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Treating the Wounds of War



 

In spring 2013, the emergency mental health unit of the Providence VA Medical Center admitted a U.S. Marine who, less than 24 hours before, had attempted to stab his mother and his brother. Now he faced off with the two social work clinicians attempting to make an initial assessment.

Michael Nordé ’12, M.S.W. ’13 was one of the two clinicians conducting the interview. A RIC graduate student in social work, he was engaged in 600 hours of required fieldwork. As he attempted to take down information about the Marine’s life – his marriage, his children, where he lived, where he worked and the environment that had affected his situation – the anger directed at Nordé and the other clinician was like nothing Nordé had experienced before.

“I’m on edge, the sweat is coming down, and I’m hiding it, but it’s there. And I don’t want to say the wrong thing or do the wrong thing.” Throughout the 30-minute interview, the energy in the room remained charged. Finally, Nordé ended the consultation, and the veteran was placed in lock-down.

“This unit could be likened to your typical hospital emergency room,” Nordé said. “Patients arrive in extreme mental distress. I’ve seen the physical effects of war – the missing limbs, the paraplegics – but what I hadn’t seen until I began working here were the mental effects of war.”

In addition to Nordé, a psychiatrist, a nurse, a URI student pharmacist from the University of Rhode Island and a clinical social worker performed individual assessments on the Marine. The team then came together to create a treatment plan. This collaborative method of care is called an “interprofessional team” approach.

“I came to the VA knowing the value of this approach after being trained in interprofessional teamwork at Rhode Island College,” Nordé said. He referred to how RIC students from the School of Nursing and from the School of Social Work would come together in a simulation lab to work on cases.

“Being a part of an interprofessional team helped me understand the role of other clinical professionals. I’ve also learned to recognize when I’ve done all that I can for a patient and have to call in another specialist for assistance,” Nordé said.

He remembered counseling a paralyzed Marine who had witnessed his company perish. Marines are trained to leave “no man behind.” Wounded in action, the vet couldn’t have helped his company escape, yet he returned from the war with two forms of guilt: military and religious. Nordé brought in the on-site chaplain to counsel the Marine on his religious guilt, while Nordé was able to address his military guilt.

“I believe when professionals work together, the value for the patient increases exponentially,” he said.

RIC’s M.S.W. program is the only program of its kind in the state. Its internship program is made possible through an agreement between the college and the VA. At the VA, students receive one-on-one supervision by experienced social work employees and engage in rotations in different units of the hospital, which exposes them to the functions of the entire facility. The hospital also includes RIC students in its own trainings. In addition to making use of the skills they’ve learned at RIC, interns are able to tailor their skills to the VA population.

“It’s a tremendous training opportunity,” said RIC’s Director of Field Education Mary McLaughlin. “Some of our students are hired directly after their internships, if there are openings.” Michael Nordé was hired a month after earning his M.S.W. degree in 2013. He now works as a case manager in the medical unit of the VA. He was also recently asked to serve as one of two therapists in a new study on veterans coping long-term with attempted suicide conducted by the VA, Butler Hospital and Brown University.

For more information on the work of RIC’s M.S.W. graduates at the Providence VA Medical Center, see this recent article in the Fall/Winter 2013-14 Rhode Island College Alumni Magazine.