The Catholic University of America

Nov. 20, 2012

Professor Researches Ethical Issues in Wartime Nursing

Associate Professor Janice Agazio is interviewing Air Force, Army, and Navy nurses who have served in Iraq and Afghanistan to find out how they manage and resolve troubling ethical issues that occur in nursing practice during wartime deployments.

As part of her research, Agazio is planning to develop a tool kit — briefing materials that nurses could use to manage the issues.

“When nurses are involved in cases they feel were not handled well — that go against their values — they can be left with moral distress that can lead to post-traumatic stress symptoms,” she notes. “We need a tool kit that enables nurses to discuss the way a case was handled and helps them cope with the feelings that come up.”

Agazio is interviewing active-duty and reserve nurses at San Antonio Military Medical Center, Walter Reed National Military Medical Center in Bethesda, Md., and Womack Army Medical Center at Fort Bragg, North Carolina.

The Catholic University professor notes that wartime nursing can raise ethical issues that don’t come up in everyday health care situations.

“Wartime nursing requires a different type of triage,” she says. “Nurses stabilize a seriously injured patient, but their primary focus is on caring for those who can be returned to combat. Other patients may have to wait to make that happen.”

End-of-life issues and the care of civilians and insurgents in wartime can also be troubling for nurses, she notes.

Agazio says her current research project grew out of an earlier one in which she had planned to explore Army nursing practice in operations other than war. Agazio received a research grant in summer 2001, but when the war in Afghanistan started shortly after 9/11, she gained permission from her funding agency to also include interviews with nurses returning from the conflicts there and in Iraq.

The revamped project looked at Army nursing practice in both wartime and non-wartime operations. In addition to the wartime nurses, it included nurses who had humanitarian mission experience and compared the experiences of the two groups.

Agazio’s research is funded by a two-year $263,286 grant from the TriService Nursing Research Program (TSNRP), based in Bethesda, Md. TSNRP funds and supports rigorous scientific research in the field of military nursing to advance military nursing science and optimize the health of military members and their families, according to its website.

Catholic University doctoral candidate Nancy Steffan, a former Army nurse, is assisting Agazio with the project.

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