Military families face several unique and significant stressors compared to the typical nonmilitary family. Parental deployment and even transitioning to civilian life after leaving the armed forces can impact the family dynamic.
Geographic separation and frequent relocation can also make it tough to develop a consistent patient-provider relationship. Additionally, there are unique treatment issues to consider, such as combat-related injuries or post-traumatic stress disorder. These distinctive traits make the work of advanced-practice nurses specializing in treating military personnel and their families critical.
These nurses, such as family nurse practitioners (FNPs) and the nurses they supervise, commonly work in a wide range of settings across all branches of the armed forces, domestically and abroad. This can include unique environments that go beyond hospitals and clinics, such as ship sick bays or mobile field hospitals. Nurses interested in this dynamic field should consider advanced education, such as post-master’s nursing certificates to gain the necessary skills for providing military personnel and their loved ones with family nurse care.
Civilian Nurses Working for Military Families
Providing family nurse care for military families is slightly different from providing the same care for civilian families. While the role is functionally the same — that is, providing patient care that evolves to match the different stages of a patient’s life — the care delivery strategy deployed by civilian nurses working for military families can be layered with specific, nuanced details.
Due to the nature of military life, patients may be subject to unique stressors that don’t exist in civilian life. These stressors can cause disruption within the family unit and can negatively affect the health and well-being of military members, their spouses, and their children.
FNPs providing care for military families should have the situational awareness to recognize the impact of these stressors and adjust their care strategies to account for this impact. Ultimately, this specialized knowledge can enable military families to receive an optimized level of care — one that meets their needs in a manner that may otherwise go unnoticed.
Four Key Difficulties for Military Families
There are four core unique disruptions military families face during an individual’s military duty. These disruptions can cause certain issues to manifest that could make attaining health and well-being difficult for family members. It’s vital for FNPs providing family nurse care to fully understand these disruptions and the effect they can have on a person’s health.
1. Deployment
Perhaps the biggest stressor military families face is geographic separation. A mix of pride, fear, loneliness, and anxiety can affect service members and their families.
Deployed family members might experience regret over missing important steps in their children’s lives. Families at home might also grapple with the uncertainties military service can bring, a situation that may induce heightened feelings of worry and uneasiness.
FNPs who care for military families with a deployed parent usually begin the process by evaluating the family to determine any physical, emotional, or psychosocial issues. Military children might feel a sense of powerlessness that causes them to act out or even hurt themselves.
Successful FNPs take these and other factors into account and help remedy them by treating any physical injuries or conditions, as well as developing plans and goals for each child’s care and treatment. They also treat patients on a holistic level, treating the bodies and minds of patients. FNPs also need to be cognizant of how pre-and post-deployment may affect the well-being of patients and the family dynamic.
2. Relocation
Frequent relocation is another major source of anxiety. Parents and children are often separated from their extended families and close friends as a result of relocation.
Aside from the emotional toll, frequent relocation can be detrimental to a family’s financial and medical well-being. With each move, families lose their primary physicians. This not only requires families to seek out new primary physicians with each move but also to build a strong rapport as quickly as possible.
Moving around can be especially problematic for families dealing with chronic conditions or disabilities because specialists aren’t always available in all locations. Relocation can also pose difficulties for landing consistent health care for children as they grow, particularly children with special needs.
Because of this, it’s imperative for FNPs to quickly establish a bond of trust with their patients. Doing so enables them to gather vital information about a military family’s physical and mental health. It can also allow them to build effective care delivery strategies that can optimize patient health regardless of age, physical needs, or mental condition.
While family nurse care can help a wide variety of patients, patients with special needs may require care beyond an FNP’s scope of practice. In these instances, patients may rely on their FNP to refer them to the proper specialist.
3. Family Dynamic
The military lifestyle can be demanding, particularly for spouses who are left to raise children without a partner. This altered household dynamic can disrupt schedules and multiply responsibilities.
Shifts in this dynamic can begin before deployment, as withdrawal and detachment may happen in preparation for being without the servicemember, according to Military.com. Once deployment occurs, the family left behind may experience feelings of loneliness, panic and stress caused by added family duties.
Deployment can also cause psychological problems for children experiencing puberty, social shifts and changes in brain chemistry, according to the National Center for Children in Poverty. This may result in their acting out with misdirected anger and having unusual or unexpected school problems. Studies indicate military children in this age group have a greater prevalence of behavioral and emotional difficulties compared to their civilian counterparts. These can encompass specific issues, such as problematic sexual behavior or substance abuse.
Family nurse care can help minimize these behaviors by developing a care delivery strategy that deters teens from developing destructive habits. One way this can be achieved is by providing a safe environment for open discussions with teenage patients. FNPs can also prescribe medications or refer families to a counselor or therapist for further treatment.
4. VA Health System
Veterans and active-duty personnel who have received referrals have access to the health care benefits provided by the U.S. Department of Veterans Affairs (VA). However, service members may have problems gaining access to VA providers because of long waiting lists.
One of the ways the VA has worked to address such issues is by granting full practice authority to advanced practice nurse practitioners (APRNs), including FNPs. This enables APRNs to offer more comprehensive care to veterans in VA facilities without the supervision of a physician. Granting practice authority creates a more efficient care delivery system and significant implications for nurse practitioners and the veterans receiving care.
In the past, many nurse practitioners have had to pay consulting fees to maintain mandatory physician supervision. The expansion of prescriptive authority and autonomy allows FNPs to reinvest the money they save into further training, expanding their practice or helping subsidize low-income patients.
FNPs with full practice authority may still be an unfamiliar concept for many patients, particularly if they’re stationed in states that don’t grant civilian FNPs the same authority as physicians. To avoid confusion, it’s wise for FNPs to take the time to explain what type of care they can provide to patients.
Developing a Family Nursing Care Plan
Providing family nurse care for military service members and their loved ones plays a key role in creating a safe, trusted environment that fosters high-quality patient care. Creating this environment involves building a care plan that creates an efficient snapshot of the family and its needs.
This care plan typically starts with assessing the families and identifying current and potential issues. Once this is established, FNPs can work with patients to set goals and objectives designed to help them maintain a consistent level of care. These plans can also include intervention strategies to help steer families back toward these goals if there’s any deviation.
The goal of a family nursing care plan is to resolve or mitigate existing health issues while also preventing future issues. Achieving the goal can help keep families healthy as long as they’re within the patient-provider dynamic.
Develop the Nursing Skills to Provide Family Care
FNPs do more than provide military families with optimal care. They also help provide healing for families dealing with unique stressors that could disrupt their well-being. Considering the critical nature of the military, the role of the military FNP is as noble as it is satisfying.
Duquesne University’s online post-master’s nursing certificates can help you gain the expertise to become an FNP and provide the care that members of the military and their families deserve. With advanced courses in pharmacology and the foundations of family care, our program can help graduates gain a deep understanding of family care at all levels. Learn how we can help you make a positive impact in this special branch of health care.
Recommended Reading
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Sources:
Indeed, How to Become a Military Nurse
MedlinePlus, Veterans and Military Family Health
Military.com, Deployment: Your Children and Separation
Military.com, How Deployment Stress Affects Families
Nurselabs, “Nursing Care Plans (NCP): Ultimate Guide and Database”
Nursing Outlook, “A Preliminary Evaluation of Full Practice Authority of Advance Practice Registered Nurses in the Veterans Health Administration”
RAND Corporation, “Access to Health Care Among TRICARE-Covered Children”
Today’s Military, Advanced Practice Nurses
Wolters Kluwer, “Caring for Military Families: Understanding Their Unique Stressors”