Deployment Experiences of Army Nurse Practitioners

Abstract

Army Nurse Practitioners (NPs) provide immediate and lifesaving care during combat operations. The most recent conflicts of Operation Iraqi Freedom and Operation Enduring Freedom have seen an increasing number of NP deployments. The uniqueness of these conflicts has also seen NPs being used in nontraditional roles. This study surveyed 50 Army NPs with deployment experience to explore and elucidate their clinical practices in a combat environment. Over 70% reported seeing greater than 11 patients a day with the top three diagnoses of musculoskeletal/soft tissue (noncombat), spinal pain (mechanical, sciatica), and gastrointestinal complaints. Over 74% reported having a physician available for collaboration, but 50% reported providing independent emergency care and 58% treating life-threatening injuries. The NPs in this study report standard credentialing privileges with most care falling within this realm. However, a few report nontraditional roles such as hospital admitting privileges. This study adds to the growing body of knowledge on NP practice in a combat environment, which shows increased decision making and advanced clinical skills. NPs are battlefield multipliers who bring additional skills and abilities to the combat environment.

Sex and Gender in Research on Healthcare Workers in Conflict Settings: A Scoping Review

“…Six studies reported that both male and female HCWs face similar difficulties when working in conflict zones, which include limited supplies and equipment, insufficient medications, shortage of qualified personnel, and increase in workload and working days, as well as low or lack of pay, and economic insecurity [ 41 , 42 , 44 , 45 , 46 , 47 ]. Studies also showed similar exposures to dangerous conditions and physical hazards, including threats, harassment, injury, death due to combat exposure, attacks on healthcare facilities, as well as arrests and direct assault for both male and female HCWs [ 44 , 46 , 48 , 49 , 50 , 51 , 52 ]. Other exposures, such as chemical hazards including dust and smoke containing air pollutants, toxic clouds, particulate matter, and demolition rubble and dust [ 53 , 54 , 55 , 56 , 57 ], as well as psychological hazards including trauma [ 38 , 58 ], were studied.…”

“…Almost all of the other studies pooled the results for both males and females for specific health outcomes and found physical health problems in EMS and other HCWs. The reported health outcomes included chronic respiratory illnesses, allergies, asthma, gastroesophageal problems, eye problems, neurological problems, musculoskeletal and systematic auto-immune disorders, and cancer [ 51 , 54 , 55 , 56 , 67 , 68 , 69 , 70 , 71 ]. In addition, a study found decreased lung functions in male and female EMS workers [ 53 ].…”

The Applicability of Resilience Training to the Mitigation of Trauma-Related Mental Illness in Military Personnel

“…Notably, all branches of the military have been adding more APRNs to their ranks; APRNs are considered "force multipliers" because of the significant contribution that they add to the medical corps, particularly in units that are deployed (Lewis, Stewart, & Brown, 2012). Additionally, APRNs are likely to interact with underserved populations, such as the homeless, who are more likely to have been affected by military trauma or other traumatic experiences (Newhouse et al, 2011).…”

Wound management provided by advanced practice nurses: a scoping review protocol

“…17 They function as consultants, educators, and researchers, 12 thereby making NPs a vital component in multidisciplinary wound care teams. 18 Globally, NPs provide wound care in various settings, including emergency departments, [19][20][21] long-term care facilities, 22 military, 23 urology clinics, 24 primary care, 25 and community settings. 9…”