True Courage Under Fire

True Courage Under Fire

Commander (CDR) , RN, an officer in the U.S. Navy Nurse Corps, doesn’t sugarcoat what it took to reach officer rank in three different branches of the military, obtain two post-graduate degrees with plans to get a doctorate, and be awarded the Purple Heart for her service in Iraq, all while remaining a dedicated wife and mother. “It took hard work, determination and support from my family to get where I am today,” she declares.

Lenora C. Langlais

Before entering the military, Langlais worked as a civilian nurse after graduating from Villanova University College of Nursing in Villanova, Pennsylvania. Her career path as a military nurse began in the U.S. Air Force Nurse Corps in 1988 and has followed a uniquely winding course over the past 17 years. Langlais served four years in the Air Force, five years in the Army and has been in the Navy for eight years.

“I’ve been blessed to be able to take my skills and use them in the military,” she says. “I wanted to travel and use my nursing skills, so I have the best of both worlds. The pay and educational opportunities in the military were [vastly superior to what was available in] the civilian sector. The military trained me and gave me the opportunity to utilize my training in a proper setting.”

CDR Langlais believes her family and faith have been paramount in her success, including her recent service in Iraq as a combat nurse. The mother of five children, including six-year-old twins, Langlais explains that her family supports her career without hesitancy. “My husband is a Navy engineer, so he has a clear understanding of what [this life is like]. He is retiring in January 2007 and I will complete my service in 2011.”

During her long and varied career in the military, Langlais has worked in many areas of nursing, including the ER, oncology, critical care and combat trauma units. Today she draws on her experience as both a civilian nurse and a military nurse to help other Navy nurses make the transition back to civilian life. “I’m on a core staff that assists nurses and helps them use the skills and experiences they have from being in the Navy in the ‘real world,’” she says.

In the Line of Fire

In February 2006 CDR Langlais went to Iraq, where she found herself serving as the only African American senior combat nurse in the town of Al Taqaddum, on the outskirts of Al Fallujah. During her five-and-a half months there, she worked in combat trauma care, serving many severely wounded patients.

“I saw a lot of people die. I saw a lot of severe injuries. That’s what happens in wars,” she says matter-of-factly. “There is a difference between witnessing trauma as a civilian nurse and as a combat nurse. Civilian nurses will see patients come in with gunshot wounds, and it’s hard. But in a war you see wounds from explosions, and human bodies so damaged. Our medical technology hasn’t advanced far enough to keep up with these types of injuries. I prayed to God for guidance on how to care for these people.”

On April 7, CDR Langlais was coming out of the galley when she was hit by the second of four rounds of mortar blasts. “The base I was on was very close to Habbaniyah and it was very busy with insurgents day and night,” she says. “Through intelligence, the insurgents learned that the base was highly populated.” Fortunately, she survived the blast and no other military personnel were injured.

Although she has now recovered from her injury, she still feels its lingering effects. “I have damage to my face,” she explains. “The injury is from my cheekbone down past my chin and neck. I went through exploratory surgery after the attack. I have no feeling at all on the right side of my face due to nerve damage. Whether or not I ever recover feeling depends on if the nerves regenerate.”

In a remarkable display of bravery and dedication to her duty as a combat nurse, CDR Langlais refused to leave work after she was injured in the blast. “There were too many junior nurses there who needed me,” she recounts. “The night of my injury, we had a patient who was having an allergic reaction to medication and I gave him care to help him breathe. They weren’t too happy with me for continuing to work, but I wasn’t going to let him die in front of me.”

She stayed on in Iraq for three months after her injury. “I was treated and recovered in a combat zone. I came home two months early and experienced a lot of guilt because of that.”

People who know Lenora Langlais say this dedication to putting the needs of others before her own is typical of her. “She is an inspiration simply because she cares,” says Chaplain Terrell Byrd, who served with CDR Langlais in Iraq. “She cares about people, her job, her profession and her family. She is an inspiration because she came to Iraq as a volunteer. She didn’t have to at her level, but she chose to be at the front of the fight. As a wife and mother of five, I can only imagine her difficulty in making that decision. Even when she was wounded she decided to stay to set an example [of courage] for her young corpsmen.”

A Humble Hero

Despite everything, CDR Langlais feels that “overall, being in Iraq was a wonderful experience.” Does she consider herself a hero? “No,” she says simply. “I consider myself a naval officer who is a nurse.”

But that’s not what the Navy thought. Upon returning home to Camp Pendleton, Calif., CDR Langlais was awarded the Purple Heart for her courage under fire.

The Purple Heart is a combat decoration awarded under the name of the President of the United States to members of the Armed Forces who have been wounded or killed by “an instrument of war in the hands of the enemy.” It is the oldest military decoration currently used in the world and it was the first to be made available to common soldiers. The Purple Heart originated in 1782 during the Revolutionary War and was reestablished by the War Department in the 1930s. The idea of honoring American soldiers for bravery in the face of war is credited to the nation’s first President, George Washington, who wrote: “Not only instances of unusual gallantry but also of extraordinary fidelity and essential service in any way shall meet with due reward.”

That description is a perfect fit for CDR Langlais. “While deployed and in her personal time she rendered the personal touch,” Chaplain Byrd says. “In Al Taqaddum, during her tenure, I don’t know of anyone who did not know her name. There were those who would stop to say ‘thank you’ to her for the time she took with an injured soldier, sailor, marine or airman. During very difficult and long medical procedures she took time to explain what was happening to the military member. CDR Langlais is a natural leader who embodies all that is best of the naval service and the healing arts.”

Through it all, she remains humble. “I am blessed,” she says. “God was watching my back that day. My head could have been blown off. But I survived my injury, I can speak and my face is fine. I served my country, took one for the country and lived to talk about it. I’m grateful for that.”

Despite being wounded, CDR Langlais is still willing to return to Iraq if she were to receive the call. “I would go back,” she declares. “I’d pray about it and discuss it with my family, but I am willing to serve my country again.”

The Face of Diversity

When the U.S. Navy is looking for a nurse who embodies dedication and hard work, they turn to someone like CDR Langlais. She was chosen in 2005 to be featured in the Navy’s recruitment advertising campaign to be the face of the Navy Nurse Corps.

“It was a selection process that included quite a few candidates,” she explains. “They picked me because they thought I had the most appealing personality and smile and I was truly living what the ad represents.”

CDR Langlais is a model in every sense of the word–not only in the Navy ads, but also a role model for others who hope to follow in her footsteps. She travels to universities around the country to recruit other minority applicants into Navy nursing. “I’m hoping that my presence is helping to make a difference, and it does hold people accountable. I lead by example,” she says. “Unfortunately, minorities still experience the glass ceiling. We see where we can go, but we can’t always get there.”

The road to personal and professional success is often paved with adversity, and CDR Langlais has been no exception. As an African American woman she has felt the pain of discrimination. But by continuing to reach higher in educational and professional pursuits, as well as serving her country, she has literally become the picture of success.

“Being the only African American nurse and female officer on the entire base came with a price,” she says of her service in Iraq. “It was a challenge for people to be open-minded enough to take leadership guidance from me. I was labeled as confrontational and mean. If you’re anything other than [the stereotype of] a video vixen or basketball star, they can’t handle you. In their mind you’re being confrontational. But other people’s small-mindedness is not my problem. I never allow those issues to interfere with my patient care.”

What advice does CDR Langlais have for other minority nurses who are considering a career as a military nurse? First, she recommends that you “really do your research” on the nursing profession as well as on the particular branch of the military that you’re interested in. “Interview recruiters and ask lots and lots of questions,” she says. “And then ask more questions and keep asking questions again and again. Check out the recruitment office after hours when they’re not expecting you to be there.”

Her next piece of advice is: Figure out for yourself what you really want from your career and your life and then set goals accordingly. Because she knows firsthand that minorities entering the field often face barriers and obstacles that their white counterparts don’t, she stresses the importance of developing a strong support network. “Your mentor doesn’t always have to look like you,” she adds, “but it sure does help.”

She also emphasizes the crucial role that professional education has played in her success. “Education and training has been paramount in my development as an officer and a nurse. As a teacher, I love to help patients understand the importance of health care. I love seeing that light go on in people when they ‘get it.’”

Ask her Navy colleagues what kind of a role model CDR Lenora Langlais is and their faces light up, too. “There is no greater example of dignity, honor and compassion I can think of than her,” Chaplain Byrd says. “To aspiring nurses she illustrates what it means to be a perfectionist. She gives to them the pride that can only come from a professional with a 17-year career of service. CDR Langlais challenges them and others to not settle for good, but to strive for great. By example, she teaches them to excel in their educational, professional and personal goals.”

Nursing for Uncle Sam

Careers in government nursing are as varied as nursing careers in the private sector. However, when many nurses hear “government nursing,” they may assume that means working for a veterans hospital. But the Department of Veteran Affairs (VA) is only one of many government agencies where skilled nurses who want to work for the government can build their careers.

In fact, there are a variety of government agencies and positions where nurses can put their skills to work, including the Centers for Disease Control (CDC), the Indian Health Service (IHS), the U.S. Army, the National Institutes of Health (NIH), and the Center for Medicare and Medicaid Services.

Think a government career might be a good fit for you? Keep reading for stories from nurses who work for the government and tips on how you can too.

Military nursing takes sacrifice

“The army’s been very good to my family,” says Lt. Col. Christopher Weidlich, U.S. Army, who is currently finishing his Ph.D. in nursing at the University of Miami on a U.S. Army Long-Term Health and Education Training Scholarship (scheduled to graduate in 2013). He has served in the military for 17 years. “I really enjoy taking care of people, and doing whatever I can to help them out.”

When Lt. Col. Weidlich graduated from high school in 1990, his original goal was to become a doctor. “I wanted to go to medical school, but I didn’t have the grades to support it,” he says. “When I graduated from high school, I found out the Army was offering nursing scholarships.”

He went on to graduate from the University of Miami in 1994 on an Army ROTC scholarship and decided to stay in the military after graduation. He worked as an army psychiatric nurse and a psychiatric mental health nurse in various locations, including Nebraska, Georgia, Kentucky, and North Carolina, in addition to Iraq and South Korea.

After several deployments, Lt. Col. Weidlich feels that while military life comes with unique challenges, he has enjoyed his career. “Being a military family has its ups and downs like any profession, but it’s hard on my kids,” says the father of four.

Despite the personal sacrifices, Lt. Col. Weidlich says his career so far has been a very rewarding experience for him and his family, and advises other nurses considering military nursing careers: “If you go into the military, take advantage of your education,” he stresses. “There are a lot of schools that you could go to within the Army. I would recommend you take any educational opportunities that are there.”

Careers with government agencies

Nurses seeking a more stable lifestyle will find an abundance of opportunities within government agencies. Many have built their careers in the government, like Dinora Dominguez, Chief of Patient Recruitment and a public liaison in the Office of Communications at the NIH Clinical Center, Department of Health and Human Services. Dominguez has worked for the NIH since she graduated from college in 1986.

Dominguez always held an interest in doing research and was attracted to the NIH due to the research involved in her position. Today, she coordinates clinical trials and educates the public on the importance of participating in clinical trials—something she’s passionate about.

Bruce Steakley, R.N., B.S.N., a nurse manager in pediatric and adult inpatient behavioral health at the Ambulatory Care Behavioral Health Clinic (NIH), has a career that spans 30 years. He first came to the NIH six years ago.

“After working in community-based mental health inpatient settings and one outpatient setting for all those years, I got discouraged with psychiatry and the state of mental health care delivery in the country,” Steakley says. “So I left and tried other avenues of nursing, but was bored. And so I always returned to mental health and discovered my current position by word of mouth. A friend of my wife told me about this job and I decided to apply for it and now, here I am.”

Clifton J. Kenon Jr., M.S.N., R.N.C.-O.B., C.-E.F.M., I.B.C.L.C., R.L.C., A.W.H.O.N.N., fetal monitoring instructor and maternal-child health nurse consultant at Indian Health Service, found his way to the IHS by posting his résumé on the USAJobs.gov website. “I was recruited to go work for the Indian Health Service as a maternal child health consultant in South Dakota in April of 2011,” he recalls. “And in this role, I’m actually able to have an influence and to lead maternal health programs for the Indian Health Service for our four-state region: North Dakota, South Dakota, Iowa, and Nebraska.”

Steakley also applied through the USAJobs.gov website, which he says is the best place for nurses interested in a government job to go. “I occasionally have people who somehow reach me on the phone and want to apply for a job,” he says. “I step way back from that and just refer them directly to USAJobs.gov. There’s a structure for applying, and I follow the structure.”

Steakley notes that nurses seeking to gain entry with a government agency should bring patience to their job search.

“The hiring process is longer and slower, but somewhat more professional,” he says. “I was here on three different occasions, interviewing with three different sets of people. My sense was that they were looking for highly qualified people. I’ve since had opportunities to participate in a number of interviews with nurse manager candidates and clinical manager candidates. Over the years, I’ve hired a lot of people myself, and I think that although I see room for improving the process, I would nevertheless maintain it’s better here than in other settings.”

If you desire to make a leap from the private sector to the government sector, Kenon’s advice is to actively seek out opportunities, put yourself out there, and post your résumé on the U.S. Office of Personnel Management (www.opm.gov) and USAJobs.gov websites.

“Continue searching for openings that would meet your qualifications or are willing to train, and call regional recruiters. Most government agencies have recruiters that are actively recruiting new talent to the agency,” he says, adding that recruiters love to hear from those interested in public sector careers. “[They] have unique and challenging opportunities for nurses that want to serve their country.”

Government work culture

Is working for the government much different than the private sector? Some nurses who have experience in both sectors note some differences.

Kenon was a labor and delivery nurse at Duke University Medical Center and the University of Virginia. “The difference between working in the private sector and public sector is being a public servant, as I like to see myself in working for the government. I am helping to fulfill the mission of the United States Department of Health and Human Services. And I’m helping to serve the American people with health care on a national level, as opposed to in the private sector where I was more concerned with serving a local aggregate of people or a specific community.”

Steakley, who worked for various community-based facilities before joining the NIH, says that he feels more supported as a government employee, adding that he has a lot of reinforcement from the three units he manages in terms of clinical management, clinical educators, and clinical nurse specialists. “That allows me to have a slightly more elevated role,” he says, which removes him from the “nitty-gritty” of direct patient care, and enables him to be more involved in management and “setting the philosophy, growth, and performance improvement plans for the unit.”

For Kenon, working for the IHS has changed his whole perspective on nursing. “As an African American nurse, being a public servant and working within the United States Government, it has given me a clearer picture and a greater professional identity for the role that nursing has in leading health care on a national and global level,” Kenon says. “Now, I see what an invaluable role nurses play all across the government with legislative change, translating change into practices, and actually being leaders for the health care delivery system.”

Abundant opportunities

If you think a career in the government is a good fit for you, Dominguez encourages other minority nurses to pursue it because there is a wide array of positions available—not just on the clinical side. She says there are many opportunities for nurses to “think outside the box.” As you start researching for a job, Dominguez says to think of the specific skills that you can bring to the role, and just go for it.

Kenon says a government nursing career is all about dedication. For nurses considering these jobs, his advice is to make sure they have solidified a mission in nursing and the core values of the profession.

“Whether you’re in the private sector or public sector, core values such as caring, innovation, passion, and diversity are going to need to be deeply imbedded in each individual nurse’s philosophy to have a successful career in government,” he says.

Most of all, Kenon believes nurses considering such a career should know that they will be dedicating their career and lives to serving the American people. “That is a calling not to be taken lightly,” he adds.

Once you get your foot in the door, opportunities are abundant for growth, Steakley says. “They’re all around. I think that the nursing leadership and the medical leadership in the clinical center are very supportive of intellectual growth of nurses,” he says. “So I think just getting one’s foot in the door is the hardest part.”

Kenon sees himself building a long-term career as a government nurse. “In five to 10 years, I certainly see myself continuing to serve the American people and hopefully continuing to work within maternal child health,” he says. “I love working for the Indian Health Service and I love serving the Native American and the Alaska Native people. And certainly, within 10 years, I still hope to be leading the maternal child health program within the Indian Health Service.”

A Magnet Moment: The Pursuit of Excellence in VA Nursing

Over the last 20 years, hospitals in the United States have become increasingly focused on the Magnet Recognition Program® (MRP), a national initiative honoring hospitals that have achieved the highest possible standards of excellence in nursing and patient care. The process of designating outstanding health care facilities as Magnet hospitals first began in the early 1980s during yet another international nursing shortage. Even though many hospitals were struggling to fill their nurse staffing needs, it was apparent that a few facilities were somehow unaffected by the shortage. An investigation of these hospitals, sponsored by the American Nurses Association (ANA) identified 14 key standards and qualities that truly set these facilities apart from the crowd.

As a result, ANA—through its credentialing body, the American Nurses Credentialing Center (ANCC)—developed what is now known as the Magnet Recognition Program. This program recognizes hospitals, medical centers and health systems which, like a powerful magnet, have the ability to attract and retain more registered nurses and other health care workers. Most importantly, the Magnet recognition is more than just an award: It is a systematic approach to the ongoing pursuit of excellence in patient care.

More recently, medical centers within the Department of Veterans Affairs (VA) have decided to join their private sector peers in the pursuit of this coveted recognition. Of the 155 VA medical centers (VAMCs) in the U.S., only three have earned the Magnet designation. The first was James A. Haley Veterans’ Hospital in Tampa, Fla., followed by the Michael E. DeBakey VAMC in Houston, Texas, and most recently, Portland (Ore.) VAMC in 2007. The medical center where I am employed, Overton Brooks VAMC in northwest Louisiana, has also decided to join the ranks of these prestigious facilities by pursuing Magnet status.

One of the criteria for Magnet recognition is that at least 20% of all direct care staff nurses hold a current nursing certification in their area of specialty. Simultaneously, there is also a national initiative within the VA’s Office of Nursing Services (ONS), encouraging certification by at least 25% of a VA facility’s direct care nursing staff.

Certification is the formal recognition of a nurse’s specialized knowledge, skills and experience that promote optimal health outcomes. It is documented by successful completion of a national standardized certification exam and adherence to practice standards identified by a professional nursing organization in a defined clinical area. It represents a benchmark and indicator of increased clinical knowledge and experience, analogous to board certification in other disciplines. Nursing certification is not a routine competency expected of all nurses practicing within a certain specialty (e.g., CPR training).

Benefits of Certification

For VA hospitals, the benefits of certification are exponential to the organization, the individual nurse and, most importantly, to the veterans we care for. Certified nurses are more competent, accountable and confident in their practice. Moreover, studies have shown that certified nurses practice in a manner that is most likely to improve patient outcomes.1 Other research has revealed that three out of four patients are much more likely to select a hospital employing a high percentage of certified nurses.2

Furthermore, nurses who hold a certification report higher levels of empowerment, which is a characteristic associated with job satisfaction and intent to stay in their current position.3 High percentages of certified nurses are found in facilities that have a reputation for recruiting and retaining the best nursing talent—for example, 26.4% of nurses in Magnet hospitals are certified.4

For the individual VA nurse, becoming certified in your competency area can:

•   validate your knowledge and expertise;

•   build confidence in your professional ability;

•   demonstrate that you meet high national standards;

•   demonstrate your dedication to nursing as a profession;

•   provide opportunities for career advancement;

•   validate you as a credible resource for your colleagues and patients; and

•   promote personal growth and satisfaction as a professional nurse.

Nursing certification is reflective of the Veterans Health Administration (VHA)’s current transformational performance measure to distinguish VA facilities as learning organizations, charged with creating an integrated and synergistic educational environment for all staff. In addition to the MRP, certification is used as an indicator of nursing excellence in other national health care recognition programs, including the American Association of Critical-Care Nurses (AACN) Beacon Award for Critical Care Excellence and the National Institute of Standards and Technology (NIST)’s Malcolm Baldridge National Quality Award.

Don’t Overlook LPNs

In general, hospitals’ efforts to increase their number of certified nurses have usually concentrated on professional nurses (RNs). But this overlooks the important role licensed practical nurses (LPNs) play in the VA health care system. Therefore, our medical center, in recognition of our LPNs’ system-wide contribution to patient care, is also including this group in our initiative to increase certification among all direct care nurses.

Overton Brooks VAMC currently employs approximately 75 LPNs serving in various areas, such as our primary care and specialty clinics, medical-surgical and mental health units, community-based outpatient clinics and community health nursing. In most instances, the LPN is working as a team member led by the RN. However, on many occasions the LPN is directly assigned to a specific provider, such as a physician or advanced practice nurse. This expanded role remains within the LPN’s designated scope of practice, in support of the veteran’s plan of care.

Several nursing associations and certifying boards, such as the Society of Urologic Nurses and Associates (SUNA) and the National Board for Certification of Hospice and Palliative Nurses (NBCHPN), offer various types of certifications for LPNs/LVNs. However, the VA Office of Nursing Services only recognizes two specific certifications offered by the National Association of Practical Nurse Education and Service (NAPNES) and the National Federation of Licensed Practical Nurses (NFLPN). The VA-approved certification offered by NAPNES is in long-term care (LTC) and the NFLPN certification is in gerontology. (See Table 1.)

The average age of a veteran at Overton Brooks VAMC is 60, and this near-geriatric population is increasing within the VA health care system in general. Therefore, it will be extremely beneficial for VA hospitals to have a pool of talented gerontology nurses on staff. For this reason, and in the absence of an LTC unit within our facility, we concentrated our efforts on the certification in gerontology offered by NFLPN.

This certification evaluates competency in four specific domains:

1. Phases of the Nursing Process: Gathering information regarding the patient; identifying the patient’s health needs and selecting appropriate goals of care; designing a strategy to achieve the goals established for the patient; initiating and completing actions necessary to accomplish goals; and determining the extent to which the goals have been achieved.

2. Areas of Patient Needs: Provision of coordinated and goal-oriented care; evaluation of patients’ basic physiological care; psychosocial, coping and adaptation needs of the patient; and developmental changes that occur in older persons.

3. Critical Thinking Skills: Identifying, gathering, discriminating and prioritizing data collection; discovering and then discerning the nature of relationships between concepts; determining how and why concepts are related; developing a process for establishing goals; and using problem-solving to achieve patient-specific outcomes.

4. Gerontology-Specific Topics: Nursing of elderly patients with physical and psychological disorders; special issues in gerontological care; foundations of gerontology; and promoting health and wellness in the geriatric patient.

Case Study: How We Did It

As the Magnet program director (MPD) for Overton Brooks VAMC, I was responsible for spearheading the LPN certification efforts. First, we sent out a call for participation to all LPNs within our medical center. The purpose of this initial call was to determine the number of LPNs who might be interested in certification, and in attending a dedicated review session to prepare for taking the gerontology certification exam. The LPNs were informed that all materials would be supplied by the medical center, the review session would be held on a Saturday and the test would be given at our facility, once again on a Saturday.

Answering this call for participation were 15 LPNs with varying levels of experience, employed in a variety of inpatient and outpatient settings. The LPNs were then asked to sign a letter of commitment acknowledging their individual willingness to attend the Saturday review session and the Saturday test. These were not scheduled workdays, and participating LPNs who worked on Saturdays were to use vacation time or request these days as scheduled days off. Unfortunately, this decreased the size of our participant group from 15 to 12. Even so, we moved forward with our initial plans to increase the number of certified LPNs.

Our next step was to obtain funding for the certification project. Initially, the project was discussed with nursing leadership, who viewed the certification in gerontology as a continuing education opportunity. Subsequently, the proposal was presented to the medical center’s executive leadership group, who determined that this very worthwhile professional development activity was appropriate for funding through continuing education funds. This enabled us to order the materials we needed.

Education Resources, Inc. (ERI) sponsors the certification testing and credentialing offered by the NFLPN. ERI has a long history of assisting practical nurses with various types of educational opportunities. The paper/pencil examination may be administered at the place of employment for LPNs or at an approved testing facility. Hence, the test was administered at our hospital and I served as the proctor.

ERI provided a review DVD, test booklet, pencils and proctor verification forms for each participant. They also provide each LPN participant with a diagnostic report, listing on the national LPN registry and individual certificates (for those who pass the exam).

When the DVD review materials arrived, my next job was to evaluate them to determine their adequacy in preparing our LPNs for this examination. I was qualified to do this because I have experience in working with practical nursing schools and NCLEX-PN® and -RN® preparations, and I hold an advanced degree in public health education and a doctoral degree in health policy. I also have more than 15 years experience in curriculum design, development and evaluation.

My initial review of the materials determined that further enhancement would be beneficial to this LPN group. Therefore, I developed our own additional review materials, including over 300 PowerPoint slides covering topics such as normal aging changes (physical and emotional), major disease processes affecting the elderly, and test-taking strategies. Additionally, the DVD was transcribed verbatim to a hard-copy format to facilitate adult learning.

As with any review course, it’s important to know your audience. Standardized review courses are generally tailored to a large audience. That’s why it’s so crucial to determine if the majority of your group members are functioning at the same knowledge level prior to conducting a group review.

In early May 2008, we conducted the review session with our 12 LPN participants. It lasted six hours, with three 15-minute breaks. Participants were encouraged to bring beverages and light snacks to the session; however, lunch was not provided.
The LPN group returned later that month to write a 105-item certification exam. They had two hours to complete the exam, though most were finished within one hour.

When ERI sent us the examination results, they arrived at my office in individual sealed envelopes to ensure confidentiality. In turn, the LPNs were notified that the results were available. Individually, each one came to my office, received their envelope and anxiously reviewed their results. Nearly all of the participants—11 out of 12—successfully passed the certification exam and are now proudly identified as certified LPNs in gerontology, holding the LPN, GC [Gerontology Certified] designation.

Cost-Effective and User-Friendly

The cost to our medical center was minimal. As itemized in Table 2, the estimated total cost was around $1,900. I volunteered a total of 12 hours of my time for the review session and the test proctoring.

In conclusion, this certification strategy has proven to be a worthwhile professional development opportunity involving a successful collaboration between direct care nurses, medical center leadership and our facility’s Education and Training Service, which provided financial resources. The benefits to our facility and our LPNs are evident. The group certification enabled us to:

•   increase the professional role of the LPN;

•   improve career advancement opportunities for these nurses;

•   help LPNs meet their personal and self-improvement goals; and

•   provide an avenue for LPNs to highlight their special skills and talents in gerontology.

We have rewarded each newly certified LPN with a within-grade step increase. The next phase of the project will be to replicate this user-friendly approach to group certification with other licensed nursing staff (RNs and advanced practice nurses), as well as unlicensed staff (nursing assistants and health care technicians). Our VAMC is well on its way to obtaining 20-25% certification among its direct care nurses—the first step in our journey toward achieving Magnet recognition.  n

References

1.  Cary, A.H. (2001). “Certified Registered Nurses: Results of the Study of the Certified Workforce.” American Journal of Nursing, Vol. 101, No. 1, pp. 44-52.

2.  American Association of Critical-Care Nurses and AACN Certification Corporation (2003). “Safeguarding the Patient and the Profession: The Value of Critical-Care Nurse Certification.” American Journal of Critical Care, Vol. 12, No. 2, pp. 154-164.

3.  Piazza, I.M., Donahue, M., Dykes, P.C., Griffin, M.Q., and Fitzpatrick, J.J. (2006). “Difference in Perceptions of Empowerment Among Nationally Certified and Noncertified Nurses.” Journal of Nursing Administration, Vol. 36, No. 5, pp. 277-283.

4.  Shirey, M.R. (2005). “Celebrating Certification in Nursing: Forces of Magnetism in Action.” Nursing Administration Quarterly, Vol. 29, No. 3, pp. 245-253.

A Win-Win Partnership, VA Style

Recruiting eager students into the future nursing pipeline has become easier in recent years, thanks to the profession’s efforts to publicize the nursing shortage and promote the benefits of nursing as an attractive career. But filling the pipeline does little good if it narrows at some point down the line so that the end product is reduced to nothing more than a trickle.

According to the American Association of Colleges of Nursing, in 2007 more than 36,000 qualified applicants were turned away from entrylevel baccalaureate degree programs in nursing schools due to an insufficient supply of faculty, clinical sites, classroom space and clinical mentors. And with a whole generation of current nursing faculty rapidly approaching retirement age, many of the nation’s top nursing employers are beginning to explore innovative new ways to make sure they’ll have enough professionally trained nurses to meet their future staffing needs and provide the best possible patient care.

That’s one of the goals behind the U.S. Department of Veterans Affairs Nursing Academy (VANA), a five-year, $59 million project launched in 2007 to provide a pipeline of highly educated nurses to serve the health care needs of the nation’s veterans. VANA consists of partnerships between selected schools of nursing and VA medical facilities throughout the country. In these unique collaborations, nursing school faculty provide education and other services at the VA facility, qualified VA nurses serve as faculty members at the nursing school, and the VA hospital provides enhanced clinical experiences for students. Currently, there are 15 such partnerships in the VA Nursing Academy, a name that represents a collection of collaborative efforts rather than an actual physical entity.

“The purpose [of VANA] is to increase the number of students that can be admitted to [nursing schools], increase the number of new graduate nurses at the VA hospitals and retain them once they’re there,” says Blanche Landis, PhD(c), RN, the VANA program coordinator at San Diego State University School of Nursing, which is partnering with the VA San Diego Healthcare System.

There are many benefits from the VA side in terms of improving the quality of care as well as elevating the practice of nurses within our organization,” adds Maude Rittman, PhD, RN, director of nursing at the North Florida/South Georgia Veterans Health System in Gainesville, Florida. Her facility’s VANA partner is the University of Florida College of Nursing, also based in Gainesville. The Department of Veterans Affairs, with 61,000 registered nurses, licensed practical nurses, vocational nurses and nursing assistants, has one of the largest nursing staffs in the world and is one of the country’s largest employers of minority nurses. VA nurses work at the department’s 153 medical centers and almost 900 clinics nationwide. The VA currently provides clinical education for some 100,000 health professional trainees each year, including students from more than 600 schools of nursing. Almost 22,000 of the VA’s registered nurses will be eligible for retirement by 2010.

Meeting Goals

The VA Nursing Academy’s Enhancing Academic Partnerships Program has four main goals:

  1. Expanding faculty and professional development at nursing schools and VA facilities;
  2. Increasing nursing student enrollment;
  3. Providing opportunities for educational and practice innovations; and
  4. Increasing recruitment and retention of VA nurses as a result of enhanced roles in nursing education.

To meet the faculty expansion goal, VANA provides funding for three full-time equivalent (FTE) VA-based faculty and two FTE school-based faculty in the first year of the program. Then it increases to six and four faculty respectively, until the last year, when the number drops to three and two respectively. This allows nursing schools to add and maintain enrollment of 20 more students for each five faculty members added, according to a national evaluation funded by the VA and conducted by the UCLA School of Public Health in 2008.

The second goal, increasing enrollment in nursing schools, has already been achieved at the University of Florida College of Nursing, which was one of the first schools to participate in VANA. In fact, enrollment has exceeded expectations, says Maxine Hinze, PhD, RN, the college’s VANA program director. Twenty-eight additional baccalaureate students were admitted in the first year of the program, and 24 additional students were admitted the second year. Enrollment has also increased in the accelerated BSN and RN-to-BSN programs, Hinze reports.

VANA’s third goal is in alignment with the VA’s overall mission of investing resources into becoming a learning organization, says Rittman. “This implies that people who join our organization continue to learn and grow within the organization,” she explains. “To me, this program is a step in that direction, in that we are implementing evidence-based practice [at our facility]. In our [VANA] model, [nursing school] faculty are actually embedded in the nursing unit and become part of the unit.”

Recruitment Results

This heightened emphasis on education and innovation is designed to not only improve patient care but also help boost recruitment and retention of VA nurses—the VANA program’s fourth goal. The VA believes that integrating nursing school faculty into its hospitals will provide more stimulating clinical and learning environments, increase VA clinical education opportunities and inspire more new nursing graduates to seek employment at VA facilities where they’ve had a positive clinical experience.

“The idea is that they will fall in love with [VA nursing] and want to continue on,” Landis says. “Students will become more familiar with the [VA] system, more familiar with veterans and will want to be more involved in the care of vets.”

The University of Florida College of Nursing and the North Florida/South Georgia Veterans Health System have a one-year nursing residency program as part of their collaboration, says Hinze. This also helps increase recruitment and retention. In its first year in the VANA program, the VA facility recorded a 92.3% retention rate, in that 36 of 39 new graduate nurses hired at the hospital were still employed there after one year. In contrast, median turnover rates for graduate nurses in general during their first year of employment currently range from 35% to 61%, depending on location.

“The first year of employment can make or break a nurse,” Hinze notes. The VA facility was also able to hire a larger-than-usual number of nurses with baccalaureate degrees after the first year of the partnership, Rittman says—18 to 20 as opposed to the normal six to 10. It also hired more new graduates than usual (39). And while the hospital hired only 24 new graduate nurses after the second year of the program, this was due in part to reduced turnover, meaning there were fewer jobs available.

“We had 70 applicants and could only hire 24 because our vacancy rate was lower,” Rittman explains. Although the VA Nursing Academy is not targeted specifically toward recruitment and retention of minority nurses and students, many of the VANA partnerships are located in areas with large minority populations.

“We have more Hispanic veterans [receiving care at our facility],” Rittman says, “and so we do like to hire Hispanic nurses and African American nurses [who can provide culturally competent care].” Nurses who work for VA hospitals must be U.S. citizens, she adds, and that requirement has at times prevented her facility from hiring promising international nursing graduates who have immigrated to the U.S. but have not yet had a chance to earn citizenship.

Because the Department of Veterans Affairs has a very high level of racial and ethnic diversity compared to the private sector—both in terms of workforce and patient population—it has long been an employer of choice for nurses of color. “It’s also a good environment for male nurses, because many of them have been in the military and have been medics,” says Rittman. “So the VA is a very comfortable place for them to be.”

Making It Work

To help ensure that the Enhancing Academic Partnerships Program is working effectively and accomplishing its goals, the VANA project calls for periodic program evaluations at both the local partnership and national levels. The evaluations include structure, process and outcomes assessments of clinical practice, education and program activities.

The 2008 national evaluation reported several challenges to making the program work, including assimilation of nursing school faculty into the broader organizational structure of VA facilities and assimilation of VA nurses into the academic culture of nursing schools. Other challenges included time-keeping for faculty, performance evaluations and reports that teaching required a more significant investment of time than VA nurses had anticipated.

But on the positive side, the evaluation identified beneficial spill-over effects, such as the strengthening of ties between VA facilities and their partnering nursing schools, opportunities for collaborative research, opportunities to expand simulationbased learning, sharing of advanced educational experiences, and increased enrollment of current VA nurses into graduate-level nursing programs.

Still another finding was that VANA’s innovative structure helps address one of the biggest problems contributing to the nursing faculty shortage—the fact that academic salaries are often much lower than what nurses can earn in clinical practice. Because the VA nurses who serve as nursing school faculty maintain their existing VA salaries, this provides an incentive for VA nurses with master’s degrees or other advanced training to become involved in teaching.

While VANA is clearly a win-win proposition for nursing schools, VA hospitals and nursing students, the program’s long-term goal is to improve care for veterans.

“The vets will ultimately benefit if [the nurses] who are providing the care have the best instruction, the best education and the support they need to develop [professionally],” says Landis. “All patients deserve the best care, but I think [veterans are a unique population with their own special needs]. This program exposes students to the [health care] needs of vets and certainly increases their understanding of those needs.”

For more information about the VA Nursing Academy, visit www.va.gov/oaa/vana.

Allied for Education

As of academic year 2009-2010, the VA Nursing Academy (VANA) comprises 15 partnerships between nursing schools and VA medical facilities:

 

VA Site
Nursing School Partner
Charles George VA Medical Center
(Asheville, N.C.)
Western Carolina University
School of Nursing
Birmingham VA Medical Center
(Birmingham, Ala.)
University of Alabama at Birmingham
School of Nursing
VA Pacific Islands Health Care System
(Honolulu, Hawaii)
University of Hawaii at Manoa
School of Nursing & Dental Hygiene
VA New York Harbor Healthcare System
(New York, N.Y.)
Pace University Lienhard School of Nursing
VA Pittsburgh Healthcare System
(Pittsburgh, Pa.)
Waynesburg University
Ralph H. Johnson VA Medical Center
(Charleston, S.C.)
Medical University of South Carolina
Edward Hines, Jr. VA Hospital
(Hines, Ill.)
Loyola University of Chicago
College of Nursing Michigan Consortia
(Ann Arbor, Battle Creek, Detroit, Saginaw)
University of Detroit Mercy and Saginaw Valley State University
Oklahoma City VA Medical Center
(Oklahoma City, Okla.)
University of Oklahoma Health Sciences Center
College of Nursing
Providence VA Medical Center
(Providence, R.I.)
Rhode Island College School of Nursing
James A. Haley Veterans Hospital
(Tampa, Fla.)
University of South Florida College of Nursing
North Florida/South Georgia Veterans Health System
(Gainesville, Fla.)
University of Florida College of Nursing VA Salt Lake City Health Care System
(Salt Lake City, Utah)
University of Utah College of Nursing
VA San Diego Healthcare System
(San Diego, Calif.)
San Diego State University School of Nursing
VA Connecticut Healthcare System
(West Haven, Conn.)
Fairfield University School of Nursing

Leaders Follow

Some of us, for one reason or another, want to be leaders. Whatever it is that motivates us, whether it be power, wealth, position, fame or glory, we strive to climb the ladder of success. The time, energy, and effort you invest is worth it all when you are recognized for your milestone of achievement. But then what? What next? Another goal? A different motivator? I am reminded of the great American motivational speaker Zig Ziglar’s trademark quote: “You can have everything in life that you want if you will just help enough other people get what they want.”

Over the course of my long career in the military, I have found that helping others along the road to success is the greatest achievement of all. With success often comes a platform, an opportunity to further a cause. My own personal cause is breast cancer. I choose to be an advocate beyond the call of duty for breast cancer awareness, prevention and treatment.

During my deployment to Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) from March 2003 to March 2004, I had the privilege of serving as a nurse at the Landstuhl Regional Medical Center (LRMC) in Germany. I provided care to wounded soldiers from the OEF/OIF battlefront as well as serving the health needs of military families in the European theater. Regardless of the day’s duty, a pink ribbon always adorned my uniform to spread the message of breast cancer awareness. As an officer in the Army, people look to me for leadership. The position requires it; the chain of command demands it.

While serving at Landstuhl, my nurse colleague, Major Shirley McKellar, and I recognized a need for a comprehensive breast cancer facility for our soldiers and their families stationed abroad. I assisted Major McKellar in establishing the first-ever breast cancer clinic at LRMC. The Landstuhl Comprehensive Breast Cancer Center proudly opened its doors during my term of deployment.

Major McKellar and I developed all the required activities for the clinic, including organizing a survivors’ luncheon and fashion show fundraiser to increase community awareness of our newly offered services. Our fashion show models were military personnel and cancer survivors/patients. Major McKellar and I also provided breast cancer screening and education seminars and organized a continuing education luncheon.

In addition to being a leader during OEF/OIF, I was also a follower. A follower is someone who recognizes the goals and achievements of others who have performed worthwhile endeavors. A follower sees merit in those same goals and adopts a similar work ethic, building upon the success of those who have gone before. By choosing to use my deployment as an opportunity to promote breast cancer advocacy, I was following in the footsteps of all those who have made a difference in the fight against this deadly disease.

Advocates Against Inequity

My military career has also allowed me to cross paths with another remarkable individual who is making a difference in that common fight. Linda Martin is a beautiful lady with a wonderful message. I met Linda through the honor of knowing her husband, SFC Craig Martin, Linda’s greatest fan. SFC Martin is one of the hardest workers and most professional soldiers at the 94th Combat Support Hospital (CSH) in Seagoville, Texas, where I am currently stationed as an Army Reserve nurse.
Linda is nationally recognized as an author, minister and Christian recording artist and she was selected as Mrs. Plus America 2005. This is a recognition designed to honor full-figured women whose accomplishments have made outstanding contributions to the community. Most important of all, Linda is an advocate for people with cancer. In 2002, she created the “Blessing Bunny,” a stuffed animal that she says brings comfort to all patients undergoing cancer treatments and hospitalizations. She actively uses her platform of visibility to speak about breast cancer.

As women of color, Linda and I have the opportunity to make an even greater impact as advocates in the fight against breast cancer, because of the racial and ethnic disparities that exist with this disease. The statistics reveal that minority women are more likely than their white counterparts to be diagnosed with breast cancer when it is in an advanced stage and are less likely to survive a bout with the disease.

African American women have an average survival rate of only five years after being diagnosed with breast cancer. Hispanic women face cultural and language barriers to screening and treatment; this may account for the fact that they have a lower incidence rate of breast cancer than white women but a higher mortality rate. These inequities are becoming increasingly critical in light of America’s rapidly changing demographics–e.g. population statistics now show that in Texas Hispanics are the majority group rather than a minority.

The first step in the fight against breast cancer disparities is cultural competence. Cultural competence is the capacity to understand, evaluate and overcome cultural barriers to achieving an acceptable standard of care. According to the National Center for Cultural Competence at Georgetown University (http://gucchd.georgetown.edu/nccc/framework.html#lc), cultural competence requires that health care organizations:

• Have a defined set of values and principles, and demonstrate behaviors, attitudes, policies and structures that enable them to work effectively cross-culturally.

• Have the capacity to:
1. Value diversity;
2. Conduct self-assessment;
3. Manage the dynamics of difference;
4. Acquire and institutionalize cultural knowledge; and
5. Adapt to diversity and the cultural contexts of the communities they serve.

• Incorporate the above in all aspects of policy making, administration, practice and service delivery, and involve systematically consumers, key stakeholders and communities.

In conclusion, as you too take your steps up the ladder of career success, look around and take a stand for someone or something other than yourself. I encourage you to join us in the fight against breast cancer. Be a follower who carries forward the work that other minority nurses have done; be a leader and blaze your own trails forward to advance the cause. The task is too large for us to accomplish as individuals, but as a team we can build upon each other’s success to truly make a difference.

An Army (and Navy and Air Force) of Opportunities

Among various assignments as a U.S. Navy nurse, Commander Ava Abney has practiced in a pediatric outpatient clinic in Puerto Rico, run an obstetric services department in Guam and cared for service men and women aboard an aircraft carrier. Spanning the globe on land and at sea, the African-American nurse’s 18-year career in the military has given her opportunities she never would have had as a civilian.

“It’s so wide open,” says Abney, who now heads up quality management at the Naval Hospital in Pensacola, Florida. “And it’s still very exciting.”

Few institutions can match the career diversity offered by the military, where nurses are groomed for leadership from day one and have wide-ranging opportunities for training and advancement.

“We’re all about leadership,” agrees Lieutenant Commander Select Darnell Hunt, an African-American Navy nurse who is a medical officer recruiter in Kansas City, Missouri. “If you follow the career paths, you’re able to progress to whatever level you choose.”

Endless Opportunities, Unbeatable Benefits

Even before the global war on terrorism and Operation Iraqi Freedom, demand was heavy for nurses to serve in the Army, Navy and Air Force. Nurses work in a variety of specialties in the military, including OB/GYN, community health, mental health, pediatrics and critical care.

The Army is focusing its current recruiting efforts on operating room nurses, medical/surgical nurses and nurse anesthetists, although it continues to recruit nurses from other specialties as well, says Colonel Ann Richardson, chief, Army Nurse Corps Division of the U.S. Army Recruiting Command. As for the Navy, Hunt says the greatest needs now are for generalists, med/surg nurses and critical care.

To join the military nurse corps, nurses must have a BSN degree from an accredited nursing school, be in good physical condition and have an RN license in any of the 50 states. There are also age limits–under 35 years old for the Navy and Air Force and under 47 for the Army–although older applicants can apply for age waivers. Nurses who join the military enter as commissioned officers and begin their military careers as leaders from the very beginning.

Military pay is comparable to that of civilian nursing jobs, especially after promotion, officers say. The military also offers signing bonuses of $10,000. Benefits include opportunities for graduate education and other training, full medical and dental coverage, up to 30 days paid vacation each year and a 20-year retirement potential.

Military nurses care for active-duty and retired personnel in military hospitals as well as serve in the field during emergencies and war. They also work in research, education, management, recruitment and training. The opportunities are almost endless.

Developing Leadership Skills

“As nurses, we are on the rise,” says Commander Select Richelle Kay, division officer of an oncology ward at Portsmouth Naval Hospital in Virginia. After serving a three-year stint in the Navy as a staff nurse out of college, Kay went on reserve status and worked as a civilian nurse in a trauma center. It wasn’t long, though, before she yearned to return to the Navy, where she says the level of professionalism and job satisfaction among medical staff can’t be beat.

Her first assignment after returning to active duty was in Oceanside, Calif., where she worked in operational management–planning and coordinating medical training to make sure the Navy was ready in case of military conflict. The experience enabled her to step away from the bedside and develop strategic leadership skills. “That gave me a bigger picture of what Navy medicine was all about and why we [nurses] are such a critical component,” she notes.

Later, Kay, an African American, became one of the first minority Navy flight nurses and was stationed on Diego Garcia Island in the Indian Ocean. Kay and another nurse developed and ran wellness programs for U.S military personnel stationed there, provided acute care and, when necessary, flew with critical patients to Singapore to keep them stabilized during the five-hour flight.

Lieutenant Colonel Yolanda Ruiz-Isales also has had many opportunities to hone her leadership skills all over the world. Her Army career highlights include an assignment as head nurse in the triage section of a MASH unit in Seoul, South Korea, and an assignment as one of three team members sent to the Czech Republic to help it establish a nursing corps similar to that of the U.S. Army.

“If you are a person who wants to remain stagnant, this is not the place to work,” Ruiz-Isales emphasizes. She joined the Army after working in a civilian hospital in Puerto Rico, deciding that the military would offer greater opportunities and compensation for her work. Now, 18 years later, she remains satisfied with her decision.

Upward Mobility

Mobility in the military isn’t just about moving physically from one place to another. It also means moving up in rank to positions of higher responsibility and pay. Opportunities for promotions are many, says Major Darlene Foley, an American Indian nurse who is from the Lower Brule Sioux reservation in South Dakota and now oversees OB/GYN outpatient clinics at Wilford Hall Medical Center at Lackland Air Force Base in Texas.

“In the 10 years I was a civilian nurse, I saw that people stayed in the same positions for years,” she recalls. “In the Air Force, I came in as a clinical nurse and started off as a lieutenant. Now I’m a major and OB/GYN flight commander and I oversee 100 people. I see a lot of minority nurses do very well in the military.”

Major Yolanda Bledsoe, an African-American flight commander and chief of group education and training at Wilford Hall, says advancement in the military isn’t about race. “It’s about how I get my job done, how I communicate with people and how I mentor people. No matter where you go, if you bloom and do a good job, the sky’s the limit.” Each assignment brings new challenges, Bledsoe adds, but “I have learned so much outside of my comfort zone.”

Ava Abney agrees. She remembers the awesome responsibility of caring for ship personnel aboard the Navy aircraft carrier. “That was when I really grew up,” she asserts. “Out on that huge boat as one of two nurses for 5,000 people, what you say goes. You become very aware of how important nurses are.”

Work/Life Balance

While the mobility of military life can provide stimulating opportunities and career advancement, it can also bring personal challenges, especially for people raising families.

Lieutenant Maria Millsap says the military works with officers as much as possible to accommodate their work/life needs. Millsap, who is of Filipino descent, joined the Navy out of high school in 1979 and served as a hospital corpsman–similar to a civilian LPN. Then she used Navy tuition benefits to attend the University of Washington in Seattle, graduating with her bachelor’s in nursing in 1996. Not wanting to move her family since then, she has managed to stay in the region, although she has held different assignments, first at the Naval Hospital in nearby Bremerton and then as a nurse recruiter in Seattle.

Although it’s possible to stay in one geographical area for more than a few years, nurse officers have to keep in mind that the military’s needs sometimes supercede their own, especially during wartime. Air Force Captain Luis Perez, nurse manager for the internal medicine clinic at Wilford Hall Medical Center, had just been transferred to San Antonio, Texas, in September 2002. Then he received word that he would be deployed to Germany for five and a half months to help expand a hospital for service men and women wounded in Afghanistan and Iraq.

Military nurses must have the support of their families to cope with the stresses of possible deployment, says Perez. “It’s a different mindset. You can be here one day, then at night the phone rings and you have to leave. Your life has to be very flexible and your family has to be the same way.”

Despite the challenges of sudden deployment, Perez recalls serving in Germany as a rewarding part of his career. He will never forget the determination of the patients and how they cared for one another.

Says Bledsoe: “I have my bags ready to go at any point in time. We have to realize we’re officers first. When you come into the military, it’s almost like you’re answering a higher calling.”

That sense of a higher calling is one of the intangible rewards of military service, nurse officers agree. Abney feels it every day as she watches the color guard raise and lower the flag and thinks about how the service men and women overseas see the same ceremony each day, too. “It puts things in perspective,” she says. “It leaves me with a great feeling–that I’m serving my nation.”

Opportunities for Learning–and Teaching

Opportunity for continued education and training is still another benefit of military nursing. All three military branches offer educational benefits through scholarships and tuition assistance programs, which can pay up to 100% of tuition costs in exchange for service commitments.

Kay, for instance, earned her master’s degree in community health at the University of North Carolina under the Navy’s Duty Under Instruction program (DUINS), which pays the full cost of tuition and fees and provides full pay and benefits for qualified applicants to attend graduate school full time.

Military nurses can also branch out beyond health care. Bledsoe earned her master’s in adult education–which enabled her to teach professional military officer courses–by taking classes at night. She paid 25% of the cost and the Air Force picked up the remainder of the tab.

Another advantage of working in the military, nurses say, is the camaraderie among medical staff. Nurses and doctors work together as peers, a relationship that gives nurses more empowerment than they would typically have in a non-military setting.

“In the military, the partnership is more evident than in the civilian world,” Foley says. “There are better team-building opportunities than in civilian life.”

Doctors and nurses go through weapons training together, for instance, and practice setting up field hospitals with one another. In some cases, nurses even outrank doctors.
The military, of course, is not for everyone. But minority nurses who are flexible, enjoy leadership challenges, like to travel and want to grow professionally and personally might want to consider serving, nurse officers say.

If you are interested in a military nursing career, Kay suggests researching and comparing all three branches to see which one best matches your needs. Then talk to recruiters in your area. Ask as many questions as possible, Kay advises, and take a friend or family member along to ask questions, too.

“After you decide which branch you want to join, ask to speak to some nurses,” she adds. “You need to know day to day what it’s like being a nurse in the service.”

The “War at Home” Needs Nurses

As the global war on terrorism places increasing demand on the military medical community, new opportunities are opening up for civilian nurses interested in working for the U.S. Army. The Army is now recruiting civilian nurses for assignments of one to four years to backfill positions held by active duty and reserve personnel who are currently deployed overseas. Civilians are needed to work in army hospitals as well as at demobilization sites all over the country to screen soldiers before and after they return from deployment.
Benefits include working in state-of-the-art medical facilities, training, 13 to 26 days of vacation time per year, 10 paid holidays, sick leave of up to 13 days and group life and health insurance. The Army’s goal is to recruit 250 RNs, 700 LPNs and 100 nursing assistants. “We think it will be a continuing need for the next several years,” says JoAnn Robertson, human resources director for the U.S. Army Medical Command.
For more information about the Army Medical Command Centralized Civilian Recruitment Program, call (800) 633-3646.

For More Information

U.S. Army Nurse Corps
(800) USA-ARMY, ext. 183
http://www.goarmy.com/amedd.html

U.S. Navy Nurse Corps
(800) USA-NAVY
www.navy.com

U.S. Air Force
www.Airforce.com

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