Likleyhood of a critical care placement is first year of Air Force service?

allnurses Guide · Sep 15, 2013

I am a member of Air Force ROTC at my university and an aspiring nursing student/aspiring CRNA. For being in ROTC I will have a four year commitment with the AF. I was wondering if anyone knows the likelihood of being placed in a critical care setting (a prereq to any CRNA program) with the Air Force right out of school? Also if I have a four year commitment and wanted to try to get into a CRNA program earlier, say after say 2 or 3 years can the additional commitment years be delayed or say rolled over until after completing CNRA schooling? Any help is greatly appreciated!

The chances are pretty much zero. The USAF has no interest in training new nurses into critical care. The USAF designed the AFIT critical care internship program to fill the needs of training new nurses how to be ICU nurses. It takes 2-3 years before you can even apply for the internship program and the program itself takes 12 months. Then it takes another 2-3 years before you can apply for the USAF CRNA program i.e. 6-7 years before you would be even able to start USAF CRNA school going this route.

SoldierNurse22, BSN, RN · Sep 16, 2013

Ditto on what WTBCRNA said.

As far as "rolling over" your commitment, I've never heard of this before, and plenty have gone the CRNA route before you. You are contractually obligated to them until the timer dings, and there are no pauses inbetween. Plenty of people go to school while on AD, either with or without govt assistance. With govt assistance will incur additional time in service. Without assistance isn't always as easy to pull off because you're doing it yourself, and pesky things like deployment, PCSing, etc can interrupt those grand plans.

logan9519 · Sep 16, 2013

Thank you wtbcnra and SoldierNurse22! So would they start you out on a med/surg floor or do you list areas that you would like to work and they "take that into consideration" but end up placing you where there is need? If a civilian ICU nurse wanted to sign on to the Air Force, would they have to go AFIT internship or would there previous experience allow them to go directly to working in a critical care area?

wtbcrna, what was you path the nurse anesthetist?

manusko · Sep 16, 2013

Thank you wtbcnra and SoldierNurse22! So would they start you out on a med/surg floor or do you list areas that you would like to work and they "take that into consideration" but end up placing you where there is need? If a civilian ICU nurse wanted to sign on to the Air Force, would they have to go AFIT internship or would there previous experience allow them to go directly to working in a critical care area?
wtbcrna, what was you path the nurse anesthetist?

You'll be lucky if there is a real hospital at your first duty station. Many state side bases have done away with in-patient care and have become super clinics or whatever they are saying now. When I got out of the AF, there was a push to downsize hospital services and move them to civilian hospitals. Many nurses I worked with either worked in the family practice clinic, flight medicine or acute care clinic.

SoldierNurse22, BSN, RN · Sep 16, 2013

You may get asked what you'd like, but ultimately, you go where you're needed. If that happens to line up with what you want, cool. If not, too bad. The AF will not lose sleep over it.

If an ICU RN joins as a civilian and they want to stay ICU, that gets written into their contract as something called an identifier. Your AOC, area of concentration, is your job in the military. For instance, a 66H is a med-surg nurse in the Army. A 66H M5 (M5= identifier) is an ER nurse. A 66H 8A is a critical care nurse.

as1013 · Sep 16, 2013

For WTBCRNA or anyone else with insight:

I am also interested in the CRNA career field and have been researching possible pathways of obtaining that goal with the Air Force. I am currently active duty and will be graduating nursing school soon through the NECP program. Correct me please if I am wrong, but through my research I've gathered, the two main ways to gain critical care experience after coming into the Air Force as a new nurse is through the AFIT fellowship or moonlighting. There may be a small possibility to get reassigned to the ICU after some time, but it's dependent upon a number of factors. At the very minimum, going through the AFIT fellowship would require 5-6 years of service before entering a CRNA program.

I have a few questions that I would like to ask:

1. How feasible is it to moonlight after coming in as a new nurse (regarding work schedule, exercises, military obligations, etc)?

2. Is there a specific number of hours required to equate to a year of critical care experience, or is a year full-time in the ICU and a year part-time in ICU equivalent for application purposes? Although if will gathering my experience part-time I would definitely want work more than a year to become familiar and proficient dealing with that level of patient care/responsibility.

3. Do you know anyone who moonlighted in a civilan critical care position while active duty to gain experience that eventually was accepted into the CRNA AFIT program? If so, did he or she have any comments/concerns about that path?

allnurses Guide · Sep 17, 2013

Thank you wtbcnra and SoldierNurse22! So would they start you out on a med/surg floor or do you list areas that you would like to work and they "take that into consideration" but end up placing you where there is need? If a civilian ICU nurse wanted to sign on to the Air Force, would they have to go AFIT internship or would there previous experience allow them to go directly to working in a critical care area?
wtbcrna, what was you path the nurse anesthetist?

As a 46N1/med-surg nurse you would probably work on med-surg or in a clinic somewhere. The other option for new AF nurses is to work in OB, but I do not recommend that route if CRNA is your ultimate goal.

Civilian ICU nurses with at least 2 years experience can go right into the ICU when they join the AF.

I came into the AF as civilian trained ICU nurse. When I joined the AF there was still big need for AF nurses and the critical care fellowship did not exist at that time. It took me applying twice to get into CRNA school.

allnurses Guide · Sep 17, 2013

For WTBCRNA or anyone else with insight:
I have a few questions that I would like to ask:
1. How feasible is it to moonlight after coming in as a new nurse (regarding work schedule, exercises, military obligations, etc)?
2. Is there a specific number of hours required to equate to a year of critical care experience, or is a year full-time in the ICU and a year part-time in ICU equivalent for application purposes? Although if will gathering my experience part-time I would definitely want work more than a year to become familiar and proficient dealing with that level of patient care/responsibility.
3. Do you know anyone who moonlighted in a civilan critical care position while active duty to gain experience that eventually was accepted into the CRNA AFIT program? If so, did he or she have any comments/concerns about that path?

1. It depends on your command, your schedule, and the local availability. A lot ICUs won't train prn nurses to work in the ICU unless they have great need for ICU nurses.

2. When you have enough hours to qualify for your CCRN you have met/exceeded the requirement.

3. Yes, but not personally. I only know of the student(s) through the USUHS NA program director. The program director recommended getting your CCRN to show you had enough experience.

SRNA4U, BSN, DNP, RN, CRNA · Sep 25, 2013

The chances are pretty much zero. The USAF has no interest in training new nurses into critical care. The USAF designed the AFIT critical care internship program to fill the needs of training new nurses how to be ICU nurses. It takes 2-3 years before you can even apply for the internship program and the program itself takes 12 months. Then it takes another 2-3 years before you can apply for the USAF CRNA program i.e. 6-7 years before you would be even able to start USAF CRNA school going this route.

Actually that's not true. I went through the AF Critical Care Fellowship program. You have to do a 2 year payback and after the 1st year going into the 2nd year, students apply for CRNA school so they can start immediately after their 2 year payback. Currently in my unit, we have 2 people who were picked up for USUHS last year and 2 who have submitted their packages with this years Call for Candidates.

As far as going straight into critical care is pretty low however, if you were in the Army, it would be very possible to come straight in and go into critical care. If you come in as a med-surg nurse, you can apply for the fellowship after 2 years as a med-surg nurse since you would have to PCS to your critical care fellowship program area.

We just closed the Critical Care program over at Walter Reed and now we're just using the one at San Antonio Military Medical Center. They may be still using the site in St Louis as well. It was too bad we lost the Bethesda site since we still have a good training platform. Not too many places are still pumping out heart patients like we do at Bethesda.

If you were to come in as a med-surg nurse, you would incur at least 2 years for the PCS in the med-surg career field and then you would be able to apply for the critical care program. We have a ton of 2nd Lt and 1st LT in our ICU currently who went through the program and are waiting for their 2 year payback to be done so they can apply for CRNA school. You would be looking at about 4-5 years instead of 6-7 years.

Another option would be to apply for a civilian critical care program and then just apply for a civilian CRNA program. But since you are in AF ROTC, not sure if you've signed a contract yet but you have options out there.

SRNA4U, BSN, DNP, RN, CRNA · Sep 25, 2013

The main thing you want to do is get into the critical care fellowship. Currently, the ICU career field is over 96% manned. We have so many nurses that are applying for Critical Care CNS, ACNP, and CRNA programs. Getting released from critical care to pursue your education is not very hard at all since our numbers are very good for manning. Now in the OR career field, we are around 76% manned. I had some fellow OR nurses who were trying to apply for the Critical Care program and were denied because the OR career field is really short on nurses. I'm glad I was able to break free and enter into the critical care program..

allnurses Guide · Sep 26, 2013

Actually that's not true. I went through the AF Critical Care Fellowship program. You have to do a 2 year payback and after the 1st year going into the 2nd year, students apply for CRNA school so they can start immediately after their 2 year payback. Currently in my unit, we have 2 people who were picked up for USUHS last year and 2 who have submitted their packages with this years Call for Candidates.
As far as going straight into critical care is pretty low however, if you were in the Army, it would be very possible to come straight in and go into critical care. If you come in as a med-surg nurse, you can apply for the fellowship after 2 years as a med-surg nurse since you would have to PCS to your critical care fellowship program area.
We just closed the Critical Care program over at Walter Reed and now we're just using the one at San Antonio Military Medical Center. They may be still using the site in St Louis as well. It was too bad we lost the Bethesda site since we still have a good training platform. Not too many places are still pumping out heart patients like we do at Bethesda.
If you were to come in as a med-surg nurse, you would incur at least 2 years for the PCS in the med-surg career field and then you would be able to apply for the critical care program. We have a ton of 2nd Lt and 1st LT in our ICU currently who went through the program and are waiting for their 2 year payback to be done so they can apply for CRNA school. You would be looking at about 4-5 years instead of 6-7 years.
Another option would be to apply for a civilian critical care program and then just apply for a civilian CRNA program. But since you are in AF ROTC, not sure if you've signed a contract yet but you have options out there.

My overall timeline is right if you look at the USAF NC Call for Candidates you will see where that timeline comes in.

1. 24 months is the minimum TOS before you can go to any AFIT sponsored school if you are CONUS applicant. 36 months minimum (for most OCONUS assignments) minus a 60 day roll back for the OCONUS candidates, so it is actually 2-3+years before you can start school since you apply approximately a year in advance depending on the program. That automatically makes it 2-3 years at a minimum before you can even go to school. Now depending on what time of year you actually get to your duty station that time can be extended i.e. if you get to your duty station in August then you are more than likely going to have wait for another calendar to year to apply versus someone that got to their duty in Jan/Feb of that same year.

2. Then the same timeline starts all over after you would complete your 12 months of training in Critical Care i.e. another 2-3 years.

3. 2+1+2 (5yrs in perfect world), 3+1+2 (if you do one OCONUS assignment), and 3+1+3 (if you did two back to back OCONUS before and after critical care training). The TOS requirements can change year to year. TOS requirements used to be longer when I initially applied for my AFIT program. That makes it 5-7 (with 5 years being unlikely for most candidates).

By the way I am an adjunct faculty at USUHS and the clinical coordinator at our base for SRNAs that rotate through for speciality training.