Need AF Active Duty Nursing Advice!!

superman07 · Oct 4, 2012

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?

midinphx, BSN · Oct 4, 2012

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.

superman07 · Oct 5, 2012

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?

midinphx, BSN · Oct 5, 2012

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.

Yammar · Oct 29, 2012

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, BSN · Oct 29, 2012

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.