
"The Secretary of Defense has said this is our second most important mission after winning the war itself. We try to make sure people have the tools they need," added Bethney Davidson, an instructor in health risk communication during the course.
The Army calls wounded, injured or ill soldiers "warriors in transition" as they recover, rehabilitate and prepare to either return to duty or leave the service for civilian life. They are assigned to WTUs where they work with a "triad of care" consisting of a primary-care medical professional, a nurse case manager and a squad leader. This triad not only ensures the soldiers receive the medical treatments they need, but also attends to details such as ensuring they make medical appointments, visiting families have housing and transportation, pay and benefits continue, and paperwork is properly completed and filed.
Learning the Ropes
The first resident course for WTU cadre was held Oct. 27-Nov. 7 in San Antonio. It trained 43 noncommissioned officers (NCO) assigned as squad leaders or platoon sergeants in WTUs and 26 nurse case managers.
Before this course, WTU cadre was trained through an online orientation and on-site by mobile training teams or local leaders.
"The inception of this resident course for training Warrior Transition Unit cadre marks the latest in a series of outstanding efforts by the staff of the Warrior Transition Office and the AMEDD Center and School," said Brig. Gen. Gary H. Cheek, assistant surgeon general for warrior care and transition and director of the Department of the Army Warrior Care and Transition Office.
"With this course, it will now be possible to provide all WTU cadres both the common training they require to prepare them to work with this most special group of soldiers and their families, as well as receive specialized training related to their specific responsibilities as social workers, nurse case managers, squad leaders, etc.," Cheek said.
"Other benefits of this outstanding program of training will be the ability to reliably ensure uniform care and treatment of warriors in transition and their family members - care and treatment born of best practices garnered from around the Army. Also, completion of the resident course will make it possible to recognize the special role squad leaders and platoon sergeants play in the success of the Warrior Care and Transition program by qualifying them to receive monthly special duty assignment pay," Cheek continued.
"It's exciting they're putting this kind of emphasis on this. It shows the leadership's commitment to the warriors," said Sgt. 1st Class Pricilla Knight-McLeary, squad leader of a 10-soldier squad in the WTU at Brooke Army Medical Center.
"As NCOs, we go through our leadership courses. All of them prepare us for leadership situations, but none provide the kind of skills needed to lead Warriors in Transition. You have to know when to push, when to pull, when to put your arm around someone, do what works. It's almost like a life-skill coach," said Master Sgt. Brian S. Thomas, NCO for the course.
In addition to classroom instruction, the class toured the Soldier and Family Assistance Center, Warrior Assistance Center and Center for the Intrepid rehabilitation facility at Brooke Army Medical Center. They listened to an injured soldier and an experience triad of care describing their lessons learned.
"They are teaching what you already know, but putting it in a different perspective - things like goal-setting, confidence, stuff you learn but with a different emphasis. Things we take for granted are centered on helping warriors heal and transition," Knight-McLeary said. "The best part for me, the most powerful, was seeing a wounded warrior, for him to speak on what we can do to help these warriors."
"We've learned a lot of resources we can tap into," said case manager Lt. Col. Carol Fox, RN. "It helps you realize how complicated it can be to take care of these soldiers, to help them heal and transition."
Fox works for the Community-Based Warrior Transition Unit in Utah, where she primarily helps reservists who often are otherwise isolated from the military support system. She formerly served at Landstuhl Regional Medical Center in Germany, the first stop in evacuation of wounded from Iraq and Afghanistan. She said wounded patients usually stay at Landstuhl only a few days, and staff there seldom know what becomes of them after transfer to hospitals in the U.S.
"This job is full circle for me. It gives closure. Caregivers need that," she said.
"The essence of case management is to develop a comprehensive clinical plan for Warriors in Transition. Their principle job is to coordinate to develop that plan with a multidisplinary team," said Col. Rebecca Baker, RN deputy director of the Warrior Transition Office in the Office of The Army Surgeon General, who taught the case managers during 3 days when they and the NCOs split for separate tracks of instruction focusing on their specific tasks.
"We have case managers with 6 months of experience and 2 weeks of experience. Even those with months of experience think it is essential to have centralized training," Baker added.
Emerich expects the course to be held 6 times a year, and all newly assigned triad members should attend.
Knight-McLeary said the course struck a balance between knowledge the cadre needs to accomplish their tasks and skills needed to build relationships with soldiers in their care.
"We want them to develop the head and the heart for their mission," Emerich said.
Jerry Harben is editor of The Mercury, the monthly newspaper of the U.S. Army Medical Command based at Fort Sam Houston in San Antonio.