Social network analysis: Exploring connections to advance military nursing science.

BACKGROUND: Military nurse scientists are embedded in service-affiliated branches (Army, Navy, Air Force) with different missions, but with the singular purpose of generating and disseminating research impacting the health and well-being of DoD beneficiaries. PURPOSE: This project examines collaboration among TriService Nursing Research Program (TSNRP) members, seeking opportunities to strengthen, diversify, and expand research collaboration. METHOD: Social network analysis (SNA) is the empirical inquiry of relations among social actors at different levels of analysis. An electronic SNA assessment and total enumerative sampling were used to explore current collaborations among PhD-prepared military nurse scientists (N = 136). FINDINGS: The TSNRP collaboration network has a complex service-driven structure with high status actors whose advice, knowledge, or skills are sought by others, and who function as connectors or bridges across service branches. DISCUSSION: For military scientists, SNA is instrumental in identifying influential individuals, visualizing opportunities for intraservice mentoring, designing responsive policy, and directing career opportunities for novice scientists.

Oficiais enfermeiros no hospital militar no ano de 1995 / Oficiales enfermeros en el hospital militar en el año de 1995 / Nursing officers at the military hospital in the year of 1995

Resumo Objetivo analisar a lotação e distribuição da primeira turma de oficiais enfermeiros, ao término do Curso de Formação de Oficiais, com a patente de 2º Tenente, no Hospital Central da Polícia Militar do Estado do Rio de Janeiro, em 1995. Método estudo histórico em fontes documentais escritas e orais produzidas por meio de 19 entrevistas, sendo 18 oficiais enfermeiros e um civil. Os conceitos de poder simbólico e capital de Pierre Bourdieu consubstanciaram a análise dos achados. Resultados a classificação obtida no curso de formação de oficiais e a experiência profissional, embora com menor peso, foram preponderantes na distribuição nos setores do hospital. Considerações finais e implicações para prática os critérios de antiguidade da vida militar influenciaram na configuração da equipe de enfermagem no hospital militar. Destaca-se que a ocupação das chefias pelos oficiais enfermeiros foi determinada pelo capital incorporado no estágio probatório, o qual foi institucionalizado pela patente.

Resumen Objetivo analizar la capacidad y la distribución de la primera clase de oficiales enfermeros al término del Curso de Formación de Oficiales, con el grado de 2º Teniente, en el Hospital Central da Polícia Militar do Estado do Rio de Janeiro, en 1995. Método estudio histórico en fuentes de documentos escritos y orales producidos a través de 19 entrevistas, 18 de las cuales fueron enfermeras y una civil. Los conceptos de poder simbólico y capital de Pierre Bourdieu fundamentaron el análisis de los hallazgos. Resultados la clasificación obtenida en el curso de formación para oficiales y la experiencia profesional predominaron en la distribución en los sectores hospitalarios, aunque con menor peso. Conclusión e implicaciones para práctica los criterios de antigüedad en la vida militar influyeron en la configuración del equipo de enfermería. Se destaca que la ocupación de los comandos por oficiales enfermeros fue determinada por el capital incorporado en la etapa probatoria, institucionalizada por el grado.

Abstract Objective to analyze the capacity and distribution of the first class of nurse officers, at the end of the Officer Training Course, with the rank of 2nd Lieutenant, at the Hospital Central da Polícia Militar of the State of Rio de Janeiro, in 1995. Method historical study in written and oral documentary sources produced through 19 interviews, of which 18 are nurse officers and one civilian. Pierre Bourdieu's concepts of symbolic power and capital substantiated the analysis of the findings. Results the classification obtained in the training course for officers and professional experience, although with less weight, were preponderant for the distribution in the hospital sectors. Final considerations and implications for practice the criteria of seniority in military life influenced the configuration of the nursing team at the military hospital. It is noteworthy that the occupation of the heads by the nurse officers was determined by the capital incorporated in the probationary period, which was institutionalized by the patent.

Military nursing: A primer for new recruits.

This article offers an overview of military nursing and provides three examples that illustrate how nurses can advance their careers within each service.

Military Nursing in "Operation Return to Brazil": aeromedical evacuation in the coronavirus pandemic.

OBJECTIVE: to describe the experience of military nursing in "Operation Return to Brazil" in an aeromedical evacuation. METHOD: this is an experience report of the nursing staff in the Aeromedical Evacuation of potentially-contaminated Brazilians who were in Wuhan, China, after the outbreak of the new coronavirus. RESULTS: the report was constructed from nursing care performed in three stages: pre-flight, screening, and flight. Pre-flight care would include aircraft configuration and material prediction. In screening, the staff was concerned with being properly attired. In the health assessment of returnees, in-flight, attention was focused on Personal Protective Equipment handling to minimize the risk of contamination by prolonged contact with potentially-contaminated passengers. Final considerations: nursing was committed to planning all the actions of this mission, which was one of the longest, strenuous and unprecedented in the history of aeromedical transport in Brazil.

Military Nursing in "Operation Return to Brazil": aeromedical evacuation in the coronavirus pandemic / Enfermería militar en la "Operación Regreso a Brasil": evacuación aeromédica en la pandemia de coronavirus / Enfermagem Militar na "Operação Regresso ao Brasil": evacuação aeromédica na pandemia do coronavirus

ABSTRACT Objective: to describe the experience of military nursing in "Operation Return to Brazil" in an aeromedical evacuation. Method: this is an experience report of the nursing staff in the Aeromedical Evacuation of potentially-contaminated Brazilians who were in Wuhan, China, after the outbreak of the new coronavirus. Results: the report was constructed from nursing care performed in three stages: pre-flight, screening, and flight. Pre-flight care would include aircraft configuration and material prediction. In screening, the staff was concerned with being properly attired. In the health assessment of returnees, in-flight, attention was focused on Personal Protective Equipment handling to minimize the risk of contamination by prolonged contact with potentially-contaminated passengers. Final considerations: nursing was committed to planning all the actions of this mission, which was one of the longest, strenuous and unprecedented in the history of aeromedical transport in Brazil.

RESUMEN Objetivo: describir la experiencia de enfermería militar en la "Operación Regreso a Brasil" en una evacuación aeromédica. Método: este es un informe de experiencia del equipo de enfermería, en la evacuación aeromédica de brasileños potencialmente contaminados que se encontraban en Wuhan, China, después del brote del nuevo coronavirus. Resultado: el informe se construyó a partir de la atención de enfermería realizada en tres etapas: pre-vuelo, detección y vuelo. En el prevuelo, el cuidado incluyó la configuración de la aeronave y el pronóstico del material. En la evaluación, al equipo le preocupaba estar bien preparado. En la evaluación de la salud de los retornados, durante el vuelo, la atención se centró en el manejo de equipos de protección personal para minimizar el riesgo de contaminación por contacto prolongado con pasajeros potencialmente contaminados. Consideraciones finales: la enfermería se comprometió a planificar todas las acciones de esta misión, que fue una de las más largas, extenuantes y sin precedentes en la historia del transporte aeromédico en Brasil.

RESUMO Objetivo: descrever a experiência da enfermagem militar na Operação Regresso ao Brasil em uma evacuação aeromédica. Método: trata-se de um relato de experiência da equipe de enfermagem, na evacuação aeromédica dos brasileiros potencialmente contaminados que estavam em Wuhan, China, após o surto do novo coronavírus. Resultado: o relato foi construído a partir de cuidados de enfermagem realizados em três etapas: pré-voo, triagem e voo. No pré-voo, os cuidados incluíram a configuração da aeronave e a previsão do material. Na triagem, a equipe preocupou-se em estar devidamente aparamentada. Na avaliação de saúde dos repatriados, durante voo, concentrou-se a atenção no manejo dos Equipamentos de Proteção Individual para minimizar o risco de contaminação pelo contato prolongado, com passageiros potencialmente contaminados. Considerações finais: a enfermagem empenhou-se no planejamento de todas as ações dessa missão, que foi uma das mais longas, extenuantes e inéditas da história do transporte aeromédico do Brasil.

Air Force Nursing Executive leadership impact on health care 2004-2008.

Recorded history allows us to recognize our past and can contribute to the present and future nursing practice. The purpose of this study is to examine the impact of the United States Air Force Nursing Executive leadership on military health care transformation, through Major General (Retired) Melissa A. Rank's personal stories and experiences. This study explores the development and impact of Air Force nursing in its historical, social, and global context between the years of 2004-2008. The oral history method was used to explore and record the professional life experiences of a great military nurse leader. The United States Air Force Nurse Corps has contributed to global healthcare via humanitarian medical support, medical disaster relief, aeromedical patient transport, development of best practices, advances in technology, education programs, and transformation in deployed medical care during times of war, peace, and natural disasters.

[From corpsman to rescuer, the missed nurse's ideal towards the end of italian Risorgimento]. / Da portaferiti a soccorritore, l'ideale mancato di infermiere militare sul finir del Risorgimento italiano.

INTRODUCTION: Military corps have always been supported by healthcare providers who took care of the injured and sick soldiers. Traditionally the military nurse's figure has never been fully appreciated to the point that, even nowadays, it is still searching for its own identity. AIM: The aim of the study is to describe the military nurse's role from the Second War for Italian Independence (1859) to the conquest of Rome (1870). METHODS: Historical investigation. Secondary sources were consulted to carry out a geopolitical and historical contextualization of the reference period, while to trace the military nurse's evolution the team referred to primary sources. All the mentioned sources were analyzed according to Chabod's methodology (2012). RESULTS: The military nurse was born as a corpsman. The Risorgimento wars contributed to highlight the major contribution that nurses could give to military healthcare. In 1863 the Ministry of War elaborated a new and innovative profile for military nurses which foresaw particular physical and moral requirements, but also specific competences. Even though a new ideal of nurse was created, the Military Nurses Corp did not experience any changes: the nurses' activities remained transporting the injured and assisting doctors. CONCLUSIONS: Primary sources analysis highlighted an important attention towards the military nurse's role and education after national unity, although the gap shown by the military healthcare service during the Risorgimento battles was evident. Such condition facilitated the development of the first rescue committees which became, at a later time, the International Red Cross. The committees popularity allowed the volunteers to gain higher fame and social prestige than military nurses.

Louisa May Alcott and Hospital Sketches: An innovative approach to gender and nursing professionalization.

AIM: To show the development of an emerging nursing profession through the eyes of Louisa May Alcott and Hospital Sketches. BACKGROUND: In Hospital Sketches, Louisa May Alcott recounts her experiences when she worked as a nurse of injured soldiers during the American Civil War, in an autobiographically and masked-referential way, which allows her to negotiate between transgression and convention. Unlike other reviews, in this paper the relevance of nursing remains highlighted. DESIGN: Discussion paper. DATA SOURCES: Existing literature in databases, history books and our own reading of facts. IMPLICATIONS FOR NURSING: Illuminating overlooked meanings hidden in nurses' personal sources enables to approach their contribution to history, improve their visibility and project the future of nursing. Nursing care, whether domestic or professional, was and remains a catalyst for change. CONCLUSION: Through Alcott's words, we understand the transition of nursing care as a gradual extension of the middle-class woman's domestic role and a progressive definition of nurses' identity. In particular, we highlight how certain professional nursing nuances which appear in the text are compatible with the gradual extension of the boundaries of women's domesticity. Furthermore, Alcott's use of literary devices reveals the delicate balance between women's domestic role and some new nursing professional features, which anticipates nursing professionalization.

Twenty years of staffing, practice environment, and outcomes research in military nursing.

BACKGROUND: Two decades ago, findings from an Institute of Medicine (IOM) report sparked the urgent need for evidence supporting relationships between nurse staffing and patient outcomes. PURPOSE: This article provides an overview of nurse staffing, practice environment, and patient outcomes research, with an emphasis on findings from military studies. Lessons learned also are enumerated. METHOD: This study is a review of the entire Military Nursing Outcomes Database (MilNOD) program of research. DISCUSSION: The MilNOD, in combination with evidence from other health care studies, provides nurses and leaders with information about the associations between staffing, patient outcomes, and the professional practice environment of nursing in the military. Leaders, therefore, have useful empirical evidence to make data-driven decisions. The MilNOD studies are the basis for the current Army nursing dashboard, and care delivery framework, called the Patent CaringTouch System. CONCLUSION: Future research is needed to identify ideal staffing based on workload demands, and provide leaders with factors to consider when operationalizing staffing recommendations.

Adaptation of the Practice Environment Scale for military nurses: a psychometric analysis.

AIM: The aim of this study was to confirm the psychometric properties of Practice Environment Scale of the Nursing Work Index in a military population. This study also demonstrates association rule analysis, a contemporary exploratory technique. BACKGROUND: One of the instruments most commonly used to evaluate the nursing practice environment is the Practice Environment Scale of the Nursing Work Index. Although the instrument has been widely used, the reliability, validity and individual item function are not commonly evaluated. Gaps exist with regard to confirmatory evaluation of the subscale factors, individual item analysis and evaluation in the outpatient setting and with non-registered nursing staff. DESIGN: This was a secondary data analysis of existing survey data. METHODS: Multiple psychometric methods were used for this analysis using survey data collected in 2014. First, descriptive analyses were conducted, including exploration using association rules. Next, internal consistency was tested and confirmatory factor analysis was performed to test the factor structure. The specified factor structure did not hold; therefore, exploratory factor analysis was performed. Finally, item analysis was executed using item response theory. The differential item functioning technique allowed the comparison of responses by care setting and nurse type. RESULTS: The results of this study indicate that responses differ between groups and that several individual items could be removed without altering the psychometric properties of the instrument. CONCLUSION: The instrument functions moderately well in a military population; however, researchers may want to consider nurse type and care setting during analysis to identify any meaningful variation in responses.

US Military Nurses: Serving Within the Chaos of Disaster.

The purpose of this article is to share US military nurses' experiences of responding to disasters. Using phenomenology, 23 participants serving as US military nurses from different service branches and the US Public Health Service volunteered for a single face-to-face interview. Five polar themes plus one final theme emerged from the narratives. Nurses expressed a sense of loss, reshaping of thoughts regarding disasters, and new appreciation of how people's lives are totally disrupted. Findings showed a need for change in nursing education, practice, training, policy, and recommendations for higher education and how the military may better educate its personnel.

"I Serve 2": Meeting the needs of military children in civilian practice.

The American Academy of Nursing launched the "Have You Ever Served in the Military?" campaign in 2013 in conjunction with the Joining Forces campaign spearheaded by First Lady Michelle Obama and Dr. Jill Biden. The "Have You Ever Served in the Military?" campaign provides guidance and resources for nurses outside the Military Health System and Veterans Health Administration where upwards of 80% of veterans receive care. However, most military personnel do not serve alone. More than half of the 2.2 million active duty, National Guard, and Reserve service members currently serving in the armed forces have families and many military children experience stress and anxiety secondary to parental military service. Although strides have been made to improve identification and treatment of the visible and invisible wounds of war for service members, little to no information exists regarding the impact parental service has on the physical, psychological, and behavioral health of military children. In addition, there is no mechanism in place to identify military children in civilian practice nor resources providing evidence-based best practices when caring for these children.

Transforming veterans health care through academic-practice partnerships.

The Veterans Health Affairs Office of Academic Affiliations (OAA) has invested in the creation of academic-practice partnerships to transform the care of veterans and their families. This article details how a long-standing relationship between the University of Alabama at Birmingham School of Nursing and the Birmingham Veterans Affairs Medical Center grew into such a partnership. The three programs that now exist within the Birmingham Veterans Affairs Nursing Academic Partnership (VANAP) umbrella are described, including an undergraduate VA nurse scholars program that has sustained beyond OAA funding, a VANAP graduate education program for psychiatric mental health nurse practitioners (NPs), and a Mental Health NP Residency. Key features of the programs are noted as are outcomes and lessons learned for building mutual goals and a sustainable academic-practice partnership. With the recent passage of the Veterans Choice Program, the importance of educating all nurses about veterans and veterans' health is stressed.

A prism of excellence: The Charleston Veterans Administration Nursing Academic Partnership.

BACKGROUND: The Veterans Administration (VA) has been committed to academic affiliate training partnerships for nearly 70 years in efforts to enhance veteran-centric health care. One such effort, the VA Nursing Academy (VANA) program, was developed in 2007 in response to the nationwide nursing shortage and began as a five-year pilot with funding competitively awarded to 15 partnerships between local VA medical centers and schools of nursing. The VANA program evolved into the VA Nursing Academic Partnership (VANAP) program following the initial pilot. PURPOSE: This article describes the development and evolution of the Charleston VANAP, which includes the Ralph H Johnson VA Medical Center (RHJ VAMC) and the Medical University of South Carolina College of Nursing (MUSC CON). METHODS: The VA Office of Academic Affiliations (OAA) funded a large portion of the initial five years of the Charleston VANAP. Once the national funding source ceased, the RHJ VAMC and the MUSC CON entered into a Memorandum of Understanding (MOU) to offer in-kind contributions to the partnership. DISCUSSION: The Charleston VANAP is the only program in the nation to offer three different nurse trainee programs and this article highlights some of the more notable achievements from each program. CONCLUSION: The Charleston VANAP is a comprehensive partnership between the RHJ VAMC and the MUSC CON that truly demonstrates a commitment to assure that the very best care be provided to Veterans, our Nation's heroes.

The Role of Army Nurse Practitioners Supporting Wars in Iraq and Afghanistan.

Family nurse practitioners are an essential member of the military medical team. They were incorporated into the Army medical system almost as soon as there was an academic program to develop the role in primary care settings. The role for nurse practitioners during deployment has not been as clear. Even though they have been around for 50 years, the specific role nurse practitioners provide is still evolving. This article explores the incorporation of nurse practitioners into Army medicine with a focus on deployed medicine. Nurse practitioners have been shown to be very versatile providers with the requisite skill sets to meet the demands of the combat environment and are able to substitute for other medical assets that are critically short due to sustained conflict. Clarifying the value a nurse practitioner brings to medical care in the combat environment is essential to insure all assets are being employed to provide the best medical care to the US fighting force.

Beyond Versailles: Recovering the Voices of-Nurses in Post-World War I U.S.-European Relations.

From late 1918 to 1922, the American Red Cross (ARC) enlisted roughly six hundred American nurses and scores of female auxiliary staff to labor in post-World War I continental Europe, Russia, and the Near East, mostly stationed in Poland, Czechoslovakia, the Balkan states, and Siberia. The ARC nurses ran health clinics, made home visits, and opened nurse training schools. Close readings of letters, diaries, official reports, and published articles help recover the place of these women in postwar European history and the history of U.S. foreign relations. Their writings reveal their perceptions about eastern European and Russian politics and culture, their assumptions about the proper U.S. role in the region's affairs, and their efforts to influence popular U.S. discourse on these topics. This article argues that American nurses and support staff are central-yet neglected-players in the history of U.S.-European affairs. Through its bottom-up approach, it offers a more personal and intimate perspective on the history of U.S. international relations during this time.

Mentoring from Afar: Nurse Mentor Challenges in the Canadian Armed Forces.

There is an integral connection between leadership, mentoring and professional career progression within the nursing profession. The purpose of this article is to examine recommendations and best practices from the literature and provide a basis to construct a formalized successful mentoring dyad program with guidelines on establishing and maintaining a productive mentoring relationship over long distance. Canadian Armed Forces (CAF) nurses practice within a unique domain both domestically and abroad. The military environment incorporates many aspects of mentoring that could benefit significantly by distance interchange. Supported through examining literature within nursing, CAF publications and other professions along with contrasting successful distance mentoring programs, the findings suggest that a top-down, leadership-driven formal mentoring program could be beneficial to CAF nurses. The literature review outlines definitions of terms for mentorship and distance mentoring or e-mentoring. A cross section of technology is now embedded in all work environments with personal communication devices commonplace. Establishing mentoring relationships from afar is practical and feasible. This article provides a guided discussion for nursing leaders, managers and grassroots nurses to implement mentoring programs over distances. The recommendations and findings of this article could have universal applications to isolated nursing environments outside of Canadian military operational frameworks.