Veteran Considering Nursing/Reserves

[a1cfox21]

Hi all,

I've perused these forums for a couple years as I figure out what I want to do in life. I'm a male 42 y/o AF vet (12 years active/guard) currently working as a Business Analyst for a health insurance company. Was pre-med for a bit in college and always dreamed of trying later but life/family changes things a bit. 

I've come back around and seriously contemplating my last career move into nursing. My goal is to become a provider (probably FNP) but I'm 50/50 on working bedside before becoming a NP. I'm aware of the debate on this already and can see points for both arguments. I'm currently looking at a direct-entry MSN-RN program then a post-grad cert in FNP. This would allow me to continue working my current job that I need to take care of my family. 

First off, is it possible to successfully get commissioned in the reserves after getting ones RN but not have any paid work experience as a nurse? A bedside position is going to likely be a decent pay cut for me and I'm not sure we can really absorb that. Perhaps if I can work nights and/or some OT but I'm guessing new grads may not be afforded that opportunity very quickly. 

I may try to enlist in the reserves again in the nearer future or even try to get a commission as a Health administrator (AF). If commissioned prior to getting accepted as a nurse, would one lose rank? Along the same lines, would an RN lose rank if converting to a NP assuming they progress to 0-3 prior to becoming a NP? 

The one big thing for me is qualifying. I will likely need some waivers to re-enter service regardless of branch/specialty (have a VA rating). Are nurse applicants afforded any additional leeway with getting waivers approved, generally? I know depending on recruiting shortfalls the services may be more likely to waive some things in order to meet their goals. But I'm not sure if there are significant shortfalls in nurse staffing these days. 

I'm also interested in working for the VA as a NP eventually and maybe as a RN beforehand. But I have no questions related to that yet as I'm reading through the threads here. 

Thanks for your time. 

[jfratian, DNP, RN, CRNA]

I know this is a nursing site, but I really think PA would be an easier road for you.  Even the fastest 0 to NP route would be at least 3 if not 4 years including pre-reqs.  It sounds like you already have a bachelors degree.  A few pre-reqs would probably make you eligible to apply to PA.  All branches of the military use PAs if that is your goal. 

As far as ability to get waivers, I really think it depends on what the medical issue is and what the military needs.  It's going to be a shot in the dark.  Give it a shot and see. Know that you give up give up some of your VA disability pension when you drill...100% of it if you're on active duty.   You may also need an age waiver depending on the branch and how much active duty time you have (I think Air Force is waiver for >47yo minus years of active duty). 

RN to any advanced practice nurse (NP, CRNA, etc) doesn't loose any rank (you're within the same promotion group).  Health admin going to nurse or PA would loose some rank (50% TIG lost is what I've seen).

[a1cfox21]

jfratian said:

I know this is a nursing site, but I really think PA would be an easier road for you.  Even the fastest 0 to NP route would be at least 3 if not 4 years including pre-reqs.  It sounds like you already have a bachelors degree.  A few pre-reqs would probably make you eligible to apply to PA.  All branches of the military use PAs if that is your goal. 

As far as ability to get waivers, I really think it depends on what the medical issue is and what the military needs.  It's going to be a shot in the dark.  Give it a shot and see. Know that you give up give up some of your VA disability pension when you drill...100% of it if you're on active duty.   You may also need an age waiver depending on the branch and how much active duty time you have (I think Air Force is waiver for >47yo minus years of active duty). 

RN to any advanced practice nurse (NP, CRNA, etc) doesn't loose any rank (you're within the same promotion group).  Health admin going to nurse or PA would loose some rank (50% TIG lost is what I've seen).

I appreciate your reply! I had previously considered the PA route. In hindsight, I should have tried applying for the IPAP program while I was on AD. Even if I had to reapply a few times I'd probably be a Maj getting ready to retire by now. 

I've got a few things going against me in pursuing PA. Mostly, financial. I can't afford to quit work even for 2-2.5 years to complete a PA program. I've got a big family and too many obligations. We're also pretty much geographically locked in. At my age and stage of life with family its just too much. I wouldn't be able to quit work to complete a ABSN in 16 months either. 

The program I'm looking at specifically would allow me to continue working while completing the DE-MSN to become an RN then work on a post grad cert for FNP. This seems like the only realistic route for me to become a provider in my particular circumstances. 

I've been wanting to get back into a reserve component for years but was overseas contracting for a while and once I was back it just seemed like an almost impossible task to get back in shape just to even attempt enlist again. I'm 42 and have 12 years of service so for reserve enlistment purposes I look like a 30 year old. I don't know if healthcare fields treat folks the same for commissioning. 

It appears the AF requires 1 year of experience as a nurse to apply. The Army site doesn't mention experience requirement and their chat representative was a bit clueless. I don't want to bother a recruiter with this well before I'd be ready to move forward.

Anyone know how the Army nursing accessions works?

Appreciate the info on promotions. It's good to know as an RN moving to NP, I wouldn't have to 'start over'. I have a brother-in-law in the USMCR and he has to deal with the VA disability pay issue every year. Doesn't sound particularly fun.

Thanks again for all your insight and advice!

[jfratian, DNP, RN, CRNA]

If you have 12 years active duty as a 42 year old, then you'll look like a 30 year old for at least the Air Force Nurse Corps.  I believe it's similar for all 3 branches.  Your medical waivers will still depend on the needs of the military branch you apply to.

Yes, you'll need >1 year of experience in the role you'll perform for the military (1 year as an RN doesn't mean 1 year as an NP) for any reservist/guard nurse corps job in any branch.  The application takes around 1 year, so I'd start looking once you start your first RN/NP job.   You're expected to be immediately deployable as a reservist/guard member, and the rules generally state you need 1 year of experience in your job to deploy.

Direct commissioning as a reservist for all 3 branches is similar.  You contact a healthcare recruiter from the service's website.  They help you do the paperwork, schedule MEPs, etc.  They'll facilitate your interview with the chief nurse at the local unit you're applying to.  

VA disability isn't too bad.  You essentially have to cut the VA a check each year.  Each day of orders/drill forfeits 1/30th of your monthly VA pension.  Because a drill weekend counts as 4 days, you forfeit 4/30ths of your pension each month.  If you made $1800/mo in VA pension, then you'd owe $240 for each month you drilled.  

[a1cfox21]

jfratian said:

If you have 12 years active duty as a 42 year old, then you'll look like a 30 year old for at least the Air Force Nurse Corps.  I believe it's similar for all 3 branches.  Your medical waivers will still depend on the needs of the military branch you apply to.

Yes, you'll need >1 year of experience in the role you'll perform for the military (1 year as an RN doesn't mean 1 year as an NP) for any reservist/guard nurse corps job in any branch.  The application takes around 1 year, so I'd start looking once you start your first RN/NP job.   You're expected to be immediately deployable as a reservist/guard member, and the rules generally state you need 1 year of experience in your job to deploy.

Direct commissioning as a reservist for all 3 branches is similar.  You contact a healthcare recruiter from the service's website.  They help you do the paperwork, schedule MEPs, etc.  They'll facilitate your interview with the chief nurse at the local unit you're applying to.  

VA disability isn't too bad.  You essentially have to cut the VA a check each year.  Each day of orders/drill forfeits 1/30th of your monthly VA pension.  Because a drill weekend counts as 4 days, you forfeit 4/30ths of your pension each month.  If you made $1800/mo in VA pension, then you'd owe $240 for each month you drilled.  

Thank you for all the additional info! Good to know all branches process is similar. I'm partial to staying AF but not opposed to changing branches. Any idea if many RNs just stick with RN in the guard/reserves even after they become NPs on the civilian side? 

Just to get some clarity on the experience part, one would need 1 year in a specific specialty trying to commission into, right? (I.e. ER, trauma, critical care, etc.)

So my BIL just let's his disability get garnished until debt is paid. Doesn't have a great civilian career so it definitely impacts him a lot. 

[jfratian, DNP, RN, CRNA]

A lot of nurses choose to stick with RN even after going back to school.  You won't make any additional money or rank in the military by becoming an NP, CRNA, CNS, etc.   However, you may be eligible for additional for retention bonuses depending on what you move to.   From my experience, NPs aren't well utilized in the AF reserves. However, they did recently open up the "flight surgeon" job to NPs so I guess that could change.  CRNAs are well utilized.  

Yes, you need 1 year of full-time civilian RN experience in the specialty you want to practice (ICU, ER, etc) before they'll let you take a reserves/guard position.  Active duty will take new grads and/or re-train you to switch specialties; reserves/guard will not re-train you to switch specialties.

[a1cfox21]

Great information! Thank you very much. I'll keep this all in mind as I decide what to do. 

[floRNda]

jfratian said:

A lot of nurses choose to stick with RN even after going back to school.  You won't make any additional money or rank in the military by becoming an NP, CRNA, CNS, etc.   However, you may be eligible for additional for retention bonuses depending on what you move to.   From my experience, NPs aren't well utilized in the AF reserves. However, they did recently open up the "flight surgeon" job to NPs so I guess that could change.  CRNAs are well utilized.  

Yes, you need 1 year of full-time civilian RN experience in the specialty you want to practice (ICU, ER, etc) before they'll let you take a reserves/guard position.  Active duty will take new grads and/or re-train you to switch specialties; reserves/guard will not re-train you to switch specialties.

Can you elaborate on the flight surgeon NP, whats the difference of that on a regular NP. Are thet ACNP, FNP or CRNAs ? Thanks

[jfratian, DNP, RN, CRNA]

I'm honestly not exactly sure how this flight surgeon NP role is shaping up.  It's brand new and I've never met one.  The theory behind the role is that flight surgeons are not doing surgery and are not surgeons.  They are essentially family medicine physicians that work in flight medicine outpatient clinics and perform flight physicals for pilots and other aircrew.  Essentially you're the person grounding pilots if they get sick.

My guess is that they are looking at FNPs for this role.  There is probably some sort of additional flight physical training that they military sends them to.  However, I'm really not sure.  This is a totally new thing.

[floRNda]

jfratian said:

I'm honestly not exactly sure how this flight surgeon NP role is shaping up.  It's brand new and I've never met one.  The theory behind the role is that flight surgeons are not doing surgery and are not surgeons.  They are essentially family medicine physicians that work in flight medicine outpatient clinics and perform flight physicals for pilots and other aircrew.  Essentially you're the person grounding pilots if they get sick.

My guess is that they are looking at FNPs for this role.  There is probably some sort of additional flight physical training that they military sends them to.  However, I'm really not sure.  This is a totally new thing.

Thanks for the reply. But do flights surgeon ride the plane too? Or part of flight teams?

[jfratian, DNP, RN, CRNA]

Flight medicine in the air force is not like civilian flight nursing.  There are 2 categories of patients in flight:

1. Flight Nursing Patients: These are med-surg patients that are monitored by a nurse and a few EMTs.  These nurses are called 'flight nurses.'  A 'flight surgeon' (a family medicine physician specializing in aerospace medicine) clears them to fly prior to the flight.  They write the orders that the flight nurses use in flight.  However, no physician, NP, or other provider typically flies with the patients.  'Flight surgeons' do have required ride along hours, but they aren't typically doing patient care in the air.  I'm honestly a bit far removed from this world so not really clear on what the point of the flight hours actually is; maybe to stoke egos?  Commonly these patients are psych patients, minor ortho etc.  Anything remotely sick...even PRN IV dilaudid...goes CCATT.

2. CCATT (critical care air transport team) Patients: These ICU patients monitored by a physician intensivist, an ICU nurse, and a respiratory therapist at all times during flight.  No NP or PA has any role in this patient's care as of now.  This is what most civilians would consider flight nursing.