TITLE

Exploring the Mental Health and Stress Management Strategies of Military

Nurses in VIP Protection Units: A Study of the Presidential Security Command
and AFP Units

ABSTRACT

This study explores the unique mental health challenges and stressors faced
by military nurses assigned to VIP protection units, such as the
Presidential Security Command (PSC) and other units of the Armed
Forces of the Philippines (AFP). It examines the coping mechanisms used
by military nurses in these high-stress roles and assesses the influence of
leadership on their mental well-being. The study aims to provide a better
understanding of the specific challenges faced by military nurses who work
in high-pressure, high-risk environments where they provide emergency care
and security in volatile conditions. Using a mixed-methods approach, this
study will gather both quantitative and qualitative data to explore the
mental health issues these nurses face, their stress management strategies,
and how leadership interventions can promote their well-being. Findings will
be used to recommend policies that enhance support for military nurses in
similar roles.

CHAPTER 1: INTRODUCTION

Background and Rationale

Military nurses assigned to VIP protection units are responsible not only
for providing medical care in emergency situations but also for maintaining
alertness in environments filled with security threats. Their roles require the
capacity to manage extreme stress while delivering care under pressure. This
is especially true for nurses in Presidential Security Command (PSC)
units or similar elite military forces tasked with protecting high-ranking
officials and dignitaries. Nurses in such positions often work in high-stress
environments, such as combat zones, hostile territory, or high-profile
public events, where the threat of attack is real and constant.

The psychological and emotional toll of working in such conditions can lead
to burnout, post-traumatic stress disorder (PTSD), anxiety, and other
mental health issues. However, there is limited research on the experiences
of military nurses in VIP protection units, especially in the context of the
Philippines, which presents a gap in the literature that this study aims to
address. By exploring the mental health challenges and leadership strategies
in these environments, the research will contribute to improving support
structures for military nurses and inform policy changes that promote mental
well-being.

Problem Statement

Despite the increasing recognition of the mental health challenges faced by

military personnel, there is a lack of research on the mental health and stress
management challenges specifically experienced by military nurses
working in high-risk environments like VIP protection units. The emotional toll
of their work, combined with the psychological and physical risks inherent in
these roles, necessitates investigation into both the mental health issues
they face and the coping mechanisms they employ. Furthermore, there is a
lack of understanding of how leadership within the Presidential Security
Command (PSC) and similar units can influence these outcomes and
support the mental well-being of military nurses.

Research Objectives

1. To identify the specific mental health challenges faced by military

nurses in VIP protection units such as the PSC and similar AFP units.

2. To explore the coping mechanisms military nurses use to manage

stress and maintain their psychological well-being in high-stress roles.

3. To assess the role of leadership in supporting mental health and stress

management among military nurses.

4. To propose recommendations for improving the mental health support

systems and leadership strategies for military nurses in these
specialized roles.

Research Questions

1. What are the primary mental health challenges faced by military

nurses working in VIP protection units such as the PSC?

2. What coping strategies do military nurses use to manage stress in

high-risk, high-pressure environments?

3. How does leadership within VIP protection units influence the mental
health and stress management of military nurses?
 4. What leadership practices are most effective in promoting mental well-
being and resilience among military nurses in high-stress roles?

Significance of the Study

This study is significant because it aims to provide valuable insights into the
experiences of military nurses who are responsible for the care of high-profile
individuals in VIP protection units. The findings of this research will
contribute to a more comprehensive understanding of the mental health
challenges faced by military nurses, particularly those working under
extreme pressure. By identifying effective coping strategies and leadership
practices, this study will inform policy development for improving support
systems for military nurses in high-risk assignments, thus enhancing their
psychological resilience and overall effectiveness in their roles.

CHAPTER 2: REVIEW OF RELATED LITERATURE

Mental Health Challenges in High-Risk Military Nursing Roles

Military nursing in high-risk environments is characterized by exposure to

trauma, high-stress situations, and the responsibility of providing critical care
in life-threatening conditions. Research indicates that military personnel,
including nurses, are more susceptible to mental health issues due to the
nature of their work. Nurses in combat zones and security detail roles are
often exposed to psychological trauma and emotional strain due to their
dual responsibility of providing care and maintaining security. Burnout,
PTSD, anxiety, and depression are among the most common mental
health challenges reported in military healthcare settings.

 Burnout: Defined as emotional exhaustion, depersonalization, and a

reduced sense of personal accomplishment, burnout is a significant
issue among military nurses. Studies show that military nurses working
in high-stress environments such as combat zones and VIP protection
units are more prone to burnout due to their extended hours, exposure
to traumatic events, and limited access to mental health resources.

 Post-Traumatic Stress Disorder (PTSD): Military nurses are at risk

of developing PTSD due to direct exposure to trauma and indirect
trauma through the patients they care for. PTSD symptoms include
flashbacks, hypervigilance, and sleep disturbances, which can
affect nurses' ability to perform their duties effectively.
  Anxiety and Depression: Due to the nature of their work, nurses in
VIP protection units may also suffer from generalized anxiety or
depression, which can lead to decreased morale, increased
absenteeism, and reduced job satisfaction.

Stressors Unique to VIP Protection Units

The VIP protection role in military units, especially in countries like the
Philippines, presents unique stressors for military nurses. These nurses must
navigate high-pressure environments where they must remain vigilant
against potential security threats while providing medical assistance in
emergency situations. Some of the stressors include:

 Constant Threat of Danger: Military nurses in VIP protection units

are regularly exposed to high-risk situations, including the possibility of
violent attacks. The psychological strain of being constantly on alert
can be overwhelming.

 Emotional Burden of Caring for High-Profile Individuals: Nurses

in these units are often tasked with protecting the health and safety of
government officials, military leaders, or dignitaries. This responsibility
can add emotional weight, as any failure could have severe
consequences.

 Long Hours and Physical Strain: The demanding schedules in VIP

protection roles contribute to fatigue and physical stress, which can
exacerbate mental health issues like anxiety and burnout.

Coping Mechanisms for Military Nurses

Effective coping mechanisms are essential for military nurses in VIP

protection units to maintain their mental health and job performance.
Research on coping strategies in military settings highlights a variety of
techniques, both individual and organizational, that can help mitigate stress:

 Individual Coping Strategies: Nurses often rely on mindfulness

techniques, exercise, social support, and personal counseling to
manage stress. The ability to “disconnect” from work when off-duty is
a critical coping mechanism that helps to reduce emotional exhaustion.

 Organizational Coping Strategies: Organizational interventions,

such as stress management programs, team-building activities,
and debriefing sessions after critical incidents, can foster a
supportive environment that helps nurses cope with the challenges of
 their roles. Peer support programs, where nurses share experiences
and strategies for handling stress, have also been shown to improve
morale and reduce burnout.

Leadership and Mental Health Support

The role of leadership is critical in promoting mental well-being in military

healthcare settings. Research in military and healthcare leadership
emphasizes the importance of transformational leadership, which is
characterized by inspiring and motivating followers, promoting professional
development, and fostering a supportive work environment. Specific
leadership practices that promote mental health include:

 Providing Emotional Support: Leaders who actively engage with

their teams, offering empathy and support, can significantly reduce
stress levels among military nurses.

 Promoting Work-Life Balance: Leaders who advocate for reasonable

work schedules and ensure that nurses have access to mental health
services can help prevent burnout and improve resilience.

 Training in Resilience and Stress Management: Leadership

programs that emphasize resilience training and stress management
techniques can help military nurses better cope with the demands of
their roles.

Relevant Studies and Frameworks

 The Conservation of Resources (COR) Theory: This framework can

be applied to understand how military nurses manage stress and
burnout by conserving their personal and professional resources. The
theory posits that individuals who perceive a threat to their resources
(e.g., emotional support, time) will experience stress, and those who
can gain or preserve these resources are more likely to adapt
positively.

 Transformational Leadership Theory: This theory, which

emphasizes the importance of leaders who motivate and empower
their subordinates, has been found to positively affect job satisfaction
and reduce stress in military healthcare settings.

CHAPTER 3: METHODOLOGY
Research Design

A mixed-methods approach will be utilized to explore the mental health

challenges, coping mechanisms, and leadership strategies among military
nurses in VIP protection units. This design will enable both quantitative
measurement of mental health issues and qualitative exploration of personal
experiences and leadership practices.

Sample and Setting

The study will focus on military nurses assigned to Presidential Security

Command (PSC) and other AFP VIP protection units. Participants will
include nurses working in these units, along with nursing leaders and
mental health professionals who provide support to the units.

Data Collection Methods

1. Quantitative Data:

o Surveys using standardized instruments like the Maslach

Burnout Inventory (MBI), Generalized Anxiety Disorder
(GAD-7), and PTSD Checklist (PCL-5).

2. Qualitative Data:

o Interviews with military nurses, nursing leaders, and mental

health professionals to gather detailed insights into stressors,
coping strategies, and leadership practices.

o Focus groups with nurses to explore team dynamics and

collective coping mechanisms.

Data Analysis

 Quantitative Analysis: Statistical methods, including descriptive

statistics and regression analysis, will be employed to analyze
survey results and identify relationships between leadership practices
and mental health outcomes.

 Qualitative Analysis: Thematic analysis will be used to identify

patterns in interview and focus group data, with the aid of NVivo
software for coding and categorizing responses.

Ethical Considerations
The study will follow strict ethical guidelines to ensure informed consent,
participant confidentiality, and voluntary participation. Ethical approval will
be sought from the relevant Institutional Review Boards.

CHAPTER 4: RESULTS

This section will present both quantitative and qualitative findings in

response to the research questions.

CHAPTER 5: DISCUSSION

The discussion will interpret findings, compare them to existing literature,

and draw conclusions regarding effective coping strategies and leadership
practices for military nurses in VIP protection roles.

CHAPTER 6: CONCLUSION

The conclusion will summarize the study’s contributions and propose

recommendations for policy, practice, and future research.

REFERENCES

A comprehensive list of sources, including academic articles, books, and

government reports.

APPENDICES

Includes survey instruments, interview guides, consent forms, and other

supplementary materials.

This revision provides a more comprehensive literature review to give

context to the study, strengthening the dissertation's academic grounding. It
includes detailed insights into the mental health challenges, stressors,
coping mechanisms, and the role of leadership, all crucial aspects of
understanding the unique position of military nurses in high-stress
environments like VIP protection units.