My Specialty

U.S. Air Force Nursing, 1st Lt. Noemi Kate Alversado

Caring for service members as an active-duty nurse officer

U.S. Air Force nurse holding a patient's head while another nurse intubates the patient.

Clinical Nurse, PACU
David Grant USAF Medical Center
Travis Air Force Base Fairfield

Tell us about your position and the facility where you work.

I’m a first lieutenant in the Air Force Nurse Corps and a clinical nurse in the post-anesthesia care unit (PACU) at David Grant USAF Medical Center, the largest Air Force acute care hospital facility.

Were you a nurse prior to joining the Air Force Nurse Corps?

I grew up in Anchorage, Alaska, and graduated from nursing school in December 2019, right before the pandemic hit. Even when I was doing my preceptorship during the final semester, I already knew that I wanted to join the Air Force.

I spent about two months studying for the NCLEX and then worked a little over a year on a medical oncology unit in the Anchorage hospital where I had done my preceptorship. That year in civilian nursing qualified me to enter the Air Force as a nurse with experience.

Six months into that first year as a nurse, I started my Air Force application, which took about a year. Nine months later, I left Alaska and started my training.

When I entered the Air Force, I thought I’d go into med-surg, so I was surprised that they assigned me to PACU right away. The civilian hospital where I’d worked was pretty high-acuity, so I had that valuable experience under my belt.

Why was the Air Force your choice among the branches of the military?

There are no nurses in the Marines or the Coast Guard, which left the Army, Navy, and Air Force. I talked to many veterans and retirees, and they all recommended the USAF as offering a better standard of living and an easier path to having a family.

When you join the USAF as a nurse, does that automatically make you an officer?

Yes — you have to have your BSN in order to join the Air Force, and my one year of civilian experience was equivalent to six months of prorated credit in terms of promotion time and rank.

What is Air Force nursing like for you?What’s different from the civilian side?

All USAF hospitals are different, so I can only speak from my specific experience.

As a civilian nurse, I worked with a patient population of Alaska Natives. Many were either homeless or lived with substance use disorders or alcoholism. Quite a few would be flown in by plane from outlying villages. These situations and the fact that the hospital was a Level II trauma center meant the level of acuity was high.

Compared to that, my current role is a total 180. David Grant isn’t a trauma center, so we don’t receive high-acuity patients. Most patients in our facility are active-duty, so they’re typically healthier and more fit than your average civilian, although there are a few older VA patients who have service-related disabilities and tend to be sicker.

Nursing Education

What is job mobility like in the USAF?

My contract with the Air Force is for about three years. It was extended a little because I was using tuition assistance, so I’ll stay in the PACU for a total of three and a half years. Applying for ICU, OR, or ER would require more training, so I’d need to do a fellowship and be sent for training in Texas or Scottsdale, Ariz.

What triggers advancement in rank as a nurse officer?

You basically rank up every two years. You begin as a second lieutenant, then move to first lieutenant, and then to captain, which is approximately a six-year process. Typically, you serve as a captain for six to eight years before you apply for promotion to major.

As long as you’re doing well, these promotions are fairly automatic. There’s about a 95 percent promotion rate from captain to major.

Is advancement in rank related to an increased role in nursing leadership?

The more you advance, the more responsibilities you have. As a captain, you usually supervise lieutenants, and you’ll have some additional duties as well. For example, my coworker is a captain, and she’s in charge of Nurse Executive Function (NEF) meetings, prepares presentations for the chief nursing officer, prepares the schedule, and does peer reviews and chart checks.

Captains and majors can apply to become a CRNA or NP. If they’re accepted, they’re basically paid to go to school. Once they’re done, they owe five additional years of service.

Do you think you might pursue the CRNA or NP route?

I’m very interested in the FNP (Family Nurse Practitioner) or AGNP (Adult Gerontology Nurse Practitioner) roles, but I’ve always wanted to be an ER nurse, so I’d like to do that first.

Could this be a lifelong career for you?

I want to do 20 years, but I’m not 100 percent sure that it will all be active duty. I can always be in the Air Force Reserves for a while and then return to active duty later in life.

My experience these last two years has been positive. My coworkers are great, I love my job, and I love my patients. I learn so much from them, including great stories and military career advice.

I have good work-life balance. Once we’re done for the day, we can leave, which gives us time to go to the gym — we need to remain physically fit and pass a PT test once a year, which includes one minute of pushups, one minute of sit-ups, and a 1.5-mile run. I stay active, work out, and enjoy my life.

Hiring Now

Civilian nurses talk a lot about ratios, overwork, burnout, etc. What’s the quality of the work like in the Air Force?

We have six or seven staff in a PACU, and we typically get 12 to 18 patients per day. Sometimes, I get two patients at once, but usually it’s just one until they’re alert and oriented. Then, there’s a 4:1 ratio.

Another difference between civilian and military nursing is our techs. Instead of CNAs, as in the civilian world, we have EMT-certified techs who can take patients who haven’t had general anesthesia.

Do you find that many people coming into the Nurse Corps have similar goals, such as staying in until retirement?

I think it’s about 50/50. Some people leave for family reasons or because they want more freedom. As a military nurse, you have to be ready to deploy at all times, and are always on call. We can’t go more than an eight-hour drive from our base unless we’re on leave. Some people don’t like the uncertainty.

Many people stay because the military pays you to go to school. Military nurses can go to CRNA school or NP school and finish without any debt at all. Others stay for the healthcare and retirement benefits.

If you stay for 20 years of service, you can retire with 40 percent of your base pay. You also get healthcare for life through the VA.

There are a lot of other perks as well, like discounts for military personnel and the G.I. Bill for education after you leave the military. If you’re a captain or major getting the ICU bonus, you can make a very good living.

How likely are you to be deployed overseas?

Some of my coworkers have been deployed to Qatar or Germany. In my unit, usually only one person gets deployed at a time.

ER and ICU nurses tend to be deployed more since they have that critical care background. Nurses who are with CCATT (Critical Care Air Transport Team), who are equivalent to civilian flight nurses, and aeromedical evacuation (AE) nurses, who are basically med-surg flight nurses who help to safely transport noncritical patients, deploy a lot more than clinical nurses do.

What happens if you want to start a family?

You get four and a half months of maternity leave on top of convalescent leave. My coworker and her husband are both active-duty and have two kids. They have to make sure they have a family care plan in case both of them are deployed, but that doesn’t happen that often.

What about bullying and incivility, which are so common in civilian nursing?

I’ve never seen any of that. Everyone helps you out, and we don’t let each other down. It’s mission-based, and we treat each other really well. In my unit, the older nurses are civilians, and they’re awesome.

You have civilian nurses on your unit?

Military hospitals are required to have civilian nurses, just in case the active-duty nurses are all deployed. We also have some nurses who are contractors, retired military, and veterans.

Are there any other reasons you’d recommend military nursing?

I really like the growth opportunities. If you want to challenge yourself and get to know yourself in new environments, this is a great place to do it. I also like that it’s so focused on selflessness, teamwork, serving your country, and giving back. I’m an extrovert, and I love meeting new people — it feeds my soul. You never know who you’ll meet or what you’ll find.

KEITH CARLSON, RN, BSN, NC-BC, has worked as a nurse since 1996 and offers expert professional coaching at

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