health problems in ambulatory clinics, community hospitals, medical centers, hospital ships, field hospitals, ships, aircraft, and other settings. They are part of a health care system that incurs annually more than $15.4 billion in expenses to provide care for approximately 1.5 million active-duty military personnel and 5 million retired military personnel, family members, and other eligible beneficiaries.1 Service members and their beneficiaries are a diverse group culturally and ethnically. For example, 22 percent of all enlisted active-duty service members are black, 7 percent are Hispanic, and 5 percent are from other racial-ethnic groups. Thirty-one percent of all active-duty forces are nonwhite (Defense Manpower Data Center, 1995).
Military nurses are responsible for controlling costs while providing state-of-the-art care ranging from the treatment of combat casualties to chronic illness and from health promotion and preventive care to maternity and gerontologic nursing for the vast range of beneficiaries. A majority of active-duty service members are young: 13 percent are age 20 years or younger, 50 percent are ages 21 to 30, and 30 percent are ages 31 to 40 (Randy T. Smith, Defense Manpower Data Center, Personal communication, 1996).
Military nurses include all nurses in the Army, Navy, and Air Force, regardless of whether they are in the active or reserve component.2 Members of the selected reserve and guard components generally serve 2 days each month plus an additional 14 days per year. Reserve and guard members can be called to active duty on very short notice and assigned anywhere in the world during both peacetime and wartime operations.
The 4,100 active-duty Army Nurse Corps officers provide nursing care in both inpatient and outpatient arenas to approximately 524,000 active-duty service members and to beneficiaries of all ages. Over 14,000 nurses serve in the reserve component. They serve in field, evacuation, and mobile facilities, as well as in the many fixed facilities in the continental United States and abroad. During Operation Desert Shield/Desert Storm, 2,265 Army Nurse Corps officers were deployed to Southwest Asia.
In Somalia, Army nurses served in a humanitarian mission executed under hostile conditions. During this mission, Army Medical Department personnel cared for the largest single-day volume of combat casualties since the Vietnam War (Feller and Moore, 1995).