combat nurse

Battlefield Nurses or Combat Medics?

combat nurseDo nurses actually work on the battlefield? Are there actually battlefield nurses? The short answer is No. In today’s modern Military, there is no dedicated MOS or position for Nurses on the Battlefield. The primary Medical Specialist on the Battlefield is the Combat Medic.

Combat Medics are almost always Enlisted personnel whereas Nurses are all Officers. We will get into both of these Medical occupations in this article to outline the duties and responsibilities of each.

What we have on today’s modern battlefield are what is called Forward Surgical Teams (FST’s). FST’s typically includes 20 staff members: 4 surgeons, 3 RNs, 2 certified registered nurse anesthetists (CRNAs), 1 administrative officer, 1 detachment sergeant, 3 licensed practical nurses (LPN)’s, 3 surgical techs and 3 Combat medics. These mobile highly specialized units travel just behind the front lines and are responsible for a wounded soldiers care within the “Golden Hour”.

Combat Medics on the front lines treat and stabilize the wounded and from that point the wounded are then moved to an FST or Medivac’d to a Battalion Aid Station where advanced care can be given to the wounded. The FST is more like a mobile small MASH unit and is the go to location if critical care is needed for a wounded soldier and there is not enough time to get the soldier to a fully equipped MASH unit or Battalion Aid Station where they can receive the necessary critical care. FST’s are the very closest that Nurses will get to the Battlefield.

Being all Officers, Nurses and Doctor’s are way too valuable an asset to lose on the frontlines. This is where the Combat Medic (Army) or Corpsman (Navy & Marines) comes in. The Medic/Corpsman are trained in immediate life saving and stabilization skills so that the wounded soldier can then be transported to an FST, BAH or MASH Unit for further care. Being so close to the front lines is a constant danger for an FST unit. But the FST’s are a proven asset to treating the wounded in battle that need immediate advanced critical care.

An FST is organized into Four areas:

1: HQ / Headquarters – Which includes Administrative and Communications functions.

2: ATLS (Advanced Trauma Life Support) – Triages and prepares multiple casualties for surgery or transport to a MASH Unit. It has a total of four beds that are also equipped with ventilators.

3: Operating Room (OR) – An FST OR can be set up and begin surgeries within one hour and can be at full functional capacity within two hours of having set up an established area of operations. The FST OR’s have two separate OR tables that can be used at the same time allowing for treatment of a greater number of casualties at any given time.

4: Intensive Care Unit Recovery (ICU) – An FST ICU normally has eight beds for Post-Op care and two beds in reserve for patients awaiting for evacuation.

The FST’s equipment and supplies are generally packed and transported in four Humvee’s and two 2.5ton Trucks. Each vehicle also has a specially designed trailer pulled behind it that carries the bulk of the equipment. The Humvee’s pull the smaller M1101 trailers and the Deuce and a half trucks pull the larger M1082 cargo trailer. FST’s are also often augmented with mobile power generators and air conditioning systems and are set up on their own trailers. There are also Airborne FST’s of which their equipment can be sling loaded beneath helicopters, normally CH-47’s, and deployed as needed, a lot faster than driving to their assigned locations near the front lines. FST’s administer acute care and surgical nursing to stabilize and resuscitate casualties with life and limb threatening injuries.

Military Nurses are a breed apart from their Civilian counterparts. On the Battlefield, nurses are required to have top notch skills and knowledge, but also have the ability to quickly adapt to the environment and rapidly changing circumstances. Often in an austere environment without the high technology equipment that would normally be readily available in a civilian Hospital or far behind the lines Military Hospital.

Military deployment, especially to a war zone, presents unique challenges and hardships for Nurses.
Some of those challenges and hardships are:

* – Long separations from family and loved ones, usually up to a year, sometimes longer.

* – Language and cultural differences.

* – Threats from local Insurgents and Terrorists.

* – Weather challenges, such as temperature extremes, Dust storms, e.t.c.

* – Supply shortages. Ranging from simple alcohol pads to syringes to bandages.

* – Major Trauma. Nurses joining the Military right out of nursing school and deployed to a combat zone are exposed to Severe Trauma injuries not normally seen by experienced civilian nurses.

* – PTSD, Post-Traumatic Stress Disorder. PTSD is a growing concern for many military members.

There are five basic levels of medical care in combat areas.

1: Level One care- Begins on the very frontlines and that care is often administered by the Combat Medics / Corpsman of which are trained as Emergency Medical Technicians and perform the critical first treatments of the battlefield wounded. The Combat medics then call for the wounded to be evacuated to an FST or Combat Support Hospital (CSH).

2: Level Two care – Also begins on the frontlines or within the combat zone. In the Army, the battalion aid station (BAS) and the FST’s provide Level two care to the wounded. These units have Physicians, Physician Assistants, Nurses and Medics. Some Physician Assistants are now being replaced with nurse practitioners at the BAS’s.

3: Level Three care – Occurs in Combat Support Hospitals. CSH’s are often like what you see on the TV show MASH, but more modernized with a network of long, insulated, interconnected tents. CSH’s provide outpatient and hospitalization for almost all patients.

4: Level four care – Provides medical and surgical care outside of the combat zone. Level Four care is provided in field hospitals, general hospitals and fixed locations such as Landstuhl Army Regional Medical Center in Germany.

5: Level Five care – Provided at hospitals in the United States. Among which are Walter Reed AMC in Washington D.C. and Brooke Army Medical Center in San Antonio, Texas. Brooke AMC is also the top tier Burn Treatment Center for the military as well.

Nursing on the Battlefield goes back to before recorded history. Earliest known records indicate that nursing was done by monk’s and nun’s of various religious orders as it was considered work of not just a physical nature, but of a spiritual nature as well. Over time, Nursing evolved and in 1854 after the Crimean War had started Florence Nightingale had become the mother of modern nursing.

Florence Nightingale had a very large impact on nursing in the United States, as many of her concepts and methods were adopted and used by nurses on both the Union and Confederate forces during the U.S. Civil War from 1861-1865. During the U.S. Civil War, some nurses were given honorary rank in the military, but the majority of Military nurses were civilians who were hired by the government.

Another well known nurse was Dorothea Dix who became known for championing for the humane treatment of the mentally ill. Dorothea Dix went on to become the ery first Superintendent of Union Army Nurses. One of her hallmark efforts was her insistence that wounded troops from both sides of a conflict be treated with the same level of dignity, compassion and nursing care.

Clara Barton is another significant woman in military nursing history due to her efforts during and after the U.S. Civil War to locate missing Union soldiers. In 1881 Clara Barton formed the American Red Cross and served as it’s President until 1904.

In 1908 the U.S. Navy formed the Navy Nurse Corps. In 1949 the U.S. Air Force established the Air Force Medical Service and the Air Force Nurse Corps was then integrated into the AFMS. When the Korean War began in 1950, Nurses were the only female military personnel allowed to serve in a combat zone.During the Vietnam War, 1964-1973, estimates place less than 7,000 nurses assigned to the conflict.

 

Are you a current or former military healthcare worker? We would love to hear your thoughts or stories on the subject. Feel free to leave us a comment below. Thank you for reading!

 

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George Tall

Author at Hug Your Nurse
George Tall works in the legal field, is a father of three, and a husband of a RN for 25 years. He enjoys writing about everything, especially nursing! He has been writing for a living, at least partially, since around 2000. As an author on dozens of websites, he enjoys being factual, while spinning a bit of humor where possible.
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One thought on “Battlefield Nurses or Combat Medics?

  1. John

    I was a medic myself in Vietnam. I really appreciate this article. If you ever want soneone to write some personal stories please email me at johnmillerwins at yahoo dot com. Thanks again.

    Reply

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