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A Nurse Practitioner and Veteran Tells Her Story

Veterans Health Care 1

Hear from Colleen Leners about her journey from registered nurse to trauma nurse in Iraq — and how she advocates for patients today.

The United States Census Bureau reports that veterans make up 15.8 million Americans and represent 6.1% of the total civilian population age 18 and over, and of these veterans, an estimated 23.5% work in “educational services, and health care and social assistance.” Colleen Leners, DNP, FNP-BC, FAAN, FAANP, is part of that percentage. Leners began her career as a nurse, served in the U.S. Naval Reserve and was deployed to Iraq as part of the U.S. Army Nurse Corps — for which she was awarded the Bronze Star. Leners continues to work as a family nurse practitioner (FNP) today, and in addition to her service and career, she has also advocated for increased access to health care as a Robert Wood Johnson Health Care policy Fellow in the office of Senator John Thune.

As we recognize those who serve and the challenges facing our veterans as they return to civilian life, the American Association of Nurse Practitioners® (AANP) works to spotlight Leners and the many nurse practitioners (NPs) who are also veterans. Leners graciously spoke with AANP about her journey to becoming a nurse and her decision to serve — and what she wants to impart to all NPs and the public about what she’s learned from her experiences.

A Family Connection to Care

While Leners grew up without any active military in her immediate family, her mother, a nurse, set an example for her to emulate when it came to caring for others. Leners remembers that her mother was the head of what was then called “a convalescent hospital — they call them long term care now, LTCs,” Leners recalls. When she was just a teenager, Leners had the opportunity to support her mother at the hospital — “120 beds in San Fernando Valley” — as there was a “huge flu epidemic going on, and all of the nurse’s aides had called off.” Leners’ elder sister was asked to come in and demurred. Colleen, the younger sibling, volunteered in her stead. That weekend, Leners worked 11 to 7 on both Saturday and Sunday — and continued to work at the hospital for years thereafter.

Leners furthered her education and found her calling in caring for others in emergency situations as a lifeguard, but it was honing her skills as an emergency medical technician (EMT) that prepared her to become an NP. “I went to a two-year registered nurse (RN) program in Victor Valley College and then started to work at Kaiser at the ICU,” she says. Following that, she moved over to the emergency room in San Bernadino County — “one of the poorest, largest counties in the country.”

As her career progressed, Leners found herself wanting more stability in her role. “You know, going through a divorce really drove me to get my NP (degree) because most of it was Monday through Friday, no weekends, no nights, no holidays. And I could still do flight nursing if I wanted to.” Leners learned that the Navy Reserve had an opening for emergency trauma nurses and joined up. In the Navy Reserve, Leners taught for the DMRTI, or the defense medical readiness training institute. Leners remembers joining the Navy Reserve in about 1994 and was serving in that capacity — until the deadly terrorist attacks of Sept. 11, 2001.

Deployment

Following this tragedy, Leners moved into army active duty as part of the U.S. Army Nurse Corps and was stationed at Fort Irwin. In 2004, she was deployed to Iraq for 14 months as the officer in charge of the 47th Combat Support Hospitals Outpatient Clinic. Asked about her deployment, Leners remarks that, “It’s funny when you look back… the people you think are going to do really well in war — maybe your first sergeant, maybe your this, maybe your that — you find that those may not be the people that handle the stress as well as you might expect. War brings out the best and worst in people.”

“I was the only female provider, and I was the officer in charge, so I had physicians reporting to me in the outpatient clinic. I had done my time in the ICU. I worked in the ER. I held the clinic down. I admitted, I transferred. Very different situation when you're in war.” When asked to describe her work during that time, Leners explains “I did OR time, I worked in the ER — I don’t think there’s anything I didn’t do. And the physicians really respected me.”

What was it like working amongst providers with different titles and military ranks? For Leners, the key is respect. “One guy, Scott, I’ll never forget it. We were talking and he started really ragging on the nurses. I said, ‘Scott, why don’t you educate them? If whatever they’re doing is bothering you, just educate them.’ And he goes, ‘Oh, I forgot you were a nurse.’ to which I said, ‘Scott, I forgot you were a surgeon.’ Everybody needs to be treated with respect. Plus, I outranked him.” Leners credits her success under pressure to her past as a nurse in the EMT, and even as a lifeguard: “The years of experience make a difference.”

Coming Home

Service during a war has its overt risks, but other wounds travel and aren’t made manifest until the soldier returns home. “Well, everybody came back from Iraq with these awful coughs. We saw a lot of non-Hodgkin's lymphoma. We did see cancers over there, probably directly related to burn pits,” Leners remembers. When commanding officer ordered a CT scan for Leners, she learned had lymphoma. At the same time, she saw that “there were a lot of Wounded Warriors didn’t have a primary care manager.”

“During that time, there were a lot of overdoses,” Leners explained. “We were losing a lot of service members because nobody was tracking them. So, while I was getting my treatment for lymphoma, I was also the primary care manager of the Wounded Warrior battalion. I saw the Marines, the Army and the Air Force at what was called C5. They liked it because they knew that I had been there. So, they could relate to me as someone who had been in their shoes.”

Her time in Iraq also gave her the experience to know when patients weren't being entirely honest. “I could also tell when they weren’t telling the truth per se (laughs). It was like, ‘No, that’s not what happened there. That’s not in your Military Occupational Specialty.’ Soldiers, sailors, airmen and Marines will get away with whatever they can, just because they do — they’re young kids. That’s what they do. But during my time as Wounded Warrior Manager, we didn’t lose one to an overdose — which I’m very proud of.”

About treating veterans specifically, Leners says: “They didn’t have to tell me all the awful things they saw. I knew the awful things they saw. Sometimes I could just hold their hand, or I could just say ‘Tell me when you want to,’ or ‘You don’t always have to tell me, because I can see the vacancy of your eyes.’ I know for a fact there were atrocities. I know that there were certain people that would sight their weapons on women and children in different towns […] You know, it’s hard to see your friend get blown up, lose his legs and lose his life. Those are things that, sometimes when you can, you just listen or just understand.”

Veteran Activism

After her cancer diagnosis and successful recovery, Leners’ “military career was cut short,” as she says. Leners decided her next phase of life would include advocating for veterans on a policy level. She recalls that “these kids — you know, army, navy, air force marines without arms, without legs — were waiting forever to get basic care. The VA was not ready to receive them, all the while we were keeping them on active duty for too long. They really weren’t moving on to their next phase of life. A lot of them were getting into trouble — they were drinking, they were taking their drugs — we had some people in this limbo status for two years.” Leners learned about the Robert Wood Johnson Healthcare Policy Fellowship and was accepted to the program in 2015. She ended up working in the office of Senator John Thune in South Dakota.

“Senator Thune was fabulous, and I worked on all the veterans’ things that came through the office.” She moved to the Senate finance committee, and simultaneously began working with nursing organizations. When her fellowship job ended, Leners transitioned to become the government affairs liaison for the American Association Colleges of Nursing, and then worked as a “policy person” for the Colleges of Nursing following that job. With Frank Harrington Leners says “we made some real successes, and Frank continues to make those successes.” Leners was able to help nurses get on the boards of MedPac and MACPAC. On the importance of having nurses at a seat at the table, Leners says that “it really helps to have a different perspective. NPs tend to work more with the patients to find a way forward instead of just dictating to patients, you know what I mean? […] I think that it’s truly holistic care. I know that may be overused, but I do think NPs bring a different lens; they bring different insights and work with people differently.”

Join Discussions on Interagency Government Care

If you are an AANP member who has served, or if you work in or are simply interested in Interagency Government Care, AANP’s newest community is available to members to join for just $20 annually. If you’d like to hear more about veterans' care from an NP’s perspective, AANP’s podcast, NP Pulse: The Voice of the Nurse Practitioner® has two episodes devoted to veterans’ issues: “Tackling Military Health In And Beyond The VA”, and “Caring For Our Veterans.”