By Matt Kelly

A combat field hospital is similar to a standard hospital — with a major exception.
“In combat you see more gunshot and shrapnel wounds,” said Army nurse Capt. Tara O. Spears, after serving three months in Iraq and Kuwait with the 86th Combat Support Hospital.

Her patients included a 5-month-old girl whose Arabic name translated to Flower. She had suffered shrapnel and burn wounds to her legs, received in an incident that killed her mother.

“We took her in and made a makeshift crib for her out of a medical supply chest,” said Spears, a 13-year Army veteran. “We kept her and took care of her legs.

Finally her aunt was found and she would stay with her and actually breast-feed her.”

After the wounds healed, Flower went home with her father.

“That was a nice, happy thing,” Spears said.

Spears, 35, a nurse in a 144-bed Army field hospital, will now incorporate her wartime medical experience into her pursuit of a master’s degree from the U.Va. School of Nursing as an acute care clinical nurse specialist with an emphasis in emergency nursing. She said her experience will help her in class, and her advanced degree will help her in future deployments.

Experienced nurses return to school so they can provide leadership, consultation and education in their workplace, said Arlene W. Keeling, director of the U.Va. Acute Care Nurse Practitioner program, which upgrades nurses’ skills.

“We take them a step further,” said Keeling. “We keep them in direct practitioner roles with higher clinical decision-making.”

Attracted by the speed and efficiency of emergency medicine, Spears also understands its limitations.

“I like being able to work with a team to help someone get better and being able to see the results of what I do quickly,” she said. “Unfortunately, people don’t make it sometimes, and that is hard. But you have to keep going.”

She treated a 13-year-old girl burned from the waist down when the kerosene stove she was lighting exploded. She had gone a week without treatment when she was brought to Spears’ facility.

“We amputated her legs just below the hip to save her, but the infection had already gotten into her system. No matter what we gave her, it didn’t help,” Spears said. “She died a couple of weeks after she got to us.”

Treating Iraqis, while having no experience with their culture or language, has given Spears an appreciation of diversity.

“In class, when we talk about cultural diversity and certain cultural aspects of nursing care, I understand a little better because I actually had to deal with it,” she said. “And this was the first time I had experienced that, plus the language barrier.”

In Iraq, which was Spears’ first combat experience, she treated everything from splinters to razor wire cuts to bullet and shrapnel wounds to tank tread injuries.
“Anytime any of those soldiers came in sick or hurt, I felt like it was part of my family and I would do everything I could to help them,” Spears said.

“Capt. Spears is at her best when it counts,” said Lt. Col. Elizabeth McGraw, acting chief nurse of the 86th Combat Support Hospital, who served with Spears in Kuwait. “During numerous mass casualty situations she could be counted on to perform with professionalism and tact.”

It was the land outside the hospital that gave Spears pause.

“It’s sand, sand and more sand,” she said. “I have never seen such a desolate place. It was well above 120 degrees in the shade, and the sand gets into everything.”

Spears endured frequent alerts for Scud missile attacks, and often the field hospital was sealed against possible chemical attacks.

“We realized really quick that this wasn’t training any more, this was the real thing,” she said. “But the training that the Army gave us had us prepared to do what needed to be done.”

The soldiers took breaks when they could, reading, pitching horseshoes, playing football, watching Fox News and having an occasional barbecue.

“We made our own fun,” she said. “Everything was so stressful all the time, almost a constant influx of patients, all of our beds were pretty full, and on top of the normal hospital busy-ness, we had alerts that put more stress on us.”

Despite personal privations, Spears had positive contact with the Iraqis.

“The people and their gratitude for what we were doing [surprised me],” Spears said. “Most of the Iraqis that I dealt with, the enemy prisoners of war and the civilians both, were so grateful to us for what we were trying to do over there.”
The Army also worked with Iraqis to restore their hospitals, so civilians could be moved back into them.

“From the medical aspect, they were really grateful because the hospitals were nonexistent,” she said. “The building was there, there was some staff there, but they had hardly any medical supplies.”

Spears clings to her memories of Iraq.

“I try to hold on to all of them,” she said. “Those that are happy, like that little girl, Flower. We helped her get well, we helped her get back with some family. And the sad ones, as well, because both teach you things.”