Experienced ICU thinking about Air Force

carolinapooh, BSN, RN · May 22, 2010

I'm not ICU but I'll answer a few of your questions if you'd like.

Yes, at some point you'll probably have to work "overtime". A typical military schedule for floor RNs is seven shifts over two weeks. Occasionally due to manning you may be required to pull extra time.

Here's what I think about: your health care is 100% free for you and your family. You don't pay a premium for health insurance. When I worked overtime as a civilian, my money was taxed out the wazoo - and I still paid $320 plus a month for health insurance. Sometimes my overtime paid that premium. This puts that in perspective for me.

Yes - you'd probably come in as a 1st lieutenant. Promotion to captain is two years after that - but it may be a bit sooner, depending on if they give you extra "time in grade". What that means is your rank might be Lt, but you might already have a few months' credit in that rank. I'll use me as an example. I had two years' experience in oncology nursing at Duke Medical Center, so I came in as a 2nd Lt - BUT, I'm a 2nd Lt with one year time in grade. It takes two years to make 1st Lt from 2nd Lt - but I'll make 1st Lt in December since my actual date of rank is December of 2008, one year before I came in. (And if you're not confused now...LOL.) Hopefully that makes sense.

Four years will get you a $30K bonus (taxed, unfortunately - but where else will you get about a half-year's salary just for signing up?) and a six year commitment will get you $20K plus up to $40K paid directly to your lender for any outstanding student loans you may have - literally, one day you open up your account and your balance has disappeared. Three years is the minimum commitment, but carries no extras.

The AF not only encourages higher education, it's required to make rank. You'll have opportunities to advance your education at the Air Force's expense (yes, you'll owe them time afterward, but they'll foot a good chunk of the bill - and there are competitive programs that they'll pay the whole bill and your "base" for that time will be your university, where your job is to go to school with full pay and benefits while you're on active duty).

You never lose seniority when you're transferred - your pay will never, ever drop - and there's still no end in sight to Congressional pay raises (at the very least, you're guaranteed an annual cost of living increase calculated against inflation). You can work just about anywhere in the world, the Feds move you at their expense, and speaking as a Navy brat let me say your kids would have opportunities you only dreamed of. You're guaranteed a retirement pension, which you're free to add to on your own - but you'll get a minimum. And when you retire, you have full health care benefits (believe me, you won't get anything resembling Tricare for Life anywhere else in the world, regardless of who you work for).

And no, it's not all sweetness and light - you'll be deployed, you'll be separated from your family sometimes for months - but while you're gone, they'll be taken care of in ways no civilian job could come close to matching. And you won't have to worry about health care or how the bills will get paid.

Think about all this when you consider giving up your overtime pay. :) Overtime can be a reality sometimes, but it's not always the rule.

bryango · May 23, 2010

Carolinapooh- Thanks for the reply. I was beginning to wonder if anyone was reading my post. Those are some good insights and advice. I am really not to worried about overtime pay. Right now I usually work only one day extra in two weeks. But I have a 2nd job that I work 2 12's in one week in addition to my 3 12's at my regular job. That second job pays me $36/ hr, which helps bring in an additional $1400 a month. That is where I may miss extra work. Does the military allow you to have a job in the civilian world?

carolinapooh, BSN, RN · May 23, 2010

If you're working one extra shift every two weeks, you'll be working the same number of hours in the Air Force that you work now.

I don't know that you'd have the time for a second job, really. I know I don't, but I also know some who do. And it would depend on your commander and the unit.

You do know that you get base pay + housing allowance + $223/month for food - AND you don't pay a health insurance premium or copays for care.

bryango · May 24, 2010

Thanks for another post, Carolinapooh. Your insights are much appreciated. Are there any other readers that have could share some insight? I talked the recruiter again today and he has sent me the app. Joining the military is a huge decision and not one I think that a person should take lightly.

rghbsn, BSN, RN · May 25, 2010

Keep in mind that the ICU's you will work in here are different than the ICU's in the civilian world. Some of them are quite slow, but that doesn't change your pay. If you get sent home or put on call for a day for a low census (yep, still happens in some places) you don't lose anything. Deployments...depends where you go. If you go to the AOR, you'll be busier than you've ever been. And you'll see things you'll never see in any trauma unit in the country.

Is it worth it? That's up to you. Is it worth being part of something bigger than you? Taking care of the men and women that ensure our freedoms and fight for a better way of life for people unable to do it on their own? I think so. If you decide that you want to do more ICU stuff, you can always look into CCATT...you'll really work your tail off then. But that costs you more time away from home.

You're right to think it's not a light decision, but if you talk it over with your wife, and she's on board...you can both love it. DO NOT think that she doesn't have as much say as you, though. I've seen this business make the strongest marriages in the world when both parties are excited about it...and I've seen it destroy them if you don't have the FULL support of your wife.

If you think you're ready, we'd love to have you! The Soldiers, Sailors, Airmen and Marines will thank you everyday for saving their lives. The families will thank you for taking care of their loved ones. There is not a greater sense of accomplishment or satisfaction around in my opinion.

carolinapooh, BSN, RN · May 25, 2010

Uh, yeah, what he said. :)

Thanks rghbsn.

bryango · May 26, 2010

rghbsn, thanks for the post. Couple questions, what does AOR and CCATT stand for? Have long have you been a nurse in the Air Force? I am coming from a smaller community ICU that is only 12 beds. We on occasion get a balloon pump or swan, but mainly deal with post cath labs, resp failures, surgeries, etc. No open heart, no neuro, no burns. Given that background, what suggestions would you make in regards to requests for 1st assignment? I understand that you dont always get what you want, but I would like to go somewhere where I would learn a lot, enjoy the city/ state/ country with my family, and make a difference.I am assuming it is just like the civilan world where I will get a training peroid.

I appericate your post as well as carolinapooh. Thanks to both of you.

carolinapooh, BSN, RN · May 26, 2010

AOR - Area of Responsibility. Older (to me, anyway!) term for any combat-ridden area we're protecting. I don't think they use it as much anymore; that's actually more of a First Gulf War term (back in my enlisted days). I don't hear it as much as I used to; in fact, I used it in conversation the other day and one of the staff sergeants (who's ten years younger than I and has done three deployments in the last five years) didn't know what I was talking about. It mainly described the areas between the southern and northern no-fly zones over Iraq, and also encompassed the countries/bases where our forces were deployed during Operations Northern and Southern Watch, both of which ended (and hence ended the Gulf War) with the deposition of Saddam Hussein from power. It included Bahrain, Saudi Arabia, the UAE, Qatar, Kuwait, and Turkey (our "areas of responsibility"). Its central commanding unit is USCENTCOM (US Central Command), oddly enough HQ'd at MacDill AFB in Florida.

Like I said, some may still say it (sounds like the pilots and aircrews more than anyone else); ground folks don't really seem to use it much anymore. I know the Pentagon still does; you probably hear it more on the line side than the medical side (which is why an aircrew member would be likely to use it - the pilots are line officers and the enlisted crew are also line side).

CCATT - Critical Care Air Transport Team - we have 15 of these teams at Wilford Hall. A CCATT is a three-person team comprised of a critical care RN, MD, and a critical care RT. They can care for three critically injured and monitored patients, or six less severely injured, for 72 hours. Their equipment consists of three backpacks, nine equipment and medical supply bags, and one drug case. Medical equipment includes: vent, cardiac/physiologic monitor, an IV infusion pump, and some sort of lab-testing device. That's all the stuff they have. They're primarily used for the transport of critically-injured combat troops, but they can also be used to transport critically ill beneficiaries of military medical care - one of my patients was flown via CCATT from Japan to Tripler Army Medical Center in Hawaii; and then, when it was determined he needed to come to Wilford Hall for further workup and eventually treatment, another CCATT from my hospital went to Hawaii, picked him up, and brought him to us because we're the only DOD medical center in the world that does what we do. We got another one - a dependent - in last week from San Diego - a Navy dependent.

But primarily a CCATT cares for combat victims - they're not aeromedevac teams, they're the care teams; if you're wounded in Iraq and you have to go to Germany, and you're seriously wounded, you're flown there with a CCATT.

rghbsn, BSN, RN · May 27, 2010

Very well put, as usual.

I am on one of the AE teams (or Aeromedical Evacuation) and we do still use AOR because it's more all-encompassing. You will also hear OIF and OEF (Operation Iraqi Freedom and Operation Enduring Freedom) used for the areas of Iraq and Afghanistan, respectively.

The only line side enlisted in the back of the aircraft, however, are the LM/BO (loadmaster or boom operator) depending on the aircraft you're on. The techs that work with us are AET or Aeromedical Evacuation Techs. They go through essentially the same school we do, at the same time in fact. So we train together and operate together. We are considered aircrew, so we also have to do water survival and SERE school (Survive, Evade, Resist, Escape) which is the same as the pilots, PJ's, combat controllers and other aircrew.

When the CCATT teams are on a plane with us, they are listed as MA's (medical attendents) and are not considered aircrew...therefore, they don't have to do the survival schools and such. They do come down to Brooks in TX to train at the same school house, just different curriculum.

As active duty, you can only fly for one tour, then you have to go back to an MTF (Medical treatment facility-hospital, clinic, whatever) for another tour. It used to be one tour for your carreer, but they are changing that I hear. If you're CCATT, you are on a team and work as a critical care nurse until it's time to deploy...then you do a mission and come back to your unit.

bryango · Jun 3, 2010

thanks again for the tips and advice. Any other air forces icu nurses out there? Or anyone interested for that matter?

bryango · Jul 1, 2010

Just wanted to give an update on my posting. I have all of my paperwork in and will be doing my physical and interview in two weeks. The recruiter anticipates that I will be going to COT in January. Any advice on the interview? I have heard that if you have your CCRN that you can get an extra $ 20 k over 4 years. Does anyone know about this? Carolina pooh, don't let me down :)