The Soldier Nurse
David Blumenkrantz | Scrubs Magazine
Nursing can be one of those fascinating careers that always brings with it new experiences. There can be plenty of drama, surprises and emotional highs and lows. Talking with Bernardino Ramos, the head nurse at a Veterans Affairs clinic and a veteran himself, it’s apparent that for those working in the military, the extremes can be even greater.
After earning his RN at the University of Florida, the Puerto Rican–born Bernardino started his nursing career in the civilian sector, working at Olive View Hospital in Sylmar, Calif., from 1990 to 1995. Then in 1997, at the relatively advanced age of 35, he enrolled in the Army.
“For some reason I liked the military life” is his typically taciturn explanation. After receiving basic training in San Antonio, Texas, Bernardino was deployed to South Korea as a first lieutenant, and was later promoted to captain. He worked at a facility called 121 Casualty, where they dealt with “all kinds of emergency situations.” Much of the nursing done in South Korea was not battlefield-related, and Bernardino recalls one tragic emergency occurring when a pediatrician, who was there covering for another doctor on leave, was stabbed in the street.
Two years later, Bernardino found himself stationed back in the U.S. at Fort Huachuca in Arizona, training medical personnel to deal with all manner of field casualties. Fort Huachuca is home to the U.S. Army Intelligence Center and School, and when the 911 terrorist attacks happened, as Bernardino casually recounts, “We were mobilized to move into bunkers, where we spent three days.”
In 2003, he switched from the Army to the Air Force. Stationed at Travis Air Force Base in northern California, Bernardino worked with what he described as a “flying ICU unit,” going into the battle zones of Iraq and Afghanistan to evacuate the wounded. His eyes take on a faraway look as he recalls the worst of it. “It’s traumatic—they are flying out for better care, missing body parts—no legs, no arms, no faces, abdominal wounds. So many people we don’t see. We only hear about those who are killed. These are things you don’t see in civilian life.”
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Four years ago, Bernardino retired from the service. He was, in his own words, “feeling crazy. Seeing patients missing arms, eyes, legs—that is stressful, not only to them, but also to those who care for them. It took me almost a year to recover from the stress,” he admits. “It was hard to incorporate myself into civilian life.” He spent six months in therapy in San Diego while searching for an elusive job in the civilian world.
The Sepulveda Ambulatory Care Center (SACC), where Bernardino eventually found work, is one of the largest facilities in the Department of Veteran Affairs Greater Los Angeles Healthcare System. Bernardino is in charge of a specialty unit known as the Blue Team, one of 10 clinics at SACC. He directs six nurses, coordinates patient care and supervises the involvement of social workers and case managers. The Blue Team sees referrals from the primary clinic—veterans suffering from physical pain, disabilities and trauma. Bernardino explains that while the majority of their patients have historically been Vietnam vets, “now we are seeing more from Iraq.”
There are also many neurological cases, as well as those that require psychology and psychiatry. While not downplaying the physical traumas that afflict war veterans, Bernardino seems particularly interested in and knowledgeable about the emotional toll of war. “I’ve been there—as a soldier. I know what’s going on with the veterans, both physically and mentally. When you are mobilized to Iraq or Afghanistan, there is stress right there. No matter if you go for three months, six months or more, you are under fire all the time. Many soldiers who come back don’t have physical wounds, but emotional ones. We see a lot of post-traumatic stress.”