Military nurse deployments: Similarities, differences, and resulting issues

Exploring the competencies of Chinese critical care nurses in mobile medical teams based on the onion model: A qualitative study

BACKGROUND

With frequent conflicts, natural disasters, and public health emergencies globally, mobile medical teams (MMTs) are becoming increasingly critical. Importantly, the competency of critical care nurses in MMTs can substantially affect the effectiveness and quality of its rescue efforts. Yet, these nurses' competencies are not well understood.

AIM

This study examined the competencies of critical care nurses in MMTs using the Onion Model.

STUDY DESIGN

A qualitative descriptive method was used to describe the competencies of Chinese MMT critical care nurses. From April to May 2022, a convenience sample of 18 participants (14 critical care nurses and 4 surgeons) from 10 MMTs was recruited for semi-structured interviews. Deductive and inductive coding methods were combined for content analysis.

RESULTS

In total, 29 competencies were identified, which were grouped into four major domains using the Onion Model. From the outer to inner layers, these domains were knowledge and skills, professional abilities, professional quality, and personal traits. Several novel competencies emerged, including field medical equipment operation skills, on-site hazard identification and safety prevention skills, triage knowledge, and field survival skills.

CONCLUSIONS

Using the Onion Model, this study furthers the understanding of the competency of critical care nurses in MMTs, especially by revealing the novel competencies. Further, the results can be used to recruit, evaluate, and train critical care nurses for MMTs.

RELEVANCE TO CLINICAL PRACTICE

Understanding MMT critical care nurses' competencies can help managers plan and provide relevant training and education before deployment, which can improve nurses' performance, and especially reduce the mortalities and disabilities from trauma.

Lived experience of critical care nurses serving in a war zone: A phenomenological study

BACKGROUND

War has always been a part of human life, and nurses are among the first people to attend to the battlefield alongside the soldiers. Nurses' experiences of being in war zones have long been of interest to researchers. In the conflicts in Syria, Iranian nurses have played a crucial role in saving the lives of many people.

AIM

This qualitative study aims to explore the lived experience of Iranian critical care nurses deployed to battlefields in Syria between 2014 and 2020.

STUDY DESIGN

This qualitative study adopted a hermeneutic phenomenology approach using Van Manen's methodology. The data was obtained through semi-structured in-depth interviews with 15 nurses who experienced war zones. Purposive sampling was used and interviews with the participants were conducted at the agreed place. Interviews were recorded, wrote verbatim and analysed with MAXQDA10 software. COREQ, a 32-item checklist, guided method selection, data analysis and the findings' presentation.

RESULTS

The four main themes that emerged include 'blossoming of talents on the battlefield', 'capable nurses at war', 'nursing jihad' and 'mental preoccupations'. These themes include 12 subthemes and 32 primary subthemes that explain the meaning of Iranian nurses being in war zones in Syria.

CONCLUSIONS

Nurses in the war zones of Syria gained valuable experiences of the blossoming of talents in themselves and others. The lived experiences of the nurses revealed that working in the war zones of Syria is a concept of nurses' capabilities. They considered being in the war zones of Syria as a form of nursing jihad. In spite of the many positive aspects of their experience, the nurses expressed their mental preoccupations during their deployment.

RELEVANCE TO CLINICAL PRACTICE

Nursing care in a war zone for the critically wounded is a unique experience. The experience and ongoing impact of those experiences offer invaluable information for nursing and health policy stakeholders who are planning future deployments.

Experience and training needs of nurses in military hospital on emergency rescue at high altitude: a qualitative meta-synthesis

BACKGROUND

Nurses play an important role in the treatment of war wounds on the plateau, and they face multiple challenges and a variety of needs in their caregiving process. This study aimed to systematically integrate and evaluate qualitative research data to understand the altitude emergency rescue experience and training needs of nurses in military hospitals and provide them with targeted assistance.

METHODS

We critically assessed the study using the Joanna Briggs Institute Critical Assessment Checklist for Qualitative Research. Extraction, summarization and meta-synthesis of qualitative data. Cochrane Library, PubMed, Embase, FMRS, CINAHL, PsycINFO, Chinese National Knowledge Infrastructure (CNKI), Wanfang Database (CECDB), VIP Database, and China Biomedical Database (CBM) were searched for relevant studies published from the establishment of the database to May 2023. Additionally, we conducted a manual search of the references of the identified studies. Registered on the PROSPERO database (CRD42024537104).

RESULTS

A total of 17 studies, including 428 participants, were included, and 139 research results were extracted, summarized into 10 new categories, and formed 3 meta-themes. Meta-theme 1: mental state of military nurses during deployment. Meta-theme 2: the experience of military nurses during deployment. Meta-theme 3: training needs for emergency care.

CONCLUSIONS

Emergency rescue of high-altitude war injuries is a challenging process. Leaders should pay full attention to the feelings and needs of military nurses during the first aid process and provide them with appropriate support.

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

BACKGROUND

With the frequent occurrence of public health emergencies, conflicts and natural disasters around the world, mobile surgical teams are becoming more crucial. The competency of the operating room (OR) nurse has a substantial impact on the effectiveness and quality of the surgical team's treatment, still there is limited knowledge about OR nurse competencies in mobile surgical teams. This study aimed to explore the competencies of OR nurses in mobile surgical teams based on the Onion Model.

METHODS

We conducted a qualitative descriptive study of participants from 10 mobile surgical teams in 2022. Twenty-one surgical team members were interviewed, including 15 OR nurses, four surgeons, and two anesthesiologists. Data were collected through semi-structured interviews. The data were analyzed using Mayring's content analysis.

RESULTS

Twenty-eight competencies were found in the data analysis, which were grouped into four major domains using the Onion Model. From the outer layer to the inner layer were knowledge and skills, professional abilities, professional quality, and personal traits. The qualitative data revealed several novel competencies, including triage knowledge, self and mutual medical aid, outdoor survival skills, and sense of discipline.

CONCLUSIONS

The application of the Onion Model promotes the understanding of competency and strengthens the theoretical foundations of this study. New competencies can enrich the content of the competencies of OR nurses. The results of this study can be used for clinical recruitment, evaluation and training of OR nurses in mobile surgical teams. This study encourages further research to develop competency assessment tools and training programs for OR nurses.

The effectiveness of simulation-based training on the competency of military nurses: A systematic review

BACKGROUND

Simulation is an integral component of healthcare education and military training. There is substantial evidence demonstrating the effectiveness of simulation-based training in nursing and the military; however, its effectiveness for military nurses has not been established in systematic reviews.

OBJECTIVE

To evaluate the effectiveness of simulation-based training on the competency of military nurses and provide guidance for future research on the training of military nurses.

DESIGN

A scoping literature review of PRISMA was used to guide the review.

METHODS

Six databases (PubMed, CINAHL, EMBASE, PsycINFO, Embase, and the Cochrane Library) were searched for English articles. The following search terms were used in different combinations: simulation, simulate, military, army, nurses, competency, training, and education. Our database search began in 2000 and ended in February 2022. Additionally, we conducted a manual search of the references of the identified studies.

RESULTS

In this review, ten studies published between 2008 and 2021 were included, nine were from the United States and one was from the United Kingdom. The results showed that simulation-based interventions were effective in military nurse competency training, including individual knowledge, skills, abilities and thinking, team communication and collaboration abilities, competency enhancement and maintenance. Simulations can effectively train the competencies of newly graduated military nurses, nurses during daily work, and in preparing nurses during deployment.

CONCLUSION

Existing studies on simulation-based training of military nurses are limited. Additional research is needed to assess other competency training for military nurses, pre-deployment training, and training using other simulation methods. It is important to find suitable simulation training methods for the different competencies required of military nurses.

Deployment experiences of military nurses: A systematic review and qualitative meta-synthesis

Aims

The purpose of this systematic review is to explore military nurses’ preparation, deployment and reintegration experiences in order to provide recommendations for effective management of the nursing team.

Background

Nurses provide health care in different settings including community, hospital and the disaster site. Military nurses have a long history of deploying for global health.

Method

A systematic review and qualitative meta‐synthesis of studies focusing on the preparation, deployment and reintegration experiences of military nurses was carried out.

Results

Five synthesized findings were concluded: (a) preparing and sharing experience are the key coping strategies; (b) transition from the civilian care to emergency situations; (c) teamwork contributing to team bonding and the growing role of nursing in the medical team; (d) devoting to nursing duty achieves growth; (e) reintegration is not easy and external support matters.

Conclusion

Transition from civilian care to deployment and from structured deployment environment to reintegration poses challenges to nurses, and better preparation, sufficient support enables them to gain growth.

Implications for Nursing Management

Nurse managers should consider how to sustain a competent and ready nursing team by proposing training protocols to nurses for the potential challenges during the deployment cycle when responding to disasters and public emergencies.

Air Force Medical Personnel: Perspectives Across Deployment

INTRODUCTION

Contingency operations during the past 18 years have exposed millions of U.S. military service members to numerous combat and operational stressors. Despite this, a relative dearth of literature has focused on the experiences of deployed military medical personnel. As such, the present study aimed to address this gap in the literature by conducting individual and small group interviews with Air Force medical personnel who had recently returned from a deployment to Iraq. Interviews targeted self-reported factors related to psychological risk and resiliency across the deployment cycle, while also seeking recommendations for future military medical personnel preparing for medical deployments.

MATERIALS AND METHODS

Inductive thematic analyses were conducted on transcripts from 12 individual and structured group interviews conducted with recently deployed U.S. Air Force medical personnel (N = 28). An interview script consisting of 18 prompts was carefully developed based on the experiences of study personnel. Two team members (n = 1 research psychologist; n = 1 military medical provider) coded exemplars from interview transcripts. A third team member (research psychologist) reviewed coded exemplars for consistency and retained themes when saturation was reached.

RESULTS

In total we report on 6 primary themes. Participants reported feeling prepared to conduct their mission while deployed but often felt unprepared for the positions they assumed and the traumas they commonly experienced. Most participants reported deployment to be a rewarding experience, citing leader engagement, and social support as key protective factors against deployment-related stressors. Finally, following deployment, participants largely reported positive experiences reintegrating with their families but struggled to reintegrate into their workplace.

CONCLUSION

Findings from the present study indicate that the military is largely doing a good job preparing Air Force medical providers to deploy. Results of the present study indicate that military medical personnel would benefit from: (1) increased predictability surrounding deployment timelines, (2) improved cross-cultural training, (3) advanced training for atypical injuries in unconventional patient populations, and (4) improvements in postdeployment workplace reintegration. The present research has the potential to positively impact the overall quality of life for deploying military service members and their families; while simultaneously highlighting the successes and shortfalls in the deployment process for U.S. military medical personnel.

Competencies of military nurse managers: A scoping review and unifying framework

Aim(s)

To identify competencies of military nurse managers and develop a unifying framework of military nurse managers’ competencies.

Background

Military nurse managers shoulder multiple responsibilities because of duality roles, and they should possess competencies that enable them to manage human and material resources during peacetime and wartime. Therefore, nursing management within military context is demanding, such that a comprehensive understanding of their competencies is needed for effective military nursing management. Although relevant studies have focused on different military branches and different levels of managers, there is no standard evaluation framework.

Evaluation

A scoping review of studies focusing on competencies of military nurse managers from seven databases was carried out.

Key issues

Nine studies were included in this review, and a framework consisting of six domains of military nurse managers’ competencies was identified: clinical expertise, role model, leadership competencies, human competencies, financial competencies and deployment competencies.

Conclusion

Existing knowledge of competencies of military nurse managers is limited, and a comprehensive understanding of this topic can provide direction for future work.

Implications for Nursing Management

Military nurse managers play substantial roles within the military nursing context. A unifying framework can facilitate personnel recruitment and competency measurement, as well as training protocol development.

Understanding Interconnectedness From the Military Nurse Perspective

BACKGROUND

Nurses who serve in the military have a unique perspective on nursing and health care delivery that nurtures wholeness and inspires peace and healing on a global scale.

PURPOSE

The purpose of this study was to explore health promotion and healing from the military nurse perspective.

DESIGN

Video-recorded interviews were conducted with 10 military nurses who represented various branches and times of service. Participants were asked to share their experiences as military nurses and discuss the challenges and rewards.

FINDINGS

Thematic analysis of the recorded interviews revealed two major themes: interconnectedness and human potential.

CONCLUSION

This study showed that military nurses have unique experiences that influenced their way of promoting health and healing. Interconnectedness with family (personal and military) had many positive and negative factors. Interconnectedness with the health care team was more prominent for the nurses during military service than in the civilian arena. Global interconnectedness included working with teams from around the world, helping children of detainees see that Americans were not evil, and caring for international communities. Military service strengthened the three human qualities of mind, body, and spirit, which resulted in increasing each military nurse's human potential by enabling them to serve as instruments of healing on a global scale.