Afghanistan: Nebraska Air Guard members hand over nursing program to local Afghans

By Erika Stetson

U.S. Forces Afghanistan

KABUL, Afghanistan  - Two Nebraska Air National Guard officers are wrapping up the U.S. role in an Afghan military nurse training program in Kabul and handing the initiative over to coalition forces.

The program, which has graduated 100 nurses, has been “one of the most successful” for NATO’s training mission at Kabul’s Armed Forces Academy of Medical Science, said Air Force Lt. Col. Shawn Zembles, chief regional adviser with the training mission and a Nebraska Air Guard member.

He and a fellow Nebraska Air National Guard officer, Air Force 1st Lt. Nicole Hansen, are the last two in a series of Nebraska Army and Air Force National Guard officers who launched and then served as advisers to the program for the last two years. Canadian Forces already serving as AFAMS mentors now will take over the guard’s role with the nursing program, which graduated its third class of students on April 3.

“The nursing program has actually been one of the most successful programs in AFAMS because for the most part they're self sufficient,” Zembles said. “We have Afghans teaching Afghans. We have Afghans directing the program.”

The program began after officials with the University of Nebraska, which has a Center for Afghan Studies and boasts a years-long interaction with the country, invited the state’s National Guard to help improve Afghanistan’s health system.

 The Guard agreed to support the effort after a series of meetings, by bringing a condensed version of an 18-month military nurse training program to Afghanistan.

The first Nebraska Guard team arrived in Kabul in January 2010 for a program assessment, and decided to phase the training into the existing, multifaceted AFAMS medical training mission at the Kabul National Military Hospital.

Since then, Nebraska’s Army and Air National Guard have deployed nursing experts in six-month rotations, bringing the training program up to its current level.

When the Guard first began working, Afghans performing many different jobs were being called nurses, Zembles said.

“Nurse ambulance driver, nurse barber – just about everyone in the hospital was being called nurse,” he said. “We discovered there was no common understanding of that term. We called that role confusion.”

Guard experts helped Afghan leaders define what professional role they wanted nurses to fill, assembled a series of skill requirements and began fine-tuning the training.

“We re-did the whole curriculum,” Hansen said. “That included streamlining it to eliminate redundant or unnecessary material and standardizing the presentation and language over the entire course, which is a 12-month, compressed version of the 18-month U.S. military program.”

The team also created a skills-lab process to give students hands-on experience.

“Before they were just lecturing,” Hansen said. “We’ve helped them get assessment tools to use in the clinical area so they can assess how far the students are progressing each week.”

She said she’s seen the process move along well during her six-month deployment.

“I’ve really enjoyed working with the nursing program and the Afghans and seeing them take what we’ve given them and run with it,” she said.

Zembles estimated work on the program involved combing through about 1.2 million words, including lectures, lesson plans, skills lab checklists and other materials.

He said mentors also developed validation and internal assessment tools for the program, including a tool to evaluate the readiness of potential regional expansion sites for training.

“The validation process took a long time because we looked at every lecture,” Zembles said.

The validation and assessment tools collectively help ensure the program is sustainable as the North Atlantic Treaty Organization scales back its mentorship role for the program to an advisory one, he said.

“The nursing students that we've seen and the previous graduates are very highly praised – praised by leadership within the hospitals themselves – physicians,” Zembles said, calling the students “extremely motivated.”