Nurses In War Part 1: The Unforgettable Experiences of Nurses in Combat Zones

Mary Ellen Doherty, PhD, RN, CNM, and Beth Scannell-Desch, PhD, RN, OCNS, are similar in many ways. Not only are they sisters, they’re twins. Both have pursued careers in nursing, but each has followed a somewhat different career path. A few years ago, they came together to research and eventually write a book about the experiences of nurses who have served in the Iraq and Afghanistan wars. They have some unforgettable tales to tell.

Dr. Doherty spent most of her career as a nurse-midwife in what she calls the “clinical trenches,” working in low income neighborhoods helping underserved populations. Eventually, she and two others founded one of the first independently owned midwifery practices in Massachusetts. After earning a PhD, she began teaching at the University of Massachusetts, Lowell campus. Later, she relocated to Connecticut where she is currently an associate professor of nursing at Western Connecticut State University.

Her twin sister, Dr. Scannell-Desch, devoted her nursing career to military service.  She entered the Air Force at the end of the Vietnam War, just after finishing her baccalaureate degree in nursing. During her 25-year tenure with the Air Force, she was stationed all over the world and retired at the rank of full colonel.  After retiring, she began teaching, first at Rutgers University and then at Mt. St. Mary’s College in New York before eventually coming to Adelphi University where she is in charge of the nursing programs at the Hudson Valley campus in Poughkeepsie.

A few years ago, Drs. Doherty and Scannell-Desch saw their careers converge when both had nursing students deploy to war zones.  Watching their students leave, headed for the Iraq or Afghanistan wars, impacted both of them. The sisters decided to undertake a research study to learn more about what these nurses would experience.

The Studies

Drs. Doherty and Scannell-Desch began by exploring nurses’ experiences in a war zone, which led to a second study on women’s health and hygiene experiences during deployment. The first two studies led to a third. Eventually, they decided to write a book, Nurses in War, which was released about a year ago. “We didn’t actually set out to write a book,” Dr. Scannell-Desch says. “We really just wanted to do the research.” But when the authors realized that they could inform the public about these wonderful nurses in combat, they decided to move forward with the book.

Their research revealed some riveting stories. “The nurses told us that not only were they fearful about getting hurt or killed and stressed by taking care of patients with horrific injuries, they were also telling us what it was like not to have a suitable place to go to the bathroom,” Dr. Scannell-Desch says. One nurse anesthetist related that she went 11 days without a shower while working in 120-degree heat either because she was too busy in the operating room or because her base didn’t always have enough water. One of their former nursing students said that she couldn’t brush her teeth or drink the water because it was contaminated. Many nurses contracted infections because of the conditions.

Stories led these led the authors to launch a second study that was focused on hygiene issues. During the second study, some nurses had talked about how they missed the children that they left at home. As best the authors could determine, no one had explored the issue of parental separation from the viewpoint of the person who was deployed. “These nurses were not just worried about their life in the war zone, but also about what was going on at home,” Dr. Doherty says. Drs. Doherty and Scannell-Desch decided this would be the subject of their third study.

Conditions on the Ground

One of the messages that reverberated in the interviews was that these nurses had suffered traumatic experiences that were equal to those suffered by combat troops—and they did it while being surrounded daily by the physical and emotional consequences of battlefield violence. Many nurses shared that they were not fully prepared for the extent of the danger they faced. One nurse who was interviewed talked about working in triage when three young soldiers were brought in after a rocket propelled grenade tore through the soldiers’ vehicle and took off all six of their legs. She also talked about other soldiers who became human torches after being burned in trucks that had been hit by IEDs.

Two of the nurses interviewed had been wounded by hostile fire. Like their fellow officers, all nurses carried handguns. Some nurses said they never took off their guns, even while showering. One nurse anesthetist kept her gun on in the operating room.

Working conditions were challenging. Nurses provided care in hospital tents where temperatures could reach well over 120 degrees or in makeshift hospitals constructed from several trailers hitched together. At times, nurses flew into hostile areas. The only “bathroom facilities” on board some of these planes might be a bucket, in partial view of a mostly male crew. Hygiene conditions were most primitive for nurses who deployed early in the war and feminine hygiene supplies were scarce. Families sent care packages of tampons and everyone shared. Some nurses choose to suppress menstruation. The hardships took a toll on these nurses who lived with no creature comforts and little connectivity with home, especially during the early years of the wars.

Every nurse said that she had at least one patient she would never forget. Many nurses wondered what happened to these patients after they were airlifted to Germany. Some nurses were surprised when they were assigned to care for enemies at prison hospitals. They had expected to care for American or coalition troops but, when assigned to prison hospitals instead, they found the work unpleasant. Many were afraid of the prisoners.

All the nurses reported taking care of many innocent pediatric patients who had suffered burn or blast injuries from IEDs, grenade attacks, or similar battlefield violence and required critical treatment. The nurses found this especially distressing, particularly those nurses who had children at home who were close in age to the children they treated.

Most all of the nurses felt the war had changed them. Some had difficulty adjusting to the slower routine in the U.S. They no longer had any patience for petty complaints. However, they felt they had learned much more about their profession by being deployed and had gained expanded skills and knowledge working under the supervision of senior nurses and physicians and found this satisfying.

According to the nurses in these studies, being separated from their children was the single hardest aspect about being deployed, even more so than being under fire. Some nurses talked about missing important events such as a child’s high school graduation. When these nurses did return to their homes, the adjustment proved to be more difficult than anticipated. They had to find a “new normal” because they had become different people and their spouses and family members had changed as well.

To be continued . . . watch for Part II, Nurses in War: Coming Home.

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