Working for the government is not really a specialty. After all, the government, if you include the city, county, state and federal levels, employs nurses in every imaginable field.

A Capitol Experience

For instance, did you know that the CIA employs nurses? Yes indeed, full and part time, and at $64,000-$70,000 a year. Getting the job, however, is no walk in the park.

First off, you have to be a U.S. citizen and pass a rigorous background investigation, including no recent drug use. You also need a bachelor’s degree in science in a health-related field with recent hospital, clinic or occupational health experience. Work is mainly in Washington, D.C., but travel is also part of the job.

The most important factor, however, is discretion: You must exercise it along with good judgment not only after you are hired but even when you are just thinking about applying!

See the World

If international travel sounds appealing, the State Department hires nurses for several postings, and 60 percent are overseas. You must be a U.S. citizen and, as with the CIA, be eligible for a security clearance. You also need a BSN and advanced practice skills. Job postings include the many different embassies and consul offices. Each country can have different stipulations for candidates, including work permits in some cases.  

Another entity to consider is the United Nations. For one thing, you don’t need to be a citizen. You do, however, need knowledge of a least one U.N. working language, preferably more. Again, many postings are outside the continental U.S., including work in areas where your personal safety might be at risk. Still, the possibility for exciting and challenging work draws many nurses to consider these positions for at least a portion of their careers.

National Public Health

Closer to home is the Public Health Service, one of the seven uniformed services of the United States. Nurses of this commissioned corps have a rank and pay structure equivalent to their counterparts in the Navy, according to LCDR Jennifer Williams, RN, MSN, MPH, FNP-BC, who works for the Centers for Disease Control and Prevention in Atlanta.

A 1996 graduate of Emory University, where she continues as an adjunct professor, she is a nurse practitioner currently involved in programs targeting birth defects and developmental disabilities, as well as efforts to address issues in pregnancy complicated by diabetes. Her entry into the service came through a fellowship in the Epidemic Intelligence Service, a two-year field epidemiology training program.

Ms. Williams, quick to point out the advantages of government service, includes the wide variety of opportunities, the ability to continue educational pursuits, and the transferability across the services as primary draws. But deployment, 24/7 responsibility and physical fitness are all part of Public Health Service life, too. “They can send you overseas because we are part of the ready-response effort of the government,” Ms. Williams says.

What does she see as the difference between working for the government and working in the private sector? Three areas stand out: greater accountability and the challenge of being good stewards of public resources; responsibility for presenting the best science possible; and the open and transparent competitive process that governs employment.

Research Entities

Teri Castrejon, RN, MSN, FNP, a 2001 graduate of Loma Linda University, is the chief nurse at Moffett Federal Airfield, a research center for biological, space and aeronautical studies, as well as home to the largest wind tunnel and computer in the world. As a nurse, Ms. Castrejon provides occasional support service for these efforts.

“There is always something new, weird, interesting and enjoyable,” she says. But most of her work is prevention and surveillance. NASA monitors for chemical exposure to 72 different elements like asbestos and lead, so about 75 percent of her time involves administrative tasks. Still, she always needs to be ready to handle emergencies that might afflict the 1,500 civilian employees and 3,000 private contractors who serve the base.

One luxury she relishes is the time to talk to patients and really help them toward wellness. The volume is lower, and so is the stress. Salaries are lower, too, but then so are liability costs. The disadvantage: the high level of regulation that prevails and the bureaucracy that increased scrutiny encourages. Moffett is the only NASA facility with a JCAHO accreditation, which ensures that quality is a top priority.

The National Institutes of Health is another federal agency that, like the CDC, employs both commissioned officers and civil servants. Clare Hastings, RN, Ph.D., FAAN, is the chief of nursing and patient care services, which is the equivalent of vice president for nursing services at NIH’s Health Clinical Center in Bethesda, Md. Like Ms. Williams and Ms. Castrejon, she finds the increased accountability and resulting bureaucracy endemic to the government.

Nurses employed at the hospital — about 650 — are all federal employees and provide support for experimental research across a wide variety of clinical categories. The greater NIH employs an additional 300 nurses who coordinate various research studies outside of the Clinical Center. Two categories are not included among their staff, however, and they are obstetrics and emergency department nursing. Since all the patients are clinical research subjects, no community care occurs at the Clinical Center.

This also means that care is often driven by research, not the health status of the patients; research almost trumps necessity when it comes to admissions. So this distinction may not appeal to every practitioner.

Local Locales

More local are the public health departments, the Veterans Administration hospitals, the Centers for Medicare and Medicaid Services, and the correctional systems of each state. The Federal Bureau of Investigation employs nurses, and it’s currently in the midst of the largest hiring surge in its history.

Over the past four years, the Los Angeles Sheriff’s Department has hired more than 900 personnel, and it still has 450 positions to fill in various capacities, such as Egzine Richardson's, RN, MSN, FNP, who works as an advance practice nurse. Her job involves screening newly arrested individuals for any condition that would make it inappropriate to put them in a regular holding cell. Patients needing acute care go to the county hospital or to an intermediate care unit in the jail.

Workloads in this department are heavy and intense, with many repeat clients. Drug and alcohol problems are also frequent; so are neglected chronic illnesses like diabetes and HIV; and scabies and MRSA are never far away.

But the combination of stable employment for a mid-level provider along with the daily variety is what motivates her. Also, which is unusual for Los Angeles, you don’t need to be bilingual.

Before working in the Twin Towers, she had concerns for her safety. Now, with experience, Ms. Richardson does not feel that is an issue. “I don’t look at the inmates as criminals, but as people.” Occasionally there are lock-downs, which is her least favorite part of the job  because they occur unexpectedly and employees need to remain in place until things are secured.

Roger Gallion, RN, and Christine Guevarra, RN, are part of the medical staff at the Sheriff’s Department and consider it the safest place they will ever work.

“Our safety is number one,” they said. “We do not perform any medical services without the presence of deputies. We are not considered a threat to the inmates, and you don’t have to look like Arnold to work here. It’s a place where you can start and finish your career.”

The one constant throughout these different agencies is they all have their own requirements. Many use civil service appointments, and in some cases give preference to groups like veterans. One benefit of working for some entities is the possibility of having student loans forgiven in exchange for a work commitment through the Education Debt Reduction Program. Others include pay for bilingual skills, uniform allotments, public transit passes and some even have home loan programs.

If you find government employment appealing, the best place to check is the government jobs site USAJOBS. Every agency lists its openings; each also has an individual webpage. Some words of warning, however: You can expect a pokey response. Six to seven months appears about average.

According to Ms. Hastings, the times can be as short as three to four weeks if you contact the agency directly. Background checks, necessary in almost every case, simply do take time. But fortunately for you, this site will keep your resume posted during that time and other opportunities may come your way.   

Elizabeth Hanink RN, BSN, PHN, is a freelance writer with extensive hospital and community-based nursing experience.

For more information about this specialty:

United Nations

USAJOBS, Federal Government Official Job Site

Federal Bureau of Investigation

Central Intelligence Agency

U.S. Department of State

U.S. Department of Health and Human Services

National Institutes of Health

Peace Corps

Los Angeles County Sheriff’s Department