Chief Nurse / Change of assignments

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This is long post.

OK the chief nurse can change assignments (I have read that here and on other sites). Needs of the military....

One would believe that an APRN who signed on "as a APRN" the intention of that APRN was to work as a APRN.

With there being the likelihood that APRN's can / are being assigned to a RN positions and since I have not read that much about it:

- How long does that reassignment last?

- How often does it occur?

- Reassignment to any nursing unit / job?

- Is the APRN's license construed to being able to handle any medical unit?

- Does this work like in the civilian hospital setting: Eventhough you were hired to be a nurse on X unit/job on any given work day you may be assigned to Y or Z unit/job?

Since APRN's are working under the rules and regulations of a least one state and one certification agency how are conflicts with those agencies handled???

Basically one is still working under said laws of given state even though on federal reservations (person has to be licensed by at least one state)????

For example: Re-licensure has to occur on occasion here in Georgia every 2 years. My APRN certification / agency I have to certify every 5 years… For both I have to meet CEU and practice requirements for continued practice.

Some states have rules about work / CEUs for RN’s as well as APRNs...

Just curious.

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JD, what service are you in currently?

If not in service - which service are you looking at?

also - please explain this: "One would believe that an APRN who signed on "as a APRN" the intention of that APRN was to work as a APRN."

When does 'this' scenario occur?

In the Army signing on "As a APRN" would occur when your become a nurse - family practitioner which is an MOS... when else would this occur?

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JD, what service are you in currently?

If not in service - which service are you looking at?

I am not in: But in talks with Air Force (over a year) and Army (last couple months). I have spoken with two chief nurses and a Nurse Practitioner on the Air Force side. Didn't consider this topic to be one of the questions I needed to ask about.

also - please explain this: "One would believe that an APRN who signed on "as a APRN" the intention of that APRN was to work as a APRN." When does 'this' scenario occur?

That is what I am asking. Going in as a Certified Registered Nurse Anesthetist , Family Nurse Practitioner, Nurse Midwife and Psychiatric Nurse Practitioner one would / could presume they would be functioning in that capacity a bulk of the time???

Entry from other post:

....if your command/chief nurse etc decide they don't need you as NP then you be working as an RN in any fashion they see fit. That is one of many reasons I picked CRNA over nurse practitioner in the military. It is exceedingly rare for a CRNA to be pulled out of their primary job.....

In the Army signing on "As a APRN" would occur when your become a nurse - family practitioner which is an MOS... when else would this occur?

So they don't pull you out of your job description if it is a specific MOS? Nurse Practitioner working as a floor nurse?

For instance the Army site states:

"There are also opportunities to attend graduate school and become an Advanced Practice Nurse such as a Certified Registered Nurse Anesthetist , Family Nurse Practitioner, Nurse Midwife and Psychiatric Nurse Practitioner to name a few". I would presume they would not train people to work in these advance fields much less accept them under those job titles unless that's what they would be doing a bulk of the time??

I know in times of war and whatnot things don't go as planned and anyone could be ordered to step outside their box. I am not asking about that what I am asking for example in my case I join as a Family Nurse Practitioner how much of my time will not be as a Nurse Practitioner?

I apologize if I seem to be arguing just trying to clarify...

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The MOS' house the basic job descriptions. The army does not have 'an adult NP' for example.. however the skills gained from that degree provide a more educated nurse and fulfills his/her professional development. As you progress in rank you are likely not to be bedside - eventually - and in a leadership role where advanced education gives you a better perspective AND is an incentive to stay in the military and to better yourself.

Just like in the infantry you can get the army to pay for you to attend masters studies..and you might be in int. relations, or MBA, or civil eng, it doesn't DIRECTLY apply as you still have limitations in your MOS or functional area etc. As you progress there are additional jobs/billets you can apply for and this well rounded education will help make you a better candidate.

IF you join as a FNP.. there is a FNP MOS...

if you join as an adult NP - there is NOT an adult NP MOS... thereby you are much less likely to be doing that strictly.. and you would have joined in some other MOS.. generic 66 - perhaps.. which case you might be anywhere...

The confusion that I keep seeing is saying 'if a person joins as a NP in ___ ___" well you are not able to just tailor make an MOS or contract when joining so that never really becomes an issue.

...you could be a certified NP and join the army and not be anurse for example..if you joined as an engineer officer - that is what you would be.. not a nurse.. far flung example :)

Your JOB description IS your MOS.. despite your previous background.. that is my summary~ perhaps there is flexibility based on manpower, current location, chain of command.. but frankly when you commission in your MOS that is your expected role - regardless of anything else.

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Specializes in Anesthesia.

When you join the military as an NP you are still an RN. You will most likely deploy, if nothing else, as an RN not as an APN. The same thing happens to many speciality physicians that get deployed as FPs vs. their speciality of dermatology/radiology etc.

I have seen NPs in the AF not be allowed to work as NPs simply because the squadron commander did not like NPs. There is a good chance during your 1st couple of years in the military if you are an FNP or some other APN that has its own MOS/AFSC code that you will get to work as an APN. You might also be put in charge of a clinic right off the bat and told you get to see patients in between your mangerial duties.

Things you should realize joining the military:

1. Your Chief Nurse/Squadron CC/Group CC etc. make the real decisions on where you will end up working, when you will deploy etc. Also, when deciding who gets to work as an APN the nurses that go through AFIT get the APN assignments 1st and then the APNs that were trained on their own.

2. Chief Nurses/Squadron CC/Group CC generally change every 2yrs (at least in the AF), and you are subject to how they see fit to utilize your skills the best to meet the mission.

3. Nothing in your contract is going to fully protect from having the Chief Nurse/CCs change your duties around.

4. No reassurance your recruiter gives means a thing. Your command is the ultimate authority, if you get a contract promising that you will work as APN I for one would like to see it. What your contract should say is that you are coming in as a X APN, but one of the 1st thing your Chief Nurse is going to want to know is what previous RN experience was......I bet you can guess why.

5. If you can accept being flexible military nursing can be a great experience.

Now saying all that if you want to be NP still get all the military benefits, and be assured of working as NP you should look into USPHS. In the USPHS you actually apply for a job opening just as you would in the civilian world, and that is where you go to work. http://dcp.psc.gov/vats/rpt_create.asp

Just as a side note: CRNAs are about the only APNs that don't get switched around from being CRNAs. In general CRNAs are undermanned, and their jobs are so specialized that it is hard to find replacements.

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When you join the military as an NP you are still an RN. You will most likely deploy, if nothing else, as an RN not as an APN. The same thing happens to many speciality physicians that get deployed as FPs vs. their speciality of dermatology/radiology etc.

I have seen NPs in the AF not be allowed to work as NPs simply because the squadron commander did not like NPs. There is a good chance during your 1st couple of years in the military if you are an FNP or some other APN that has its own MOS/AFSC code that you will get to work as an APN. You might also be put in charge of a clinic right off the bat and told you get to see patients in between your mangerial duties.

Things you should realize joining the military:

1. Your Chief Nurse/Squadron CC/Group CC etc. make the real decisions on where you will end up working, when you will deploy etc. Also, when deciding who gets to work as an APN the nurses that go through AFIT get the APN assignments 1st and then the APNs that were trained on their own.

OK

2. Chief Nurses/Squadron CC/Group CC generally change every 2yrs (at least in the AF), and you are subject to how they see fit to utilize your skills the best to meet the mission.

I wonder if that is one of the factors in retention problems.

3. Nothing in your contract is going to fully protect from having the Chief Nurse/CCs change your duties around.

Interesting

4. No reassurance your recruiter gives means a thing. Your command is the ultimate authority, if you get a contract promising that you will work as APN I for one would like to see it. What your contract should say is that you are coming in as a X APN, but one of the 1st thing your Chief Nurse is going to want to know is what previous RN experience was......I bet you can guess why.

Yep! sure can

5. If you can accept being flexible military nursing can be a great experience.

Flexibility is one thing, the possibility of a wrecked a career is another…….

Now saying all that if you want to be NP still get all the military benefits, and be assured of working as NP you should look into USPHS. In the USPHS you actually apply for a job opening just as you would in the civilian world, and that is where you go to work. http://dcp.psc.gov/vats/rpt_create.asp

Just as a side note: CRNAs are about the only APNs that don't get switched around from being CRNAs. In general CRNAs are undermanned, and their jobs are so specialized that it is hard to find replacements.

Thanks for the information...

Also since I am now under a commanders notice I will be more than happy to share the info.

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Just to add my experience. I worked with a nurse who was Air Force trained to be a neonatal NP. She was working as a lactation consultant and helping kids with diabetes, in the case management sense. However,,,, her pay was still the same. :)

What is most important to you?

Good Luck,

Pam

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What is the most important? Well considering I took the time to go to school to become a Family Nurse Practitioner...

I know the requirements for re-licensing / re-certification (which I much prefer than over re-testing)...

I know skills learned and not practiced can be easily lost.

I know lost skills can lead to delayed or improper decisions which in turn can injure or kill.

I have been in the health care field for 28 years and I have seen the good side and bad side of health care. I have seen enough to know that the theory that a nurse is a nurse is a nurse: Is not true.

As for pay: I have more than several nursing friends that make as much if not more than I do. If it was all about the money I would have stuck with computers.

Don't get me wrong I do appreciate hearing of all the experiences I can.

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Specializes in Med/Surg, PCU, Geriatrics, Family Practi.

JD, what's your calling? Notice I'm not speaking to your profession? If being in Military Service is your intention I would think that "running towards the rattle of muskets" and the cries of our soldiers and Marines in need to medical attention would be the service you are interested in. The Services are civilianising most of those functions of military medicine that have to do with stateside, family, retirees, babies, etc. Military service medicine is best displayed on the battlefield when nurses are working at breakneck speed to stop the bleeding, clear the airway, and treat for shock. Holding the hand of a young Marine with a sucking chest wound who is afraid to succume to the lure of morphine because he may not wake up is the job of a nurse who is called to service as a true professional. The cry of "medic" should make the real pro champ at the bit like an old fire horse.

So, let's ask the question that is asked of all of us in the medical field (Nurses), "Do we want to serve, or be served?"

Thanks, Ladyviola . . . .

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JD, what branch are you looking at?

You can enter the Army as an FNP.

Your prior concerns that were voiced about NPs not being an NP was for being an ADULT NP within the Army- which there is no MOS for that role.

What is YOUR goal? Please elaborate,

Thanks!!!

v/r

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JD, what branch are you looking at?

You can enter the Army as an FNP.

Your prior concerns that were voiced about NPs not being an NP was for being an ADULT NP within the Army- which there is no MOS for that role.

What is YOUR goal? Please elaborate,

Thanks!!!

v/r

I believe I was responding to a post (What is most important to you?)... What is my goal???

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Specializes in Anesthesia.

JD,

One other thing the recruiters may have not mentioned to you (which I just noticed seeing your age) is that you will more than likely be ineligible for military retirement. You need to have 20yrs of military service in by the time you are 62. Waivers are available, but I wouldn't count on it unless you have prior service time in already.

Retirement is not guaranteed even though you would still be allowed to enter the military past the age where you would be allowed to retire from the military.

Just a thought......

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