Need AF Active Duty Nursing Advice!! - page 2

I am currently 3 weeks from completing my BSN through the NECP program. I am scheduled for COT and NTP and will be going to Joint Base Richardson-Elmendorf as my first nursing assignment. I would like to know if it would be... Read More

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    Quote from midinphx
    ICU is very appropriate on an ADP. Let your Chief nurse know that you would love the opportunity to go to the fellowship, but exude how happy you are to be there as a med-surg nurse right now!

    I have my ADP in with Elmendorf being my #1 wish - my commander commented that she fully supports me going there. I know it is a slower paced ICU which would could make a nurse rusty - but I've been a nurse 16 yrs and can handle a little rust I think. I deploy over the winter and I hope my PCS orders come through while I'm there. I do know Elmendorf has issues between military and VA nurses - it's well known. Here in San Antonio we have the struggle between Army, AF, and GS civilians. GS is in the lead, Army in 2nd, and AF has a foothold on certain units (not mine). As a nurse, I'm really not terribly effected, nurses on my unit get along regardless of army/AF/civilian. But the AF leadership doesn't have any space for offices at the hospital. They are across town over at Lackland. getting paperwork and checklists done is a challenge ( I just pretend it is a fun scavenger hunt and celebrate when I get a box checked off). I just want to be in a facility where I can grow in my AF career with leadership there. Luckily, I do trust my leadership to be there when I do need them, but they aren't around for mentoring.

    Well, probably more than you need to read! lol
    Thank you so much for the great advise and information! Can you kind of explain how the RSV checklists and the residency program work? I have seen a lot of documents on the KX page but it doesn't really explain how that training is accomplished. When I get to Elmendorf do I get assigned a preceptor, or do I just ask any other trained nurse that is working with me that day to help train me on something I may need help with?

    I am thinking this is like OJT when I was doing my enlisted upgrade training. I'm not sure if I should compare that to how nurses train though

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    Your RSV's will get checked off usually in a simulator lab on a training day. The nurse residency program is new. I actually just learned about it in a 3 week NSM class, most haven't heard of it yet on the floors. Basically, the residency is meant to give the new nurse a mentor and solid support base as he/she develops skills. Don't worry about it too much. After NTP you will in process at Elm and have like a month of processing and CBT's before you finally get to go to work. I was begging to just work! lol. Then you get a preceptor for a few weeks. When you are finally set free to be a nurse on your own, it will feel amazing! Scary too. lol.

    You're very forward thinking. But don't forget to just relax, it'll all happen. Enjoy the journey.
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    I have been contemplating what to do...I will be changing afsc to 46N3 soon and am currently in med./surg. And have been asked what I want to do after. I want to ultimately become a crna, but want to do the ICU fellowship before. I have had many people say not to do it because I will have to commit 6-8 yrs. I don't mind spending time in ICU before crna, but I do realize there is a time frame in regards to rank and progression . I have a 3.6 GPA, and am starting to study for GRE and also get my med. Surg. Certification. What do you all suggest?
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    Isn't ICU experience required for CRNA? And you don't owe them 6-8 years as an ICU nurse after the ICU fellowship. The AF ICU fellowship is 1 year long here in San Antonio. It's a good program, they come through my unit regularly. If CRNA is your end goal, ICU is a great place to acquire some critical skills.
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    Thank you! I am at SAMMC, since Feb. and hope to do the fellowship here as the next step. I know you have to state in writing that you will be pcs'ed but I wouldn't mind staying. Do you know if staying here is an option? I like it here. What do you recommend from your experience?
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    It is really about the needs of the AF at the time. Some do stay here at SAMMC after the fellowship (often with deployment orders shortly thereafter). There aren't many places for ICU nurses to go. Travis, Nellis, Elmendorf, Langley, Ramstein, to name a few. SAMMC has a higher acuity than most others since we have the CABG program and are a level 1 trauma facility. I think those who PCS down to ICU's that are glorified stepdown units may not keep their skills up - as I realized when deployed with them, sadly. I think starting at a higher acuity facility helps to solidify skills. IMO, of course.
    lindarn likes this.
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    Haha! I deployed with a slew of sAMMC and Travis nurses and was expecting them to be up to par, but many of them scared the heck out of me.It does not necessarily guarantee you are more prepared coming from a bigger facility. We had writ patt folks who demonstrated far better skills than any of those from Travis. I would still steer newbies to SAMMC just because you have more opportunity to see sicker and more complex patients, but it is still up to the individual to learn in their own and not develop lazy habits. Sadly, I see AF nurses not developing to the point of their civilian peers. I think a lot of it has to do with the structure of military service and the teaching aspects of the facilities when it comes to teaching residents. We take away so much of the judgment from out nurses and place it all in the hands of the residents. We basically end up following orders and do not create situations for nurses to grow and build on their skills. I can't explain it, but if you have worked in the outside and been forced to write your own orders and fill in all the gaps that the attending a cant fulfill then you will understand where I am coming form....just my two cents!!!!
    midinphx and lindarn like this.
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    Yammar - I can not agree with you more!! I can't believe I have to call a new young doctor for every silly little order so that he/she can develop his/her critical thinking. I was civilian RN for 14 years and I am used to having protocols and parameters and dealing with my sick pt on my own. Here at SAMMC the CCU nurses just have to call the doc on call for everything.

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