Nurses on the front lines: The work of Army nurses

Experienced hospital nurses realize that nursing positions don't vary that much, no matter where you work. Some facilities may have higher nurse-patient ratios, while others might have more flexible scheduling, but basically, not too much is different in the nursing field.

However, this is not the case for Army nurses on the front lines. The work of Army nurses in combat zones encompasses a much different and broader scope of practice than any civilian hospital. Now that many of these nurses have returned home from war-torn areas like Kuwait, Iraq or Afghanistan, their stories are becoming more publicized, and the real truth about their experiences is available.

From many of their personal accounts, there seem to be several themes that are common to most of these Army nurses’ duty tours. They include:

• Caring for a different type of patient
• Dealing with emotions
• Being flexible
• The element of danger and violent death

Caring for a different type of patient

Working in a combat hospital near the front lines, one of the major differences is the type of patients you treat. Army nurse Captain Tara O Spears, 35, worked in the 86th Combat Support Hospital in Kuwait, and reports “in combat you see more gunshot and shrapnel wounds.” The patients are usually younger and healthier if they are American soldiers. They are not the typical patients needing medication tweaking for congestive heart failure or poorly controlled diabetes.

In Afghanistan, even though many of the patients are soldiers, the Army nurses are treating Afghan women and children who may have been victims of explosive devices. Some patients have had no previous medical care, and are being diagnosed for the first time with uncontrolled asthma, pneumonias, scorpion bites, etc.

Army nurses are also working with people of different cultures and with language barriers. This can be challenging, and at the same time, provides them with a new “appreciation of diversity,” as Captain Tara O Spears shares. At times, your patient may be an enemy soldier, and this circumstance calls for the utmost professionalism and setting aside of emotions.

Dealing with emotions

It is only natural as a caring human being to become emotional during some of these life-and-death circumstances. Army nurses have to deal with these experiences professionally, realizing that they have a job to do. Being away from home and loved ones for a long period of time is a challenge in itself.

Flight duty is one of the duties assigned when you are an Army nurse on the front lines. Major Randall Mitchell, Army Reserve Emergency Room Nurse, served a 20-month tour of duty in Iraq as his first combat deployment. As a flight nurse, he had to fly soldiers who were critically injured to the hospital in Balad and then on to Germany. Major Mitchell had his share of dealing with emotions, as his hospital in Mozul was hit by a rocket attack and a surgeon was killed. He reported that the hospital “lost 10 that day … it was a difficult time for the whole hospital and unit.”

Being flexible

One of the duties assigned to Army Capt. Michelle A. Racicot, RN, last year in Afghanistan, was to “set up small, mobile surgical teams referred to in military terminology as an FST (forward surgical team).” She had three weeks to set this up with less than optimal numbers of personnel, supplies and equipment. She realized that these FSTs saved lives by treating soldiers near the action before transport to a larger hospital was available. Other responsibilities discussed by Racicot included integrating and training a Polish medical team. The situation is always fluid, and flexibility is key.

The element of danger and violent death

Army nurses must perform their duties with professionalism, just as they would on home soil. This can be very stressful and challenging, especially when faced with the threat of danger from rocket and chemical attacks. The field hospitals frequently go on alert for these situations, reports Captain Tara O Spears, as heavy fighting often occurs very near the field hospitals.

Above all, these Army nurses shared a sense of pride in their roles as nurses for their fellow human beings and for their country.