Other Titles

PechaKucha Presentation

Abstract

Background/Purpose: Evidence-based national guidelines establish traditional palliative care standards, yet there are gaps in applying competencies amidst combat nursing complexity, frontline fluctuations, and mass casualties. During the most recent wars, nurses related reluctance in triaging and not knowing how to care for severely ill and dying young service members (Kenny & Kelley, 2019; Kelley, Kenny, & Donley, 2017). Relevant nursing theory integration is lacking to guide this distinctly difficult context marked by severity and suffering, requiring theoretical nursing models attuned to combat conditions.

Aims/Outcomes: This presentation aims to describe an ongoing study using an adapted unitary caring science model (Reed 2010) to guide military nurses’ combat palliative praxis by synthesizing the literature, theory, and clinical guidelines. The study will bridge gaps in knowledge and allow for the development of standard palliative competencies for use in deployed military situations by integrating unitary caring science concepts matched to evidence-based guidelines and described by military nurse participants.

Methods/Practice: We first matched the Adapted Unitary-Caring Conceptual Model for Palliative Care developed by Reed to potential competencies needed by military nurses. We then conducted a systematic literature review of medical care and triage studies in the deployed context. We continue by using the literature and the model to build a beginning set of questions for a Delphi approach (Trevelyan & Robinson, 2015) using active-duty military nurse participants who deployed to the most recent wars in Iraq and Afghanistan. Using three rounds of questioning, we plan to build consensus to develop unique nursing competencies for military nurses in deployed scenarios. We will then translate the information gained with current palliative and end-of-life care guidelines into curriculum, processes, protocols, and decision support for military nurses in deployed and wartime scenarios.

Conclusion/Implications: This study will create the ability for military nurses to provide competent palliative and end-of-life care in austere environments. Moreover, the developed model will serve as a robust framework guiding combat palliative nursing in transformative ways. It offers specific pathways for further research endeavors, informing evidence-based practices in the demanding context of combat care, and enriches educational curricula for military nurses.

Notes

References:

Kelley, P., Kenny, D. J., & Donley, R. (2017). Experiences of vulnerability and uncertainty during the Iraq and Afghanistan wars: Stories of wounded service members and the nurses who cared for them. Nursing Outlook. 65(5s), S71-80. https://www.sciencedirect.com/science/article/pii/S0029655417301938

Kenny, D.J., Kelley, P.W., (September 30, 2019). Heavy burdens: Ethical issues faced by military nurses during a war. OJIN: The Online Journal of Issues in Nursing, 24, Manuscript 1. Doi:10.3912/0JIN.Vo124No03Man01

Trevelyan, E. G., & Robinson, P. N. (2015). Delphi methodology in health research: How to do it? European Journal of Integrative Medicine, 7(4), 423-428. https://doi.org/10.1016/j.eujim.2015.07.002

Reed, S. M. (2010). A unitary-caring conceptual model for advanced practice nursing in palliative care. Holistic Nursing Practice, 24(1), 23-34.

Description

Past research has shown that military nurses have difficulty in providing end-of-life care for young, injured service members. There are gaps in applying established palliative and end-of-life guidelines amidst combat nursing complexity, frontline fluctuations, and mass casualties. This multimethod study describes the exploration of theory, use of a model specific to military nurses, and development of care competencies for military nurses during wartime and deployed scenarios.

Author Details

Deborah Kenny PhD, RN, FAAN; Sean Reed PhD, APRN, ACNS-BC, ACHPN, AHN-BC, FCNS, SGAHN

Sigma Membership

Alpha Kappa at-Large

Type

Presentation

Format Type

Text-based Document

Study Design/Type

Systematic Review

Research Approach

Other

Keywords:

Competence, Hospice, Palliative, End-of-Life, Military Nurses, Combat

Conference Name

36th International Nursing Research Congress

Conference Host

Sigma Theta Tau International

Conference Location

Seattle, Washington, USA

Conference Year

2025

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

Click on the above link to access the slide deck.

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Bridging Theory-Practice Gaps: Military Nurses' Combat Palliative Praxis and Care Competency

Seattle, Washington, USA

Background/Purpose: Evidence-based national guidelines establish traditional palliative care standards, yet there are gaps in applying competencies amidst combat nursing complexity, frontline fluctuations, and mass casualties. During the most recent wars, nurses related reluctance in triaging and not knowing how to care for severely ill and dying young service members (Kenny & Kelley, 2019; Kelley, Kenny, & Donley, 2017). Relevant nursing theory integration is lacking to guide this distinctly difficult context marked by severity and suffering, requiring theoretical nursing models attuned to combat conditions.

Aims/Outcomes: This presentation aims to describe an ongoing study using an adapted unitary caring science model (Reed 2010) to guide military nurses’ combat palliative praxis by synthesizing the literature, theory, and clinical guidelines. The study will bridge gaps in knowledge and allow for the development of standard palliative competencies for use in deployed military situations by integrating unitary caring science concepts matched to evidence-based guidelines and described by military nurse participants.

Methods/Practice: We first matched the Adapted Unitary-Caring Conceptual Model for Palliative Care developed by Reed to potential competencies needed by military nurses. We then conducted a systematic literature review of medical care and triage studies in the deployed context. We continue by using the literature and the model to build a beginning set of questions for a Delphi approach (Trevelyan & Robinson, 2015) using active-duty military nurse participants who deployed to the most recent wars in Iraq and Afghanistan. Using three rounds of questioning, we plan to build consensus to develop unique nursing competencies for military nurses in deployed scenarios. We will then translate the information gained with current palliative and end-of-life care guidelines into curriculum, processes, protocols, and decision support for military nurses in deployed and wartime scenarios.

Conclusion/Implications: This study will create the ability for military nurses to provide competent palliative and end-of-life care in austere environments. Moreover, the developed model will serve as a robust framework guiding combat palliative nursing in transformative ways. It offers specific pathways for further research endeavors, informing evidence-based practices in the demanding context of combat care, and enriches educational curricula for military nurses.