By Craig Coleman, Northern Regional Medical CommandSeptember 16, 2013
FORT BELVOIR, Va. -- Col. Rachel Armstrong broke ground for all Army nurses when she was selected in August for the prestigious Robert Wood Johnson Foundation (RWJF) Executive Nurse Fellows program.
Armstrong, the regional nurse executive for the Northern Regional Medical Command (NRMC), is the first active duty military nurse selected for the very competitive fellowship. She is one of only 20 nurse executives selected for the program in 2013.
The purpose of the fellowships is to develop executive nursing leaders who will influence the transformation of the nation's healthcare system through professional development, coaching and education.
"I'm very excited about this opportunity," Armstrong told RWJF. "In addition to the program curriculum itself, I expect to learn a lot from interacting with the other new Executive Nurse Fellows."
Like their civilian counterparts, Army Nurse Executives develop evidence-based practices, build nursing capabilities in their organizations, act as advocates for patients, encourage healthy work environments and enhance communication. There is, however, often a difference in the scale of responsibility.
"The regional nurse position (RNE) I have here at NRMC was regarded as huge compared to the civilian world," Armstrong said. "They can really understand what I do here as an RNE, much like you can compare it to Kaiser or some other big company. The volume of our inpatient status and the amount of outpatient care we provide -- they get that."
Executive nurses are responsible for nursing plans and strategies, as well as budget administration. Armstrong said Army nurses gain the opportunity to lead nursing departments at earlier phases of their careers as compared to civilian nurses.
"In Army Nursing we have a step-wise progression in developing nurses for executive positions," she said. "Starting as a clinical nurse officer-in-charge all the way to deputy commander for nursing (DCN) in a small hospital and progressively larger hospitals to a medical center. We grow our nurses to be executives.
"Our DCNs are considered nurse executives," Armstrong continued. "That is one thing we do very well in the Army Nurse Corps. We recommend that people get board certified as a nurse executive, then we reward them with incentive pay. We prep people for their future life if they choose to go into the civilian world, making the credentials behind our nurse executives really meaningful."
The three-year fellowship starts with personal development for the executive nurses and culminates in a major research project. Armstrong sees the personal benefits she will gain from the program, but hopes that her project will benefit NRMC.
Armstrong hopes to tailor a project that will have a business payoff for NRMC.
"I hope to translate civilian business processes from the nursing community and bring that back to NRMC." Armstrong said. "I want it to be geared toward nursing practices -- how I as a regional nurse executive look at the nursing care provide in the region. I want to look at how that's done in the civilian world and pull aspects that apply here. I want to be able to cut and paste things they're doing in the civilian world."
Armstrong also sees the changing budget landscape that means decreasing funding for the Department of Defense as a major a factor in Army Nursing.
"Over the past five years we've had a lot of money," Armstrong said. "It's hugely important right now that we are doing things efficiently and effectively with the pot of money we're given."
After learning about the program years ago through a mentor, Armstrong requested RWJF consider her. She credits former regional commanding general, Maj. Gen. (Dr.) Joseph Caravalho and chief of staff Col. Michael Kieffer with supporting her application.
Maj. Gen. M. Ted Wong, the current NRMC commanding general, also fully supports the fellowship.
"Col. Armstrong's selection for the Executive Nurse Fellowship reinforces the fact that NRMC is staffed with highly skilled and talented healthcare professionals," Wong said. "Our efforts in transitioning NRMC into a system for health will be greatly impacted by the knowledge and fresh perspective she brings back to the organization."