Military/VA RN's - Please post experiences for Students

Jeager23 · May 16, 2011

Hello everyone,

I have read this entire thread as I am heavily debating the route my nursing career will take. I am currently a BSN student and am considering the Army and Air Force as possible career choices in comparison to civilian life. I have had significant trouble finding enough information to make a reasonably confident decision and would greatly appreciate the input of this experienced community.

The first, general question I would ask is: Given the desire/willingness to relocate/travel (even or especially overseas), do the benefits of military service outweigh the potential drawbacks in comparison to a civilian career and why/how? Specific elaborations follow.

1. What is the degree of fast-tracked leadership experience (and other relevant experience) gained compared to civilian work and what is its value in the subjective nursing experience as well as job seeking?

2. What degree of professionalism is present in the military compared to the civilian world and what is its value in nursing practice as well as one's experience as a nurse?

3. How significant is the possibility of receiving an assignment that doesn't give you required experience toward a desired advanced practice degree, thereby "wasting," in a sense, your time in service (in regards to your professional goals)?

4. How does work experience toward an advanced degree compare between military and civilian work?

5. How do deployment risks and rewards (monetary, experiential, and other) balance out?

6. How does compensation compare (taking into account bonuses, housing allowances, health plans, pay differentials, and--especially--work hours) and is the overall experience worth the difference, if there is one? *Please Note: I understand this question may seem repeated, but I am asking for the answer after taking into account many factors. Not even a health professions recruiter has been able to give me these numbers--hopefully a person who has lived it can provide an idea.*

7. How would this compare to something like a traveling nurses program, for a nurse who wishes to travel?

8. Any other key factors evident to persons with more experience.

The second question I would have is whether to choose the Air Force or the Army, specifically if one has nurse anesthesia in mind (again, a repeated question, but please consider the following factors).

1. Relative danger between the two branches

2. Relative experience gained

3. Promotion opportunities (a previous post mentioned that Air Force promotions drop substantially after O-4)

4. Relative lifestyle (to include degree of professionalism, differences in life on base, differences in deployment location/duration, any additional aspects)

5. Differences in education assistance (I read that army offers more assistance than air force?)

6. Differences in type of experience acquired (if either, which would be better for a prospective nurse anesthetist?)

7. Any additional differences relevant to a student

Finally, if the military is the best choice and the branch has been decided, what is the best method of entry into service? Is ROTC the best way to avoid a 12-month experience requirement for post-graduation commissioning? Or does commissioning after graduation with a BSN give desirable leverage for negotiation in some aspects and, if so, what aspects?

I realize this is a very long and detailed post, but I would appreciate help anyone with experience could provide. I greatly value the words of experience and, as has been stated before in this thread, it is difficult to get consistent and complete information from recruiters.

Thank you.

SFC JIMENEZ · May 16, 2011

Jeager,

Here are the answers to your questions.

1. As a brand new 2d LT, as long as your Head Nurse is confident that you meet the qualifications and experience you can become a Charge Nurse in as little as 6 months. For Civilian sector it takes many years to get the opportunity to become a Charge Nurse. As an Army Nurse you will get advancements to the rank of CPT in less than 4 years as long as there are no UCMJ or negative evaluations against you.

2. The military is ranked structured and based upon the level of expertise. There are times where a Nurse outranks a Dr but it is a team effort. While the Nurse may outrank the Dr. when it comes to military customs inside the OR room (for example) the Dr is in charge.

3. The military will train you as to how they will use you. They will provide the education based upon your Nursing role or job assigment.

4. Your career is monitored by your specific career manager. The Army will provide education for advancement, for example: attaining your Masters degree (and sometimes PHD) while serving on Active Duty.

5. During deployment you will be assigned to a hard structured facility (Hospital) doing what you were educated to do as a Nurse. Monetary wise if you are deployed in Afghan/Iraq it is tax free plus you will receive danger pay/hazzard pay and seperation pay if you have dependants.

6. Pay ranges widely based upon zip code of assignment, specialty (OR, ICU etc..) and rank. It is really hard to predict what your pay will be without knowing where you will be assigned and if you have a specialty. Every specialty Nurse gets a bonus but you have to take and pass a board certification. You do not need to be board certified to serve - only if you want the bonus pay.

7. The military is all about traveling : ) As a traveling Nurse you may not be provided health benefits or given full housing allowance which you will receive in the Army.

8. With 3 years or more of experience you will be coming in as a 1st LT instead of a 2d LT.

Next series.

1. Danger is not a factor between the branches. You might be working jointly with different branches either on Active Duty or while deployed.

2. You will never experience deployment patient care (trauma) in the private sector. This will only enhance your resume and make you more marketable. You will learn how to work under pressure.

3. Promotion after O4 is dependant on the number of LTC and COL that are slotted for Active Duty.

4. Coming from an Army Nurse Corps Officer, (Major, OR) quality of life is much better than private sector with few exceptions such as hardship tours while you are deployed.

5. The Army does offer a larger amount of slots for education benefits for advancement as well as Leadership schools.

6. The Army Nurse Anesth. program is in the TOP 5 of the nation.

7. The Army still offers new grads the opportunity to be Commissioned in the Army Nurse Corps. 6 months are required for US Army Reserve. This past year they were mainly targeting experienced Nurses but as the norm there are positions for new grads as well. This year looks as if there will be more openings for new grads come October.

I happen to have a Major (OR Nurse) assigned to my station and he gave me the information that I provided for you. If you should have any questions you can always contact me at 877 725 1399. As always, you will be working with your local AMEDD Recruiter should you decide to join the Army Nurse Corps. I just happen to be lucky and have a Nurse assigned to our station and he is more than willing to speak to you if you need more clarification. Not all AMEDD stations have a Nurse assigned to them. Just give me a call and I will provide you with his number.

Columnist · Aug 3, 2011

Jeager,
Here are the answers to your questions.
1. As a brand new 2d LT, as long as your Head Nurse is confident that you meet the qualifications and experience you can become a Charge Nurse in as little as 6 months. For Civilian sector it takes many years to get the opportunity to become a Charge Nurse.

Just to clarify, this is not true.

I've had many classmates in the civilian sector who became charge nurses in 6 months. Myself, within 18 months I was a charge nurse, scheduling and supervising 4 other RNs. And the only reason it took so long was because I changed specialties. (I became an RN in 2008.)

I'm not knocking the benefits of going into military nursing (I think it's GREAT!), but I wanted to provide accurate information from the civilian community.

Best of luck to you!

Elizabeth

SFC JIMENEZ · Aug 3, 2011

Elizabeth,

You may want to disclose where your at so that those interested may have an opportunity for growth and advancement, because at the hospitals where I visit and recruit from that is the norm.

nursemae · Aug 9, 2011

Hello Jeager! I figure I'll throw my $0.02 here. I have been in the military healthcare system for 11 of my 13 years of nursing - 7 years active duty AF (3 of those years serving at an Army hospital) and 3 years of civil service at Army hospitals. These answers are related to what I feel I can answer to from personal experience. :)

Some of these things are hard to answer because a lot of the 'worth' of military vs. civilian nursing is based on personal issues. Yes, the financials come into play but each individual rates the importance of home/family life, individual freedoms, etc. Often you're not really going to know until you're in the situation, I think.

1. What is the degree of fast-tracked leadership experience (and other relevant experience) gained compared to civilian work and what is its value in the subjective nursing experience as well as job seeking?

In the military there are leadership courses you go to (Head Nurse course (Army), Nursing Services Management (AF)) which help add to the leadership you've already learned in your BSN program. I have known several people in the military who were nurse managers of a clinic/unit after only a few years of experience. While I was made a charge nurse in about 6 months during my stint in a civilian hospital I think part of that were the circumstances on my unit as well as the fact that I had considerable charge experience in other facilities already. I don't believe it's common to find such young (experience wise) nurses in management in the civ world. With that being said, once you have gone into that track it is harder to get out in subsequent assignments unless you are going to a very large facility and want to do floor work, or are going to advanced practice.

2. What degree of professionalism is present in the military compared to the civilian world and what is its value in nursing practice as well as one's experience as a nurse?

I have found a significantly higher level of professionalism on the military side. As with any place there are going to be individuals who don't seem to have a professional bone in their body but in the whole there has been no comparison in my military/civilian experiences. Nurses are a vital part of the health care team in either setting, and your personal experience credit is given its due as well. In the military you hold 2 professions - first and foremost you are a military officer which has its own accord of duty and professionalism. On top of that you have the professionalism of your clinical career.

3. How significant is the possibility of receiving an assignment that doesn't give you required experience toward a desired advanced practice degree, thereby "wasting," in a sense, your time in service (in regards to your professional goals)?

This is always a possibility. The needs of the military are the priority over your personal desires. However, they have a vested interest in meshing their needs with people's wants. This is where it is important to be honest and direct about your professional goals so they can hopefully mesh. The other important part is to realize that there are few 'wasted' opportunities. When I was first in the service I was frustrated that I was moved around so much (within the facility, not around the world). After I had a little perspective I was very thankful for the varied experiences I had. It has made me a far better nurse to have the 'breadth and depth' I have. That being said, if you are tagged with a specialty identifier (L&D, ICU, ER, etc.) there is a much better chance that you can remain in that lane of practice...actually it can be difficult sometimes to break out if you decide you want to do something totally different! However, if CRNA is your goal then being 'stuck' in critical care would be to your benefit.

4. How does work experience toward an advanced degree compare between military and civilian work?

I have no answer for this one...

5. How do deployment risks and rewards (monetary, experiential, and other) balance out?

This is really one of those personality questions. Obviously there are monetary rewards. You will gain experience on a deployment that you can't get anywhere else, even if you were in a large urban trauma center. However, there are many deployments you can go on which won't see 'action'. If you go somewhere like Qatar or Diego Garcia it will be like a rather short vacation with clinic hours. If you get deployed to Germany for a year that will be a long vacation. If you deploy for a year with a Combat Support Hospital to a hot spot...well that will be totally different. How it balances out will be a truly personal choice. Is the money, clinical experience, importance of your work and camaraderie worth the lost time with your family, the long hours, sometimes spartan quarters and the forever memory of what you've seen? No one is going to be able to tell you that except yourself.

6. How does compensation compare (taking into account bonuses, housing allowances, health plans, pay differentials, and--especially--work hours) and is the overall experience worth the difference, if there is one?

When you take into account base pay, housing, insurance, etc. there is little comparison to the civilian world after the first few years. I started out making a bit less than my civ. counterparts when I was a 2Lt, but once you've been in for a short while the pay and benefits far outstrips the pay you'd receive in the civilian world as a staff nurse. I can't speak much for CRNAs or providers although I know several of my docs took home less money after they got out because of the unknown costs of working private practice, paying for malpractice insurance, paying for health insurance, etc. Each place is individual, and you're a salaried employee. There were times when I had a cush job with fewer hours and got paid to go to lunch and the gym. There were other times when I worked almost 60 hour weeks because things went to crap downrange and our patient census tripled in 24 hours.

7. How would this compare to something like a traveling nurses program, for a nurse who wishes to travel?

I would say there's no comparison. Yes, you move but I don't think it's like travel nursing at all. There you can pick and choose assignments, they can be a few weeks or extended up to a year. In the military you can move, yes, but you will be there for 3-5 years at a time unless it's a short remote assignment to Korea, Turkey, etc. You can move within a facility though; that's not to say you have to work in the same unit for all of those years.

1. Relative danger between the two branches

Medics are the health care workers that really take the brunt of danger in the military. As a nurse you're much more removed most of the time. I would say, given the length of deployment and the areas of deployment, that the Army will always be the more dangerous of the two when it comes to deployment.

2. Relative experience gained

I'm not sure what kind of experience you're talking about, so I'm not sure how to answer this. As an Armyfied Air Force nurse I worked in 5 different specialties in 7 years (L&D, Family Practice, Med/Surg, Ortho trauma and nurse manager of an Ortho Clinic). I know several nurses in both branches that have also experienced that variety. However, I've also known many nurses that have pretty much stayed in one lane of experience for many years. It kind of depends what you want, and what they have to offer.

3. Promotion opportunities (a previous post mentioned that Air Force promotions drop substantially after O-4)

While I think the AF has improved since I have been in, you will still promote faster in the Army and they promote more of O4 and above.

4. Relative lifestyle (to include degree of professionalism, differences in life on base, differences in deployment location/duration, any additional aspects)

I have seen similar levels of clinical professionalism. I think the Army has a higher level of military professionalism in the medical setting, if that makes sense. While the medical field is lax compared to line units in both the Army and AF, there is a stricter sense of military bearing in Army hospitals. I think on-base life in the Army has improved a lot over the past decade or so but in general the housing and accommodations on base will be nicer on AF bases. While you can volunteer for a year-long deployment in the AF, most are still 4 or 6 months while the Army typically deploys for a year at a time. I haven't heard of any of my friends/coworkers in the Army deploying anywhere but Iraq or Afghanistan in quite some time while the AF still has deployment locations in Kuwait, Qatar, Kyrgyzstan, etc.

5. Differences in education assistance (I read that army offers more assistance than air force?)

I don't know the numbers, although I know they fluctuate depending on the needs of the AF/Army. Each one has CRNA programs (I think they both still have to go through USUHS). Each has tuition assistance if you want to continue schooling while on active duty. Both have programs where your active duty job is to be a graduate student at a civilian university and you continue to get your rank pay while they pay for all your school expenses. Both branches offer many amazing programs, but I have no clue on percentages of availability.

6. Differences in type of experience acquired (if either, which would be better for a prospective nurse anesthetist?)

Things may be changing now with the trend toward combining health care facilities, but I believe the Army still has more facilities overall where you can get the critical care experience necessary to do the CRNA program.

7. Any additional differences relevant to a student

Not that I can think of right now. Work out a lot! :)

Finally, if the military is the best choice and the branch has been decided, what is the best method of entry into service? Is ROTC the best way to avoid a 12-month experience requirement for post-graduation commissioning? Or does commissioning after graduation with a BSN give desirable leverage for negotiation in some aspects and, if so, what aspects?

I'm not sure how far along you are in your studies. You can cram the ROTC program in in a couple of years provided you can handle the increased credit hours on top of nursing school. I personally think ROTC is better than doing a direct commission because I feel it gives you a much better understanding of what it's going to mean to be a military nurse, especially if you didn't grow up with the experience of living in a military household or something similar. You come out with an understanding of some military history, dress & ceremonies, military rating, etc. You'll understand more why being a military nurse entails some of the things it does and the training it does. While ROTC isn't a guarantee of commissioning (I have known people who were released from their contract after 4 years of the ROTC program rather than being commissioned) I think it offers a better chance. With the current financial situation in our country more and more people are turning to the military as an option so it has become much more difficult to get in than it used to be. Since a BSN is the base requirement for any of the Nurse Corps I don't imagine that will give you any special leverage in either situation. As far as I know those are your only 2 options when it comes to nursing - either direct commission after at least 12 months of experience or ROTC...unless you're prior service and can go the OTC/OCS route, which it doesn't sound like you are. :)

I don't know if this blathering on has helped you, but I hope there's something useful in there!

allnurses Guide · Aug 9, 2011

You can search the military forum for the answers to your questions they have been answered on there before.

As far as education: The Army is the bigger service so it has more education spots overall, but percentage wise between the two I don't know which one has more slots per nurse. I believe it is the Army though.

The Army is currently rated #1 by US News for their CRNA program. It has become a friendlier program from what I understand, but the message obviously hasn't got out to some of the Army CRNAs. My Walter Reed Army Medical Center/WRAMC rotation was the worst of my CRNA training with the AF.

The Army will allow you to apply directly to nurse anesthesia school. The other services will not at this time.

When thinking of joining the military don't forget about all the services including the Navy and USPHS (not the military but has the same basic benefits/promotes the fastest/USPHS will send you to nurse anesthesia school also).