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In response to the 2004 tsunami disaster in the Indian Ocean, the U.S. Navy deployed teams aboard the USNS Mercy to provide aid during Operation Unified Assistance (OUA). To date, few research studies have examined how Navy nurses prepared for and clinically performed during this relief operation. The current article describes the challenges faced by Navy nurses throughout OUA. A purposive convenience sample was recruited; 11 participated. Data were collected from interviews, observations, field notes, memos, and a demographic tool. Information was categorized, coded, compared to incoming data, then analyzed using Strauss and Corbin's open coding, axial coding, and selective coding methods. A theoretical model was developed to illustrate how participants experienced the mission. Key lessons learned were that most were unprepared for providing pediatric care, and saying "No" in delivering care. Recommendations include: deployment of advanced-practice nurses (specialists in pediatrics and well-mental health) and predeployment training on moral distress. [ABSTRACT FROM AUTHOR]