Tech. Sgt. Amanda Carter and Capt. Robin Petkewich help move U.S. Marine Maj. Keith Schuring from one gurney to another after Schuring arrived at Landstuhl Regional Medical Center to be treated in November. Last fall, the hospital widened a program to treat staff members for stress related to the wars in Iraq and Afghanistan. (Ben Bloker / S&S file photo)
LANDSTUHL, Germany — Even thousands of miles from the fight, Landstuhl Regional Medical Center’s doctors, nurses and staff constantly see the realties of war.
From a 21-year-old Marine missing both legs to a soldier burned over 70 percent of his body, some images cannot be forgotten.
The personal investment in treating the troops and the patriotic bond among servicemembers contribute to emotional strain among hospital staff. With patients at Landstuhl for only three to four days, hospital staff rarely sees full recoveries.
The secondary trauma or stress experienced by military health-care providers once known as compassion fatigue is being classified as combat and operational stress.
Landstuhl began a program in 2005 for compassion fatigue, but last fall widened its program to all staff members for the treatment of any stress reaction related to the wars in Iraq and Afghanistan. It is now known as the combat and operational stress reaction/staff resiliency program.
Psychologists, psychiatrists, nurse practitioners, social workers, volunteers and chaplains will work with any staff member having negative reactions, said Air Force Maj. David Reynolds, acting director of the program and chief of health psychology.
“We’re willing to talk with them one-on-one, whether that’s a quick hallway consultation or more formally in the office,” he said. “One of the big selling points for our program here is that if there’s no diagnosis, we really don’t need to keep any notes. That’s where we have the big stigma related to any kind of counseling, and we want to set that to the side if we can.”
The most common reactions to the stress among Landstuhl staff are irritability, anxiety, difficulty sleeping, conflict at work, conflict at home, physical fatigue, nausea and some anger, said Army Lt. Col. Mary Hull, psychiatric nurse practitioner at Landstuhl.
“These are all expected and normal reactions, given the situation and given the exposure of both direct caregivers and indirect caregivers,” she said. “The indirect providers and caregivers listen to stories over and over and hear just terrible stories about human suffering and tragedy in combat.”
Indirect providers are those at the hospital who do not provide direct care to the wounded, such as finance or support staff.
Roughly 400 staffers have completed surveys that show there are signs of operational stress at Landstuhl, Reynolds said.
“It’s not to that level where there needs to be this huge clinical intervention,” he said.
The program aims to help build and maintain staff member resiliency so stressful situations have less impact on their bodies and minds, Hull said.
“When we build resilience, we increase our inner strength and confidence,” she said. “Resiliency gives us the will to preserve in complex times and hardships.”
Every other week, group sessions are held where people can discuss their reactions. Program team members visit different wards in the hospital to make recommendations and allow workers there to get things off their chests. They also conduct workshops, presentations, conflict resolution sessions and team-building activities, Hull said.
