Military Nursing

by Pixie.RN, BSN, RN, EMT-P Senior Moderator | 11,555 Views | 42 Comments

Military nurses work in all nursing specialties while serving in the military or other uniform service. Military nurses can be found worldwide, even in combat zones. This article gives an overview of the specialty, discusses education requirements, work environment, job outlook, salary, and provides resources for further exploration.

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    Military Nursing

    What is Military Nursing?

    Military nurses care for those who serve, or those who have served, while in an active duty, reserve, or national guard capacity. In this article, we are primarily considering RNs. The only branch of the military that utilizes LPNs/LVNs is the Army, who has LPNs/LVNs that are enlisted soldiers. In general, military nurses are located all over the world, from clinics to hospitals to austere compounds in war zones. This unique specialty can be quite demanding and stressful, especially when nurses are deployed away from loved ones and families. Disclaimer: I am an Army nurse, and that is the segment of military nursing with which I am most familiar. The information for other services may vary, but an attempt has been made to include information for all branches as well as the US Public Health Service (USPHS).

    What are the Requirements for Military Nursing?

    Education Requirements

    For active duty military nursing, RNs are required to have a BSN, generally from a school with ACEN (formerly NLNAC) or CCNE accreditation. The Reserves currently have the same BSN requirement, though this does change with the needs of the service. When ADN-prepared nurses are allowed to commission into reserve branches, he/she is usually unable to promote above a certain rank without attaining a BSN. Currently the only branch accepting ADN-prepared RNs is the National Guard, but those individuals must be pursuing a BSN.

    Health and Physical Fitness Requirements

    Other requirements for commissioning include US citizenship and meeting minimum health and physical fitness standards. All persons seeking commission will undergo a baseline physical examination to ensure physical health. Some chronic conditions are automatic disqualifiers, such as ulcerative colitis. Depending on the needs of the service at the time, waivers may be granted for some conditions. There is some excellent information about the waiver process at Medical Waivers and also helpful information about disqualifying medical conditions by body area at Military Medical Standards for Enlistment, Appointment, or Induction.

    If you are considering commissioning or you have been selected for commission and you’re not already in excellent physical condition, START NOW. Do NOT wait to get to your branch’s officer training before you begin a physical fitness regimen. With as long as application and selection takes these days, reporting to officer training out of shape is a failure on your part, because you have had plenty of time and should have the discipline to work on your personal fitness if you are going to be an officer and leader in one of the branches of service. Start off on the right foot! Pun intended. We are held to the same standard as any other soldier/sailor/airman (airperson?!) in our service, and we should lead from the front in this area.

    Air Force Fitness Standards
    Army Fitness Standards
    Navy Fitness Standards

    Other Requirements

    The Army, Air Force, and Navy have age and citizenship restrictions or requirements, among other things. The following are basic requirements for each branch, taken directly from their respective websites.

    Army Nursing Information

    Basic requirements for active duty:
    • BSN or MSN from a CCNE or NLNAC-accredited school
    • U.S. Citizenship
    • Unrestricted Nursing License
    • Must be between 21 and 42 years of age (may request a waiver)

    Contact an AMEDD recruiter

    Other sites and opportunities that might be of interest to those seeking a career with the Army include the site for Reserves and the site about ROTC.

    Air Force Nursing Information


    Basic requirements for active duty:
    • BSN or MSN from a CCNE or NLNAC-accredited school
    • U.S. Citizenship

    Contact an Air Force recruiter (Be sure to check "Healthcare Professions")

    Navy Nursing Information

    Basic requirements for active duty:
    • Be a US citizen currently practicing in the US
    • Be a student or graduate in good standing of a US education program granting a BSN and accredited by the Commission on Collegiate Nursing Education (CCNE)
    • Be licensed to practice in a US state, the District of Columbia, the Commonwealth of Puerto Rico or a US territory (new graduates must obtain a license within one year of beginning Active Duty service)
    • Be willing to serve a minimum of three years of Active Duty
    • Be between the ages of 18 and 41
    • Be in good physical condition and pass a full medical examination

    Contact a Navy recruiter

    Where are the Recruiters?

    Wondering why recruiters are difficult to reach, or why they haven't responded to your call or email? As with all recruiters, the healthcare recruiters are very busy and typically cover large territories. There might be a significant delay in receiving replies because they are simply inundated with inquiries from awesome nurses just like you. A little patience and persistence will likely pay off in the long run.

    Another tidbit: don’t bother going to the recruiters located in malls or plazas. The recruiters in those offices are not educated in commissioning healthcare professionals; they are typically for those seeking enlistment. These recruiters do not generally have information about officer recruitment.

    Work Environment

    This will vary depending on specialty and location of duty assignment. In the Army, for example, new nurses are assigned to the larger medical centers, or MEDCENs. Experienced nurses that are ready to hit the ground running with a minimum unit orientation are sent to the smaller community hospitals, known as Medical Activities or MEDDACs. The reason for this is the structured orientation the new nurses receive at the MEDCENs. This orientation is known as the Clinical Nurse Transition Program (CNTP), and it gives new nurses a solid foundation in nursing while exposing them to the many kinds of nursing available at a MEDCEN that might not be present at a MEDDAC.

    For the nurse assigned to a hospital or clinic, daily nursing tasks are not so terribly different from those of their counterparts in the civilian world. When I left my civilian ER to work in an Army ER, I found that the only thing that really changed was the average age of my patient population (much younger at my installation than the typical patients I saw in Virginia) and my outfit (uniform instead of scrubs; yes, really, I wear my uniform in the ER). I do have some additional duties that stem from being an officer/leader and I also have to fulfill military obligations (PT tests, going to the range and qualifying with weapons, etc.), but otherwise it’s not so different.

    Deployment is another matter entirely. The Navy does have some ship deployments, but the majority of military nurses will likely end up somewhere in Afghanistan until the war truly winds down. The environments in Afghanistan vary widely, from working in hard-structure Combat Support Hospitals (a Role 3 facility in military terms, which has most of the functionality of a large stateside hospital) to being out in the boondocks with a Forward Surgical Team (a Role 2 asset that is more “forward”/tip of the spear that can provide immediate life-saving care and surgical intervention/damage control).

    Deployment lengths vary depending on the branch of service and the role of the nurse. But those who are interested in military nursing must realize that when it comes to deployment, it’s not a matter of “if,” but a matter of “when.”

    Job Opportunities or Outlook

    Currently the military is in a time of personnel reduction, and the needs of the military trump all else. And while the military used to take every nurse that applied because they were in the “bulking up” phase, the current trend is quite the opposite: they are extremely selective, and the boards held to select new accessions (new officers) have decreased in frequency, some to only once each year. A miniscule number of nurses are selected each year from a large pool of very qualified and skilled applicants.

    Often people post in the government/military forum asking about joining the military so that the military can pay them to go to school to become nurses. Right now this just isn’t going to happen. The military isn’t likely to send you to school just because you want to go, even if you agree to give them time in return; it doesn't make fiscal sense for the military to do so when it is full (or more than full!) of experienced nurses and there are plenty more who are trying to get in that are ready to hit the ground running with little to no monetary investment from the military.

    There are some special programs for enlisted soldiers to transition to officer/Nurse Corps, such as the Army Enlisted Commissioning Program (AECP); however, these are very competitive and new enlisted recruits would not qualify for these opportunities for some time.

    As the military downsizes, the need for new accessions will continue to decrease. However, as these needs tend to be cyclical, there may come a point in which the military finds itself in need of new nurses again, and the floodgates may open. For now, the military is continuing to be very selective in its new accessions to the various services’ Nurse Corps.

    Skills/Qualities

    The military nurse is more than a nurse; he/she is also a leader, as well as a soldier/sailor/airman. In the Army, our annual performance evaluations are not based on our clinical skills — it is a given that those should be solid. Instead we’re rated on areas of leadership, as we are expected to lead others and be developing our skills in those areas. The military nurse must be adaptable and agile and must be able to put the mission before all else. Being in the military means giving up a certain amount of personal freedom, and one must make peace with that. We are expected to maintain excellent physical health and fitness so that we can perform our duties without issues.

    Duties/Responsibilities

    Military nurses have similar duties and responsibilities as their civilian counterparts, with the additional leadership and military aspects and requirements. Many nurses have extra duties that are part of their overall nursing responsibilities, such as tracking a department’s fulfillment of certification requirements like ACLS and BLS, or taking call as a SANE nurse. As a nurse rises in rank, he/she will take on additional responsibilities, such as becoming a department's nurse manager. These duties may replace direct patient care.

    Salary

    A military nurse’s salary depends on his/her rank. Initial rank for experienced nurses is calculated by various formulas. For the Army, one year of civilian nursing time counts as six months of Army experience. Constructive credit will be calculated and awarded to new accessions, which may result in new accessions entering the service at a higher rank, or an accelerated timeline to the next rank.

    Military pay charts can be found at Military Pay Tables - 1949 to 2013

    Other entitlements military members receive include subsistence benefits and Basic Allowance for House (BAH). BAH can be viewed via the BAH Calculator.

    While deployed, military members may receive Hardship Duty Pay (HDP), Hostile Fire Pay/Imminent Danger Pay (HFP/IDP), and other benefits, in addition to paying no state/Federal taxes while deployed. You can find more information about military special pay at Special and Incentive Pay Index.

    Army deployment pay calculator

    Bonuses are still available, but are diminishing in size and availability. Some branches still offer loan repayments and accession bonuses. Specialty nurses may qualify for annual bonuses that serve to equalize military pay with the often higher pay that specialty nurses may receive in civilian facilities. For example, the Army offers Incentive Specialty Pay (ISP) to nurses holding certain board certifications such as CCRN or CEN. This amount is generally $20,000/year (taxed), but the nurse must apply for this bonus. The Army is no longer paying ISP to nurses who pass Med/Surg certification as of the start of this new fiscal year, an indicator of diminishing budgets.

    The US Public Health Service

    The USPHS has a commissioned corps as well: http://www.usphs.gov/profession/nurse/.

    The USPHS’s rank structure and uniforms are very similar to those of the Navy. Recruiting for nurses for the USPHS had been closed to new inquiries until very recently, so they are also experiencing results of drawdown and budget cuts (i.e., fewer slots for nurses). You can download a brochure this branch at the USPHS website.
    Last edit by Pixie.RN on Nov 24, '13
  2. About Pixie.RN, BSN, RN, EMT-P

    LunahRN: a short green-eyed redhead, very tattooed, Army ER nurse, 1LT(P)/66HM5. Avid reader, addicted to good shoes, allnurses, and her Android smartphone.

    Pixie.RN has 'NREMT-P: 11, RN: 6' year(s) of experience and specializes in 'ED/Trauma, 66HM5 (Army)'. From 'everywhere and nowhere - global nomad'; 42 Years Old; Joined Aug '05; Posts: 12,561; Likes: 7,141.

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    42 Comments so far...

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    you can join the nat'l guard with your adn?!
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    Yep, that's the info on the National Guard site right now -- Healthcare Officers | NATIONAL GUARD -- it does say that the RN must be enrolled in an RN-BSN program, though: "RN applicants need a minimum of a bachelor's degree in nursing (BSN) or to be currently licensed and attending a BSN program" [bold/italics mine]. So there it is.
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    Thanks for the excellent write up! I'm in the initial stages of changing careers and I'm interested in military nursing. My plan is knock out my pre-reqs and then do an accelerated BSN. With this in mind, what do you suggest would be the best way to get commissioned in the future? Do you think joining the reserves, maybe as a Corpsman or 68w in the Army, would be a good move considering my ultimate goal?

    I guess going active would be another option and hope to qualify for the Navy MECP or the Army AECP, but like you said, that's very competitive.
    Last edit by BradS on Nov 3, '13
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    If you live in USA be very careful about the military route, this is probably the worst time to consider a military career due to massive budget problems at the Pentagon and the wars winding down. The military is looking forward to reducing personnel, esp. commissioned officers, and many officers are going to be released from the services in the coming years, a majority against their will.

    When you are talking to recruiters avoid regular recruiter stations. Those stations recruit infantry, and are staffed by people who don't understand who you are. They don't understand the concept of earning a BSN and then transitioning to an officer school; they live in a different world where you join as a private and work your way up to staff sergeant or something, which takes years. If you talk to the infantry recruiters, they will try to send you through the enlisted man route, to train you as a battlefield medic (private). That's not where you want to be.

    A nurse joins as a second lieutenant or better, so you must speak to a special recruiter who recruits officer candidates for the nursing corps and knows how to put you in an officer training program. Those military healthcare recruiters are hard to find, they don't always return phone calls promptly, so if you make just a couple of phone calls and find yourself talking to some enthusiastic character who wants you to come over right away and sign enlistment papers, you did something wrong!! That's not your person.

    Good luck.
    Last edit by Concerto_in_C on Nov 3, '13
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    Quote from BradS
    My plan is knock out my pre-reqs and then do an accelerated BSN. With this in mind, what do you suggest would be the best way to get commissioned in the future? Do you think joining the reserves, maybe as a Corpsman or 68w in the Army, would be a good move considering my ultimate goal?
    I don't think enlisting will help you reach your goals, with the exception of familiarizing you with the military. Accelerated BSN programs tend to be intense, and the Reserves would take time away from your school. And what would happen if your unit deployed? That would really mess up your school schedule! I would focus on getting that BSN and going from there. Best of luck!
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    Thank you both for the replies.

    Concerto, very true and a good point you bring up about the downsizing. I'm not sure I'd want to make it a "career", meaning the full 20, but I would like to experience at least one tour. I'm well aware that the recruiters are looking to fulfill their quotos or whatever and some will do anything they can to get you to sign. The more I read, the more I see people saying don't enlist, especially if you have a degree already. I thought being a medic in the reserves might look good for my future application and train me for what I think I would like eventually; ER nursing. IDK what to do. I have a degree already so I would be E3/E4 depending on the service.

    Lunah, do you work with 68W's? I think that job is pretty dangerous but I'm assuming they get great training that would come in handy when you're looking to get into an ER.
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    Quote from BradS
    Thank you both for the replies.

    Concerto, very true and a good point you bring up about the downsizing. I'm not sure I'd want to make it a "career", meaning the full 20, but I would like to experience at least one tour. I'm well aware that the recruiters are looking to fulfill their quotos or whatever and some will do anything they can to get you to sign. The more I read, the more I see people saying don't enlist, especially if you have a degree already. I thought being a medic in the reserves might look good for my future application and train me for what I think I would like eventually; ER nursing. IDK what to do. I have a degree already so I would be E3/E4 depending on the service.
    .
    Be sure to ask about the length of service specifically. If the military trains you as an officer, they expect a commitment for x-number of years. I don't know if it's 5 or 8 or 10, the last time I spoke to a recruiter the number came up but I forgot what he said. It's much simpler in the civilian life-if a employer annoys you, you can just walk away. Having said that, I think most, if not all armed services nurses I ran into on the Internet were happy with army/air force nursing.
    BradS likes this.
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    Great information. Being a military lady was always my plan, but unfortunately I have keratoconus which I understand to be non waiver condition. But boy, did I have the all the right scores lol. /sigh.
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    Quote from BradS
    I thought being a medic in the reserves might look good for my future application and train me for what I think I would like eventually; ER nursing. IDK what to do. I have a degree already so I would be E3/E4 depending on the service.

    Lunah, do you work with 68W's? I think that job is pretty dangerous but I'm assuming they get great training that would come in handy when you're looking to get into an ER.
    I do work with combat medics, both here in Afghanistan and at home in my Army ER. As a matter of fact, my significant other was a 68W until he got out last year; he's now doing his undergrad/pre-med. I would never discourage anyone from enlisting, especially in such a great MOS, but I don't think it would really match up with your goals. I think 68W experience would benefit you greatly if you wanted to be a paramedic, but probably not so much for ER nursing. As a paramedic who became an ER nurse, I can tell you there is some skill overlap, but other than that, it's apples and oranges. If your goal is to be an ER nurse, I would recommend going for your BSN and looking for some civilian experience. You might also consider doing an EMT-Basic (EMT-B) course locally for a little emergency hands-on. 68Ws are trained to the EMT-B level with some extra skills thrown in, by the way.

    One of my very favorite medics back home in the states has a BA from Vanderbilt, but she wanted to come in as a medic, and she did. She came in as an E-4 (Specialist). She's awesome. She has been lucky in that she has gained a lot of good experience both in the ER and also as a deployed line medic, but that doesn't happen for everyone. I know some people who have spent their entire enlistment in Army hospitals, basically working as a CNA or tech. Probably not what they signed up for.

    The other benefit of enlisting and serving would be the GI Bill -- it would likely cover most/all of your school once you got out. And hey, if you just want to serve to serve, then go for it ... but make sure you don't get stuck in an MOS you don't want. The needs of the Army are always more important than what an individual needs/wants, and if they decide they need you to be a fueler, that's what you'll be. Just more food for thought.
    BradS likes this.


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