What does each branch have to offer for a new grad?

[aferg002]

Hello, and thank you for reading.

Bio. 29 male graduating in 12/2017 with a BSN RN. Previous history: EMT > Paramedic > nursing school. I'm pretty comfortable with what I know which is trauma and emergency medicine. And I love it. I've always wanted to serve in the military, and from a military family my dad told me officer over enlisted. So as a new grad nurse, what are my options as far as duties in different branches.

My ultimate dream military job would be a medievac crew, but there's no officer nurse positions for that. I would love to become a flight nurse in the civilian side and I want to learn all I can to strive my best to get to that goal

All i know is from recruiters and enlisted, so I don't have any first hand experience. About me as well, I would like to excel and learn more things and get great experience. I don't want to be stuck in a small clinic somewhere doing paperwork (yes I know I don't have say) but I want to have the flexibility of working outside in the field/theater and still get great critical care/ emergency experience.

I would like to ask the community what your advice or thoughts are.

Thank you.

[aferg002, BSN, EMT-P]

Thanks jfratian,

I see. Thats really cool. Thank you for clarifying all those different ICUs. I did a rotation in the Burn ICU at the level 1 in my town and it was pretty crazy but good. Crazy drug dosages they use, but definitely needed. I have applied to all those ICUs for my preceptorship, hopefully I can get into one of them and also get into a new grad position there.

And I see about how all the bases with ICUs have the CCATT. How often do they fly out to do missions? Or are they on call status?

Thanks again.

[aferg002, BSN, EMT-P]

Wow, thanks so much Euro_Sepsis!

I see. How often do you see openings? And if they are so rare in the meantime, and you are assigned a ICU nurse role, what are your roles? Where are you stationed at? Or are you allocated to different hospitals based on need?

Ah, I see. The whole shebang. I also learned and saw different cardiac caths (i.e., Arterial caths, swans Cath) pretty meticulous and crazy stuff. But its those things that Im most interested in learning and doing. For burn pts, do you use the Parkland formula and all? Or mostly monitoring?

And thank you so so much for the explanation. You have by far given me the most concise and clear explanation that I have found in years.

For all of these specialized assets, are they all part of the Air Force?

And for sure. Im not at all about my slay. Im too old, too ignorant, too nerdy, and too ugly for that. My main focus in serving is, as well as feeling its my civic duty, is to learn and experience as much as I can to become a better clinician to better help those all under my care.

[jfratian, DNP, RN, CRNA]

You're on call 24/7 by virtue of joining the military. They can deploy you whenever they want.

Unlike the Army, which deploys entire units, the Air Force deploys UTCs. UTCs are deployment teams that consist of a combination of people with needed skills, regardless of where they work. For most people, CCATT is a deployment UTC (unit type code). It's not a full time job for most, although there a few full time active duty CCATT positions. The CCATT UTC consists of an ICU nurse, a respiratory therapist, and a critical care physician. When not deployed, your RT might work in an outpatient sleep clinic, you ICU nurse works in the ICU, and your doctor might be an anesthesiologist who does elective procedures.

There are other deployment teams, such as EMEDS. EMEDS sets up your mash-esq field hospital, and I would say is one of the more common AF deployment UTCs. Just because you are on the CCATT UTC, that doesn't mean that you will ever necessarily deploy as a CCATT nurse. You will get the pre-deployment training for that team, but you might not deploy.

I really can't say how often different UTCs and different bases are used. It depends on what's going on in the world and where it is.

[aferg002, BSN, EMT-P]

Thank you all so much for your help and information. It has been very meaningful and I took the time to talk to some recruiters about it.

I'm sorry I didn't respond to you all promptly. I finished my preceptorship. I was in the Surgical ICU at the level 1 trauma hospital in my city. And it was a great learning experience. It made me more aware that I need to learn more time management and organizational skills for ICU. Which I don't mind griding out to learn.

Ultimately I do want to join the military. As of now, I'm studying for NCLEX, and working as a medic in the time waiting.

I came across a new mos recently. It's called an ECCN? En route critical care nurse? Seems like a medivac flight nurse? Do you have any information or experiences with that? Thank you.

[jfratian, DNP, RN, CRNA]

The Air Force doesn't use MOS, which is the Army's terminology. The Air Force equivalent is the Air Force Specialty Code (AFSC). There is no AFSC for what you described, but there is instead a general 'critical care nurse' AFSC (46N3E) for all ICU nurses.

ICU nurses in the AF are used in many different UTCs and in many different roles. As a current active duty AF ICU nurse, I have never heard of the en route critical care nurse. I think that if it does exist, it is a very limited job role that is only utilized for deployments or very isolated, infrequent special assignments.

Please know that the vast majority of non-deployed AF ICU nurses work in a standard brick and mortar ICU. These air evac and transport roles are for experienced, high-performing ICU nurses who have applied for, been selected to, and completed advanced training. Even then, CCATT and TCCET duties are largely a part-time gig for those people.

So you know, new grads in the AF cannot start in the ICU or ER. There is a 1 year critical care fellowship that you must apply to after 2 years of med-surg experience at your first base. Or, you must enter the AF with ICU or ER experience. If you entered the AF right now as a new grad, it would be 4 years minimum before you would be eligible to start training in one of those air evac roles.

[aferg002, BSN, EMT-P]

Thank you so much for your insight on all this. It really makes me more aware of what is out there versus what I read and researched on.

I agree with you in regards to different jobs like that are very infrequent and very specialized. Especially with a troop reduction now from what I had heard from other recruiters now.

As far as brick and mortar ICU positions, which hospitals do military nurses work in? For the Air Force, do they work at a V.A facility? or do they go to other hospitals in given cities and areas. And how is one assigned to it while they are still in the military?

And yes, thank you again for reminding me about the roles of new grad positions. I had no idea the length of time before they could train for air evac roles. I plan on starting on med-surg tele (or whatever I can get accepted to frankly) first for about a year, and then from there moving to ICU. Then hopefully I can get enough ICU experience to transfer to the military.

Also another question. For ICU....would you suggest going through med-surg or ER first? Ive heard med0-surg gets your fundamentals of time management and organization down but ER is more fast paced and you see a lot of things going through. However, with ER, its so short that you can't really critically think or wait for labs to get back or what to do next before they get transferred out.

What would be your advice for a new grad who has aspirations to being in ICU?

Thank you again.

[jfratian, DNP, RN, CRNA]

AF nurses typically work at hospitals on AF bases. These are generally small community hospitals with around 50 inpatient beds. Some hospitals have joint VA-DOD agreements. Those hospitals would accept VA patients as well as the active duty AF personnel, AF retirees, and AF dependents.

I would look at large university medical centers for your first job. These hospitals typically have new grad fellowships that allow new grads to start in the ICU. If you can't do that, then I would try to get a step-down floor where the nurses take 3 patients and handle drips and stable vents.

[loganchase13, BSN, EMT-B]

Can a person be a TCCET in reserves or guard?

[jfratian, DNP, RN, CRNA]

There are certainly CCATT nurses in the reserves and guard. TCCET is sometimes filled by a CCATT nurse, so I think it is possible.

So you know, TCCET is really an Army job that the Air Force does sometimes. I keep hearing that the Army is taking it back permanently...but they never seem to be able to fill all the spots. If you really are into rotary wing/POI, you probably should look at the Army.

[Bhebe55]

Current USAGPAN student. If you want to come into the ARMY as a nurse my advice would be get 1-2 years of critical care experience and your CCRN. They are in critical need of ICU nurses and with civilian experience you can come in as a first lieutenant and skip the medsurg rotation that most new grads have to go through before you can apply for the critical care or ER course.

[GreenOranges]

On 10/28/2017 at 10:15 PM, jfratian said:

You're on call 24/7 by virtue of joining the military. They can deploy you whenever they want.

Unlike the Army, which deploys entire units, the Air Force deploys UTCs. UTCs are deployment teams that consist of a combination of people with needed skills, regardless of where they work. For most people, CCATT is a deployment UTC (unit type code). It's not a full time job for most, although there a few full time active duty CCATT positions. The CCATT UTC consists of an ICU nurse, a respiratory therapist, and a critical care physician. When not deployed, your RT might work in an outpatient sleep clinic, you ICU nurse works in the ICU, and your doctor might be an anesthesiologist who does elective procedures.

There are other deployment teams, such as EMEDS. EMEDS sets up your mash-esq field hospital, and I would say is one of the more common AF deployment UTCs. Just because you are on the CCATT UTC, that doesn't mean that you will ever necessarily deploy as a CCATT nurse. You will get the pre-deployment training for that team, but you might not deploy.

I really can't say how often different UTCs and different bases are used. It depends on what's going on in the world and where it is.

This is such an incredible comment, thank you for taking the time to share this information. Are you aware if individuals deploying in air evac roles/missions require depth perception as part of their flight physical? I recall when I initially enlisted, I was disqualified from a variety of 1A aircrew AFSCs because I unfortunately lack depth perception.

Thanks again!

[jfratian, DNP, RN, CRNA]

Any flight crew need to pass a flight physical. CCATT nurses also must pass a flight physical even though they aren't technically air crew. You would require a waiver to do CCATT, and I'm not really sure what types of waivers are being granted right now. You'd have to talk to a recruiter.