Both full-time military service members (MSMs) and part-time Reserve and National Guard component (RC) personnel face multiple transitions related to training, education, deployments, and reintegration to accomplish the Armed Force’s missions. This chapter’s purpose is to provide a better understanding of the complex transitional phases of deployments and/or the reintegration from the military to civilian life. It provides information about the physical, behavioral, and social impacts during the various stages of deployment for the MSM/RC, along with their families/loved ones. The Ecological Model of Veteran Reintegration and its four levels of system factors—individual, interpersonal, community organizations, and societal effects—are used to illustrate the interchanging psychosocial and environmental aspects. The chapter presents specific reintegration challenges of employment, education, and caregiving. Nurses have a pivotal role in screening psychosocial and physical needs, while promoting healthy coping and parenting, to expand the delivery of family-centered care during these transitions.

The management of psychosocial effects begins with a sound plan to mitigate the adverse impact of the disaster on the emotional, cognitive, and behavioral capacity of the individual. Involvement of mental health professionals, such as psychiatric nurse practitioners and clinical nurse specialists, should begin with the development of the community or agency disaster plan. Management of the psychosocial effects of disaster will continue long after the initial impact. Psychological first aid is an evidence-informed approach designed to reduce distress in the immediate aftermath of a disaster and foster adaptive functioning and coping. Major depression and PTSD can be disabling consequences of exposure to disaster among those of any age group, thus, early diagnosis and treatment are critical to the prevention of future disability. There is a growing body of research identifying that effective treatment for PTSD and cognitive behavioral approaches along with exposure therapy are most likely to be beneficial.

Mental health workers need to be members of the disaster response team from the onset and take mental health services to survivors. A range of psychological and emotional responses to disaster are normal and should not be “pathologized” or “medicalized”. This chapter helps the reader to identify the psychosocial effects likely to occur in various types of disasters, identify the elements of a community impact and resource assessment, and describe the normal reactions of children and adults to disaster. It provides brief description on bioterrorism and toxic exposures, community impact and resource assessment, normal reactions to abnormal events, special needs popluations, and community reactions and responses. The psychosocial impact of a disaster and the resources that will be needed to respond to the disaster can be estimated based on data from past experiences with a variety of natural and man-made disasters.

This chapter reveals the experiences of 35 nurses who were deployed for the wars in Iraq and Afghanistan. The nurses describe how “doing nursing” in a war zone changed them personally and expanded their nursing skills, and how reintegration was more difficult than they had anticipated. Some nurses reported a fairly smooth transition with strong support from their families and communities. They wanted people to be patient with them, listen to their stories, and be nonjudgmental. They wanted to be thanked for their service and feel appreciated. On the other hand, nurses who felt a lack of support and connection were devastated. Some nurses struggled in their relationships with family and friends who did not seem to understand that they needed to heal themselves emotionally, psychologically, and spiritually after being deployed. Some nurses reported turmoil in their extended families with the sharing of responsibilities for elderly parents.

This chapter focuses on the family and its role in maintaining health and well-being. Family-centered nursing is the appropriate nursing system in these instances. The family may be a factor that conditions the therapeutic self-care demand and self-care agency of the family member who is the identified patient; it may be the setting within which dependent care is provided; or it may be the unit of service for which nursing is provided. Much of the knowledge the nurse has regarding family is from the foundational sciences or antecedent bodies of knowledge such as sociology or psychology. The chapter looks at the family as it relates to the proper object of nursing. It helps the learner to describe important elements of Family Systems Theory, identify types of family function, describe nursing in family situations in terms of self-care, and differentiate between family-centered nursing and Family Systems Nursing.

Psychiatric-mental health professionals need to have a comprehensive knowledge foundation about mental illness and the theoretical underpinnings associated with it. Definitions of theory, as well as theories of mental health and illness, abound. Variation in these definitions can be influenced by or contingent on a number of factors, including the disciplinary and specialty perspective. This chapter provides an overview of various prominent theories of mental illness. Mental health and psychology are associated with numerous theories, such as grand, middle-range, and micro-level theories. The chapter describes the work of influential theorists, researchers, and practitioners from several disciplines, including but not limited to nursing, medicine, and psychology. It presents theoretical concepts and explanations of the potential etiology of mental illness from within the framework of psychodynamic, behavioral, cognitive, social, humanistic, and biological theory. The chapter includes pertinent definitions, historical background, epidemiological incidence and prevalence rates, and comparative disease burden of mental illness.

This chapter presents the philosophical and theoretical perspectives of caring, knowing, and story underpinning the study of nursing situations. It describes underpinnings of the caring nature of the discipline and practice of nursing, patterns of knowing in nursing, theories of narrative knowing. The chapter also describes the use of situated stories of professional practice supporting the process of teaching/learning from nursing situations as essential to the study and practice of nursing. Nursing begins with a call for help with a health-related concern. Knowing in nursing is essential to the study and practice of nursing and is foundational to the use of case studies, stories, or nursing situations in nursing education. Prior to the development of nursing theories, the knowledge of nursing was primarily drawn from other related disciplines such as medicine, biology, and psychology combined with traditions of caring.