The relief I felt on reading the headline "Last American Combat Brigade Leaves Iraq" in an August 18 press release from U.S. Central Command was quickly tempered by the statement that "50,000 U.S. troops will remain in country." In Afghanistan, U.S. forces increased by 30,000 troops this year, bringing the total to about 100,000. The Department of Defense (DOD) estimates that more than 1.4 million troops will serve on active military duty during 2010; as of September 7, an additional 102,000 National Guard and reserve personnel were also on active duty. According to a 2008 demographic profile of the military community, 38% of active duty military personnel are married with children; another 5% are single parents. This means that there are hundreds of thousands of families with at least one family member who's been deployed, many to war zones.
With Veterans Day occurring this month, we chose to use our cover to draw attention to the problems faced by such families. As Erin Gabany and Teresa Shellenbarger explain in "Caring for Families with Deployment Stress," that stress can be considerable. In families with children, deployment means that a two-parent household becomes in effect a single-parent one; when a single parent is deployed, grandparents, aunts, or uncles may find themselves filling that role. The deployment period may be especially difficult for families of soldiers in the National Guard or in reserve units—they're less likely to be living on or near a military base or to have access to its resources and to other families going through the same experience. They're also likely to have less income when the reservist's civilian pay stops. Such stressors can play a role in a range of physical, emotional, and behavioral problems.
Nurses in all settings—not just those in clinics serving military families—may encounter these family members, and need to be aware of the issues they face and the resources available to them. Gabany and Shellenbarger provide a list of such resources. The DOD, acknowledging "unprecedented demands" on existing family support programs for military families, has proposed a half-billion-dollar increase to that budget, requesting $8.1 billion for 2011. Family support programs include child care and youth programs, military spouse employment and education aid, and the Military OneSource Call Center, among others.
And let's not forget the families of nurses who've been deployed. This month marks the debut of Letters from Afghanistan, a new series by army nurse Major Christopher A. Vanfosson; he'll tell us about his work and day-to-day experiences in a combat zone. AJN spoke recently with Vanfosson's wife, Kelly, about what life has been like for her and their four young children during Chris's deployment; you can listen to the interview at www.ajnonline.com (click the podcast icon on the issue's table of contents).
Sharon Stanley, chief nurse and director of Disaster Health and Mental Health Services for the American Red Cross and an AJN editorial board member, has experienced deployment stress from both sides. When she was deployed during the Persian Gulf War's Operation Desert Storm in the early 1990s, her husband became the caregiver for their three young children. Since then two of her sons have been deployed to Iraq, and one will soon be returning. She says you never get used to deployment and feel concern "every day, every hour" for loved ones in war zones. She explains, "This chronically layered state of mind becomes a normal part of the activities of daily living—but has a tendency to lower normal tolerance," adding that nurses need to be aware of this. (For more on dealing with a loved one's deployment, see Alison Buckholtz's blog Deployment Diary at www.slate.com.)
As a mother and spouse myself, I can't imagine what a year-long (or longer) separation from a loved one is like, and I hope I never have to find out. Stanley says, "My marking of time is done by 'next holiday' dreaming. The next Thanksgiving we will . . ." Regardless of how you or I might feel about the conflicts the United States becomes involved in, we owe these families our compassion and support, as this month they'll celebrate yet another holiday with an empty place at the table.