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Emergency Room Nursing in the Army

Hello everyone!!! I am currently a charge nurse in a level one trauma center and have been working as an ER/Trauma nurse since I graduated in 2013. I have obtained my CEN (Certified Emergency Nurse) this year and am looking at joining the Army. I am wondering if anyone has any insight on the steps involved in joining and about how long it takes to join once you start talking with a recruiter? I would like to continue to work in an ER and since I have my CEN am I guaranteed a position as an ER nurse. What is the training like? Do you find that the advancement in the military is better than that in the civilian work force? Would I get any credit for my years as a civilian nurse? I really appreciate any answers someone has or any advice they have to offer! Thank you!!!!

Pixie.RN, MSN, RN, EMT-P

Specializes in EMS, ED, Trauma, CNE, CEN, CPEN, TCRN.

Two questions for you, because I never assume: 1) are you a US citizen? and 2) Did you graduate from an accredited BSN program? Both answers must be yes for you to proceed.

Your timeline is okay if you want to join, but you need to start soon — there is only one selection board for active duty, and that is typically in November. The Army is overstrength (yes, even with ER nurses) and they are extremely selective about who they take at this point. They will want to see a high GPA in your BSN program, and having your CEN is helpful. The only thing that will allow you to come in as an ER nurse is if you are granted that specialty identifier code (66T). It used to be called 66HM5; 66H is the Army identifier for a med/surg nurse, and the M5 indicates ER specialty. Now the Army has converted the 66HM5 area of concentration to 66T — ER/trauma. Anyway, when I commissioned as a M5 nurse, I had to prove that I had a certain amount of hours in the last two years that were in the ER. This involves a lot of paperwork, and then review by the Army to grant or deny the specialty identifier. It took months to accomplish this (we have a saying in the military — "Hurry up and wait," and it's so true). I submitted paperwork to my recruiter in March and didn't get the M5 approved until October, just before the November selection board.

Once you are in the Army, your career is completely in their hands. You will not have control over where you live or where you work. There are NO guarantees of any kind. I know plenty of ER nurses (specialty identifiers, deployment/trauma experience, the works) who were placed in clinic jobs because the Army needed them in a leadership role. The Army model is not to leave nurses at the bedside, but to move them away into leadership roles, usually when they are in the rank of Captain (CPT or O-3). As a nurse with about three years of experience, you'll get constructive credit equal to 1.5 years of Army time. If you commissioned right now, you'd come in as an O-2/1LT (First Lieutenant), skipping O-1/2LT. Time to CPT is 48 months.

Army ERs are usually not trauma centers. As an experienced ER nurse, you're more likely to be placed where the Army needs you, and that's typically at a community hospital. I went to one with 15 beds. You'll still see some sick patients and random traumas and you'll be very, very busy, but you might also want to moonlight at local trauma centers to keep your skills sharp. However, this is only doable with the permission of your chain of command, you are subject to recall to work at any time no matter what you have scheduled elsewhere, and you might find yourself "voluntold" to perform too many collateral duties to spend any "days off" at another job (though it's fun to try, haha).

The pay is excellent, especially if the Army is still granting Incentive Special Pay (ISP) bonuses for nurses with board certs. I initially took a pay cut when I left the Army for the civilian world, but a move and a different job in trauma made things equal out again.

The training isn't that impressive unless you are deploying with a Forward Surgical Team (FST), and then you will be up to your neck in trauma training, then traumas (depending on where you deploy). Deployments are difficult to come by these days — I have friends who have made it to CPT who are still trying desperately to deploy, and it's just not happening often now.

As I said earlier, the Army is overstrength and just had early separation boards — that is when they select people for involuntary departure from the Army. I know some amazing nurses (including those in critical care) who were selected to separate. Some of them bleed Army green, seriously, and I was shocked. But the numbers are the numbers.

The Army can be an amazing choice. I have no regrets about serving, it was awesome and I'd do it again in a heartbeat. But it's a strange climate right now. I am technically still in the Individual Ready Reserve (IRR) and subject to recall, and I sometimes think about looking for a Reserve unit, but I hesitate because it's nice to have my life and my choices back in my own capable and experienced hands. :)

Anyway, if you're down for the experience, be sure to only contact a healthcare recruiter. Don't bother with the strip mall guys, they don't have a clue. You can find your closest recruiter here: Medical Careers & Jobs: AMEDD | goarmy.com - make sure you select "Medical (AMEDD)" under the interests. You might not have anyone nearby — sometimes the closest AMEDD recruiter will be in a neighboring state, and because they cover large regions they might be slow in responding to you. Be persistent!

Good luck, and feel free to ask more questions as they arise.

Thank you for all the information Pixie.RN!! I am a US Citizen and did get my BSN from an accredited school. As an RN do you have a decreased chance of getting your top choice of duty station? Were you ever stationed in a European century or so you know anyone that was?

Pixie.RN, MSN, RN, EMT-P

Specializes in EMS, ED, Trauma, CNE, CEN, CPEN, TCRN.

Thank you for all the information Pixie.RN!! I am a US Citizen and did get my BSN from an accredited school. As an RN do you have a decreased chance of getting your top choice of duty station? Were you ever stationed in a European century or so you know anyone that was?

I didn't really get to make a list of duty stations; rather, I was given four places from which to choose where they needed ER nurses at the time. I was not stationed in Europe, though I grew up there as a military brat. A couple of people from my class at the Basic Officer Leader Course (BOLC, it's basic training for officers) were stationed at Landstuhl, but they were new nurses. I was given a choice of three stateside posts and Korea. It really just depends on the needs of the Army at the time.

Talk about an AMAZING answer!

It really is an amazing answer!!!!

Pixie.RN, MSN, RN, EMT-P

Specializes in EMS, ED, Trauma, CNE, CEN, CPEN, TCRN.

That's why we're here — to share information! :) Good luck!!

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