The discussion, entitled ‘‘The Continuum of Care for our Injured Servicemen and Servicewomen —Navy Nurses Share Their Experiences, was presented by four Navy Nurse Corps officers and one registered nurse who care for or have cared for service men and women in theatre.

The WMANNCA was established in July 1990 and currently has 170 active members. Membership is open to all Navy nurses, active and former, active duty, retired and reserve. The purpose of WMANNCA is to maintain a social, professional and support network that encourages continuous identity with all Navy nurses. Luncheon meetings are held twice a year in the spring and fall.

The panel spoke of their personal experiences with wounded warriors, both in theatre and on the home front. They spoke on a variety of subjects including the dangers and likelihood of post traumatic stress disorder, medical evacuation from the battlefield to stabilization facilities and then onto Bethesda, care for the wounded and care for the caregivers.

Lieutenant Junior Grade Suzanne Fierros, Bethesda’s ICU charge nurse who recently completed a six-month tour as a critical care nurse in Kuwait said she worked with the Army in a four-bed ICU tent in Kuwait.

‘‘We had a wide variety of patients. The patients we couldn’t take care of, we medevaced to Landsdahl, Germany,” Fierros said. ‘‘Our motto was to not turn anyone down.”

In theatre, the wounded troops go from the battlefield to the hospital in either Baghdad or Kuwait, said Lt. Mark Thomas, Bethesda’s 5 East Surgical Ward division officer and medevac coordinator. From there they go to Landsduhl to be stabilized and then onto Bethesda, he added.

‘‘They often arrive in Bethesda within 48 hours of their injury,” Thomas said. ‘‘They still have dirt under their nails.”

As Bethesda’s medevac coordinator, Thomas said he is responsible for the safe transport of combat casualties arriving at Andrews Air Force Base and in transit to NNMC.

‘‘It is a very rewarding experience to be the first person to say ‘welcome back to the United States’ to the medevac patients,” Thomas said.

Three-year staff nurse on Bethesda’s 5 East Surgical Ward, Lt.j.g. Gabrielle Crane, said it’s easy to get involved with the wounded warriors’ family members as well as the patients.

‘‘Sometimes they are at NNMC for a long time and their families become our families,” said Crane, who is also certified in wound care and medical-surgical nursing.

Commander Patricia Kisner, Bethesda’s assistant director for Mental Health, who works with PTSD, traumatic brain injuries and the ‘‘Care for the Caregiver” program, talked about the high rate of suicide, which has been seen in service members returning home from the Long War.

She said one of the differences between this war and the Vietnam War is the number of tours service members are doing.

‘‘In Vietnam, you only did one tour unless you wanted to do more,” Kisner said. ‘‘In this war, they do 15-month tours, and are back for 6 to 12 months [then return] for another tour.”

She said service members are constantly being exposed to multiple traumas and the more traumas they endure, the harder it is to recover when they are removed from the source of trauma.

‘‘With repeated exposure to trauma, the hippocampus part of the brain begins to disappear. [Victims] are in a fight or flight [status] 24 hours-a-day, seven days-a-week. Their bodies are constantly invaded by hormones,” Kisner said.

‘‘PTSD is a very real and a very sad diagnosis,” she said.

Kisner said that preventive measures are being taken for PTSD. When dealing with PTSD, she explained, providers and patients are being taught what to look for, and service members should not be afraid to seek help or admit they are having trouble.

‘‘PTSD doesn’t mean discharge from the military,” said Kisner who also explained that there are often positive outcomes with talk therapy, rehabilitation centers and possibly medication.

Registered Nurse Maureen Merkl, Bethesda’s embedded Veterans Administration and Department of Defense polytrauma rehabilitation nurse liaison said it is her responsibility to ensure communication between DOD, the military treatment facilities, and the VA, and to make sure all involved are constantly informed of the patient’s condition and history.

‘‘It’s a positive [experience] to see these patients that have suffered such severe injuries make the transition and do so well,” Merkl said.