title: Preparing British Military nurses to deliver nursing care on deployment. An Afghanistan study.
abstract: BACKGROUND
  This paper forms part of the first British Armed forces qualitative nursing research study undertaken on deployment.
  
  
  OBJECTIVE
  To provide an analysis of the impact and effectiveness of the pre-deployment educational preparation and clinical placements provided for military nurses.
  A Constructivist Grounded Theory was utilised with data collected through semi-structured interviews with 18 nurses based in Camp Bastion Hospital, Afghanistan during 2013.
  
  
  RESULTS
  Initial coding indicated 21 educational preparation and clinical placement categories that influenced the delivery of nursing care. Analysis of these elements led to the identification of four major clusters: Military Nursing Care; Military Nurse Education; Unique Hospital Environment and Clinical Placements.
  
  
  CONCLUSIONS
  Educational preparation consists of completing deployable operational nursing competencies, specialist training and individual tailored courses. This strategy was viewed as proving the appropriate academic requirement. However, training would be enhanced by introducing a formalised military preceptorship programme focussing on fundamental nursing skills. Caring for children was a particular concern, and it was emphasised that educational courses must be combined with a standardised clinical placement policy. Adequate clinical exposure can be challenging as nurses are not routinely exposed to War Zone levels of trauma in the UK. Clinical placements need to be standardised and harmonised, and located in areas where nurses cared for patients with similar injury patterns to those witnessed on deployment. Current NHS Trust placements can reduce the opportunities for employment in suitable clinical environments and diminishing the openings for collective military training. Better use should be made of clinical rotation programmes, including high dependency units, elective surgery, medical assessment units, paediatrics, and outreach teams such as burns and plastic surgery and pain management. Practice Educators should be utilised to provide education, mentorship, supervision and continuing personal development in the operational arena. The paper considers post-Afghanistan future options.
authors.affiliation: Academic Department of Military Nursing, Royal Centre for Defence Medicine, ICT Centre, Birmingham Research Park, Vincent Drive, Birmingham B15 2SQ, United Kingdom. Electronic address: alan.finnegan526@mod.uk.
authors.forename: Alan
authors.initials: A
authors.lastname: Finnegan
authors.affiliation: Eastham Group Practice, Treetops Primary Healthcare Centre, 47 Bridle Road, Bromborough Wirral CH62 6EE, United Kingdom.
authors.forename: Sara
authors.initials: S
authors.lastname: Finnegan
authors.affiliation: Army Medical Directorate, Former Staff College, Slim Road, Camberley GU15 4NP, United Kingdom.
authors.forename: David
authors.initials: D
authors.lastname: Bates
authors.affiliation: Defence Healthcare Education & Training, Defence Medical Services (Whittington), Lichfield, Staffordshire WS14 9PY, United Kingdom.
authors.forename: Debra
authors.initials: D
authors.lastname: Ritsperis
authors.affiliation: Faculty of Health & Life Sciences, University of Northumbria, E210, 2nd Floor Coach Lane Campus, West Benton Newcastle upon Tyne NE7 7XA, United Kingdom.
authors.forename: Kath
authors.initials: K
authors.lastname: McCourt
authors.affiliation: Faculty of Health and Social Care, University of Chester, Senate House CSH109, Parkgate Road, Chester CH1 4BJ, United Kingdom.
authors.forename: Mike
authors.initials: M
authors.lastname: Thomas
mesh_terms: D000328:Adult; D000346:Afghanistan; D003695:Delivery of Health Care; D005260:Female; D066296:Grounded Theory; D006801:Humans; D008297:Male; D008875:Middle Aged; D008888:Military Nursing / Q000193:education*; D024802:Nurse's Role; D036301:Qualitative Research; D006113:United Kingdom
keywords: Afghanistan; British Army; Clinical placements; Defence; Deployment; Educational preparation; Military; Qualitative research methods