(Part one of two-part series)
MARCH AIR RESERVE BASE, Calif. – Jon Davies, 50 and a nurse by trade, joined the Royal Air Force Reserves seven years ago as a flight nurse and has risen up through the ranks to sergeant (equivalent to a U.S. Air Force technical sergeant). Yes, a flight nurse and a sergeant. Confused?
According to Davies, the RAF Reserves provides two weeks of basic training for medical professionals wishing to serve, after which, recruits are given the opportunity to enlist or become officers. The difference between those entering the enlisted force as opposed to the officer ranks is the amount of military experience, Davies said. Becoming an officer usually takes longer and requires having more military leadership and skills training.
“We don’t all do that (apply for commission) because we don’t have the degree of immersion into the military lifestyle that your trainees do,” Davies said. “The U.S. trainees have pretty large blocks of military involvement at the beginning of their training.”
“In our army reserves, as soon as a medical professional completes basic training, they automatically become a leftenant (lieutenant), or sometimes a major, if they have more skills and knowledge in their selected career field,” he said. “I’m not sure why the RAF doesn’t do that. I guess it makes us cheaper to keep. But the skills are still there, we are just not commissioned.”
Prior to enlisting, Davies was already a senior nurse in a hospital, but said he needed to do something else with his nursing qualifications. He had gone as far as he could go clinically without stepping into a purely administrative role.
“I was very comfortable with the job I was doing and was doing it quite easily, so I wanted to move on and find a new challenge.”
That is when Davies visited a recruiting booth during an airshow at RAF Fairford, where he learned that he wasn’t too old to join the RAF.
“It’s taken my skills into a completely different environment. Flying adds extra stresses and problems. So it was a good way of advancing and it also benefitted my civilian job performance,” Davies said. “I took back skills that I would not have acquired there, like leadership skills and additional trauma management skills.”
Davies said he finds the most surprising thing is the fact that they (RAF Reserves) are so well-respected in the military versus the weekend-warrior-type of years ago.
“Now, when we deploy alongside the regulars, people are hard-pushed to see where the join is because we equally match their clinical competency,” Davies said. “The only way they can tell we are Reserves is by our low rank. Our experience and maturity levels takes them by surprise.”
There are currently 70 nurses in his squadron, Davies said, with only 10 being commissioned and the rest enlisted.
“It took me a good three days to get it in my head that he is a flight nurse in the Royal Air Force, but enlisted,” said Chief Master Sgt. Raejean Huch, 452d Aeromedical Evacuation Squadron.
Although there are several enlisted throughout the U.S. Air Force Reserve who are nurses in their civilian jobs, they don’t all choose to join the officer ranks, Huch said.
Davies, assigned to the 4626th Aeromedical Squadron (RAF Reserves), Royal Air Force Lyneham, United Kingdom, came to March this summer to train and share experiences with the 452d AES.
“I’ve been overwhelmed with kindness, hospitality and the day-to-day that goes on here,” Davies said. “There are a lot of interesting things about how you work and how things are structured differently.”
Davies first heard about the exchange program through an email he received requesting three enlisted or officers in the RAF Reserves to exchange with American units.
Although the British Army had been doing this for some time, they tend to move as units, Davies said.
The application for involvement in the exchange program requested a list of current achievements, unit contributions, assignments and specifics of what the applicant had done to put the RAF in a good light over the last few years. In addition, applicants had to have at least one deployment within the last two years.
“I’ve been very fortunate, because I’ve been involved in a lot of publicity activities for the RAF,” Davies said. “I’ve done a few presentations at home, during one of our Armed Forces Days and also was one of the Queen’s representatives at a royal function. I’m also an instructor in the squadron for all disciplines and ranks.”
Davies’ list of accomplishments was enough to get him selected.
“Since arriving in America, I have been welcomed and looked after very well by the chief (Huch). We are slightly, as you say, joined at the hip,” Davies said.
Davies explained that the degree of training U.S. medical technicians get far exceeds what their British counterparts receive. The RAF training includes some basic aeromedical skills, familiarization with aircraft systems and safety and basic patient intervention and observations.
“Your med techs spend time in hospitals so they can provide a higher level of care for patients, which means they’ve got greater flexibility,” Davies said. “You can give higher levels of care, whereas our med techs have less clinical experience.”
Now, the RAF med tech role is being looked at very closely. One of the suggestions made was that they should spend some time working in a hospital environment to get hands-on patient care experience, Davies said.
“That’s exactly the recommendation I’m going to take back, because we’ve talked about it and it’s been asked, ‘Is it going to work?’ Well it works here!”
Davies assesses nursing skills and trains subordinates at his civilian job. One of the best practices he saw on the training flight here during his three days with the March team was done by a med tech, he said.
“Tech. Sgt. Adrian Lopez (452 AES 4N0 functional training manager) just stood out; he was fantastic, brilliant, phenomenal! I think the benefit of having a med tech is they follow the guidelines. They don’t try and second-guess the problem,” Davies said. “Whereas a trained nurse with loads of experience might say, ‘I think I know what this is.’ That is dangerous because you are going to miss something. He (Lopez) went through the guidelines as he has been trained and he got the correct answer. But, he did it in a way that nothing was missed and there were no safety issues with the patient. He checked the important things first and dealt with those if they were a problem.”
The U.S. Air Force uses a Master Task List to define skills and proficiencies for each level of training. This allows the doctors and nurses to know what each medical technician is clinically competent to do.
“All (USAF) med techs have to be national-registered emergency medical technicians, with focus on assessments. If all I can do is assess a patient because I don’t have the license to administer drugs or narcotics, I can make sure that I am handing over the best assessment that I can do,” Huch said. “We really stress that. We are sharing our Master Task List with him (Davies) and getting him in touch with our schoolhouse. If they (the RAF) are considering this, why re-invent the wheel when we can benchmark?”
Davies said they may need to pull their med techs from a different civilian population group or from the assistant practitioner field, who he said are nurses by any other name except they cannot administer medication.
The medics tend to have a longer time in the squadron, he said. They know where to stand on the aircraft, not to upset the loadmaster or loadie, and how to keep the medical kits safe and working.
“The nurses save the patients but the medics save the nurses,” Davies said. “They’re great from that point of view, but I think in order for them to maintain job satisfaction and for us to retain them, they have to have something to work toward,” he said. “If we provide them with the opportunity to train, not only does it give them more (ownership) in the squadron, it also gives them opportunities in civilian life as well to acquire better jobs than they possibly hold at the moment.”
It’s difficult to say how long it will take to implement a formal plan in the U.K., Davies said. However, they have talked about the possibility of having their medics work in hospitals for the time being.
(The next edition will talk about what training Davies received during his exchange visit.)