Background: This paper forms part of the first British Armed forces qualitative nursing research study undertaken on deployment. Aim: To provide an analysis of the impact and effectiveness of the pre-deployment educational preparation and clinical placements provided for military nurses. Theory & methods: A Constructivist Grounded Theory was utilised with data collected through semi-structured interviews with 18 nurses based in Camp Bastion Hospital, Afghanistan during 2013. Results: Initial coding indicated 21 educational preparation and clinical placement categories that influenced the delivery of nursing care. Analysis of these elements led to the identification of four major clusters: Military Nursing Care; Military Nurse Education; Unique Hospital Environment and Clinical Placements. Discussion: Educational preparation consists of completing deployable operational nursing competencies, specialist training and individual tailored courses. This strategywas viewed as proving the appropriate academic requirement. However, training would be enhanced by introducing a formalised military preceptorship programme focussing on fundamental nursing skills. Caring for children was a particular concern, and it was emphasised that educational courses must be combined with a standardised clinical placement policy. Adequate clinical exposure can be challenging as nurses are not routinely exposed to War Zone levels of trauma in the UK. Clinical placements need to be standardised and harmonised, and located in areas where nurses cared for patientswith similar injury patterns to thosewitnessed on deployment. Current NHS Trust placements can reduce the opportunities for employment in suitable clinical environments and diminishing the openings for collective military training. Better use should bemade of clinical rotation programmes, including high dependency units, elective surgery, medical assessment units, paediatrics, and outreach teams such as burns and plastic surgery and pain management. Practice Educators should be utilised to provide education, mentorship, supervision and continuing personal development in the operational arena. The paper considers post-Afghanistan future options.

Background. Between 2001 and 2014, British military nurses served in Afghanistan caring for both Service personnel and local nationals of all ages. However, there have been few research studies assessing the effectiveness of the military nurses’ operational role and no papers naming the core values and characteristics. This paper is the only qualitative nursing study completed in this period where data was collected in the War Zone. Objective. To explore the characteristics and values that are intrinsic to military nurses in undertaking their operational role. Design. A Constructivist Grounded Theory was utilised. The first author designed the interview schedule, then following a pilot study, conducted and transcribed the discussions. Informed consent and UK Ministry of Defence Research Ethical Committee approval was obtained. Setting. Camp Bastion Hospital, Afghanistan, in 2013. Method. Semi-structured interviews were conducted with 18 British Armed Forces nurses. Results. A theoretical model was developed that identifies the intrinsic characteristics and values required to be a military nurse. Nursing care delivered within the operational environment was perceived as outstanding. Nurses consciously detached themselves from any legal processes and treated each casualty as a vulnerable patient, resulting in care, compassion and dignity being provided for all patients, irrespective of their background, beliefs or affiliations. Conclusion. The study findings provides military nurses with a framework for a realistic personal development plan that will allow them to build upon their strengths as well as to identify and ameliorate potential areas of weakness. Placing nurses first, with a model that focusses on the requirements of a good nurse has the potential to lead to better patient care, and improve the quality of the tour for defence nurses. These findings have international implications and have the potential for transferability to any level of military or civilian nursing practice.