My job

Military advanced nurse practitioner

Lynda Mathias, a clinical staff officer in the army with the rank of lieutenant colonel, describes the primary care challenges she has faced

Lynda Mathias, a clinical staff officer in the army with the rank of lieutenant colonel, describes the primary care challenges she has faced

Picture of military advanced nurse practitioner Lynda Mathias, a clinical staff officer in the army with the rank of lieutenant colonel, who describes some of the challenges she has faced

What is your job?

As a clinical staff officer I work in division headquarters and am responsible for providing clinical leadership and promoting professionalism among our healthcare personnel as well as ensuring the delivery of high-quality, safe and effective patient care when we deploy. My background is as a military advanced nurse practitioner (ANP) in primary healthcare.

Why did you become a nurse?

Joining the army to become a nurse meant that I could combine an adventurous spirit and love of being outdoors with an exciting career as a healthcare professional. Joining the army really has been nursing with a difference.

Where did you train?

I have been in the army for 23 years, having joined to commence nurse training. Training was primarily from a military hospital in conjunction with civilian university providers and NHS hospital placements.

What does your job involve?

As a military ANP, when deployed on operations or exercises the care I provide is primary healthcare and pre-hospital emergency care. I have deployed to many remote locations without emergency services and often no immediate access to secondary care facilities. This means training and experience in pre-hospital emergency care and medical evacuation of a casualty is equally as important.

When not in headquarters I run an ANP clinic for soldiers and their immediate families in a military general practice medical centre to keep my clinical skills up to date.

What is your greatest challenge?

The obvious challenge is the environment we work in when deployed. We may be in tents with only basic heating or lighting in very hot or very cold countries, and water can be limited. Drugs need to be kept at the correct temperature and equipment needs to be correctly maintained, as there is often no replacement readily available. Many of the difficulties can be unexpected and at times unimaginable, such as literally hanging on to your tented medical facility to stop it blowing away in gale force winds.

Picture of military advanced nurse practitioner Lynda Mathias, a clinical staff officer in the army with the rank of lieutenant colonel, who describes some of the challenges she has faced

What has given you most satisfaction?

I have deployed to remote locations, including Iraq, Afghanistan, Sierra Leone, Nepal and Kenya, many of which had little or no access to emergency or secondary care services, and worked in Canada and Germany. I have sometimes been the clinical lead in these challenging locations, with senior medical officer support and advice available only by phone. Keeping the soldiers healthy and able to do their jobs effectively while caring for those who become sick or injured is very rewarding.

What are the biggest differences between primary care in a military and general NHS setting?

Care provided for soldiers follows NHS standards and guidelines – as much as possible given the environment – for what a civilian patient would receive. The biggest difference is the environment and the situations that we may find ourselves working in. We need to be able to take care of ourselves as well as our patients. The other difference is the training we are required to undertake to do our jobs effectively and the responsibilities we have in our deployed role.

What skills do primary healthcare nurses need?

In the army, nurses need to be resourceful, adaptable, innovative and physically and mentally robust to overcome the challenges they face, and ultimately provide safe and effective clinical care to soldiers and patients.

What nursing achievement makes you most proud?

I have had so many amazing opportunities to positively influence and promote advanced practice nursing in the armed forces. These have included research, publication and policy writing, clinical nurse mentorship and career management, and collaborative working practice with medical colleagues.

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