1. Halloran, Edward J. PhD, MPH, RN, FAAN


The military might just provide a way to curtail the nursing shortage.


Article Content

Many men and women enlisted in the all-volunteer military are trained in and provide nursing care, principally as medics. The training manuals they use cover the same ground that civilian nursing manuals do, and competency-based measures of performance are used to evaluate their work. A majority of medics take advanced courses in military health, and many also earn college degrees during their service. The U.S. Army alone has 13,000 medics on duty and prepares 8,000 per year as replacements and for service in the Army Reserve and National Guard. Medics who reenlist are encouraged to earn the equivalent of associate's degrees, and a few of these earn them at nursing schools in order to become RNs. My analysis of the army manual for medics leads me to believe that what they learn equals or even exceeds that of those who attend community colleges for associate's degrees in nursing and accelerated RN programs for college graduates.


In many ways, then, military medics make ideal candidates for nursing careers after leaving the armed forces, but one barrier is the requirement for would-be nurses to undertake a specific course of education to obtain licensure. West Virginia is the only state that allows discharged medics to sit for some health care practitioner examinations, including the National Council Licensure Examination-Registered Nurse (NCLEX-RN), without undergoing further training. But there's a troubling nursing shortage and an impending surge in the numbers of elderly who will need nursing care-as will the veterans returning from Iraq and Afghanistan, whom medics already cared for in the field. State legislators should take a second look at easing the way for medics to secure RN certification during or after military service.


Men encounter an additional barrier: the longstanding perception that nursing is a woman's profession. The proportion of women in medicine has been profoundly altered in the past generation, but not so that of men in nursing. The 2004 federal survey of the RN population found that only 5.8% of RNs were men. This results from the profession's use of caring philosophies that perpetuate the stereotype of women being more caring than men, as well as from the use of language that isn't gender neutral and the failure to recruit men. As a member of an undergraduate admissions committee, I see an unconscious preference being given to younger women applicants to nursing programs, with recruiting efforts being directed primarily at undergraduate women. Veterans are given preference only when they have some special skill, such as certification as an emergency medical technician or experience as a nursing assistant.

Figure. Edward J. Ha... - Click to enlarge in new window J. Halloran

Men have always nursed sick and wounded troops. Members of the armed forces receive nursing services from both medics and nurses, and for the past 100 years, military nurse corps officers have educated and supervised enlisted medics. The improved training of medics has produced a large number of well-trained and experienced enlisted personnel who now have the equivalent of technical nurse preparation.


I don't see military medics or men as a panacea for what ails the nursing profession. What I do see is a ready supply of trained personnel who could help to lessen the shortage of nurses if the barriers that face them could be broken down in the interest of serving us all.


For the first time, beginning in 2011, all the service branches will train all medics together at Fort Sam Houston in Texas. Why not tweak their education to increase the nursing and medical science components and orient it toward giving medics the skills they'll need for later certification as RNs? Since Florence Nightingale described military men as the worst nurses in 1863, veterans have routinely been discouraged from pursuing the occupation. But isn't it time for a change?