The "Nursing Officer" Merged Thread

[IamBloggins]

Does anyone out there have any information about the role of a military nurse (esp Army)? ie/what sort of clinical stuff do they do? is it mostly managerial work? how likely is it that they‘d go overseas? where could one be posted? etc.

 

[nhb388]

Military Nurses are nowadays all civilian trained RN‘s. There are many RN‘s in the reserve Fd AMB‘s who are not employed as nurses, as they are not "Commissioned" nursing officers. NO‘s are all commissioned. Most are posted to HSOTU‘s, and there are NO‘s on prety much every deployment. Best of all, if you get accepted to a civilian nursing (Degree) school, you can join the CF and have schoolpaid for, while you are paid to attend school. Contact your local CFRC for details.

 

[IamBloggins]

Thanks! Do you know what sort of roles the NO‘s have on deployments? And when you say "pretty much every deployment," are we talking Afghanistan, Bosnia-Herzegovina,...? (What I‘m trying to ask for are examples of places that NO‘s are now if you know any)

Thanks again.

 

[gj connors]

Nurses can/are employed almost anywhere (though there are none on ships). While on my tour of Bosnia, our unit medical section was located next to the area sugical unit. Though we had no nurses with the UMS, the ASU had plenty. Next to meda‘s, nurses were the next plentiful medical support personnel. Nurses provide the same scope of skills as their civilian counter-parts (and then some due to the nature of military training/duties). Hope this helps.

 

[Armymedic]

No‘s...The bain of every good medics exsistance.

There are NO in Afgahanistan with the HSS platoon in Kabul,
In Bosnia 2 are tasked with the NSE in VKand some are at the 3rd role hospital for MND NW in Sipovo with the surgical team. Some stay for 6 months some shorter.

There are NO NO‘s with the battle groups, and Med Tech do all that nurses normally would do in Canada, but won‘t becuse of some licence thing when we are home.

 

[brin11]

X031/@711,

I had no idea there were no nursing officers on ships. How is the medical structure set up there?

Jill

 

[gj connors]

Jill, on most (if not all) ships there is a physician‘s assistant (warrent officier) and a "junior" medical assistant (or now as were called medical technician - I‘m too long in the tooth and will always consider myself a medical assistant). The med tech is usually a mastercorporal or corporal. Though when I was on one the replenishment during a couple of MARCOT exercises with the navy some years ago (I am and always will be army LOL)the senior medical support personnel was a masterwarrent officier and his junior was a mastercorporal. These persons are the fronline of medical support/coverage and are highly trained (and I believe like most of us are). Though they usually have vioce-to-voice contact with a physician "onshore", they are first medical personnel to triage, screen, and treat patients.

 

[fusilier955]

are you able to not have a degree in nursing as a reserve officer? must you be obtaining one? or can it just be a BSc without the nursing courses? i have a friend that would like to know the requirements.

 

[Fraser.g]

For most Officer roles you can have a BA and get your scroll. There are several that require a specific degree.

For example, to be and engineering officer you must have an engineering degree or in the reserves be in and engineering school.
To work for JAG you have to be a Lawyer, To be an MO you must have done your medical school and your internship and finally you have to have a BScN to be a NO.

The scope is changing for NOs here and overseas. Stay tuned.

 

[MedCorps]

Ref Army Medics post:

There ARE Nursing Officers on OP ATHENA (Afghanistan) in HSS Coy right now.   In fact there are about 5 of them (1 General Duty - Ward, 2 critical care - critical care and rresuscitationand 2 OR)   There also MAY be a mental health nurse also.     I know 3 of them personally and they are doing quite well there.  

There also is one hard Nursing Officer per Bde.   This is the Training Officer at the Field Ambulance.   2 Fd Amb in fact thas 6 Nursing Officers on the establishment.   (2 mental health, 1 Trg O, 1 NP (who is off to Haiti soon) and 2 NOs at the BMC (Lt and Capt).

There are currently 4 NOs going to Haiti.   Including a Major as the Senior NO and Resus NO.  

Depends when you where in Bosnia, but we had at least 2 GDNOs and 1 CCNO with the Role 3 (R3MIMU) hospital in Sipovo, and sometimes another 2 OR Nursing when it was Canada's rotation.  We also had a 2 NOs at the UMS in VK and another 1 or 2 in one of the other camps (TSG?). 

Reference Nursing Officers on ship... Nope none of them.  Not required as the PA and the Med Tech can sort out just about everything that comes along.  There have been NOs on ship when we place a surgical team on ship.  The last time this happened (that I know of) was for Gulf War 1.  We had a surgical team (c/o 5 NOs) on the AOR.  This is was also contempatecontemplatedLO (Haiti) but for a number of reasons was a no go (and thus an Advanced Surgical Team) is going out the door to be on the ground with 2 RCR UMS). 

The planning cycle is just about to start for placing a Advanced Surgical Centre (Sea) on the new logistics support shipsthe Navy is buying.  Due to the concept of this new piece of kit, we can attach a ASC right onto the deck.  There will be NOs are part of this establishment as there will be resus, critical care, ward and surgical care involved. 


Hope that helps.

Cheers,

MC

 

[Armymedic]

That would be me bad typing skills....

There were (are) many nurses in ISAF HSS platoon...
There were 2 nurses attached to the NSE in VK, and 3 attached to the role 3 MIMU in Sipovo on roto 13, but none with the Battle group. There were 2 in Tomaslovgrad but those postions disappeared with roto 9.

As for right now with roto 14, I believe there is still 1 or 2 nurses in VK, but as the new MIMU has moved to Banja luka, I do not know if there are any Canadian nurse there right now.

 

[yot]

so overall, Med Tech will take the role as nurse?

 

[MedCorps]

In Banja Luka (BLMF) it is now a British Role 2+ facility (with some Dutch - RNLA I am told and no Canadians)  thus UK NO's / NCO Nurses will take over the nursing duties.

MC

 

[Armymedic]

There was one Canadian Med Tech Cpl in BLMF when I left in Apr but, correct, no Canadians replacements for the Nurses.

As for Med techs taking over for nurses, not in that senario, but it can happen, similarly to the use of Engineers or Artillerymen to take and hold ground, which is a traditional infantry skill. While they are able to do the job, thats not what they are trained to do, and while the Med Techs might have the right skills, there is a lack of deeper knowledge and understanding thru acedemic training and experience learned in school the nurses have. Also because of some insider politik situation which is beyond my understanding, basic nursing skills are no longer taught at CFHSA to QL 3 med techs there by ensuring the place of nurses in the CF. Saying that there still are no nurses in true Role 1 (frontline) or VERY few nurses currently role 2 (Brigade Medical facilities)., which maintains a demand for Cpl and MCpl Med Techs to maintain some of those skills which flow into the admitted patient care role.

 

[MedCorps]

Agreed - Espcially in OOTW and/or on the noncontiguous battlespace there is a real risk of casualties been held at the role 1 / role 2 medical treatment facility because of a break down in the evacuation chain (for all kinds of reasons from enemy action to crappy infrastructure).  This is compounded by the fact that Canada has no dedicated air ambulance assets.

Med Techs starting at the QL3 level really need to be taught some fundamental nursing skills in order care for the warrior past the inital pre-hospital stage.  I am not sure why the CFMS has moved away from these skillls (beyond my pay-grade).  Some of the best medics I know have an equal blend of paramedic skills, nursing / MIR skills (left over from the days of military - inpatient care mostly), soldier skills and social skills.  The Med Tech trade is complexed and people need to consistantly think outside the box.  I am also concerned at the lack of "military medicine" being taught to QL3 / QL5A Med Techs, but that is another topic all together. 

The civilian ambulance world is great, but the hospital is only about 10 minutes away in most cases.  Then you dump your patient on an "advanced" medical team of docs / nurses / RTs.  In war (or OOTW or training areas for that matter) this is not a reality and medics will almost always have care times of greater than 30 minutes.... if not hours before they reach the surgery team at the ASC.  A BMS holding policy can be 72 hours! (for non-surgical cases by doctrine, history also holds this true) that is a long time for a medic looking after a casualty not to have some basic nursing skills!

Cheers,

MC

 

[Brad Sallows]

Please don't confuse "holding policy" with delays in evacuation.

"Holding policy" (aka "evacuation policy) is not the length of time a facility might keep a patient before further evacuation.  It effectively defines a limit of treatment and care by setting an upper time limit within which retained patients should be returned to duty; all who can not be returned to duty within that time should be evacuated as soon as conditions and resources permit.  Evacuation should proceed (as uninterrupted as possible) until the patient reaches a facility which can provide the required treatment and recovery within its holding policy.  Even a theatre-level evacuation policy is typically short enough that most serious cases must be evacuated out of theatre.  This means the only long stop should be at a surgical facility to stabilize the patient for the trip, but the patient is still not held any longer than necessary to perform the surgery and recover sufficiently for continued evacuation.

If the Role 2 holding policy is 72 hours, a BMS will only retain and treat sick and wounded who are expected to return to duty within 72 hours.

For any holding policy much longer than a few hours, the point is correct: medics should have some basic nursing skills.

 

[MedCorps]

I guess I did not articulate myself well enough.  Thanks Brad for the clear up.  Yes two different issues. 

MC

 

[Fraser.g]

I agree that both the Regular Force Medtec and Reserve Med A hare sadly deficient in their nursing skills.
By employing more NOs at the Med platoon level they can pass on that information and skill set that they are missing. 

When non-medical (and some older medical pers) refer to Nurses and NOs they envision Nightengale and her lamp dabbing brows and comforting soldiers in the Crimea or in a controlled hospital environment.
What they fail to envision is the advance practice nurse who can do much of the same functions of a MO or a PA under his or her own license and practice. The big difference is that A med Tec or Med A works under the licence of the MO or NO and not their own licence.


I am now double hatting it within my unit as the Platoon Commander and NO. I work and keep my medical skills current in my job in a Trauma facility and the army has sent me on my HCA courses.

This way the army gets the best of both worlds. A Reg Force nurse will only see a small fraction of trauma that I see on a daily basis not to mention all the specialty and complex care that is required.

Grant Fraser RN BScN CD

 

[Armymedic]

True enough Grant,

But rare are those nurses who;

a, Have a clue about field ops, dispite the best efforts of the directing staff on the BNO course,
b, Actually want to get thier boots dirty, and
c, give two cents to actually training the medic in the nursing skills.

In eight yrs as a Medic in Petawawa, I can only count 3, but on the positive side I'll say, so far.
(BTW the most checked out nurses I have met were either reservist who do it full time, or ones who were troops and then went back to school)

Anyway back to my point, If we med tech can fill that 2nd line care role...who will?

 

[Fraser.g]

The answer to who will fill the second line if the MedTec can't is simple. Reserve Med As who have been trained by "the most checked out nurses I have met were either reservist who do it full time, or ones who were troops and then went back to school" LOL.

Seriously, the reserve NO (and MO for that matter) who maintains their skills daily on a ward or ER are exactly the ones that you want teaching the Med Tec and Med A's. We now have one contract with VGH in Vancouver to act as our trauma training center. We should make it more diffuse and use as many centers in a preceptor program that we can. If there is a Nursing school or PCP training program in the area  the hospitals are used to having students in that role. Why re-invent the wheel when we don't have to to get a desired product. I would like to see a 2-4 Month practicum with yearly or biyearly refreshers.

Comments

Grant