War-zone nurses put their skills on the front line

Sunday, May 25, 2008
Angels of the battlefield

War-zone nurses put their skills on the front line

By Andi Esposito TELEGRAM & GAZETTE STAFF
aesposito@telegram.com


Severely injured with a tunneling wound through his liver, the Marine lay sedated, clinging to life, in the intensive care unit at the 399th Combat Support Hospital in Al Asad, Iraq, under the care of U.S. Army Reserve Lt. Melinda A. Nekervis of Sterling.

“He ended up getting well over 100 different blood products,” said Lt. Nekervis, a soft-spoken Army ICU and flight nurse who returned in October from Mosul and Al Asad, Iraq. When everything but whole blood was exhausted, Lt. Nekervis asked if the Marines keeping vigil would donate their own.

“They were more than willing to do that,” she said. “We transfused the buddies’ blood into the patient. It was quite a moving experience. We were very lucky not to lose him. He was pretty sick. They had to do surgery right at the bedside, and he survived.”


Stabilized, the Marine was later sent to Germany aboard an Air Force medical evacuation flight.

“I know that the doctors, from the extent of his injuries, didn’t know if he would make it and what his deficits would be,” said Lt. Nekervis, 32, who in civilian life is a registered nurse working in intensive care at UMass Memorial Medical Center — University Campus.

“I had him for four long days,” she said. “I will never forget him, but he will never remember me.”

Military nurses in Iraq and Afghanistan are a critical link in a chain of medical care that has enabled more soldiers to survive injury than ever before in the nation’s history of warfare. In World War II, about 30 percent of soldiers died from wounds, a rate that fell to 24 percent in the Vietnam War. Since the start of combat seven years ago in Afghanistan, and since 2003 in Iraq, more than 32,000 service members have been wounded in action. Statistics recently released by the Department of Defense show that 4,579 have been killed in action or died under non-hostile conditions during Operation Iraqi Freedom and Operation Enduring Freedom.

But the survivability rate — the portion of people dying from wounds on these fronts — has fallen to about 10 percent.

“We are doing such a good job saving soldiers that there is a much higher rate of survival,” said Col. Andrea J. Wallen, chairperson of the Department of Nursing at Worcester State College and chief nurse with the 804th Medical Brigade at Devens, which oversees the 399th and 12 other medical units.

Nurses and military medical experts say the survival rate is higher because soldiers wear more and better equipment, and because medical help has been pushed closer to the battlefront and dispersed into smaller teams reaching more locations. More people are being trained in lifesaving procedures, specifically in response to trauma; surgery is done earlier; and better communication has allowed medical equipment and supplies to be quickly sent where needed.

But most important is the speed at which the wounded are attended.

People are moved in record time by helicopters, aircraft and specially fitted flying hospitals — in C-17s and KC-135s — to higher-level or more specialized care in Germany and the United States, including Brooke Army Medical Center in San Antonio, known for its burn center.

“The goal was to get the critically injured to Landstuhl (Regional Medical Center) in Germany within 72 hours,” said Lt. Nekervis, who also logged 50 hours of retrieving and nursing the wounded aboard a Blackhawk helicopter medevac air ambulance and earned a Bronze Star Medal for her service.

Much as Civil War soldiers called Oxford’s Clara Barton, founder of the American Red Cross, “angel of the battlefield” for care she gave the injured in makeshift hospitals close to the battlefront, military nurses, often working under fire, help make the difference between life and death. Most are in the National Guard or Reserve on deployment from hospital and health care jobs. These weapons-carrying nurses, wearing Kevlar body armor, helmets and dressed in desert fatigues, are combat-ready professionals who, faced with the terrible consequences to flesh and bone of roadside bombs, guns and rockets, save lives under challenging conditions and at risk to their own safety.

Many have been deployed several times; most would go again in a moment.

“Battlefield nursing is about service, and if you can serve your country, make a difference and be a powerful force on the battlefield helping people, that is life-changing,” said Col. Bruce A. Schoneboom, a nurse anesthetist and acting dean of the Graduate School of Nursing of the Uniformed Services University of the Health Sciences, Bethesda, Md. The school specializes in military and public health medicine and trains people for battlefield medicine in Iraq and Afghanistan.
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