68W Combat Medic to Emergency Room Nurse: Complete Career Transition Guide (2025)
Transform your 68W experience into $75K-$110K+ ER nursing career. Complete pathway from combat medic to RN with bridge programs, costs, timeline, and salary data.
Bottom Line Up Front
Army 68W Combat Medics have a proven, accelerated pathway to becoming Emergency Room Nurses, earning $70,000-$110,000+ annually. The fastest route: 68W → Paramedic (6-12 months, optional) → ADN/BSN Nursing Program (2-4 years) → RN License → ER Nurse. Total timeline: 2-4 years from separation to working ER RN. GI Bill covers tuition ($0-$10,000 out-of-pocket at public universities). New graduate ER nurses earn $70,000-$85,000, experienced ER nurses earn $85,000-$110,000+, and travel ER nurses can earn $100,000-$140,000+. Your 68W training provides 40-60% of the clinical knowledge needed for nursing school—you're not starting from zero.
Why 68W Combat Medics Make Exceptional ER Nurses
Every hiring manager in emergency departments knows this truth: former military medics outperform traditional nursing students in high-acuity settings.
You've already proven you can:
- Assess and treat patients in life-threatening situations
- Perform medical procedures under extreme pressure
- Make critical decisions with incomplete information
- Manage trauma patients from initial assessment through stabilization
- Work effectively in chaotic, unpredictable environments
- Maintain composure when others panic
- Document medical care accurately and thoroughly
- Function as part of multidisciplinary teams
- Adapt protocols to resource-limited situations
- Provide compassionate care in horrific circumstances
That's not "basic first aid"—that's advanced emergency medicine. You've practiced emergency nursing in the hardest possible environment.
The Complete 68W to ER Nurse Career Path
Phase 1: Pre-Nursing Preparation (Months 0-6)
Before applying to nursing school:
Complete Prerequisite Courses
- Anatomy & Physiology I & II (8 credits)
- Microbiology (4 credits)
- General Chemistry (4 credits)
- English Composition (6 credits)
- Psychology (3 credits)
- Statistics or College Math (3 credits)
- Nutrition (3 credits)
Timeline: 1-2 semesters (4-8 months) Cost: $0 (GI Bill covers community college) GPA requirement: 3.0+ minimum, 3.5+ competitive
Military Credits Transfer: Your 68W training typically transfers as 8-15 college credits. Submit your Joint Services Transcript (JST) to maximize transfer credits.
Alternative: Work as Paramedic Many 68W veterans get paramedic certification first ($6-12 months), work earning $55K-$75K while completing prerequisites part-time, accumulating patient care hours, then apply to nursing school. This pathway takes longer (5-6 years total) but requires zero loans.
Phase 2: Nursing School Selection (Months 6-12)
ADN vs. BSN Decision:
Associate Degree in Nursing (ADN) - 2 years
- Pros: Faster, lower cost, same RN license and pay initially
- Cons: Many hospitals now prefer BSN, limited advancement without bachelor's
- Best for: Those needing fastest path to RN income
- Cost: $10,000-$25,000 (community colleges)
- Timeline: 2 years full-time
Bachelor of Science in Nursing (BSN) - 3-4 years
- Pros: Preferred by major hospitals, required for management, graduate school entry
- Cons: Longer timeline, higher cost
- Best for: Long-term career, major medical centers, advancement goals
- Cost: $40,000-$80,000 (public universities, GI Bill covers most)
- Timeline: 4 years traditional, 16-18 months accelerated BSN
Accelerated BSN (ABSN) - 12-18 months
- Requirements: Already have bachelor's degree in any field
- Intensive: Full-time only, no work during program
- Best for: 68W with existing bachelor's degree
- Cost: $40,000-$90,000
- Timeline: 12-18 months
Military-Friendly Nursing Programs:
- Chamberlain University (multiple locations, military scholarships)
- Western Governors University (online BSN, competency-based)
- University of Texas at Arlington (strong veteran support)
- Excelsior College (online RN completion)
- University of Maryland (Yellow Ribbon participant)
Competitive Nursing School Admission:
- Average ADN acceptance rate: 40-60%
- Average BSN acceptance rate: 30-50%
- Accelerated BSN acceptance rate: 20-30%
What strengthens your application:
- High prerequisite GPA (3.5+)
- Your 68W experience (thousands of patient care hours)
- HESI A2 or TEAS entrance exam scores
- Healthcare volunteer work
- Strong personal statement highlighting military medical experience
- Letters of recommendation from physicians, PAs, or nurses you worked with
Phase 3: Nursing School (Years 1-4)
Typical BSN Curriculum:
Year 1-2 (Pre-nursing/General Education):
- Prerequisites and general education requirements
- Introduction to nursing courses
- Health assessment fundamentals
Year 3-4 (Nursing Clinical):
- Medical-surgical nursing
- Pediatric nursing
- Obstetric nursing
- Psychiatric/mental health nursing
- Community health nursing
- Critical care nursing
- Clinical rotations: 600-800 hours in hospitals and clinics
Where Your 68W Experience Helps:
- Pharmacology: You've administered medications and understand drug classifications
- Medical-surgical nursing: Your trauma and sick call experience translates directly
- Critical care concepts: You've managed critically ill patients
- Patient assessment: You've performed head-to-toe assessments routinely
- Emergency response: Civilian emergencies are less stressful than combat medicine
- Clinical confidence: You won't be intimidated by first clinical experiences
Where You'll Need to Focus:
- Obstetrics: Unless you delivered babies deployed (some SOCM medics did)
- Pediatrics: Assessing and treating children requires different approach
- Nursing theory and documentation: Civilian nursing has specific frameworks
- Holistic care: Nursing emphasizes psychosocial aspects more than military medicine
- Academic writing: Nursing school requires extensive papers and care plans
Cost During Nursing School:
- Tuition: $0-$10,000 (GI Bill covers public university BSN)
- Books and supplies: $2,000-$4,000 total
- Uniforms, stethoscope, equipment: $500-$1,000
- NCLEX prep course: $300-$500
- Living expenses: Covered by GI Bill housing allowance OR savings/loans/spouse income
Total out-of-pocket: $3,000-$15,000 for entire BSN
Phase 4: NCLEX-RN and Licensure (Months 1-3 post-graduation)
NCLEX-RN Examination:
- What it is: National Council Licensure Examination for Registered Nurses
- Format: Computer adaptive test (CAT), 75-145 questions
- Time: Up to 5 hours
- Cost: $200 exam fee + $150-200 state application
- Pass rate: 87% first-time (for BSN graduates)
- Study time: 4-6 weeks full-time recommended
NCLEX Content:
- Safe and effective care environment (30%)
- Health promotion and maintenance (12%)
- Psychosocial integrity (10%)
- Physiological integrity (48%)
Your 68W Advantage: Medical knowledge you already have makes physiological integrity questions easier. Focus study time on obstetrics, pediatrics, and nursing theory/prioritization.
NCLEX Preparation:
- UWorld NCLEX prep: $129-$249 (best resource, highly recommended)
- Kaplan NCLEX review: $300-$500
- Hurst Review: $375 (good for content review)
- Mark Klimek lectures: Free (YouTube, excellent prioritization strategies)
State RN License:
- Apply to state board of nursing
- Submit transcripts and graduation verification
- Pass NCLEX-RN
- Background check and fingerprints
- Cost: $150-$300 depending on state
- Timeline: License issued within 48-72 hours of passing NCLEX
Compact Nursing License: Many states participate in the Nurse Licensure Compact (NLC), allowing practice in 39+ states with single license. Valuable for military spouses and those considering travel nursing.
Phase 5: ER Nurse Employment (Immediate post-licensure)
New Graduate ER Nurse Positions:
Most emergency departments prefer RNs with 1-2 years medical-surgical experience before ER. However, many hospitals hire new graduates directly into ER residency programs, especially veterans with military medical backgrounds.
New Grad ER Nurse Residency Programs:
- 3-12 month structured orientation
- Preceptor-guided learning
- Didactic education combined with clinical practice
- Gradual increase in patient assignment complexity
- Salary: Full RN pay from day one
Starting ER Nurse Salaries (New Graduates):
- Small community hospitals: $60,000-$70,000
- Mid-size regional hospitals: $68,000-$78,000
- Large urban medical centers: $75,000-$85,000
- Level I trauma centers: $78,000-$90,000
- California/Northeast: $85,000-$100,000+
- Veterans Affairs hospitals: $70,000-$90,000 (federal pay scale)
Experienced ER Nurse Salaries (3+ years):
- Community hospitals: $75,000-$90,000
- Regional hospitals: $80,000-$95,000
- Urban medical centers: $88,000-$105,000
- Level I trauma centers: $95,000-$115,000
- California (union hospitals): $110,000-$145,000+
- Travel ER nurses: $90,000-$140,000 (13-week contracts)
Additional ER Nurse Compensation:
- Shift differentials: +$4-$8/hour for nights, +$2-$5/hour weekends
- Certification bonus: +$1,000-$3,000/year with CEN (Certified Emergency Nurse)
- Charge nurse premium: +$3-$6/hour when serving as charge
- Sign-on bonuses: $5,000-$20,000 (especially ER, critical care, travel positions)
- Benefits: Health insurance, 401k matching (3-6%), pension (some hospitals), PTO (15-25 days)
Phase 6: Career Advancement
Specialty Certifications:
CEN (Certified Emergency Nurse)
- Eligibility: 2 years ER nursing experience
- Cost: $370 (BCEN members)
- Salary increase: $2,000-$5,000 annually
- Recognition: Gold standard for ER nurses
TNCC (Trauma Nursing Core Course)
- Cost: $300-$500
- Timeline: 2-day course
- Required by many trauma centers
ACLS/PALS (Advanced Cardiac Life Support / Pediatric Advanced Life Support)
- Cost: $200-$400 total
- Required for ER positions
- Renewal every 2 years
Advanced Practice:
Nurse Practitioner (NP) - Additional 2-3 years
- Emergency Nurse Practitioner
- Family Nurse Practitioner (many work in ER)
- Salary: $105,000-$130,000
- Autonomy: Higher scope of practice
Clinical Nurse Specialist (CNS)
- Emergency/trauma CNS
- Leadership and education focus
- Salary: $95,000-$120,000
Leadership Roles:
- Charge Nurse: $90,000-$110,000
- ER Nurse Manager: $100,000-$130,000
- Clinical Nurse Educator: $85,000-$105,000
- Director of Emergency Services: $120,000-$160,000
Skills Translation: 68W to ER Nurse
| 68W Combat Medic Experience | ER Nursing Equivalent |
|---|---|
| Trauma stabilization and TCCC | Trauma resuscitation and ATLS protocols |
| Patient triage and prioritization | Emergency Department triage (ESI system) |
| Advanced airway management | Critical airway management and intubation assistance |
| IV access and medication administration | Venous access and pharmacology |
| Sick call and primary care | Fast track/urgent care within ED |
| Documentation and medical records | EMR charting and nursing documentation |
| Working with physician oversight | Collaborative practice with ER physicians |
| Mass casualty management | Disaster nursing and surge capacity |
| Field sanitation and infection control | Hospital infection prevention |
| Patient advocacy and education | Nursing care coordination and discharge planning |
Complete Financial Analysis: 68W to ER Nurse
Total Investment:
Nursing Prerequisites (Community College):
- Tuition: $0 (GI Bill)
- Books: $500
- Out-of-pocket: $500
BSN Program:
- Tuition: $0-$10,000 (GI Bill covers public university)
- Books and supplies: $3,000
- Equipment and uniforms: $800
- Living expenses: $0 (GI Bill housing allowance)
- Out-of-pocket: $4,000-$14,000
NCLEX and Licensing:
- NCLEX prep: $400
- Exam and state license: $400
- Out-of-pocket: $800
Total Investment: $5,300-$15,300
Earnings Timeline:
During Prerequisites (6-12 months):
- GI Bill housing allowance: $1,500-$2,800/month
- Part-time work: $15,000-$25,000
- Total: $30,000-$50,000
During Nursing School (2-4 years):
- GI Bill housing allowance: $45,000-$100,000
- Summer work as CNA/EMT: $10,000-$30,000
- Total: $55,000-$130,000
Year 1 as ER RN:
- Base salary: $75,000-$90,000
- Shift differentials: $5,000-$10,000
- Total: $80,000-$100,000
Years 2-5 as ER RN:
- Average salary: $85,000-$105,000 annually
- Total 4 years: $340,000-$420,000
Years 6-30 (Career ER RN):
- Average salary: $95,000-$115,000
- Total 25 years: $2,375,000-$2,875,000
Lifetime Career Earnings: $2,850,000-$3,575,000
ROI Comparison:
Scenario A: 68W → Paramedic Career (30 years)
- Average salary: $65,000
- Total career earnings: $1,950,000
Scenario B: 68W → ER Nurse Career (30 years)
- Investment: $10,000 (average)
- Total career earnings: $3,200,000 (average)
- Net additional earnings: $1,240,000
- ROI: 12,300%
Payback period: Less than 1 year as working RN
Best Hospitals for Military Veteran ER Nurses
VA Healthcare System:
- Familiar environment serving veterans
- Federal benefits and job security
- Salary: $70,000-$95,000 (locality adjusted)
HCA Healthcare:
- 180+ hospitals, large ER network
- Military hiring programs
- Salary: $70,000-$95,000
Mayo Clinic:
- World-class medical institution
- Excellent benefits and professional development
- Salary: $75,000-$100,000
Cleveland Clinic:
- Top-ranked hospital system
- Strong trauma programs
- Salary: $72,000-$98,000
Johns Hopkins Hospital:
- Premier academic medical center
- Level I trauma center
- Salary: $78,000-$105,000
Kaiser Permanente (California):
- Excellent pay and union representation
- Work-life balance
- Salary: $105,000-$145,000
Level I Trauma Centers:
- Highest acuity emergency medicine
- Best utilization of combat medic experience
- Salary: $80,000-$115,000+
Real 68W to ER Nurse Success Stories
Miguel, 31, Former 68W E-5 → ER RN at Level I Trauma Center
After 8 years as combat medic (2 deployments), Miguel completed ADN at community college (2 years) using GI Bill. Passed NCLEX first try. Hired into ER new grad residency at regional Level I trauma center at $76K. After 3 years, makes $89K plus $8K shift differential (nights). Completing online BSN part-time (hospital pays 100%). Plans to pursue ACNP (Acute Care Nurse Practitioner).
Rachel, 28, Former 68W E-4 → Travel ER Nurse
Rachel did accelerated BSN (18 months) after earning bachelor's in psychology. Worked 2 years at community hospital ER ($72K), then switched to travel nursing. Now takes 13-week contracts at $110K-$125K annualized, works 8-9 months per year, travels extensively. Says 68W training gave her confidence with trauma patients that most civilian nurses take 5+ years to develop.
James, 35, Former 68W E-7 → ER Nurse Manager
James completed BSN while active duty using Tuition Assistance. Separated, passed NCLEX, hired at VA emergency department ($74K). Promoted to charge nurse after 2 years ($88K). Got MSN in Nursing Leadership online (VA tuition assistance). Now ER Nurse Manager at VA ($112K) overseeing 40+ nurses. Says military leadership experience was crucial for management role.
Action Plan: Your 68W to ER Nurse Roadmap
Months 1-3 (Pre-separation if possible):
- Research nursing programs (ADN vs BSN decision)
- Take nursing school entrance exam (HESI A2 or TEAS)
- Apply to nursing programs (apply to 5-8 schools)
- Submit Joint Services Transcript for credit evaluation
- Begin prerequisite courses if needed (using TA before separation)
Months 4-12 (Post-separation):
- Complete any remaining prerequisites (GI Bill)
- Get accepted to nursing program
- Optional: Work as CNA or paramedic for income + patient care hours
- Secure housing near nursing school
- Connect with veteran nursing students for mentorship
Years 1-2 (Nursing School):
- Maintain 3.0+ GPA (required to keep GI Bill benefits)
- Excel in clinical rotations (your 68W experience shines here)
- Join student nurse association
- Network with ER nurses during clinical rotations
- Pursue ER clinical rotation if available
- Consider part-time CNA/EMT work for income
Years 3-4 (Complete BSN if 4-year program):
- Focus on critical care, emergency, and trauma electives
- Complete senior capstone/preceptorship in ER if possible
- Apply for new grad ER residency programs
- Prepare for NCLEX (final semester)
- Interview for positions before graduation
Graduation → 3 Months:
- Take NCLEX within 45 days of graduation
- Apply for state RN license
- Accept ER position (or med-surg with plan to transfer to ER)
- Begin orientation and residency
- Join Emergency Nurses Association (ENA)
Years 1-3 as RN:
- Complete ER orientation/residency
- Get ACLS, PALS, TNCC certifications
- Gain experience in all ER areas (triage, fast track, trauma, critical care)
- Build rapport with ER physicians and advanced practice providers
- Consider charge nurse opportunities
Years 3-5:
- Obtain CEN certification
- Pursue leadership roles (charge nurse, preceptor)
- Consider travel nursing for higher pay
- Or consider graduate school (NP, CNS) for advanced practice
Frequently Asked Questions
Q: Can I go straight from 68W to nursing school without prerequisites? A: Most nursing programs require prerequisite courses regardless of military training. However, your 68W training may transfer as elective credits. You still need formal college courses in anatomy, physiology, chemistry, microbiology, etc.
Q: Will the GI Bill cover nursing school? A: Yes. The Post-9/11 GI Bill covers tuition at public universities (up to ~$26,000/year at private schools) plus housing allowance. Most veterans complete BSN with $0-$10,000 out-of-pocket costs.
Q: Do I need prior RN experience to work in an ER? A: Many hospitals prefer 1-2 years med-surg experience first. However, new grad ER residency programs exist specifically for hiring new RNs into emergency departments. Your 68W combat medicine background makes you competitive for these programs.
Q: Is ADN or BSN better for ER nursing? A: Both give you the same RN license and same starting pay. However, many major hospitals now require or strongly prefer BSN. If you have time and GI Bill benefits, go directly for BSN. If you need income faster, ADN→work→complete BSN online while working is viable.
Q: How hard is nursing school compared to 68W training? A: Nursing school is academically rigorous with extensive reading, papers, and exams. However, the clinical components are less stressful than combat medicine. Most 68W veterans report that the medical knowledge comes easily; the challenge is academic writing and nursing theory.
Q: Can I work while in nursing school? A: ADN and traditional BSN programs allow part-time work (weekends, per diem). Accelerated BSN programs typically prohibit work due to intensity. Many students work as CNAs or EMTs for 10-20 hours/week.
Q: What's the difference between ER nurse and paramedic? A: Paramedics work pre-hospital (ambulances, fire departments), assess and treat in the field, transport patients. ER nurses work in hospital emergency departments, continue patient care, broader scope of practice, higher education requirement, better pay long-term ($85K vs $65K average), more advancement opportunities.
Q: Will my security clearance help as an ER nurse? A: Not directly for civilian hospitals. However, some government healthcare positions (VA, military treatment facilities, federal agencies) value cleared nurses. Clearance can provide hiring advantage for those positions.
Q: Should I get paramedic certification before nursing school? A: Optional. Benefits: Income during school, maintains clinical skills, some overlap in content. Drawbacks: Delays RN timeline by 1 year, costs money. Best strategy: If financially stable, go straight to nursing school. If need income, get paramedic cert first.
Resources for 68W Veterans Pursuing Nursing
Nursing School Prep:
- RegisteredNursing.org - NCLEX and nursing school resources
- AllNurses.com - Forum for nursing students and veteran nurses
- NursingProcess.org - Military to nursing transition guides
Financial Aid:
- GI Bill Comparison Tool (va.gov) - Compare nursing programs by GI Bill coverage
- NURSE Corps Scholarship - Full tuition + stipend for underserved area commitment
- State veteran nursing scholarships - Many states offer additional funding
Professional Organizations:
- Emergency Nurses Association (ENA) - ER nursing specialty organization
- American Association of Critical-Care Nurses (AACN) - Critical care focus
- Student Nurses Association - Networking while in school
Veteran Nursing Networks:
- Veterans in Healthcare - LinkedIn group
- Veteran RN groups - Facebook and LinkedIn communities
- Your local VA hospital - Shadow opportunities and networking
Exam Prep:
- HESI A2 Pocket Prep - App for entrance exam
- UWorld NCLEX - Best NCLEX prep resource
- Mark Klimek Lectures - Free NCLEX review (YouTube)
Bottom Line for 68W Combat Medics
The 68W to ER nurse transition is one of the highest-ROI career paths for military veterans.
Your combat medicine experience translates exceptionally well to emergency nursing. Patient assessment, trauma management, critical thinking under pressure, teamwork in chaos—you've mastered these in environments civilian nurses will never experience.
The investment is modest: $5,000-$15,000 out-of-pocket (GI Bill covers most costs) and 2-4 years. The return is substantial: $75,000-$110,000+ starting salary, excellent benefits, job security, and $1+ million additional lifetime earnings compared to paramedic career.
Nursing school will challenge you academically, but the clinical practice leverages your strengths. You won't be intimidated by first patient interactions like traditional students. Your field experience makes you confident, competent, and ready for high-acuity emergency medicine from day one.
ER nurse managers actively seek former military medics. They know you bring maturity, experience, and crisis management skills that take civilian nurses years to develop. Your resume stands out.
The pathway is proven: thousands of 68W veterans have completed nursing school and now work as successful ER nurses earning six-figure incomes. The demand for emergency nurses is growing 6% annually. Job security is exceptional.
You've already done the hardest part—providing emergency medical care in combat. Civilian ER nursing is the natural evolution of your 68W skills into a rewarding, well-compensated healthcare career.
Ready to start your 68W to ER nurse transition? Use the career planning tools at Military Transition Toolkit to research nursing programs, connect with veteran nurses, and plan your education timeline.