Non-Technical Competence for UK Military Nurses in their Operational and Non-Deployed Roles: A Grounded Theory Investigation.

Introduction

British military nurses are required to deploy to some of the most challenging and austere environments to deal with an array of situations. Within the UK, their preparation for deployment is undertaken within the NHS. Whilst clinical technical competence requirements are widely covered in the literature and national clinical guidance, there is a dearth of information on non-technical competence (NTC). This results in a lack of clarity in NTC expectations of military nurses in both their operational and UK roles, which in turn impacts on the assessment and assurance of deploying individuals and teams. This study investigates what non-technical competencies are required by military nurses and how these can be structured to guide a future assurance process.

Method

Using a Straussian Grounded Theory method, twenty-six clinicians from a variety of military settings were interviewed across four focus groups. The initial purposive sample and question schedule was then refined using a theoretical sampling approach. The resulting qualitative data was coded to identify core themes and a theoretical structure firmly grounded in the data.

Findings

The coding process revealed a substantive theory grounded in the data which organised British military nurse competence as a structure of competence domains relevant to their non-deployed and operational roles. Within this framework, participants identified emotional intelligence, leadership, and communication as non-technical competence domains sandwiched between general underlying characteristics and technical competence. Continued exploration of the data facilitated emergence of a formal theory based on the four Cs of conditions, construct, and conduct underpinned by the core theme of context. This second theory provides a competence structure, based on the findings for British military nurses, which can be applied to wider professional settings.

Conclusion

The development of a theoretical structure for military nurse NTC, grounded in the views and experiences of military nurses is an important step in understanding their operational roles and what can be done to support preparation in the UK. In doing so, it creates a new, valid basis for professional development and organisational assurance for the deployment into the some of the most demanding settings in the world.