Yammar

SICU is where the fun is!! Your patients actually get better and move on (for the most part). MICU is where all the chronic paintings hang around forever!! I personally enjoy coming into work and seeing a different patient each day and not the same ones for months and months! Another evil of MICU are all the CIWA patients - oh they drive me crazy!! SICU - acute in and out vs MICU - chronic and never leave

I am fighting the VA currently! I have been attending a yellow ribbon school for six months - all the time waiting for reimbursement- only to hear that the program is ineligible!!! Per the VA the schools rep has avoided calls and does not respond and the program was never submitted for approval. So I keep shelling out money while waiting for this process to be completed. No a fun process!!!

I deployed with some amazing Army nurses!! I was referring to the scads of middle managers that SAMMC has an endless supply of - it gets in the way of getting anything done. I have many friends there that love the work and the nurses they work with but hate the bureaucracy that comes with the facility.

The ICUs that come to mind are Sammc (Army-yuck), Travis(drama-drama-drama), Wright-Pat, Eglin, Nellis, Kessler, Elmendorf, there may be one more stateside but no better than a step-down. Truth is most of the ICUs in the AF are not the same as you would be exposed to on the civilian side and they way they do things is so not the way it would be done on the civilian side. I don't see a real benefit of taking a larger over a smaller hospital as a first assignment as I have worked with both and the skill set is indistinguishable. You will be as good as you decide to be wherever they place you (bloom where you are planted). I have worked with excellent nurses from the wee tiny Eglin and horrible nurses from Travis. In Sammc you may see more types of patients but you deal with the Army and all the political garbage that takes place that you may not deal with at a smaller facility. Also, at Sammc you tend to deploy with every bucket (so it seems). It would also be easier for you to get a CCATT spot at a smaller base because you are competing with fewer people.

Finding the preceptor I never thought would be that hard, but then again I did not realize that NPs just do not want to precept anyone. I sent out 78 requests and received about 8 emails back declining to precept for all sorts of reasons. "My physician does not allow students", "I am in the ED and the hospital does not allow students", "We only precept students from local universities", "our practice is going through changes so it is not a good time", blah blah blah. I think the only replies that i actually believed were the ones telling me they had students already. Most people did not even bother to reply. I got concerned and actually paid for a 90 day membership to the ENP website! Save your money people it is a RIPOFF!! I sent a request to everyone and not a single response. I feel cheated by them and I hope Karma catches up to the thief's you own that site! Did have one person respond with a yes only to vanish after I wrote her back. She flaked big time!! I am thankful I finally found one!! I am freaking out that I still need to undergo this process at least two more times. However, once I am physically living in the city I will be precepting in I think my odd will increase as I network and get more involved in the local organizations.

i would have to disagree with the statement that those facilities are on par with any university medical center. You are not going to get the level of experience in the AF that you will in a larger medical center. No shame on the AF - its just the facts. Then again no medical center can match the experience of deploying.

No, not much luck at all. I had one who agreed then vanished (flaked out) so I decided to seek one in Dallas where I finally found one!! Now I have to repeat the whole process two more times.....what have I gotten myself into LOL

Anyone know of a FNP who is available to precept?? This finding your own preceptor business is not as easy as the school claimed it would be..

Our hospital had someone come in and do a 2-day review. We all signed up for the test without any study time, and all but one passed (the one had test anxiety). I think the statistics state that 70% of first-time testers pass. That is a pretty good number, and the test is broad if you have practiced for 3-4 years you should be pretty good, providing you keep up with learning on the job and take advantage of those around you who can share their wisdom! Good luck.

Seriously, COT does not push anyone physically! Pass a PT test, march a little, learn a song or two and take easy tests. It is cake!! It is like a vacation! Just one with rules that make no sense.

I think a suit is a bit much. I don't ever remember an interviewee coming in a coat and tie.

Mid, I agree with you about deployments. You really can't explain it to people who have never been. There are moments from my deployment that are burned in my brain forever. You just do not get use to seeing all these young soldiers coming through all mangled and disfigured for life and the moment you start feeling all safe here comes an IED that shakes the ground and makes you very aware where the hell you are. Deployment life is so much like groundhog day and you do the same thing day in day out and the people you are with become family. If you are lucky, you deploy with stupid-silly-funny-crazy people & if you are not you are trapped with a bunch of well...hopefully you don't meet those folks. I also get a bit of a hoot out of al these people still stressing out about COT. It seems like a 100 years ago. I know it has changed a bit since I went, but if I had to give any advice...I would tell people to get fit before you show up and have fun while you are there!! Make it fun - its worth it. Also, sometimes we work much more than 7 shifts a week! Sometimes much more! I starting to wish for a deployment so I can take a break. LOL

Times they have changed. I have yet to meet a CCATT nurse with more than a few years experience and none have had their cert. Now a days its a task they let anyone do in the ICU - we had a nurse with less than 6months experience (AF ICU experience only) tasked for CCATT. Its pretty much whoever wants to do it. And the prior comment was correct that no wings, flight pay nada, it is just a duty. Yup you go with newbie Docs also, but I see the most important player to be the RT. These days the nurses are pretty much AE nurses with fewer patients.

TJC has to always attempt to create more and more obstacles just to make their surveys appear relevant. In the old days the order would simply be for the drug and to titrate as needed for Map >60, but now there are the parameters that have been built into the system as notes to the order. We still titrate based on the need of the individual patient and in accordance with all the other titratable meds going at the time.

Rumors are everywhere. The buzz has been the ones close to retirement 15+ years are the first to be trimmed and then they take aim towards force shaping boards for the rest of us. I have had people tell me the specialties are pretty safe that with attrition and the early retirements we should not see that much blood in the water, but this is al speculation. I am just taking it all in stride. If I go tomorrow then so be it.

Worked an HCA facility where we often had staffing issues and worked 3:1 ratios. It was not all that bad. What makes it dangerous to me was navigating the annoying families. When you add that third patient you also add another family with their questions, concerns and multiple BS. I would gladly take 3 patients everyday if I could avoid the crazy family members and their 50 billion phone calls a day.

Things they are a changing in the Air Force. Experience is nice, but it doesn't mean you will get into the Air Force any time soon. They are accepting fewer and fewer and boards are being cancelled, people are made alternates. Just a big old mess! The economy has made the armed services much more attractive and also the drawdowns have cause much fewer needs in the military. So you end up with a bunch competing for only a handful of spots. Also, coming in with experience can be a frustrating as the great majority of AD nurses lack experience and clinical decision making. However, they want to come to work and put forth effort I never witnessed on the civilian side. Pay? I never think about it and if that were my sole driving force I would still be a civilian making much more money and having more control over my life. The hours are not bad and you just do not work nearly as hard as a civilian nurse. Our ICU has techs and are ratios are cake. We can be on call, but we get loads of down time as well. Extra duties, but none are even difficult. Also, the higher you move up the ranks the less time you spend at the bedside. This can be good and bad! Also, take into account all the benefits you receive as AD vs Civilian. Free med and dental, tax free BAH and 30 days leave a year with all sorts of additional days here and there (Bday, PT, low census, admin days). the comment earlier about moving every 2-3 years is not happening. The majority will stay on station 4 years and with threats of canning PCS it may turn out to be longer. I have seen nurses extend but you will not stay in one base over 5 years. buying a house is a decision that has become more difficult with this economy. Back in the good old days members would PCS, buy a house and sell it for a profit when they moved. Now some people are forced to rent out their homes, sell at a loss or short sale their homes. Most of us now seem to either live on base or rent, but if I was stationed in a location I wanted to retire in I would buy maybe rent it out and return to later.

Grad school gives you additional years of service. It has been a while but MS degree adds 1 year and a PhD and additional year...So if you are an FNP with 7 years you would come in with 4.5 years and an 03.

Since I entered the AF things have changed and it was not that long ago. The entire military is downsizing and many nurses look to the military as a better option than what is available on the civilian side. I can't tell you why you were turned down twice other than they just are not accepting people in and fewer are choosing to get out. I recently saw early retirement and NC was indicated and no one can ever remember NC being included in the early retirement packages. Bottom line is if you want to serve keep it up and apply every time. It may take getting turned down several more times, but if it is what you want keep trying. Also just as important is keep improving your skills while you wait to get in and maybe even consider the guard or another branch. Just my 2 cents. Good luck!

I am surprised at the low numbers being taken. We seem to see a new batch of newbie nurses coming i all the time.

Day to day life as a nurse in the AF is not too different than that of a civilian nurse. There are some differences. As an AF nurse you will be tasked with all sorts of additional duties that can eat up a lot of your time. Most of us try to attend to these duties when it gets a bit slow but as you move up a little you find you spending many of your off days at work attending meetings, tracking down individuals or catching up on paperwork. It becomes a part of your routine and is a small price to pay for the opportunity to serve. You will be introduced to terms like, "face time", "hi viz" and "voluntold". You can either gripe and complain or step up to the plate. In the end you need all these special duties and experiences to build better bullets for your OPRs and present well to the boards. It is structured to be somewhat competitive and you need to be seen as an asset to get the right people within the organization behind you. In the end if you are motivated and maintain a good attitude the opportunities are there. You also move away from the bedside more and more, but you still need to keep your skills fresh. There is training and training and more training and at times it seems overwhelming. But, even the absolute worse day as an AF nurse is still a billion times better than working as a civilian nurse.

MICU - chronically ill patients who return over and over. Depressing sometimes. SICU - Surgical patients who need to be pushed and recover. Love SICU!! Faster paced with more positive outcomes. Plus, you make these patients get up and move and in the end they thank you! No-brainer

I have seen much made about how studies support open visiting in the ICU. However, I do not see where all considerations were taken into account in any of these studies. Where is the consideration of the stress when family members feel obligated to stay bedside each and every day? Sometimes sending a family member home allows them to recharge their batteries and protects their health. Also, are the families that hinder care of the ill. Anxiety and suspicious of everything or have the need to call the nurse to the bedside for every single issue. The hospital where I work we have designated visiting hours and kick everyone out at change of shift. We do open reports and to comply with HIPPA and insure a proper handoff we have found that the families got to go. Exceptions are made and often left to the nurse caring for that patient. I would never work in a facility that had open visiting (if I were civilian) as sometimes we as caregivers need to focus on out patient and not the family.

If I remember correctly. You are given 1 year credit for every 2 years of experience and that caps out. For a graduate degree you are granted an additional year, but in nursing you max out at six years total. Nursing maxes out and I am not sure if any other speciality does.

I agree PT baby!!!! Run, lift and eat right and everything else will take care of itself...