Overseas Contingency Operations
Deploying or being stationed overseas is an exciting and rewarding part of military service. Many nurses select assignments based on the availability of such international travel. Whether being stationed in Cairo, Egypt with a Naval Medical Research Unit or assigned as an Air Force Critical Care Nurse with the Special Operation's Surgical Team in Lakenheath, UK, nurses are ubiquitous to military operations across the globe.
Establishing Mobile Medical Units
Nurses who are stateside in the Army Nurse Corps are routinely involved in training exercises to establish temporary medical units, called Combat Support Hospitals (CSH), anywhere a military hospital is needed. These portable facilities, previously known as Mobile Army Surgical Hospitals (MASH) can be organized quickly to provide wards, operating rooms, and critical care units for injured military personnel. The ideal location of a CSH is as close to the injured as possible without putting the hospital personnel at risk. As the CSH can be established and ready for patients within hours, moving the temporary hospital takes much longer. Nurses providing care in a CSH during combat operations, such as Afghanistan, must be able to work efficiently under stressful conditions.
Nurses serving in the Navy Nurse Corps can be assigned aboard one of the two dedicated hospital ships: the USNS Comfort and the USNS Mercy. These two non-combatant vessels are deployed from San Diego, CA and Norfolk, VA to provide support for operations with all military branches as well as civilian operations such as natural disaster relief. Nurses serving aboard these ships are part of a crew of over 200 medical and support personnel. Missions or deployments can last from a few weeks such as providing support to medical systems in South America or several months during active combat engagements.
Air Force Nurses receive flight nurse training to prepare for aeromedical evacuations all over the world. The medical flight, aboard a C-17 or C-130 aircraft, can consist of a full medical team with OR and ICU capabilities. This is a unique care environment as it is unstable given the air pockets and currents, and extremely loud. Nurses providing care on these medical flights manage not only the medical needs of the patients, but psychological issues that may arise during flight. Many aeromedical evacuation aircraft have been fired upon during combat situations and nurses receive specialized training in simulators to prepare for such ordeals.
There are five levels of care for military operations during times of combat. Level One is at the frontline where the combat medic who is trained in emergency medical care can triage, perform emergency care, and call for an evacuation. Level Two is the Battalion Aid Station and is within the combat zone. Here there is a team consisting of a surgeon, physician assistant or nurse practitioner, and medic to provide essential care. Level Three takes place in a CSH where all levels of patients and injuries are managed. Level Four occurs at field hospitals in the region, but outside of the combat zone. Level Five is care given by military facilities in the U.S., such as Walter Reed Army Medical Center in Washington, D.C.
Nurses serving with the U.S. military in any branch must be trained in the art of cultural competence when being stationed outside of the U.S. All branches require region-specific training to ensure personnel behave in a manner that is both respectful to the hosting country and always positively representing the U.S. For example, nurses serving in Middle Eastern countries such as Saudi Arabia or Bahrain are educated to the customs, particularly in regard to women in public, so as not to offend the local citizens.
When serving on international bases, such as Camp Leatherneck in Afghanistan, nurses must also learn the rank of the fellow international military units stationed on the base. Being able to visually identify rank will aid the nurse with following protocols that are expected in military environments.
There is an inherent risk of safety when traveling or being stationed abroad. Nurses must follow directives from their branch regarding methods to keep safe in each particular area. For example, certain shopping areas may be determined unsafe for military personnel and therefore off-limits for travel. Additionally, the military has strict rules, limits, and expectations for posting information on social media platforms in regard to safety.
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