Nurses in War Part 2: Coming Home

Mary Ellen Doherty, PhD, RN, CNM, and Beth Scannell-Desch, PhD, RN, OCNS, set out to conduct a research study. The first study led to another and then another. Ultimately, they wrote a book, Nurses in War, about the experiences of nurses serving in combat zones.

Post-traumatic Stress Disorder

One thing the authors learned is that a fair number of nurses who had returned from combat zones experienced post-traumatic stress disorder (PTSD). Some weren’t aware that they were experiencing PTSD until they began having problems reintegrating with their families and communities and in the workplace. Most eventually sought help either through the military facilities where they were assigned, the Veteran’s Administration, or support groups. What these nurses experienced wasn’t different from what combat soldiers had experienced. But, because the nurses’ intense and continuous experience of war received significantly less attention than that of fighting troops during the early years of the Iraq and Afghanistan conflicts, the initial response in diagnosing and treating PTSD among nursing veterans following deployment was even less adequate. “PTSD symptoms are now more readily recognized, and medical support services have improved for military nurses in recent years, thanks in part to the willingness of nursing veterans to talk openly about their experiences,” Dr. Scannell-Desch notes. Despite all of the difficulties and dangers, most of the nurses in the study said that, if they were called again, they would go back to Iraq or Afghanistan in a heartbeat.

How can nurses on the homefront be supportive of their nurse colleagues returning from war zones? One finding that came out in the research study was that active duty nurses who came home to a supportive environment fared better than those who did not. The authors recommend that nursing colleagues thank them for their service and ask them if they would like to talk about it. “Telling stories about their experiences is often cathartic,” Dr. Scannell-Desch explains. She suggests having your “nursing radar” on alert to sense how these nurses are readjusting. Sometimes a kind word from a colleague can open a door, but tread carefully and be sensitive.

Stress at Home

The fallout from these wars will affect many more nurses than those who served overseas because the casualties from these wars will have a lasting impact on civilian nurses as well when these casualties return to the states for long-term care. In the study, some nurses returning from war believed that the job of caring for casualties was going to be even more difficult for civilian nurses because they will have these patients—many with traumatic brain injuries, amputations, and spinal cord injuries—for a long time. Military nurses in the studies said that their heroes are the civilian nurses who will care for these casualties in rehabilitation facilities because they won’t see dramatic results overnight, whereas military nurses could sometimes see significant improvements in a short timeframe.

Another important lesson, the authors warn, is this: Just because civilian nurses are not working in combat, they should not believe that they may be spared from the traumatic consequences of violence and natural disasters. “In today’s world, no one is safe from the impact of caring for patients with traumatic injuries,” Dr. Scannell-Desch explains. She cites the events of 9/11, the shooting of elementary school children at Sandy Hook, the Boston Marathon Bombing, and violence in urban areas as examples. “It’s a dangerous world,” she says, “and nurses had best be prepared for it.”

Because trauma is inescapable, even at home, Dr. Scannell-Desch believes that today’s nursing students need to learn about disaster preparedness. “Disaster preparedness needs to be in every nursing curriculum, and it needs to be on every nurse’s radar screen,” she says.

What’s Next?

For Drs. Doherty and Scannell-Desch, the nurses they interviewed for the research studies became their personal heroes. In some ways, they are unsung heroes. “You hear about the soldiers,” Dr. Scannell-Desch says, “but the nurses fulfill a role that is just as important as anyone else on the team. They are just not as visible.”

To learn more about their stories, Drs. Doherty and Scannell-Desch are hoping to conduct more research, focusing next on nurses who have come home. Some nurses have now been back from war for nine years, so the authors will study their reintegration over time.

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