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Horoho first woman, nurse to head U.S. Army Medical Department.

Tuesday May 1, 2012
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With the end of combat in Iraq and the planned withdrawal in 2014 of U.S. fighting forces in Afghanistan, the Army’s healthcare providers still face daunting challenges, according to Lt. Gen. Patricia D. Horoho, RN, the first woman and nurse to head the U.S. Army Medical Department.

Horoho became the 43rd Army surgeon general and commanding general of the Army Medical Command on Dec. 7, 2011, after serving as chief of the Army Nurse Corps since 2008.

Though the public may turn its attention to other issues, the Army’s nurses, physicians, psychiatrists, medics and specialty therapists do not have that luxury, Horoho said during a teleconference last month with writers from Nurse.com and three other nursing publications.

The men and women who served in the Iraq and Afghanistan wars will be coping with physical and emotional damage for years to come, said Horoho. "Ten years of war has absolutely taken its toll," she said. "But we have a resilient force. The greatest challenge is ensuring that we maintain the right behavioral health capability so that we can take care of those service members who have been supporting these conflicts."

The wars’ wounds include PTSD, a high suicide rate, traumatic brain injuries, amputations, blindness and other permanent physical disabilities primarily caused by improvised explosive devices. The Army also is plagued with a rising rate of sexual assault.

Horoho assumed the surgeon general role in January. Her appointment is particularly noteworthy because only male physicians had served in the role dating to 1775, when the job title was chief physician and director general of the Continental Army. Lt. Gen. Eric B. Schoomaker, Horoho’s predecessor, said she was chosen from a large and talented pool of physicians, dentists, veterinarians and medical administrators.

She was selected by high-ranking Army and Department of Defense officials including the chief of staff of the Army, the secretary of the Army, the secretary of Defense and President Obama.

"Gen. Horoho was seen as the premier candidate and the one who had the greatest potential," Schoomaker said during a phone interview with Nurse.com. "She’s an extraordinary leader."

Horoho’s leadership capabilities, including strategic vision, courage and the ability to communicate with others and rally others them to common causes, were recognized quickly by many as she rose through her career, Schoomaker said.

Horoho said when she became an active-duty Army nurse in 1983, nurses could not command major medical units, such as a hospital. The thought of one day becoming surgeon general did not even occur to her, she said.

Her appointment "was humbling and exciting," Horoho said. Both Horoho and Schoomaker said they heard no objections about her appointment from physicians or other officers across the medical department.

"My biggest supporters were actually physicians," Horoho said. "Regardless of your clinical background, I believe people just want you to lead, and they want to know that you have the best interest of the command and the best interest of the mission at heart."

Horoho first gained national attention when she was selected as a nurse hero by the American Red Cross and Nurse.com because of her actions after 9/11. Horoho was working at the Pentagon when it was struck by one of the planes hijacked by terrorists. She quickly helped other medical personnel triage and treat the wounded.

While chief of the Army Nurse Corps, Horoho and her fellow nursing officers transformed the corps to incorporate nursing research, evidence-based practice and leadership development through all nursing areas, including the war zone. The transformation included not only active duty nurses, but Reserve, National Guard and civilian nurses working in Army facilities.

Horoho wants to change the U.S. Army Medical Department from a healthcare system to a system for health. She plans to focus on influencing the health behaviors of soldiers and their families not only when they are at military treatment facilities but when they are off duty.

Horoho said she has a particular interest in the unique healthcare needs of military women. While in Afghanistan this past summer, she set up focus groups for women, asking them to discuss their healthcare needs. Those focus groups are continuing, she said. Horoho views sexual assault and sexual harassment as gender neutral because men as well as women are being assaulted and harassed. "It’s an affront to our core values in the military," she said. •


Janet Boivin, RN, BSN, BA, is a freelance writer, former editor at Nurse.com and staff nurse at the Family Health Partnership Clinic in Woodstock, Ill.Write to editor@nurse.com or post a comment below.