Nurisng care for active-duty-servicepersons sustaining a blast and subsequent polytrauma injuries is a developing specialty within the Veterans Health Administration (VHA). Polytrauma is defined as two or more injuries sustained in the same incident affecting multiple organ systems. These injuries have changed the definition of traditional rehabilitation and acute care because of unique, unpredictable, and unfamiliar presentations. Moreover, because of the complex needs of these servicepersons, health professionals found themselves in a new practice paradigm for the entire VHA organization; the dominant patient population changed from older veterans to younger individuals with new and dynamic physical and psychosocial issues. Therefore, expert direct care nurses (DCNs) who provided care based upon sound rehabilitation principles and evidence-based practice principles were now faced with yet undiscovered and evolving standards of professional practice. The outcome of this capstone project was to implement the reflective narrative as a staff development modality in preparing expert nurses. The reflective narrative is an educational technique using the nurse’s own story of the patient-significant encounter as a method to improve clinical and patient-centered skills and knowledge. The evidence supporting this modality is convincing and serves to unmask the wisdom of decision-making in patient care. This report summarizes the evidence supporting reflecting narrative, how it is framed conceptually and preliminary outcomes of its implementation in the polytrauma system of care and its sister nursing units.
