Do Gaps in Pre-Deployment Preparedness Raise the Risk of PTSD for Military RNs?

Purpose: Describe the perceptions of military registered nurses (RNs) on being prepared to provide nursing care during a deployment. Background: Injuries sustained by war are different from trauma-related injuries occurring within the Unites States. Nurses who provide care during overseas deployment encounter patients with poly-trauma, multiple and highly complex injuries; consequently, this type of nursing requires strong clinical skills beyond what is required in stateside facilities. Additionally, military nurses undergo intense stress related to overseas deployment in a war zone. In fact, military medical providers have one of the highest rates of post-traumatic stress post-deployment. Methods: This project employed a qualitative, case study approach. Semi-structured interviews were conducted with military RNs who worked as nurses during overseas deployment. A script was developed to guide the interview, and further discussion stemmed from participant responses. Recorded interviews were transcribed into text and analyzed for commonalities. Findings: Five military nurses who previously provided nursing care during overseas employment participated in this study. Commonalities included the realization that higher acuity injuries are seen in a deployed setting versus a military stateside hospital. Participants also shared fears that they would not be prepared enough to provide excellent patient care. Another commonality was not knowing how to prepare for an unknown experience. A positive commonality was the sense of pride expressed by the participants regarding their military service and deployment experience. All participants outlined what they had learned and what might have helped them to better prepare for deployment. Unanimously, more clinically relevant training was recommended. The participants shared that they had grown and changed from their deployment experience. Implications: All five participants felt a gap in perceived adequate pre-deployment preparation. They believed they lacked the training to care for the high acuity patients they would encounter during overseas deployment; this shook their self-confidence and caused them to worry about being an effective team member. Military preparedness programs should be expanded to include skills and knowledge relevant to nursing in high acuity, hostile environments. Research looking at the personal preparations, specifically mental and emotional, of military members may be helpful in determining any links between mental resilience and the development of PTSD