11
Family and Social Networks: Support Versus Lack of Support
Most nurses received the greatest support from family and friends. Community support was also recognized and appreciated. Some nurses reported a fairly smooth transition with strong support from their families and communities. They wanted people to be patient with them, listen to their stories, and be nonjudgmental. They wanted to be thanked for their service and feel appreciated. On the other hand, nurses who felt a lack of support and connection were devastated. Some nurses struggled in their relationships with family and friends who did not seem to understand that they needed to heal themselves emotionally, psychologically, and spiritually after being deployed. The renegotiation of roles in the family was important, but could be fraught with a myriad of difficulties if the father was tired from childrearing and domestic duties, and if the mother returned fatigued and troubled. Some nurses reported turmoil in their extended families with the sharing of responsibilities for elderly parents. They worried that they would be deployed again when they were needed at home. Some questioned whether they should stay in the military, not knowing what the future would hold for them and their families.
MAJOR FRED
Fred was a critical care nurse who had served many years in the Air National Guard and Air Force Reserve. Fred reported, “I’ve been gone various times over the last 20 plus years, and my family is always supportive of my military career as well as my civilian nursing career.”
LIEUTENANT COLONEL CHRISTA
Christa was an air force reservist who had been deployed to Balad Air Base, Iraq. Her unit performed the Aeromedical Staging mission.
Christa related:
I remembered one more action that had a huge impact upon me on my return. That action was the regs [regulations] that said we had to stay within driving distance of the base for the first 2 weeks we were back, just in case they wanted to bring us back for something. The impact for me was that I was not able to see my family for almost 3 weeks, and by the time I was able to go, then my leave was almost gone.
For my first deployment to Kuwait in 2004, both my parents were alive, but my brilliant father was dying of COPD [chronic obstructive pulmonary disease]. The lack of oxygen had robbed him of his wonderful mind and spirit. In December while still in Kuwait, I would call home. The first half of the allotted 15 minutes was spent just trying to get connected. The second half was trying to explain to my father (a B-29 pilot in WW II) why I wasn’t coming home for Christmas. Christmas was always a very special time for Dad and me. I finally got to see Dad the end of January 2005. He passed away the beginning of March.
Just prior to going to Iraq, I had to put Mom in a nursing home down in Cincinnati where my brother lived. I was sad to have to do this, but glad, because I wasn’t going to be able to go home to take care of her. When I returned from Iraq, I just wanted to see her so bad. I was never able to talk to her while I was gone. That first week back from Iraq, I also found out that my brother and his wife had separated, and my family was falling apart. I couldn’t go home to be with my brother and my mom because of our travel restrictions. This was very hard to deal with. They were my family, and I just wanted to be with them.
LIEUTENANT KATE
Kate was a navy nurse assigned to a forward resuscitation and shock trauma unit in Afghanistan.
Kate reported:
My reintegration with my husband was pretty difficult. My husband is retired navy and had deployed to Iraq the year before I deployed to Afghanistan. It seemed that every time I tried to talk with him about my deployment, he would cut me off and lead into a story about his deployment. I needed to talk, and he wasn’t listening to what I wanted to say. It made me feel awful that he didn’t want to hear about my experience, and what I needed to talk about. We both had terrible coping skills. I drank too much after I came home. He drank too much after he came home. This would lead to fights. It was a very negative experience for both of us.
We lived off-base as did most of our friends. There is no on-base housing at the Navy Hospital complex. We did not have a tight knit community because there were no other military members in our neighborhood. Our neighborhood was a combination of mostly young families and elderly couples. I didn’t feel particularly close to anyone in our neighborhood.
Kate talked about her extended family:
When I got back from Afghanistan, it was 2 days before Thanksgiving; so, my husband and I drove from Virginia to New Hampshire where my parents and family were getting together. Everyone in my extended family was supportive. They had lots of questions. They wanted to know what it was like, and everyone sort of had the same questions: Did you see anyone dead? Did you take care of people with their limbs blown off? Did anyone die while you were caring for them? I didn’t feel right to be talking about this stuff. I mean, here it is Thanksgiving, and those dead or injured soldiers’ families are missing them or missing the way they used to be before getting injured. I was 29 when I deployed, and many of the casualties were a lot younger than I was. Many of those marines were 19 or 20 years old.
My family was concerned while I was deployed. They knew I was in a hospital, but I never told them about all my helicopter medevac flights outside the wire until I came home. They knew I wasn’t out there walking patrols, but they knew that we were all susceptible to bombings. We were shot at when we were flying medevac; I could see the tracer bullets coming up from the ground at night. There were medevac helicopters that crashed over there.
LIEUTENANT COMMANDER KATHLEEN
Kathleen, a navy nurse assigned to the emergency department (ED) at the busy British-run Camp Bastion Hospital in Afghanistan, described her neighborhood:
I lived in an area near my military base, but it was very densely populated with civilians. There were retired senior citizens, families with kids in elementary school, and young couples. You kind of stuck out when you were in uniform. The community didn’t do a homecoming when we came back. I was an “IA” [individual augmentee]; so, it was not like the base deployed a lot of people. We were selected for deployment based on what kind of skills were needed, such as orthopedic surgeon, dentist, or critical care nurse. Only a handful of people from my hospital were needed for deployment.
LIEUTENANT COLONEL JULIE
Julie, an experienced Air Force Reserve flight nurse and Critical Care Air Transport Team (CCATT) nurse, described her difficulties when she returned home from Iraq.
Coming back from my first deployment from Iraq in 2004 was the hardest for me and my family. My husband was active duty in the air force for 20 years working in Special Operations as a combat controller; so he was gone a lot in that career field. We had always made it work. He retired in early 2001. Then 2003 came around, and I deployed to Iraq. So, he was at home and that was a new role for him, having to manage the kids and do household stuff. He really did a good job in his own way. The kids, twin boys, were 8 years old when I left for Iraq, and our older boy was 14. My husband did quite well overall. I learned over time that it will never be the way you would do it, but your way is not the only right way. Before I left for Iraq, one day my husband said to me, “You know, I haven’t gone grocery shopping since I met you, and we started dating.” And I laughed and said, “Welcome to my world.” On that first deployment to Iraq I was gone for 6 months. I had never really been gone much from my family over the years; so, it took some getting used to for my husband and the kids.
When I came back from that first deployment, I wasn’t in the right mindset to step right back into the role of working mother, housekeeper, grocery shopper, child chauffer, and cook. My mind just wasn’t there. So, I sort of eased back into it, but he seemed to want me to take over right away, and my mind just wasn’t there yet. I think my brain was a little oversaturated with the Iraq war and the trauma patients I had cared for. I’m sure he thought I’d want to jump right in, but I wasn’t up to it. I think he was tired, and he wanted a break from childcare stuff. Then 4 months later, I deployed again. I had about a week’s notice. I was going to be gone over Christmas; so, I spent that week doing a lot of Christmas shopping before I left. The second deployment was to Ramstein Air Base, Germany, to fly air-evac missions between Iraq and Germany, but we lived in Germany, not Iraq. I was gone that time for 4 months. When I came home, I took some time to go visit my parents.
Julie described her third deployment:
When we did the troop surge, and the casualties went so high, I was deployed again. Because I flew air evac, when casualty counts were high, more air evac crews were deployed because there were more missions that needed to be flown. So, air evac crews didn’t have a lot of stability in their lives. By about mid-2008, things seemed to stabilize a bit, and we usually knew how long we would be home, and how long we would be out flying missions. But all these deployments took a toll on the whole family. My husband and I were constantly having role reversals. As the kids got older, they could help their dad more when I was deployed.
Julie described how some people in her community were shocked and surprised to learn that she, a middle-aged woman, had deployed to Iraq. She reported:
One day I was driving home from shopping, and the police were blocking the road because evidently they were blowing up the dam over the river. I stopped and asked, “What are you guys doing here today?” And they said, “Haven’t you heard, it has been advertised in the papers and on the radio for months, we are blowing up the dam as an energy conservation project!” I said, “Really, I just got back from deploying to Iraq, so I have no idea.” They seemed shocked to hear this response from a middle-aged woman driving a van.
I found that our group of friends would be talking about things in the community as if I was there when these events occurred. Most of the time I had no earthly idea what they were talking about. It might be the high school football games, or an event at the church, or a fire in a downtown store, but they were not consciously aware or mindful that I was gone during those 6 months. Or, someone would say “Did you know that so-and-so and so-and-so are having problems in their marriages and are getting divorced?” I’d say, “No, when did all this happen?” There were huge gaps, although I got e-mails when I was deployed.
Julie described her parents and why she decided to retire from the Air Force Reserve. She stated:
My parents were one of the reasons I decided to retire from the Air Force Reserve. My parents were getting to be elderly, and my dad was a nervous wreck each time I deployed. I had to come home early from my last tour in Iraq because my dad had to have cardiac surgery. He had to have his mitral valve replaced. I only have one sibling, a brother, so my parents depend on me for a lot. Dad had the usual mental fogginess immediately post-op that we see with patients who have been put on bypass during the surgery. When he was waking up, he was talking very loud and saying things like, “Be careful, honey, they are going to blow your plane up.” So, somewhere in his psyche, he was thinking about me getting blown up in Iraq.
My parents never told me not to join the reserves, but I think they were always proud and nervous at the same time. They were always supportive when my husband needed help with the kids. They were always wonderfully supportive, but I think they were always scared of what could happen. Even in peacetime as a flight nurse, I still had a relatively dangerous job. Plus, I had other deployments before 9/11 and humanitarian missions, too. I had been to Kosovo, Haiti, and Desert Shield/Desert Storm. I think all of this took a silent toll on my parents. I think the “in-your-face media coverage of the Iraq and Afghanistan wars” was additionally upsetting for my parents, and a lot of other families as well. Now, you have media folks imbedded with combat units; so, people see the fighting and bombing and blood right in their own living rooms every day. People can have so much more of a connection to the action if they so choose. I think that induced more anxiety in my family. Whatever they saw in the news, they thought that I must have been there.
FIRST LIEUTENANT ALLISON
Allison is an active duty air force emergency room nurse who was deployed to Afghanistan.
She remarked:
It was great to see my mom and stepdad in person, but the way technology is today, I was able to Skype them and e-mail them fairly often while deployed. We stayed in touch every week while I was gone, even though I was 8,000 miles from home. Finally, being with them was so great and comforting. They were definitely worried about me when I was gone, but I think our frequent contact buffered their worry to a degree. They also knew that I joined the air force to do the kinds of things I was doing, like deploying to war. They knew that I wanted to be where the action was. I was doing exactly what I wanted to be doing, and I think on some level my parents understood. They knew I was happy, motivated, and learning. Being on deployment was one of my goals when I joined the military, and I got to fulfill that goal during my first 3 years on active duty.