July 28, 2020
Male veterans who are homeless often feel undervalued when they seek care in the emergency department and perceive a lack of empathy from health care providers there, according to a study published in the Journal of Emergency Nursing.
“It is important for providers to be aware, when providing services to our nation's heroes, and allow them the appropriate time, space, and support to adequately explain their health care needs,” wrote Jillian J. Weber, PhD, RN, CNL, of the Cincinnati VA Medical Center, and coauthors.
The study described the experiences of 25 male veterans who were homelessness and accessing care in the emergency department. Consistent with previous studies linking homelessness with high use of emergency department care, the investigation revealed similarly high rates of emergency department use in the study sample—often for chronic health problems such as diabetes or chronic obstructive pulmonary disease. In recorded interviews, the men said their lack of health insurance provided no other care options beyond the emergency department.
When accessing care at emergency departments, whether at a Veterans Affairs or community hospital, the veterans said they typically felt discounted by healthcare providers who do not listen to them.
“I just would like to be heard sometimes. I don’t like to be talked at. I definitely do not like to be talked down to,” said one study participant. “But I would just like to be heard.”
Despite the generally unpleasant care-seeking experiences, 14 out of 25 veterans were still about to identify positive experiences in the emergency department that made them feel value and self-worth. Many were quick to praise staff who they perceived as genuinely trying to help.
“When health care providers listen, support open communication, and convey that they value the patient, these interactions may increase receptivity to learning about other healthcare options,” researchers wrote, “and have a positive impact on follow-up care.”
Weber JJ, Lee RC, Martsolf D. Experiences of Care in the Emergency Department Among a Sample of Homeless Male Veterans: A Qualitative Study. J Emerg Nurs. 2020;46(1):51-58. doi:10.1016/j.jen.2019.06.009