Military Nurses' Deployment Experiences: A Qualitative Metasynthesis

Introduction Military medical personnel, including nurses, face a wide array of emotional and psychological issues while deployed. Understanding the challenges military nurses face in the deployed setting may prove useful in effectively preparing nurse leaders for future disaster responses in the military and civilian sectors. The purpose of this metasynthesis is to answer the following research question: What are the experiences of U.S. military and allied nurses deployed to medical facilities in combat operations and support areas since 9/11/2001?Methods A qualitative metasynthesis was conducted to determine commonality of combat-related deployment experiences for U.S. military and allied nurses. After development of the research question, this metasynthesis included 4 steps: (1) perform structured literature search, (2) critical appraisal, (3) reciprocal translation, and (4) synthesize findings. Studies were limited to the years 2004-2023 to focus the search on Operation Enduring Freedom and Operation Iraqi Freedom-related deployments. Reference review of studies retrieved through database search also contributed to the final sample. Screening criteria included: (1) qualitative or mixed methods studies, (2) sample comprised of U.S. or allied country medical/nursing personnel, and (3) care primarily occurring in a fixed facility located in Iraq, Afghanistan, or Kuwait. Studies focusing on reintegration after deployment or air evacuation personnel/nonfixed facility settings were excluded. A total of 11 studies met inclusion criteria. Critical appraisal was conducted on all studies. Data analysis utilized an inductive and iterative process. Reciprocal translation and meta-ethnographic techniques were used to identify words/phases that contained significant meaning and to identify themes/subthemes. Themes formed that described commonalities across nurses' experiences.Results Three primary themes arise from critical examination of military nurses' deployment experiences: (1) "care in a combat zone," (2) "leadership in a combat zone," and (3) "personhood." The subthemes address experiences or concerns related to an individual participant's role as a "care giver," "leader," or "person." The 3 themes formed by this qualitative metasynthesis represent a holistic view of a military nurse in a deployed setting.Conclusions Military nurses' deployment experiences relate to their multiple role(s) as a clinician, officer, and human being. By better understanding military nurses' past deployment experiences and related themes, nurse leaders and individuals can better prepare for supporting staff in future combat operations. The complexities of "caring," "leading," and "personhood" may contribute to emotional distress among deployed military medical personnel.