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Navy Nursing

Navy Nurse Corps… Outstanding Care…. Anytime, Anywhere! LCDR Denise M. Gechas, NC, USN Specialty Leader, Community/Public Health AAACN Conference 16 April 2008. Navy Nursing. 1908 - 2008. Presentation Objectives:. At the end of this presentation the participant will be able to:

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Navy Nursing

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  1. Navy Nurse Corps…Outstanding Care….Anytime, Anywhere!LCDR Denise M. Gechas, NC, USNSpecialty Leader, Community/Public HealthAAACN Conference16 April 2008

  2. Navy Nursing 1908 - 2008

  3. Presentation Objectives: • At the end of this presentation the participant will be able to: • List and describe Navy Medicine and Navy Nursing’s priorities • Discuss current and projected Navy Nurse Corps manning and demographics • Review current 1940 subspecialty code practice issues • Discuss methods to increase promotion potential

  4. Navy Surgeon General’sPriorities: Maintain a fully ready force by recruiting and retaining outstanding healthcare personnel Excellence in clinical care, graduate education and research, the foundation stones of Navy Medicine Responsive and compassionate care to all our beneficiaries, focusing on the health of our service members and their families while providing

  5. FY 08 Nurse Corps StrategicPriorities • Leadership • Competencies identified for senior & mid-level leaders; Gap analysis completed for leadership training. Creation of a new and fluid leadership continuum, and implement recommendations of this team. • Force Shaping • Recruiting & Retention Force Shaping. Focus will be on wartime relevance of maintaining adequate numbers in each specialty. Understand migration patterns and values of Active Duty, Reserves and Civilian Nurses as it relates to retention. • Education Policies and Programs • DUINS Utilization Policy for APN and CNS dual degree, Mentorship programs for students in NC Pipeline programs (MECP, NCP, ROTC, STA-21) • Readiness & Clinical Proficiency • Clinical skills sustainment for operational assignments; Tri-Service competencies; Pilot Competency assessment and orientation/ skill assessment. Standardize competency-based orientation among RC. • Productivity • Pursuing selection and funding for commercially available products to streamline workload capture and scheduling across health care and the three Services. • Communication • Communication to the Deckplate - Overhaul of NC Website, VTCs with new accessions, Newsletter, NC News, Semiannual VTCs, Bimonthly meetings with Regional SNEs, Semiannual VTC with DNS & Admiral by Region

  6. Updates Clinical Sustainment Policy 13 Deployment Health Clinics Comprehensive Combat Casualty Care Center, NMC San Diego Mental Health Nursing and Practitioners 28 Military Treatment Facilities 135 Medical Clinics and Branch Clinics Navy Nurse Corps MTFs and Clinics

  7. 242 (13%) Navy NC currently deployed as of FY ‘07 Assigned to Marine Corps and Navy Operational around the world. Navy Nurse Corps Operational & Humanitarian

  8. Nurse Corps OfficerCurrent Manning Profile Nurse Accession Bonus; HPLRP Accession tool Missed recruiting goals in FY04/05 and increased losses have caused these gaps. HPLRP Retention tool CSRB proposal RN ISP/ DUINS/ War College Years of Commissioned Service Data as of Aug 2007

  9. Nurse Corps Force Structure FY98 - FY08 (Projected) *FY08 Gains Projected at 260; Losses at 290 Source: BUMIS, PERS, 31DEC07

  10. Nurse Corps Force StructureBillet Authorizations vs Inventory Source: BUMIS, 31DEC07

  11. Nurse Corps Force Structure Losses by RankFY03 - FY07 Source: BUMIS, PERS, 31OCT07 (*Includes Plan Adjusts)

  12. Nurse Corps Force Structure by Specialty *Based on Primary Subspecialty Code *In Trng not included *1900 – Inventory = 802; Billets =812 Source: BUMIS, 31DEC07

  13. Nurse Corps Force Structure by Specialty Phasing out community Phasing out community *Based on Primary Subspecialty Code *In Trng not included Source: BUMIS, 31DEC07 1901 and 1903 communities will become 1900

  14. Nurse Corps Force Structure FY04 - FY07 Projected Actual Inventory Source - BUMIS, PERS Billet Source - TFMMS extract 30 SEP of Applicable Year.

  15. Nurse Corps Force Structureby Education *Based on highest level of education Source: BUMIS, 31DEC07

  16. Nurse Corps Force Structureby Gender Source: BUMIS, 31DEC07

  17. Nurse Corps Force StructureGrade Distribution by Gender Source: BUMIS, 31DEC07

  18. Nurse Corps Force Structure by Race/Ethnicity Source: BUMIS, 31DEC07 Hispanic = 5.8%

  19. High Demand Specialties • Losses exceeded gains for 7 of last 10 years – most losses from LT • Cannot continue LTs • Direct accessions difficult due to National nursing shortage • Loss of CRNAs – highly remunerative specialty in civilian sector • Will continue to monitor loss rates post RN-ISP

  20. Nurse Corps OfficerIncentives FY 08 New Initiatives: • Accession Bonus rate: $20K/3 yrs; $30K/4 yrs • May accept $20K/3yr and up to $38,300 in HPLRP = 5 yr • Continue Health Profession Loan Repayment (HPLRP) as accession (20 slots) and retention incentive (Board to be held 1st Qtr 08 and 26 Slots) • Continue Nurse Anesthetist Incentive Special Pay (ISP) • Critical Skills Retention Bonus (CSRB) proposed for FY04 & 05 for nurses at first decision point • RN ISP implementation, focus on clinical practice, for critically manned wartime specialties <90% • Tiered bonus: 5K/1 yr; 10K/2 yr; 15K/3yr; 20K/4yr. Requires working in specialty full-time, certification, and SG approved Course or MS. Requires active mentoring and long range career planning. • Critical Care, Perioperative, FNP, PNP

  21. Nurse Corps: Inventory: 2774 Training: 149 Billets: 2942 Manning: 94.3% Public/Community Health: Inventory: 20 Training: 4 Billets: 42 Manning: 38.1% **Billets authorized may not be correct; current billets based upon historical need for Ambulatory Nurses. If BA is decreased, then manning will improve. Nurse Corps 1940 Stats Data source: BUMIS ao 29FEB08 NAVMED MPT&E

  22. Community Status – Active ComponentBillet Authorizations to Inventory Strength *Does not include # in training or training billets; FY08 is as of 29FEB08 Data Source: BUMIS, 30JUN06

  23. Public/Community HealthSubspecialty 1940 BA 42* Inventory 20 38.1% Data source: BUMIS ao 29FEB08

  24. Community Health NeedsDuring San Diego Wildfires

  25. Director Branch Clinics Role at Emergency Operations Center • Initial exposure of DBC to the EOC function • Facilitated communication between branch clinics, base EOC’s and NMCSD EOC • Provided direct report to NMCSD Commander • Collaborated with the Director of Public health to educate community regarding “after-fire clean-up”

  26. Community Health Needs • BMC staff served as medical representative to base EOC • 4,000 evacuees • Housed in tent cities at NAB and BOQ • Housed military members, retirees, families, pets • Provided on-site medical care 24/7 • Provided flu shots • Monitored air quality and provided masks • Coordinate with Marine Corps recruit training impact of air quality • Assisted Preventive Medicine staff to ensure proper sanitation at evacuation

  27. Transition from Ambulatory Careto Public Health • Operational Relevance: • OIF/OEF & Humanitarian • Utilization in MTF Mission: • Public Health Directorate • HEDIS measures • Health Promotion • Emergency/Disaster Response Team • Pandemic Influenza

  28. Career & PromotionPlanning • Emphasis on Clinical Expertise (translate to outcomes) Leadership & Mission Accomplishment • Diversity of Assignments/Commands • Stretch yourself, don’t stay in your professional “comfort zone” • Expand your leadership ability and influence • Leadership position, # led, $ budget, scope & command impact • Interdisciplinary involvement and leadership • Large commands allow large competitive comparison groups

  29. Nurse Corps Typical Career Path ~100% ~100% ~80% ~70% ~50% ~12% (2007) O-1 O-2 O-3 O-4 O-5 O-6 CO/CO Equiv Staff Nurse Staff Nurse/Division Officer/Instructor/Duty Under Instruction/ Advanced Practice Staff Nurse/Div Off/Instructor/ Duty Under Instruction/Dept Head/Advanced Practice/ Research/HQ Staff Dept Head/Advanced Practice/HQ Staff / OIC/Research/Senior Nurse Executive Clinical Proficiency, Admin. Acumen, and Leadership throughout the career continuum Exec. Med. /SNE APN/ HQ Staff/Research CO 0 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30 Years of Commissioned Service Clinical Proficiency & Leadership Career Tracks Clinical Administration Education Research Operational 6

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