Presentation To The Committee On Appropriations Subcommittee On Defense United State

[JDCitizen]

Section of the PRESENTATION TO THE COMMITTEE ON APPROPRIATIONS

SUBCOMMITTEE ON DEFENSE UNITED STATES SENATE April 16, 2008

http://www.sg.af.mil/shared/media/document/AFD-080617-022.pdf

Recruiting, Retention, and Force Development

Just as with the civilian sector, at the top of our list of concerns is what has become a

chronic struggle with increasing nursing requirements and the growing national nursing shortage.

Human resources are the single greatest influence on health care. The latest estimates

developed by the Bureau of Labor Statistics indicate that the U.S. will require an additional

587,000 registered nurses (RNs) by 2016 to meet the nursing needs of the country

The Air Force is not immune to these statistics. Over the next three fiscal years, 28.6

percent (953) of our nurse inventory will be eligible to retire. Over the last 10 years, 54 percent of

the Nurse Corps separated as Captains and 19 percent left as Majors. In FY06, 161 nurses

retired and 195 separated for a total loss of 356 (10.4 percent total attrition rate). Our loss rate

has increased slightly in FY07, with a total loss of 404--178 to retirement and 226 to separation

(12 percent total attrition rate). Almost half of Nurse Corp officers who have separated have less

than 8 years of military service.

In FY06, Air Force nurse recruiting was reported at 62 percent of 357 with a slight

increase in FY07 to 63 percent. Our recruiting services forecast places our risk for nurse

recruiting at 'high' for FY08 and 'severe' for FY09. We are currently offering an accession bonus

to our nurse recruits in exchange for a four-year commitment; this bonus will increase FY09. In

addition to our recruiting services, we also bring novice nurses into the Air Force through several

programs. Utilizing the Air Force Reserve Officers' Training Corps (AFROTC), Airmen Education

& Commissioning Program (AECP), and the Enlisted Commissioning Program (ECP), we brought

in 47 nurses in FY06 and 61 in FY07.

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In FY09, we plan to support the nurse incentive special pay with $12.5 million. We

anticipate that offering the nurse incentive special pay will retain approximately 31 percent (1,000

nurses of 3,262 as of 11 January 2008) of our current inventory for an additional two to four years

beyond their current active duty service commitment. Additionally, we currently offer incentive

special pay to Certified Registered Nurse Anesthetists (CRNAs) at variable rates dependent on

active duty service commitment. The annual average for this incentive special pay is

approximately $35,000 per CRNA. Air Force Nurse Practitioners receive board certification pay

at varying rates that are dependent upon the amount of time served in the specialty. Both the

CRNA incentive special pay and the Nurse Practitioner board certified pay will continue to be

offered in FY09.

In this time of increasing nursing shortages, the need to grow our own has become

evident. Since my last testimony, we have launched our Nurse Enlisted Commissioning Program

(NECP). NECP is an accelerated program for enlisted Airmen to complete a full-time Bachelors

of Science in Nursing (BSN) at an accredited university while on active duty. This program will

produce students completing their BSN and obtaining their nursing license in just 24 months.

Airmen who successfully complete this program will be commissioned as second lieutenants.

Our goal is to select 50 candidates per year by FY10 for this new commissioning opportunity. On

a recent trip to Ramstein Air Base, Germany, I spoke with Staff Sergeant "Rae" Amaya who is

stationed at Ramstein with the 86th Aeromedical Evacuation Squadron. She has been serving

her country for nine years and expressed her desire of becoming a nurse with this statement,

"The vision of getting back to the 'True North' (which is bedside nursing) was inspiring, especially

since I'm trying to become a nurse. I have been fortunate to be mentored by some very

awesome nurses who have made me the technician I am today. When I become a nurse--

whenever that might be--I will do my best to remember, pass on and enforce this vision." With

the NECP program in full swing, we can make dreams like this come true.

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In addition, we have continued robust advanced practice nursing educational programs

through the Uniformed ServicesUniversity in Bethesda, Maryland Graduate School of Nursing,

the Air Force Institute of Technology, Civilian Programs and the Army-Baylor Master's Program.

This year we anticipate the graduation of 49 advanced practice degrees such as, Family Nurse

Practitioners, CRNAs, and PhDs. Enrollment for FY08 includes 45 advanced practice nurses.

Opportunities such as advanced degrees foster an environment of professional growth and

leadership. This further supports retention, recruitment and a bolstered force development.