AF new grad program vs civilian experience

[edvaz90]

I was not sure if there was a thread about this or not, but I was hoping anyone could help me with this. I know that if an individual is considering joining the military they can direct commission into a position via two ways, a new grad residency within the military, or coming in with experience (example of having 5 years experience as an ICU nurse or an ER nurse). I am currently a second bachelors student who would be starting his application for the new nurse grad residency program for the AF this coming February. Could anyone shed some light on the pros and cons of starting off as a brand new nurse in the military as opposed to a new grad residency program in the civilian world. Is there a concern of a loss of skills or exposure? How was the experience? Thank you everyone I greatly appreciate it.

[jfratian, DNP, RN, CRNA]

I think the AF's new grad residency is as good as any civilian residency. Most major civilian hospitals have 3-6 month residencies these days, and the AF version is a 3 month TDY. The downside is that all AF new grads must do either med surg or OB; specializing (ED, ICU, OR) will require 5 years of extra AF time. Civilian new grads can immediately specialize.

The other issue is that military nursing can be a step back at times acuity wise when you're not deployed. Most military hospitals are pretty small (

[edvaz90]

How would a new grad (after completing the residency program) go about transitioning into an area of interest (keeping in mind that the needs of the air force comes first)? I would gladly serve the needs of my country, but at the same time there are also career goals I have had for myself for awhile now.

[jfratian, DNP, RN, CRNA]

In the AF, you can't do a specialty fellowship until you've got 2 years under your belt. Generally, you would start the application to apply for the fellowship after your first year...your record against other people that are interested in the specialty you want to do (ICU, flight, ED, OR, etc). You meet with your chief nurse annually and discuss your career goals; you'd mention your interest at that time.

[edvaz90]

Are you able to apply to more than just one specialty, lets say I wanted to do ER but didn't get into the ER, but flight nursing had a spot could I apply to both and see where I get in, or would I have to wait another year? Also, for active duty nurses, do they mainly work in hospital, or do they get stuck working as clinic nurses?

[jfratian, DNP, RN, CRNA]

As a new grad, you will definitely be doing inpatient. However, most AF nurses do practice in the clinic setting. Most military healthcare is clinic based. Even if you specialize (say ICU), you will likely end up in a clinic once you're doing management around O-4 (major).

To be honest with you, I haven't applied to any of those fellowships yet...just talked with my chief nurse. It seems to me that everybody gets what they want, because the time commitment is so extensive. Also, just about all specialty areas are critically manned (ER, ICU, OR, flight). Finally, there actually aren't a ton a people applying for spots. Every one I know who choose to specialize is getting the opportunity to do so.

[edvaz90]

Did you do the nurse residency program in the AF? Where are you working now as a nurse and how has that been?

[jfratian, DNP, RN, CRNA]

No I did a civilian nurse residency program and direct commissioned after a few years. I'm fairly familiar with the Air Force NTP program, since I work with so many new grads who did it.

I work inpatient med-surg, which is what I did as a civilian. Although the acuity is a bit lower in my military job, I would say the day-to-day is largely very similar. It was overall the correct decision for me due to the improved career projection, but it's not for everyone. It's not very flexible, especially for people in serious relationships who are considering kids.

[edvaz90]

Where else is there a lack of flexibility? I'll be in my mid twenties so children are far from my mind at the moment ha

[jfratian, DNP, RN, CRNA]

Well, the military expects you to be flexible for them; they don't always reciprocate.

Although you have some say, you ultimately don't have control over where you live or what role you play at work. You might really want to move from med-surg to PACU after your first year, but they might need you to do med-surg for another year or two (my situation). PACU doesn't require a fellowship like ICU does by the way. You might want to do more day shifts than nights (even though staffing doesn't require equal numbers of nurses on both), but some regulation stipulates equal 3 month rotations.

Every time you want to take a vacation or do a minimally risky activity outside of work (skiing, rock climbing, etc), there will be a mountain of paperwork. In generally there is a lot of stupid, needless paperwork in the military.

[edvaz90]

I think I am comfortable with the whole paperwork for vacations thing, but I am nervous of having my career ladder being limited.

[jfratian, DNP, RN, CRNA]

If you're a new grad who has to do ICU right away, then you might consider the civilian side for a few years first. I wouldn't say that you're really limited, because there are a lot of things that you'll get to do that no civilian would ever do at work; there isn't a whole lot you'll miss out on either. I very well might get to do four different 3-week mercy trips this year (Philippines, Vietnam, Thailand, New Guinea).

I would say that your ability to switch specialties or go back to grad school will be much slower. If you're one of those 'bedside nursing is a stepping-stone to CRNA/NP' people (which I probably would classify myself as to a degree), then patience/waiting will certainly be essential to enjoying military nursing. The good news is that everybody else is in the same boat.