On Memorial Day, we turn our thoughts to those who served and gave the ultimate sacrifice for their country in every branch of the Armed Forces.  Frida and I also turn our thoughts and prayers to those nurses currently serving in all branches of the military, and especially to those who are in active combat regions. I am constantly amazed by how combat nursing has evolved over the past decades.

Ever since Florence Nightingale’s time, military nurses have supported soldiers in military conflict around the world, with key roles in both world wars and in most conflicts of the twentieth and twenty-first centuries. But the role of military nurses in combat has changed significantly with the Middle Eastern conflicts. Today, the battlefields in Iraq and Afghanistan have no “front lines,” and everything is at increased mobility. Injuries are far different and on these battlefields, life- and limb-saving surgery is practiced in a bare-bones environment without high technology.

Prior to 2000, the role of combat military nurses was to care for service members in a field or combat hospital with a large staff of medical personnel, well behind the front lines. During the past decade, because of the absence of the “front line,” roles have expanded. Nurses are now deployed within the combat zones, assuming roles as diverse as forward surgical team members, critical care transport nurses, combat brigade nurses, and advanced practice nurses.

Combat nurses are expected to make key bedside decisions and manage multi-trauma casualties when physician availability is limited. Early in the wars in Iraq and Afghanistan, there was a shortage of medical providers at the forward levels of military operations. This shortage provided the “opportunity” for advanced practice nurses to fill this significant gap.
These nurses took and continue to take on duties normally reserved for combat surgeons.  Advance practice nurses are often the medical personnel making the decisions as to trauma care and immediacy of treatment. In recognition of the changes in the roles of nurses in combat, Army regulations were amended in 2007 so that advanced practice nurses could be assigned to positions traditionally filled by physicians and physician assistants.
Frida and I are proud to be supporters of a profession that continues to evolve and develop methods for quicker treatment of combat injuries and the saving of lives of our brave soldiers. And acknowledge that advancements in training have led to increased responsibility for our military nurses.
We wish all our military nurses, past and present, a very Happy Memorial Day.
~Michael Donner