USU Nursing Students Return to American Samoa, Sharpen Skills in Austere Environment

Following a pause during the pandemic, Uniformed Services University nursing students have resumed clinical rotations in American Samoa to gain critical experience in resource-limited healthcare.

USU students, guided by faculty, collaborated with the American Samoa Department of Health (DOH) to gain practical experience in limited resource environments during their clinical rotation in February. (Photo courtesy of Department of Health, American Samoa Government)

December 2, 2025 by Hadiyah Brendel

The Uniformed Services University (USU) Daniel K. Inouye Graduate School of Nursing (GSN) has revived its clinical rotation in American Samoa, reopening a vital training ground for future advanced practice military healthcare providers. After a suspension caused by the COVID-19 pandemic, students from the Family Nurse Practitioner (FNP) and Psychiatric Mental Health Nurse Practitioner (PMHNP) programs are once again working in the South Pacific territory.

The program sends students to the island for four-week rotations. While the territory is geographically defined by its volcanic, tropical terrain, the training itself centers on the unique challenges found within the island's community clinics. These facilities are often isolated and resource-limited, mirroring the constraints uniformed health care providers face in austere, deployed, or humanitarian missions. The rotation is designed to bridge the gap between classroom theory and the realities of patient care, preparing officers to manage diverse patient populations in environments where standard resources may not be readily available.

This year's return marks the latest chapter in a partnership that was established in 2010. While the global pandemic paused the program in 2020 due to travel restrictions and quarantine requirements, the rotation has long been a defining experience for USU students. In previous years, participants like then-Army Capt. Chelsea Johnson described the rotation as a way to "find my purpose again," noting that the challenges of working in these remote clinics taught her how to treat patients effectively without the tools typically available in large military treatment facilities.

Pictured left to right: Deputy Director Fara Uta, Lt. Hannah Tumae, Cpt. Jessica Little, Capt. Connie Braybrook, Dr. Jennifer Trautman,  DOH Director Motusa T. Nua, and other DOH staff members. (Photo courtesy of Department of Health, American Samoa Government).

Reviving this opportunity required significant persistence. After a five-year hiatus, Dr. Jennifer Trautmann, deputy director of the FNP program, and Navy Capt. Connie Braybrook, program director of the PMHNP program, successfully reconnected with the American Samoa Department of Health. Trautmann views the training as a critical advantage, describing it as another "bow for their quiver" that equips students to navigate interagency communication and conduct community needs assessments. "When you're in a lower-sourced area, how do you provide standard of care and preventive health care for communities?" Trautmann asks.

That question became a daily reality for two second-year students when the program resumed in February. Army Capt. Jessica Little from the PMHNP program and Navy Lt. Hannah Tumae from the FNP/Women’s Health Nurse Practitioner program deployed to the island to collaborate with the Department of Health. While Tumae provided primary care services in community clinics, Little focused on behavioral health evaluations.

Little found that social determinants of health heavily influenced her patients in these remote settings. One interaction, in particular, stood out to her: a patient could not afford their own medication because their son’s mental health needs were more urgent. To address these gaps, Little partnered with local health leadership to improve health education. She implemented integrated mental health screenings into primary care and prenatal clinics, demonstrating that psychotherapy could often provide better outcomes than reliance on medication alone.

For Little, the mission was personal. Her grandmother was a missionary, and seeing her serve in remote areas inspired Little to pursue medical missions. "Participating in the clinical [rotation] to American Samoa provided training in compassionate and empathetic care for future medical missions and aligns with my ethical values that everyone has the fundamental right to necessary medical care," Little says.

Building on these individual successes, USU plans to continue the clinical rotation annually and may add additional rotations throughout the year. The university is also working to address specific public health needs in American Samoa, such as RSV in infants and information on infectious disease outbreaks. As part of this exchange, faculty and students have connected with the local nursing school to learn about their educational needs and offered to provide instructional courses. Along with current sites at the National Park Service and in Hawaii, the American Samoa rotation ensures USU students are ready to navigate diverse healthcare environments.