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One of the key goals of the new chief of the Army Nurse Corps is to ensure that future generations of nurses or soldiers don’t suffer from posttraumatic stress disorder (PTSD) when they return from Iraq, as did a previous generation on return from Vietnam.

Since becoming the 22nd chief of the Army Nurse Corps last summer, Maj. Gen. Gale Pollock has been traveling the country talking to nurses and soldiers who served in Iraq and Afghanistan.

Unfortunately, Pollock is finding that “PTSD is alive and well,” as she told an audience of Army nurses during a military medical conference in Denver last November.

The Vietnam War taught the military that soldiers and nurses returning from war need to talk through their disturbing experiences to prevent PTSD and its debilitating symptoms.

“We’ve learned so much more since then,” Pollock said. “I think it would be inexcusable to have another generation experience PTSD.”

During a visit to the Brooke Army Medical Center in San Antonio, Pollock talked to 14 soldiers who had amputations or burns from wounds they received in Iraq. When she asked them if they were sleeping, many said they were trying not to sleep because they didn’t want to dream about their experience in Iraq. She also asked the soldiers if they startled easily when something was unexpectedly dropped on the floor. Some of the soldiers told her they did.

“Every one of them had signs of PTSD,” she said.

Pollock said she’s not the only high-ranking Army officer to be concerned about PTSD. Other senior officers and noncommissioned officers are also worried that many soldiers, regardless of rank, are suffering from combat stress.

One obstacle to the prevention of PTSD is the reluctance of many nurses and soldiers to talk about their wartime experience. But the Army, Pollock said, is working on several programs to identify and assist soldiers returning from Iraq and Afghanistan who might be having problems. Combat stress debriefings, one-on-one interactions with mental health professionals and chaplains, and small-group discussions are all techniques used to deal with combat stress.

“We’re trying to prevent long-term disabling post-traumatic stress,” Pollock said. It’s normal for soldiers to have emotional responses to combat trauma. But bottling up these emotions can cause long-term, disabling PTSD.

Pollock also told nurses the war on terrorism is transforming the Army and the Army Nurse Corps. In particular, Iraqi insurgents and their nontraditional warfare of suicide bombers, rocket-propelled grenades, and street fighting have taught the Army that all soldiers, not just members of the infantry, must be trained and ready to defend themselves. Even nurses and physicians must be “warriors first,” said Pollock. “There is no excuse for anyone in the Army to not have a warrior mindset and to not have enough skills to survive in a hostile environment,” she said.

The Army leadership is also concerned about the nursing shortage and its effect on the Army Nurse Corps. At a meeting in Chicago, Pollock said the Army Chief of Staff, Gen. Peter Schoomaker, told her he understood that the Army needs highly qualified nurses to provide the level of nursing care required for soldiers wounded in combat. Schoomaker’s staff now tracks the retention and attrition of Army nurses, she said.

Pollock doesn’t want the frequent rotation of Army nurses to Iraq and Afghanistan to cause people to leave military service rather than reenlist. So far, about 2,000 nurses have served in the war on terrorism.

“We can’t keep deploying the same people all the time,” says Pollock. “We need to work on shorter deployments.”

The average length of deployment for a nurse sent to Iraq or Afghan­ istan is about one year. Pollock would like to see deployments of only six months.

To keep its Reserve nurses, said Pollock, the Army needs to find ways to help Reservists better cope with deployment overseas. Civilian employers of reservists who are sent overseas in the war against terrorism more than once might not hold position opens for them when they return to the U.S., Pollock added.

To encourage civilian nurses to join the Army and to keep those it already has, Pollock is trying to boost salaries, which are usually lower than those of civilian nurses. The Army, Navy, and Air Force nursing corps are discussing ways to boost recruitment and retention of military nurses, said Pollock.

The Army is also working on setting up an online program for Reserve nurses to earn their BSNs. A BSN is a requirement to become an active duty nurse in the Army.

The largest percentage — 65% — of Army nurses are in the Army Reserve. Active duty nurses make up 29%, and 6% belong to the National Guard.

Pollock told the audience of Army nurses she feels responsible for all of them, whether they are Active Duty, Reserve, or Guard. “IDDm really proud of all of you,” she said.

Janet Boivin, RN, is editorial director of the greater Chicago edition of Nursing Spectrum.