The Key to Combat Readiness Is a Strong Military–Civilian Partnership

Abstract

Introduction In peacetime, it is challenging for Army Forward Resuscitative Surgical Teams (FRST) to maintain combat readiness as trauma represents <0.5% of military hospital admissions and not all team members have daily clinical responsibilities. Military surgeon clinical experience has been described, but no data exist for other members of the FRST. We test the hypothesis that the clinical experience of non-physician FRST members varies between active duty (AD) and Army reservists (AR). Methods Over a 3-year period, all FRSTs were surveyed at one civilian center. Results Six hundred and thirteen FRST soldiers were provided surveys and 609 responded (99.3%), including 499 (81.9%) non-physicians and 110 (18.1%) physicians/physician assistants. The non-physician group included 69% male with an average age of 34 ± 11 years and consisted of 224 AR (45%) and 275 AD (55%). Rank ranged from Private to Colonel with officers accounting for 41%. For AD vs. AR, combat experience was similar: 50% vs. 52% had ≥1 combat deployment, 52% vs. 60% peri-deployment patient load was trauma-related, and 31% vs. 32% had ≥40 patient contacts during most recent deployment (all P > .15). However, medical experience differed for AD and AR: 18% vs. 29% had >15 years of experience in practice and 4% vs. 17% spent >50% of their time treating critically injured patients (all P < .001). These differences persisted across all specialties, including perioperative nurses, certified registered nurse anesthetists, operating room (OR) techs, critical-care nurses, emergency room (ER) nurses, licensed practical nurse (LPN), and combat medics. Conclusions This is the first study of clinical practice patterns in AD vs. AR, non-physician members of Army FRSTs. In concordance with previous studies of military surgeons, FRST non-physicians seem to be lacking clinical experience as well. To maintain readiness and to provide optimal care for our injured warriors, the entire FRST, not just individuals, should embed within civilian centers.

PAs in the National Guard and Reserves

“…The key to disaster readiness is a strong military-civilian partnership. 19 This study of military PAs was undertaken with the intent to set the stage for a more refined examination of the dual employment role of PAs. 20 …”

“…How part-time uniformed PAs fit in with a larger medical team of physicians, nurses, corpsmen and medics, and administrators is beyond the scope of this study but of interest to military medical planners. The key to disaster readiness is a strong military-civilian partnership 19. This study of military PAs was undertaken with the intent to set the stage for a more refined examination of the dual employment role of PAs 20…”

Exploring the competencies of operating room nurses in mobile surgical teams based on the Onion Model: a qualitative study

“…They can provide advanced care with sufficient flexibility and versatility, and they are more convenient and suitable for surgery than field hospitals [ 7 ]. So more and more countries and hospitals establish mobile surgery teams, including International Committee Of Red Cross (ICRC) mobile surgical teams [ 8 ], U.S. Navy Fleet Surgical Team (FST) [ 9 ], U.S. Army Forward Surgical Teams (FSTs) [ 10 ], Army Forward Resuscitative Surgical Teams (FRST) [ 11 ], French Forward Surgical Teams (FSTs), French Surgical Life-saving Module (SLM) [ 12 ], Emergency medical rescue surgical team, China Naval forward surgical team (NFST) [ 13 ].…”

Registered Nurses’ Views and Experiences of Delivering Care in War and Conflict Areas: A Systematic Review

“…At established armed forces treatment facilities, similar to civilian hospital systems, Registered Nurses develop key nursing skills and critical thinking abilities to enable the provision of care and support [ 18 ]. Registered Nurses in the armed forces must also be aware of best practices in civilian hospital settings to enable the provision of care and support in situations that are unregulated and with limited resources to deliver safe and effective care where normal treatment cannot be provided or is impractical [ 8 , 18 ].…”

“…At established armed forces treatment facilities, similar to civilian hospital systems, Registered Nurses develop key nursing skills and critical thinking abilities to enable the provision of care and support [ 18 ]. Registered Nurses in the armed forces must also be aware of best practices in civilian hospital settings to enable the provision of care and support in situations that are unregulated and with limited resources to deliver safe and effective care where normal treatment cannot be provided or is impractical [ 8 , 18 ]. According to Tom-James [ 8 ], a clear understanding of the evidence that informs nursing practice equips Registered Nurses in the armed forces with the expertise and skills to adapt nursing care appropriately, for example during transport, under fire, or on rough seas [ 8 ].…”