Nurses in Command

Colonel Dawn M. Harl, US Air Force Nurse Corps, is my wife. I have this philosophy in life: "If you can't be a nurse – marry one." We were married before I entered the Air Force. It only took my being transferred with the Air Force twice for my wife to figure out that every time I moved, she started at the bottom of the work schedule at some new hospital. So, after I was in the Air Force for a year and a half, my wife joined.

She came in as a first lieutenant while I was still struggling to get past being a "baby" second lieutenant, and she outranked me the rest of my military career. Because joining the Air Force Reserve was a six-year commitment, she originally joined the active duty Air Force, which had a three-year commitment. Twenty-four years later, she is still an Air Force nurse and I am her old, eccentric, retired, dependent husband.

If you want to do only hands-on patient care, as a military nurse, you are working for the wrong HMO. You are hired because you are a nurse, but you are a commissioned officer first, and then a nurse. For the first couple of years of your military nursing career you will be performing direct patient care, but whether you want it or not, you'll find that you have people working for you. The military uses medical technicians in direct patient care, and even as the most junior nurse working on a floor, you'll find yourself in charge of people. In charge means leadership, and this is where the officer part of military nursing comes in.

You start leading troops right away, and it never stops until you retire from the Air Force. If you do not want to take on the responsibility of leadership, do not become a career military nurse. I doubt most nursing education programs teach much leadership, but you will acquire that skill very rapidly in military nursing, or you will move back into the civilian world of healthcare. Military nurses become outstanding leaders.

When my wife entered the Air Force in 1981, only doctors could be military medical commanders. Think of Colonel Sherman T. Potter in the old M*A*S*H TV series. He was the "doc" so he was in charge. Major Margaret "Hotlips" Houlihan had plenty of military leadership skills, but she was a nurse and there was no way they would put her in command.

In 1984, my wife attended an Air Force eight-week leadership class called Squadron Officers School. My wife was the senior person in the class, but because nurses could not command, she was not even allowed to be the class leader. Today, when you attend a training course in the military, they check your date of rank and whoever is senior becomes the class leader of that course.

Times have changed.

Nurses, along with dentists and military medical administration officers, can now be commanders. Somebody finally figured out that all the leadership skills a military nurse acquires on the job could be effectively channeled into commanding a medical unit. There have been times in the past 10 years when close to half the medical units in the Air Force were commanded by nurses.

Now we are at war. The Air Force does not have M*A*S*H units, they have Expeditionary Medical Squadrons. Since September 11, 2001, our Air Force has been deploying these units into the heart of the war on terrorism. Six of these field units have been commanded by senior nurses. Major "Hotlips" Hoolihan would be proud.

The biggest nursing concern in the Air Force is the same as in the civilian nursing world: finding and recruiting qualified Bachelor's-prepared RNs. The Air Force has not met its recruiting goal in the past five years.

I know that there are some locations in this country where a new graduate nurse can make more money than a new Air Force nurse, but the advantage does not last long. In a 20-year career, as an experienced civilian nurse, you will be hard-pressed to come close to the money a nurse makes as a Lieutenant Colonel or Colonel. While under the age of 40, with few exceptions, you will never be offered the leadership roles in your civilian nursing career that are found in military nursing.

This is not an article about nurse recruiting: It is about the need for military nurses and about the military medical leadership demonstrated by nurses.

As all branches of our armed services spend more time deployed to the far reaches of the globe, there will continue to be a need for military medicine and strong medical leaders. There is no question that Air Force nurses will meet and exceed those expectations.

Interested in other articles about nursing in the military? Read: Nurse Under Fire and The Best You Can Be.

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