Careers in the Military

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By land, sea or air, a career in the military offers nurses broad opportunities with few limitations

By Paula Lipp

Major Vanessa Wise envisioned her entire career in an instant, while working as an emergency room nurse in St. Louis. “There was no progression in the ER,” she recalls. “The charge nurse was about my age and I could see that I would be a staff nurse until she left.”

Hearing of the opportunities at the Air Force base not far from her home, Wise spoke with a nurse recruiter there and was pleasantly surprised by what she saw at the base hospital. “Many of the nurses there had fewer years of experience than I did, and they were already officers,” she remembers. “I really wanted to move up in my career and decided I could try anything for three years,” referring to the minimum period for which she could commission (nurses entering the military do not “enlist;” they join as “commissioned officers”).

And so she did. Now, 16 years later, she is chief, Medical and Nurse Officer Accessions, at Randolph Air Force Base in San Antonio, Texas, overseeing the recruitment of Air Force medical personnel.

When Wise reminisces about her experiences over that time, she cites a broad list of assignments, including three years in which she served as a flight nurse, caring for patients as they were being transported by plane. “It was like working in a flying hospital,” she explains, “with IV bags and ventilators and everything else at 33,000 feet.”

Wise’s career typifies the range of opportunities—both clinical and administrative—open to military nurses. The need for qualified nurses to care for active duty and retired personnel and their dependents in any of the various military hospitals or other medical settings around the world is constant and deep. Minority nurses in all branches attest to the challenges and rewards—as well as the lack of discrimination—that they have enjoyed as proud members of the U.S. Army, Air Force and Navy.

A Few Good Nurses

Whether in peacetime or war, all branches of the military engage in consistent nurse recruitment efforts. According to the National Career Information System, the services have about 10,800 registered nurses. On average, they need 2,600 new registered nurses each year.

“The need for nurses in the Army Nurse Corps, as well as in the other services, is always categorized as heavy,” reports Colonel Gwendolyn Fryer, chief, Army Nurse Division, Health Services Directorate at U.S. Army Recruiting Command Headquarters in Ft. Knox, Kentucky.

The Army maintains two types of health care facilities—fixed facilities that meet peacetime needs to treat personnel, and field facilities that focus on deployment during war or other emergency situations. “We also respond to hurricanes and other humanitarian missions,” she notes.

In times of war, personnel trained in critical care, emergency and OR medicine become especially valued. “Although 99% of the time we operate in peacetime, our readiness requirements are to go to war and support our fighting forces,” says Captain Hector Quiles, Navy Nurse Corps career plans officer in Washington, D.C.

Uncle Sam Wants You!

To explore the career opportunities in the military, check these Web sites for information:

U.S. Air Force: Greatest needs are in clinical, mental health, obstetrics, ambulatory and home health care. Web site: http://usafsg.satx.disa. mil/sgn.

U.S. Army Nurse Corps: Continued need for generalists, as well as nurse anesthetists, critical care nurses, family nurse practitioners, and nurses in psychiatry, ob/gyn and OR. Visit www.goarmy.com.

U.S. Navy: Greatest needs are in critical care, OR and maternity/infant care nursing. Web site: www.navyteam.com.

Good information about life in the military, including wages and nursing positions, can be found through the National Career Information System, at http://cis.uoregon.edu/ ohcis99/mil_fr.htm. Click on “Registered Nurses” under the listing of health care professions.

In the Air Force, Army and Navy, the minimum length of a commission is three years; the minimum level of education for a nurse to be accepted into active military duty is the B.S.N. degree, granted by an accredited school of nursing. Similar to the civilian sector, most branches are also looking for nurses with some experience, especially in several key specialties—critical care, OR and maternity/infant care, most notably. “Those are the specialties that are always in great demand,” Quiles says of the Navy’s needs.

Fryer ascribes the consistent need for nurses in part to the military’s structured promotion system, which continuously moves nurses from the lower ranks into higher positions. The Army uses a “lifecycle model” to gauge a nurse officer’s career progress at any given point in time, with regard to his or her rank and position. “In the military, once you get to a certain rank, then you could go to any of the positions that are available to” that rank, Fryer explains.

In addition to the lifecycle model, the Army assigns personnel managers (or “career monitors”) to each rank, who help individuals identify the kinds of jobs that are available and prepare them to go before the accession board, the body that selects candidates for positions and promotions.

“If the career monitor can make [a requested career move] happen, she will,” Fryer adds. Although the needs of the Army supercede the desires of an individual, she notes that for the most part, nurses will get their first choices when they’ve requested a particular assignment (they are required to list three choices). “The career monitor will apply the lifecycle model to a request and give good guidance as to whether or not the nurse can expect to receive that position.”

Compounding its own nursing shortage is the military’s commitment to advanced training for nurses. All branches of the military are noted for their support of education. After reaching a minimum level of service in the Navy, for example, R.N.s there can pursue a graduate degree—all expenses paid—and still collect their salaries. The Navy will also send a nurse to receive his or her Ph.D. degree, to be applied to research, education or a clinical specialty.

Nurses in the Army receive similar encouragement, supplemented by on-the-job training. Nurses just out of school will be classified as medical nurses, Fryer explains, “and they will work as generalists. Someone might then decide she’d like to become a critical care nurse. The Army has a critical care course, which is coupled with clinical training in the critical care unit.” A variety of specialty training programs are available, including surgical, psychiatry and community health.

Don’t expect that these benefits are dished out to just anyone. Applicants to any of the nurse corps must uphold the values and responsibilities of the armed forces, go before a review board and demonstrate personal characteristics such as honor and integrity. “We’re looking not only for clinical competence,” explains Quiles, “but also for the personal qualities that will make someone a good Naval officer—courage, honor and commitment.”

Similarly, says Wise, the Air Force is looking for leaders. “We need people who can take command.”

Where To?

With stints in a medical/surgical ward in Florida, a multi-service unit in Puerto Rico and several deployments on amphibious medical ships, Quiles can attest to the diversity of experience offered by the Navy. “There’s no limit. It’s not just at the bedside, but hospital structure has changed,” he notes. “You may have a nurse in charge of other nurses, physicians or ancillary services, such as the laboratory.”

Military nurses have essentially five career tracks—sometimes called tours—open to them during their active involvement in the service: The operational tour would see a nurse assigned to a ship, flight crew or other special duty. A clinical track would place a nurse in a military hospital or clinic, acting perhaps as a staff nurse or clinical coordinator. Other concentrations focus on administration, education and research.

Within each of these tracks, nurses can pursue a variety of interests. The Army, for example, offers opportunities in its clinical classification working with new technology in patient care, such as telemedicine, or working with managed care.

“We offer a broad career path for health care providers,” notes Fryer, “especially in some positions that were not previously open to nurses. For example, nurses can compete for the role of commander of a hospital, equivalent in the civilian sector to a hospital administrator.”

Indeed, nurses hold high-ranking positions throughout the military branches. Last November, the National Naval Medical Center in Bethesda, Maryland, named a nurse to its commander position. “We have several hospitals where the commanding officer is a nurse,” Quiles notes.

“How many civilian hospitals have nurses as CEOs?” asks Wise. “You will see that in the Air Force.”

In another contrast to civilian careers, moving from one specialty, one hospital or even one country to another doesn’t mean a loss of seniority. “For me in civilian life, in order to move up, I had to move out,” Fryer notes, and begin anew at another hospital or medical center.

In the service, “a person could be working at a hospital for a year or 18 months,” Quiles explains, “and then go to another area. We find that people like to try different things. It’s encouraged that we serve in different roles, because you never know where you will be assigned.”

Join the Service, See the World

What attracts many people to military service is the opportu-nity to travel to exotic ports of call, and indeed that remains a factor in current nurse recruiting efforts. The Navy, for instance, maintains 16 hospitals in the United States and nine in countries including Japan, Italy, Spain and Iceland.

Most newly commissioned nurses, however, will not find themselves shipped to a foreign setting immediately. “A nurse without prior military experience and just coming out of nursing school,” explains Quiles, “will be assigned to a hospital in the United States. It’s too much to put someone in a new environment and expect them to learn a new profession and the way the Naval service works all at once.”

Relocation is often short-term as well, as when it is related to medical exercises or in the name of humanitarian relief. Wise, for example, recalls a recent mission that took her briefly to Del Rio, Texas, after that area was hit by a devastating flood: “We worked with the Red Cross in one of their shelters.”

She notes that the amount of travel depends upon a nurse’s job, but even the positions most likely to travel come with a certain degree of stability. “We won’t move you every year or two. You will stay in one area for three or four years.”

Diversity Among the Ranks

A recent article published by the World African Network says that 50 years after President Truman issued an executive order desegregating the military, all three military services have African Americans serving as four-star generals for the first time in history. A 1996 report from the U.S. Office of Personnel Management also reflected favorable diversity statistics in the Air Force, Army and Navy (see table below), compared to similar figures for the civilian work force.

“The military was the first one to really get on board with the Civil Rights movement,” affirms Quiles. “As with every place, there have been problems, but since I joined in 1976, I have seen very fair treatment for everybody. The Navy does not tolerate any case of discrimination.”

The Navy has made training that addresses issues of discrimination and sexual harassment mandatory, together with regular assessments of the climate of individual commands with regard to diversity and tolerance.

Still, diversity among the different arms varies. “The largest minority sector [in the Air Force] is African American, but you will probably find larger percentages in other branches of the military,” notes Wise, who is African American herself. She is quick to add, however, that although most people in the military are not minorities, she firmly believes that equality reigns. “I don’t think people look at color. They look at your job performance. If you do your job and you do it well, you will move up the ranks,” she says.

Fryer, who is also African American, testifies to the Army’s record in opening doors to minorities. “When you see minorities in key positions in nursing, as the Army has,” she says, “it’s always a plus and an encouragement because you know that you can attain that, too.”

How Would You Look in a Uniform?

A career in the service builds not only a broad range of clinical medical skills, but abilities related to leadership and decision-making that nurses may not find in any other setting. Recruiters admit, however, that the commitment is not right for everyone. Fryer says a willingness to work hard, to work smart, to go the extra mile and to be out for an adventure are absolutes.

To that list, Wise adds, “I would ask someone if he or she is a leader, likes a challenge and is flexible. If the answers are yes, I would encourage that person to consider the Air Force.”

Paula Lipp is editorial manager of Minority Nurse. E-mail her at paula.lipp@casscom.com.