The learning process for our Second Lieutenants does not stop after graduation and commissioning. Once candidates pass their NCLEX-RN exam, they are accessed into the Army Nurse Corps and eligible to attend the Basic Officer Leaders Course (BOLC) for 2.5 months in Fort Sam Houston, TX. Nurse officers begin their career development through different stages of clinical and administrative assignments. These stages allow them to gain experience and become proficient in both patient care and personnel management.
Upon arriving at their first duty station, the officer will be paired up with a preceptor to facilitate the transition of new graduates (with less than six months experience) into practicing nursing in a military environment. In this program (known as the Clinical Nurse Transition Program), the new health care provider is partnered with another, more experienced health care provider (preceptor), who is responsible for orienting the new graduate to the clinical area as well as assisting with the transition into the military environment.
When new graduates arrive to their first assignments, they are briefed on the preceptorship program either by the Education Chief or a senior instructor. The program is based on the Army mission, values, and goals and includes program objectives and performance standards that apply across the AMEDD. CNTP lasts for six months and must take place in one of the eight major Army Medical Facilities. The new health care provider and the assigned preceptor work the exact same schedule for the entire length of the preceptorship. The preceptor is responsible for providing the initial unit orientation, assessing the individual learning needs of the new graduate, coaching and constructive feedback, and providing appropriate learning experiences.
After completing the preceptorship, a Clinical Staff Nurse will usually spend one year on a general medical--surgical ward to hone their clinical and time management skills, gain a greater understanding of the military healthcare system and develop their interests in specialty areas of the nursing profession. They will be members of treatment teams and primarily be responsible for direct hands-on patient care. During the first year, the nurse develops the required foundation of techniques and knowledge that will guide them and be developed upon throughout their career.
After the first year, the clinical staff nurse will be given opportunities to demonstrate their management and organizational skills by being placed in the role of Charge Nurse. As Charge Nurse, the Lieutenant will be responsible for staff/patient care assignments, overall operations of the patient care ward, and be the "go to" person for any concerns or patient care/ward procedure questions. This is the time that they learn accountability and responsibility for the actions of others and how to integrate the entire healthcare team together for quality patient results. This role can best be compared to that of a Platoon Leader. At this point in their careers, nurses may also be selected for a nurse specialty school where they will be transferred to a unit of their specialty upon completion.
As a nurse attains the rank of Captain, and the experience that goes with it, they are eligible for a Head Nurse position. It is not uncommon to see a staff nurse become a Head Nurse in just three or four years. As a Head Nurse, they are responsible for all actions on their ward or clinical area to include budget management, logistics, staff actions and management, training requirements and maintaining top quality patient care. Depending on their specialty and desire, an Army nurse may hold the position of Head Nurse during 3 or more assignments. This role can best be compared to that of a Company Commander.
At the rank of Captain, there are also many crossroads for the nurse officer to take that allow them to apply for graduate studies, specialty training, staff officer roles, educators or administration. In some cases, Army nurses will have the opportunity to practice in nontraditional environments such as research institutes, government agencies, Nurse Counselors within Cadet Command or Health Care Recruiters within Recruiting Command. Other unique roles include White House Clinical Staff Nurse and Instructors at the Army Medical Department Center and School.
Dependent on the path taken and assignment location, officers can maintain a closer association with the clinical or administrative component of nursing. In order to ensure a varied background and to integrate both the administrative and clinical aspects, careers usually involve both types of assignments. As nurses attain the rank of Lieutenant Colonel and Colonel, positions such as Clinical Section Supervisors, Assistant Chief Nurse and Chief Nurse of hospitals, and special staff officers are available for assignments. Colonels are also considered for Hospital Command positions through the Army.
Professional advancement within the Army comes much quicker as compared to civilian counterparts. Army nurses earn regular increases in rank and responsibility and are provided with many opportunities to prove their abilities and potential for promotion. Seniority is maintained during change in assignments with each new position building on the previous experiences. In many civilian hospitals, opportunities for upward mobility are limited, with management positions filled by nurses with many years of seniority within the organization.
Army ROTC is just the beginning of a long and successful career for nurses.