How nurses can hone clinical skills through military-civilian partnership

Partnerships with civilian trauma centers and health systems provide an underused way for military medical personnel to obtain clinical experience relevant to both combat medicine and general hospital care, according to an article published in Critical Care Nurse (CCN).

Due to less frequent deployments, varied patient acuity and other factors, military clinicians, especially critical care nurses, have limited opportunities to care for acutely ill patients or regularly use the trauma skills needed for a competent medical military force.

“Using a Military-Civilian Partnership to Enhance Clinical Readiness and Sustainment for Air Force Critical Care Nurses” provides an overview of a regional partnership that allowed active-duty military critical care nurses to complete rotations of multiple standard 12-hour shifts at a civilian medical facility. The article is one of several in the October issue of CCN that focus on military, disaster and trauma nursing care.

Co-author Jennifer Armon, MSN, CCRN, is a major in the U.S. Air Force Nurse Corps pursuing her doctorate in nursing practice at University of Nevada, Reno.

“The peacetime effect of skill atrophy poses a significant threat to mission readiness,” she said. “Nurses and other health care providers must be included in efforts to develop military-civilian partnerships and sustain a clinically competent nurse force. These partnerships have to be flexible in order to respond to the dynamics of staffing, budget, nursing skill sustainment and the military mission.”

From November 2021 to January 2023, the partnership enabled 39 military critical care nurses to complete 511 shifts at the civilian medical facility, obtaining clinical experience seldom achieved at the military treatment facility.

Among their assignments, they cared for patients who required an intra-aortic balloon pump (IABP), continuous renal replacement therapy (CRRT), ventricular assist devices, intracranial pressure monitoring or vasoactive intravenous infusion manipulation.

Collectively, the nurses accumulated 297 hours of IABP management, 96 hours of ventricular assist device management and 156 hours of CRRT management in the first year of the partnership.

The partnership began with a staffing model that mirrored nursing student preceptorships already in place at the civilian facility. After completing onboarding requirements, the military nurse was provided a facility badge, read-only electronic medical record capabilities, and access to the medication dispensing machine. During the rotation, the nurses completed three 12-hour shifts per week.

Further collaboration led to a second type of rotation in which a military nurse was still paired with a staff nurse, but granted only a visitor badge with more limited access. Participating nurses rotated through various units at least twice a month for standard 12-hour shifts.

The authors point to the successful readiness training program at Nellis Air Force Base, Nevada, as a model for sustainable military-civilian partnerships.

As part of the partnership, an active-duty nurse is fully embedded at a civilian institution and serves as an on-site preceptor for other military members, allowing for more consistent rotations and providing the opportunity for hands-on experience.

Provided by
American Association of Critical-Care Nurses (AACN)