Allowing Corpsman to Become Nurses

[Asystole RN]

Watching the Presidential debate tonight and a statement by Obama made my head turn. He was relating a story when a corpsman was stating that he has treated wounded soldiers but when he became a civilian he could not use his training or experience to count towards becoming a nurse (unknown which kind). The corpsman was upset that he had to start his education/training from the beginning.

Obama stated that the requirements to be a nurse (assumed licensure/NCLEX requirements) should be changed to allow corpsman to become nurses (did not state which kind).

Any thoughts?

[just_cause, BSN, RN]

The role of combat medic and nurse are completely different role, skill set, scope, etc. The Army combat medic can apply to attend a 1-year long school to gain a skill identifier M6 where they then can get licensure to work as an LPN in military hospital setting.

If you get out as a combat medic then you have a great application and the GI Bill where you can attend school to become a nurse if that is what you seek, or have a great foundation for PA application.

I'm sorry how was corpsman pronounced this time? :)

[nursieman]

I am a former Navy Hospital Corpsman. I served with a Marine Corps infantry unit but not during wartime. I served at several duty stations from 1983-1987.

California allowed Navy Corpsmen and Army Medics, at that time (1994 when I challenged the California LVN NCLEXPN), to challenge the LVN boards for licensure.

I challenged the boards by flying from Arkansas to California and then received reciprosity in Arkansas to Practice. I am now practicing in New Mexico. I have been an LPN for 18 years and have worked in almost all fields of Nursing.

My current employer has a program that fst tracks LPN's to ADN's however, having had very little college, I too had to "start from scratch". It's been a difficult road and I have met resistance at all turns. I'm still working towards my ADN but progress has been very slow. I'm questioned at every turn as to "how I managed to get my license".

I'm an exceptional nurse and hae received several awards to that effect yet every time I meet a new nurse, any nurse, I'm asked all of the same questions.

I do think that qualifying "what type of nurse" the President was suggesting is important. I have to say I was pleased to hear him mention the subject in the debate.

The next question is; is this in reference to "all Corpsmen/medics, only certain branches, only wartime veterans, or all former and present Corpsmem"?

At any rate, I'm pleased to see the topic posed and am interested in the thoughts and feelings of all persons involved in the development of this issue."

Thanks,

Tim H, LPN former HM3 USN.

[nursieman]

Actually, Sali22. My first duty station as a hospital corpsman was Labor and Delivery at Balboa Naval Hospital and "in emergency situations," I did deliver babies and scrub in for C-sections. I was also trained in NICU, PICU, and HemeOnc OB.

From there I went to a Marine Corps infantry unit after attending Emergency Field Medicine school.

I understand your confusion though. After all, "you don't know what you don't know".

[Ginger's Mom, MSN, RN]

Sounds like corpsman have lots of hands on experience without the theory.Perhaps the military provide this training to make the transition easier.

[nursieman]

elkpark. With Compact States reciprocity is given. I was licensed in CA, AR, and currently NM.

I'm from Oklahoma and contacted the OSBN and was notified that I could apply for Licensure by Endorsement. Hope the information is helpful.

[nursieman]

Actually theory is highly stressed, or was at the time I served. Hospital Corps School is a 3 month intensive course and then if one is sent to the Marines, as almost always happens, FMF (Fleet Marine Force) School is required to learn structure within the Marine Corps with a focus on Emergency Field Medicine.

Granted, in my 18 years as an LPN and in college my understanding of theory has increased by leaps and bounds. I learn something new every day.

BTW, when I served, there was NO GI bill. I'm paying for my education entirely out of pocket.

[classicdame, MSN, EdD]

the education and training is not the same. Period. Some of the tasks are. Just because Obama had no experience in government does not mean we should have non-nurses in nursing.

[nursieman]

I'm highly offended by your remark. It sounds as though your political views are skewing your Nursing Judgement and Openmindedness classicdame.

[mmm333, LVN]

Corpsmen carry out delegated tasks in acute care, everything they do is monitored and checked by an RN who is their superior officer and whom they report to. Attending to patients and independently managing their care are two different things. Also, operating in a nonlitigious environment vs. a litigious environment makes a big difference. Yes, many do incredible things in every and any setting- and act independently in the field (and let's face it, that RN just signs off on alot of what they trust them to accomplish). Still, their job scope and training is intentionally designed to interface with an RN as their manager.

9 months of GI Bill-funded college LPN-RN training is not too much to ask our corpsmen to take on, and they can do it. The post-9/11 GI Bill would pay for even the most expensive RN program from start to finish, plus living expenses.

I was part of the movement during the Bush administration to allow Corpsmen and medics nationwide to challenge NCLEX-PN and also to gain priority enrollment in RN programs. I wrote hundreds of letters and made phone calls. There is a certain senator behind this movement, and he continued putting the pressure on Obama once Mr. Bush left office.

Now, some of the same senators who are pushing for tons of work Visas for nurses from India and other countries are the same ones not supporting turning our medics into nurses. Get the drift? The competition for the (mythological?) "baby boomer healthcare goldmine" is on, and many large healthcare organizations are already thinking about getting the bigger piece of the pie and hiring less, paying less, sharing less, and caring less while making more. They would rather have thousands of temporary workers on visas, and they already have lobbyists in place.

Second, ANA and the other professional organizations want diploma programs phased out. I think I remember hearing that there were only one or two left in the country, and that was years ago. What we are essentially talking about is a diploma program out of a military hospital. In this day and age it does not help nurses to say "I don't need no fancy book learning, I learned it all on the job". See how far that gets us when genetic therapies and nanotech become a normal aspect of medicine. This is a huge stumbling block for turning medics into RNs and a big reason you will probably see this end up as a national program for medic>LPN via NCLEX-PN coupled with an accelerated LPN-to-RN college option for medics, (probably supported with some nice federal grants).

My service was 8 years long and my work was in the field. I went to college on the GI Bill and I can tell you I learned a whole lot in college/nursing school that the military does not teach alls medics even with advanced training. I do maintain that there are many corpsmen/medics who just don't get the hospital exposure needed to step into an RNs shoes immediately after enlistment ends with no additional training- and all corpsmen could benefit from a year of college-level nursing coursework that puts them on the competitive edge in a world where "BSN required" or "BSN preferred" is starting to pop up everywhere on applications and not just in California but Alaska, the midwest, and the east coast as well.

This is lively debate here. The subject is important. I realize that this issue is politically and emotionally charged for many people, but let's consider one another's opinions respectfully and understand that nobody here knows who they are talking to and what their experiences (military, nursing, or otherwise) have been. Let's not stumble over logical fallacies such as "My friend X is a stellar medic doing the work of a nurse (while being monitored and checked by an RN or not), therefore ALL medics should be able to challenge NCLEX-RN". Finally, let's pay attention to words like "many, most, all" etc. (when someone says "many", please don't respond as if I said "all") while considering one another's claims, because these meanings matter. Failing at any of the above makes this conversation far less constructive.

In the UK and Canada, military medics have transitioned into their civilian version of the LPN after careful consideration of these scopes and roles, though many go to RN schools afterward. The same considerations have led to the same conclusion in the US- these jobs correspond to LPN, not RN, though there is some very real overlap depending on the person and situation and in many if not most cases, they far exceed what LPNs do.

Any military medical experience makes for a great RN, just as MA, EMT, or ER tech experience makes for great RN student. It also gives them an edge in employment screening and interviews. Most medics that become nurses really stand out and impress their peers and supervisors. They all deserve the opportunity to challenge NCLEX-PN in my opinion, and I fought toward that years ago. All of them could benefit from a BSN in this competitive market oversaturated with new grads and new-ish nurses. Within 3-4 years they won't even be eligible to apply for many hospital jobs without a BSN. That's not exactly giving them an advantage. What they need to do is fund more LPN-RN programs, preferably online ones tailored to medics. They should allow medics to enter these programs without the LPN license. Excelsior was mentioned as a rapid track to RN but there are others. Excellent medics should be able to eat up these courses of study like breakfast, and benefit from them as well. These programs should get massive grants from the federal govt to accommodate medics. That would be the best way to serve medics, the nursing profession, and patients.

[mmm333, LVN]

There are programs for documenting the hours spent on various types of equipment, getting it all signed off, and getting civilian qualifications. They briefly tell you about the "Journeyman program" but very few people take advantage of it while in the military and it takes alot of initiative to penetrate bureaucracy. The journeyman program is key here and should be updated, funded, and advertised.

Again, the military does not especially want to lose all of its talented mechanics to the civilian sector- They were not happy about losing special operations people to Blackwater, etc., and they don't want to lose all of their medics after the first 4 years. So they don't really want to advertise it or make it too easy to the point where they lose their own workforce. However, now is a "sweet spot" since after the Iraq/Afgh drawdown there will be actually too many medics- and they don't want to pay for all of those retirements. Flag-waving aside, it's all about the money. Veterans know that the day they get out, much patriotism is just lip service, very few employers ACTUALLY lend major preference to vets and many do discriminate. Some managers know that it is very hard to win an employment or contract dispute with a veteran, especially one rated for disability, and unfortunately find excuses not to hire them if they can. Ask any VFW rep and they'll confirm that as the unfortunate truth.

Veterans need access to all of the certifications and education they can get, and it pays to start that stuff during and immediately after enlistment. Knock it out, fellow vets. You'll be glad you did. And DO NOT waive that GI BILL! for a few measly thousand bucks. You never know when you might want to retrain, go to law school, or whatever!

[netglow, ASN, RN]

Now, some of the same senators who are pushing for tons of work Visas for nurses from India and other countries are the same ones not supporting turning our medics into nurses. Get the drift? The competition for the (mythological?) "baby boomer healthcare goldmine" is on, and many large healthcare organizations are already thinking about getting the bigger piece of the pie and hiring less, paying less, sharing less, and caring less while making more. They would rather have thousands of temporary workers on visas, and they already have lobbyists in place.

This is reality. A similar move has started in the MD world. Calls to open more med schools and residencies/fellowships. Already they cannot place all the grads in residencies and fellowships. The powers that be in the quote above have something to do with all this too. Open more MD schools/residencies!! Bring foreign MDs in!!(lot's here already). Cries of an MD shortage!!! So it's begun ...flood the market and belittle the profession and drive down salary and working conditions, just like nursing is currently. Make it so no US citizen can afford to go to college for an "iffy" degree that gets one nothing but RN/MD with no residency and horrendous college debt, and no hope for skills/degree allowing them to gain work in another field.

[Lemon00]

I am a Paramedic (that worked in a prison with a military type structure and expanded duties/ scope) transitioning into the Registered Nurse role. Many of you have commented that the job is different; I can say that working on an ambulance presents different challenges than working in a hospital. Starting an I.V in the back of an ambulance going down the highway or working a cardiac arrest with just you and your partner can be exceptionally nerve racking add the environment of a combat situation or in my case being in a dormitory surrounded by 70-90 murderers and rapist, you do have a very different "job". But, those skills should be considered when a person is taking the next step to become an RN. Where I worked we have an ambulance fleet and Paramedics run the ED/triage unit, I was responsible for advanced head-to-toe assessments, acquiring and reading ECGs, determining the need for x-rays, preparing (NO PREMIXED bags) infusions from amiodarone to zosyn then delivering them with no infusion pump just good old fashioned calculated drip rates, I treated everything from ingrown toenails to pediatric cardiac arrest. We treated inmates and officers and the surrounding community much like the corpsman do in the field. The thing that is the most different from what I did and what I have learned in my nursing program is the psychological aspect of healing. The nurse's role as the person supporting the patient emotionally, I feel that part of the job comes pretty naturally for most that love their joband enjoy helping people. Other than that much of it is the same (at an entry nursing level). I am frustrated right now because I can't even get a job as a patient care assistant (or the like). I'm looking to transition into the hospital setting (since I've moved to another part of the state) until I take NCLEX-RN. I can't even "test out" and become a CNA or LPN. I'm just stuck unless I want to work on an ambulance. I am in the Excelsior College nursing program because I would not have gotten any consideration/advanced placement for my accredited paramedic program and would have started in the same position as someone with no experience, had I enrolled in a traditional Nursing Program. It is very frustrating because now I have to go out of state to work, and then apply for reciprocity because my state doesn't honor the Excelsior program (because there is no "clinical" portion). I can say from this perspective it is a very hard pill to swallow when you are used to doing so much but you can't even find a job changing beds and helping with ADLs. I'm not sure what the solution should be and I realize that every Paramedic has not functioned in the role that I have (or been trained in an accredited program)but there should be consideration for those that have, like me and many corpsmen.

*Let me say, I don't think the standards should be lowered*

Maybe just schools have advanced placement or reduced clinical time for these situations or employers be more willing to consider hiring these people even though they don't have the specific cert (like CNA) for a job, in which the level of"skill" is within their training and scope of practice.