What is Military Nursing?
Military nurses care for those who serve, or those who have served, while in an active duty, reserve, or national guard capacity. In this article, we are primarily considering RNs. The only branch of the military that utilizes LPNs/LVNs is the Army, which has LPNs/LVNs that are enlisted soldiers. In general, military nurses are located all over the world, from clinics to hospitals to austere compounds in war zones. This unique specialty can be quite demanding and stressful, especially when nurses are deployed away from loved ones and families. Disclaimer: I am an Army nurse, and that is the segment of military nursing with which I am most familiar. The information for other services may vary, but an attempt has been made to include information for all branches as well as the US Public Health Service (USPHS).
What are the Requirements for Military Nursing?
Education Requirements
For military nursing, Registered Nurses (RN) are required to have a BSN, generally from a school with ACEN or CCNE accreditation.
Health and Physical Fitness Requirements
Other requirements for commissioning include US citizenship and meeting minimum health and physical fitness standards. All persons seeking commission will undergo a baseline physical examination to ensure physical health. Some chronic conditions are automatic disqualifiers, such as ulcerative colitis. Depending on the needs of the service at the time, waivers may be granted for some conditions. There is some excellent information about the waiver process at Medical Waivers and also helpful information about disqualifying medical conditions by body area at Military Medical Standards for Enlistment, Appointment, or Induction.
If you are considering commissioning or you have been selected for commission and you're not already in excellent physical condition, START NOW. Do NOT wait to get to your branch's officer training before you begin a physical fitness regimen. With as long as application and selection takes these days, reporting to officer training out of shape is a failure on your part because you have had plenty of time and should have the discipline to work on your personal fitness if you are going to be an officer and leader in one of the branches of service. Start off on the right foot! Pun intended. We are held to the same standard as any other soldier/sailor/airman (airperson?!) in our service, and we should lead from the front in this area. You can search the internet for "military fitness standards" for more info.
Other Requirements
The Army, Air Force, and Navy have age and citizenship restrictions or requirements, among other things. The following are basic requirements for each branch, taken directly from their respective websites.
Basic requirements for active duty:
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BSN or MSN from a CCNE or NLNAC-accredited school
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U.S. Citizenship
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Unrestricted Nursing License
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Must be between 21 and 42 years of age (may request a waiver)
Contact an AMEDD recruiter
Basic requirements for active duty:
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BSN from an accredited school
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U.S. Citizenship
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Must be between the ages of 18 and 47
Contact an Air Force recruiter
Basic requirements for active duty:
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Be a US citizen currently practicing in the US
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Be a student or graduate in good standing of a US education program granting a BSN and accredited by the Commission on Collegiate Nursing Education (CCNE)
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Be licensed to practice in a US state, the District of Columbia, the Commonwealth of Puerto Rico or a US territory (new graduates must obtain a license within one year of beginning Active Duty service)
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Be willing to serve a minimum of three years of Active Duty
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Be between the ages of 18 and 41
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Be in good physical condition and pass a full medical examination
Contact a Navy recruiter
Where are the Recruiters?
Wondering why recruiters are difficult to reach, or why they haven't responded to your call or email? As with all recruiters, the healthcare recruiters are very busy and typically cover large territories. There might be a significant delay in receiving replies because they are simply inundated with inquiries from awesome nurses just like you. A little patience and persistence will likely pay off in the long run.
Another tidbit: don't bother going to the recruiters located in malls or plazas. The recruiters in those offices are not educated in commissioning healthcare professionals; they are typically for those seeking enlistment. These recruiters do not generally have information about officer recruitment.
Work Environment
This will vary depending on the specialty and location of duty assignment. In the Army, for example, new nurses are assigned to the larger medical centers, or MEDCENs. Experienced nurses that are ready to hit the ground running with a minimum unit orientation are sent to the smaller community hospitals, known as Medical Activities or MEDDACs. The reason for this is the structured orientation the new nurses receive at the MEDCENs. This orientation is known as the Clinical Nurse Transition Program (CNTP), and it gives new nurses a solid foundation in nursing while exposing them to the many kinds of nursing available at a MEDCEN that might not be present at a MEDDAC.
For the nurse assigned to a hospital or clinic, daily nursing tasks are not so terribly different from those of their counterparts in the civilian world. When I left my civilian ER to work in an Army ER, I found that the only thing that really changed was the average age of my patient population (much younger at my installation than the typical patients I saw in Virginia) and my outfit (uniform instead of scrubs; yes, really, I wear my uniform in the ER). I do have some additional duties that stem from being an officer/leader and I also have to fulfill military obligations (PT tests, going to the range and qualifying with weapons, etc.), but otherwise, it's not so different.
Deployment is another matter entirely. The Navy does have some ship deployments, but the majority of military nurses will likely end up somewhere in Afghanistan until the war truly winds down. The environments in Afghanistan vary widely, from working in hard-structure Combat Support Hospitals (a Role 3 facility in military terms, which has most of the functionality of a large stateside hospital) to being out in the boondocks with a Forward Surgical Team (a Role 2 asset that is more "forward"/tip of the spear that can provide immediate life-saving care and surgical intervention/damage control).
Deployment lengths vary depending on the branch of service and the role of the nurse. But those who are interested in military nursing must realize that when it comes to deployment, it's not a matter of "if," but a matter of "when."
Job Opportunities or Outlook
Currently the military is in a time of personnel reduction, and the needs of the military trump all else. And while the military used to take every nurse that applied because they were in the "bulking up" phase, the current trend is quite the opposite: they are extremely selective, and the boards held to select new accessions (new officers) have decreased in frequency, some to only once each year. A minuscule number of nurses are selected each year from a large pool of very qualified and skilled applicants.
Often people post in the government/military forum asking about joining the military so that the military can pay them to go to school to become nurses. Right now this just isn't going to happen. The military isn't likely to send you to school just because you want to go, even if you agree to give them time in return; it doesn't make fiscal sense for the military to do so when it is full (or more than full!) of experienced nurses and there are plenty more who are trying to get in that are ready to hit the ground running with little to no monetary investment from the military.
There are some special programs for enlisted soldiers to transition to officer/Nurse Corps, such as the Army Enlisted Commissioning Program (AECP); however, these are very competitive and new enlisted recruits would not qualify for these opportunities for some time.
As the military downsizes, the need for new accessions will continue to decrease. However, as these needs tend to be cyclical, there may come a point in which the military finds itself in need of new nurses again, and the floodgates may open. For now, the military is continuing to be very selective in its new accessions to the various services' Nurse Corps.
Skills / Qualities
The military nurse is more than a nurse; he/she is also a leader, as well as a soldier/sailor/airman. In the Army, our annual performance evaluations are not based on our clinical skills-it is a given that those should be solid. Instead, we're rated on areas of leadership, as we are expected to lead others and be developing our skills in those areas. The military nurse must be adaptable and agile and must be able to put the mission before all else. Being in the military means giving up a certain amount of personal freedom, and one must make peace with that. We are expected to maintain excellent physical health and fitness so that we can perform our duties without issues.
Duties / Responsibilities
Military nurses have similar duties and responsibilities as their civilian counterparts, with the additional leadership and military aspects and requirements. Many nurses have extra duties that are part of their overall nursing responsibilities, such as tracking a department's fulfillment of certification requirements like ACLS and BLS, or taking call as a SANE nurse. As a nurse rises in rank, he/she will take on additional responsibilities, such as becoming a department's nurse manager. These duties may replace direct patient care.
Salary (2020)
A military nurse's salary depends on his/her rank. Initial rank for experienced nurses is calculated by various formulas. For the Army, one year of civilian nursing time counts as six months of Army experience. Constructive credit will be calculated and awarded to new accessions, which may result in new accessions entering the service at a higher rank, or an accelerated timeline to the next rank.
Salary/pay information (2020 Military Pay Tables & Information example only) can be found at Defense Finance and Accounting Service.
Other entitlements military members receive include subsistence benefits and Basic Allowance for House (BAH). BAH can be viewed via the BAH Calculator.
While deployed, military members may receive Hardship Duty Pay (HDP), Hostile Fire Pay/Imminent Danger Pay (HFP/IDP), and other benefits, in addition to paying no state/Federal taxes while deployed.
Bonuses may be available. Some branches still offer loan repayments and accession bonuses. Specialty nurses may qualify for annual bonuses that serve to equalize military pay with the often higher pay that specialty nurses may receive in civilian facilities. For example, the Army offers Incentive Specialty Pay (ISP) to nurses holding certain board certifications such as CCRN or CEN. This amount is generally $20,000/year (taxed), but the nurse must apply for this bonus. The Army is no longer paying ISP to nurses who pass Med/Surg certification as of the start of this new fiscal year, an indicator of diminishing budgets.
The US Public Health Service
The USPHS has a commissioned corps as well.
The USPHS's rank structure and uniforms are very similar to those of the Navy. Recruiting for nurses for the USPHS had been closed to new inquiries until very recently, so they are also experiencing results of drawdown and budget cuts (I.e., fewer slots for nurses).
