Military Acute Care Nurse Practitioner

Goldenfox · Sep 4, 2016

I am not in the military but what that recruiter told you doesn't make any sense. They have plenty of opportunities in all branches of the military for NPs and you are coming in with experience...no need to work as an RN to get your foot in the door. If they credential you as an RN and they have more pressing needs for bedside RNs then you will be working as an RN until whenever they decide that its ok for you to transfer to the NP function. And unlike in the civilian world you will not be able to just leave if you don't like it. Make sure that you are talking to a medical recruiter and not a regular one.

bnw6385 · Sep 4, 2016

He is the medical/nursing recruiter for the Navy for the greater Houston area. I can see where he is coming from in that ACNP slots are not even really publicized and planned for as there are so few. I have messaged as many ACNPs in the service as possible and hope to get information from them soon. The military is very familiar with FNPs, Psych NPs, Pedi, Women's Health, but Acute Care throws them for a loop.

I specifically requested to interview with an ACNP in the Navy before making my decision. He is working on that for me right now. What you said about the needs of the military is exactly what I am afraid of, but I would hope they would see value in my NP training. I haven't worked at the bedside in 5 years. I would definitely be rusty.

Salter444 · Sep 4, 2016

While I was AD the ACNPs also were CNS and mostly did not work patient care. I did hear that the AF was trying to put them in a more clinical setting and I was told that at BAMC they were being used much like a resident. That was the plan and the NP/CNS I worked with thought that was a not a good idea working like a continuous resident with all the bad hours. FNPs faired somewhat better working in the clinic but then again most stayed late to chart....

bnw6385 · Sep 4, 2016

Thank you for the reply. That is good to hear. The duties are like that of residents, but they would not be having the NPs pull 80 hour weeks barring some disaster. I very much work like a resident now in duties and hierarchy, but I definitely would not claim to work their hours. I realize the military is different, but I could only see 48-60 hour weeks being realistic.

reggaemuffin, MSN, NP, CNS · Sep 4, 2016

I went to school with a ton of students in the service. My program was a hybrid AGACNP and CNS program. Every one of the military students were getting their CNS rather than NP. I was told that they use a CNS model rather than NP.

bnw6385 · Sep 8, 2016

So, I have heard from a number of ACNPs in the military since posting this. I found them on LinkedIn. Basically, the recruiter is telling the truth. They do not have Acute Care NP billets in the military. They stick with FNP, Pediatric, Psych/Mental Health, typically. Not one branch has billets for the ACNP, so they credential as an ACNP and Critical Care bedside RN. There are a FEW, very few, ACNPs working at the Naval hospital at Portsmouth, VA, but they take Critical Care RN billets, and the Director of Nursing and Physicians support their use as ACNPs. That is the only reason there are any there, and they can be pulled back to the bedside at any time, should the need arise. I hate that this is the case, but I want to serve enough that I may be willing to go back to the bedside. I am 31 years old, so if I want to move up from where I am now, I will have to go into administration anyway. My other future career track will likely include teaching as well. I want to believe I have not topped out in my career at 31 years old, haha.

carolinapooh, BSN, RN · Sep 10, 2016

I'm active duty Air Force.

If I were credentialed as an NP, there is no way on this planet I would let the military also recognize me as an RN. You're giving them too much opportunity to stick you in an RN billet (where every service has a shortage - don't believe the hype - they created a huge mess for themselves in the last round of drawdowns) and not care that you're an NP. Then you'll spend your time fighting to get the service to recognize that you have that NP and came in to use it.

But that's just me.

Snow_cone · Sep 10, 2016

I was an active duty nurse in the Air Force. I worked with many NPs who were billed to general nursing slots and were not happy. The Air Force even sent a few of them to school for their NP then reassigned them back to an RN position because that was the "need" at the time. At one assignment, I sponsored a new incoming CNS In critical care and they sent him to our unit (med/surg) because we were billed on "paper" as having a critical care area, which we really only had a room by the nurses station to put a critical patient in until we shipped them off to an outside hospital for higher level care. In the military you are assigned a tag. That tag dictates what slots you fill. If they give you a bedside nursing tag and not a practitioner tag....... Expect to be at the bedside for a long long time.

bnw6385 · Sep 10, 2016

I understand I am looking at working at the bedside, but let's be clear about this. If you have not been an NP, you do not know what it is to be an NP. My bedside RNs are making the same money I do, and they are responsible for 2 critical care patients. Their work is more physically demanding, to be sure. However, they are not nearly as responsible for the outcome to the patient as I am. They are responsible for 2 patients. I am responsible for 32 patients, and I make the same money. I do intubations and central lines and new admissions. If something goes wrong, the RN is off the hook and the MD throws me under the bus. I have a TON of difficulty getting extra money from other jobs. I cannot get extra money from my regular job. Granted, I will not get OT in the military. I understand that. This is all about perception, though. Honestly, as much as I thought the same things when I am at the bedside, I know what it is to be on both sides of this. The RNs have many more advantages to their position than NPs do. I will attempt to work on being used an NP, but if it doesn't happen, I will take my opportunity to work on management concepts and principles. I will work on getting a doctorate so I can teach in the future. The only reason I would attempt to work as an NP is to not lose skills, but that is pretty much it.

Snow_cone · Sep 10, 2016

I am not sure if this was directed at my comment or not, but I was just trying to caution you on your tag. In the AF it will be called you AFSC. Any recruiter can tell you anything they want and make you all the promises in the world, but in the end, you are a number on a piece of paper and they can and will do with you what they like. You are your tag. If you want to maintain your NP function, I would not let them tag you in a nursing AFSC, that's all I was trying to say.. Because if they do, they will more than likely use you as that and not utilize your NP. As a prior poster mentioned a lot of people seem to be getting their CNS and that's because the Military does have incentive pay for certifications, but not so much degrees unless you are a MD/DO. My husband has 2 doctorates in his field but only gets a small incentive pay for the extra certification he acquired and nothing for his two doctorate degrees. Otherwise your pay will be based on your rank no matter what you do, be it clinical nursing, bedside nursing, administrative work, ect. The NPs I worked with that functioned as regular nurses were not happy because they were told they would be NPs only to be clinical nurses in the end. I may not know what it's like to be a NP at the moment, but I do know the military system, and that's what I was trying to caution you about. The CNS I sponsored to my last duty station left after his first tour because he was told he would be in the ICU. They sent him to us because "on paper" we had a RN ICU slot for our "special room" that never really was utilized, so he spent 3 years being a med surg nurse and not the ICU nurse he was promised. I had an AF general tell me one time that the Army had one thing right, be an "Army of one." Watch out for yourself, because no one else has your best interests in mind, no matter what your recruiter tells you.

PG2018 · Sep 11, 2016

He is the medical/nursing recruiter for the Navy for the greater Houston area. I can see where he is coming from in that ACNP slots are not even really publicized and planned for as there are so few. I have messaged as many ACNPs in the service as possible and hope to get information from them soon. The military is very familiar with FNPs, Psych NPs, Pedi, Women's Health, but Acute Care throws them for a loop.
I specifically requested to interview with an ACNP in the Navy before making my decision. He is working on that for me right now. What you said about the needs of the military is exactly what I am afraid of, but I would hope they would see value in my NP training. I haven't worked at the bedside in 5 years. I would definitely be rusty.

Familiar isn't the word. My surveys of health professions recruitment staff are along the lines of "we know they exist but what you do or where you go" is as well documented and understood as the taxonomy of a unicorn regarding psych NPs.

Btw, I didn't know brain ventricles were ostomied. Is that pressure monitoring?