Modern Healthcare

Struggles for ex-military

Former medics starting careers face uphill battle

- Ashok Selvam

Raymond Fletcher returned from 2½ years of service in the Vietnam War as a U.S. Army helicopter medic in 1974 and started his postmilita­ry career working for Chase Manhattan. But he quickly realized that nursing offered the best chance to use his battlegrou­nd experience­s.

Fletcher eventually earned a four-year degree to become a registered nurse, and he’s now a nursing informatic­s specialist at the Manhattan campus of the Veterans Affairs New York Harbor Healthcare System. But he says it should not have been so hard to get there.

“I think I should have gotten more credit for my service,” Fletcher said. “I did more in Vietnam than I have ever done as a nurse.”

Now, federal and state agencies are working to make it easier for veterans to make that leap as the U.S. winds down its presence in Iraq and Afghanista­n and thousands of medics separate from military service each year.

The credit awarded for military experience varies depending on location. Eleven state nursing boards allow graduation from a military medical training program as a substitute for a nursing degree when awarding a nursing license, according to the National Council of State Boards of Nursing.

Many would-be nurses discharged from the military, though, hit a wall because their experience doesn’t qualify them to take the examinatio­n for entry-level nurses, the National Council exam for registered nursing, known as NCLEX-RN. State boards demand the passage of that test for licensing.

The White House attempted to address this issue in April with a new program to prepare ex-military for the test. The initiative, run by HHS’ Health Resources and Services Administra­tion, along with the Defense and Veterans Affairs department­s, will award individual grants of up to $350,000 to institutio­ns with accredited nursing programs that build on military training and get more veterans on track to earn bachelor’s degrees in the field.

There is disagreeme­nt, though, about the appropriat­e credit that combat medics deserve. Many schools see the experience as equivalent to that of a basic EMT, an entrylevel certificat­ion that requires about 100 hours of training.

Sandy Summers, executive director of the Baltimore-based nurse advocacy group, The Truth About Nursing, said extra training is needed. Nursing, she said, involves more than treating traumatic injuries. “It’s about helping people; nursing is about helping people live life to it fullest, to be as well as possible,” she said. “It’s just not about tying a tourniquet and calling it a day.”

But a job as an EMT or even a paramedic doesn’t bring the same income or prestige as nursing. The 2010 median pay for a paramedic was $30,360, according to the Bureau of Labor and Statistics, while an RN’s was $64,690.

The subject drew national attention on “The Daily Show” in October. Host Jon Stewart interviewe­d two Army medics recently back from Afghanista­n who told him they were struggling to find nursing jobs in the civilian world. Stewart challenged the government to make it easier for veterans to find nursing jobs.

The federal government has tried. Starting in 2011, it paid more than $102 million to nursing schools and other training programs so they could better align military medic training with accredited nursing programs. These programs aim to train medics as nurses and physician assistants.

Also, some states are developing programs that provide veterans a bridge to nursing. San Antonio College launched a program in January that allows Army combat medics, Navy hospital corpsmen and Air Force medics to earn associate’s degrees in nursing in one year and fast-track them toward four-year degrees elsewhere. Most medical personnel in the Army, Navy and Marines are now trained at the sprawling Medical Education and Training Campus at Fort Sam Houston in San Antonio. The community college program is part of the state’s College Credit for Heroes initiative announced in 2010.

But turning military experience into a civilian career is complicate­d, said Sadie Hughes-Young, a National Guard member, an RN at Cincinnati VA Medical Center and executive director of the Cincinnati chapter of National Nurses United. Combat medics, she said, need additional training to develop their critical-thinking skills, and the transition to civilian life can be challengin­g for veterans, who are sometimes coping with post-traumatic stress disorder.

“Many of them that come back and try to go back to school may have difficulty concentrat­ing in the classroom,” Hughes-Young said.

 ?? ISTOCK ?? In 2012, there were slightly more than 75,000 active duty, guard and reserve members in healthcare support occupation­s. Last year, nearly 10,000 separated from the military.
ISTOCK In 2012, there were slightly more than 75,000 active duty, guard and reserve members in healthcare support occupation­s. Last year, nearly 10,000 separated from the military.

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