the-job training. Medical specialists (91A20) are more experienced and perform routine
patient care with normal supervision. They are sometimes referred to as patient care
assistants. An advanced medical specialist (91B30) who has attended the Advanced
Medical Specialist Course at AHS has received additional training in trauma and
emergency medical situations. Advanced medical specialists (91B30/40/50) also serve
as section sergeants, platoon sergeants, first sergeants, senior medical NCOs, and
other position of responsibility.
(2) 91C. The practical nurse (91C) is an experienced medical specialist
who has had additional instruction in preventive, therapeutic, and emergency health
care. This additional training is equivalent to the instruction offered in civilian institutions
to prepare students to become licensed practical/vocational nurses. At ski II level
91C30, the clinical specialist is qualified for supervisory duties and may progress, with
additional experience, to ward master (91C40/E-7), chief ward master (91C50/E-8), and
senior senior/senior clinical NCO (91C50/E-9).
3-41. ORGANIZATION OF NURSING SERVICES IN TABLES OF ORGANIZATION
AND EQUIPMENT HOSPITALS
Although the nursing services provided patients in various Army medical
treatment facilities are the same; the organizational pattern differs between
MEDCEN/MEDDAC hospitals (see paragraph 2-7i) and numbered TOE facilities. Army
hospitals organized under tables of organization are specifically designed for
employment in a theater of operations. Although the nursing techniques are the same
as those employed in fixed CONUS hospitals, there are organizational differences due
to the differences in missions. In a fixed CONUS hospital, the Department of Nursing is
subdivided according to specialty services--medical, surgical, maternal, community
health, and so forth. Tables of organization and equipment hospitals, however, are
designed to support combat troops and the organization of the nursing service is based
upon severity of wounds or illnesses and the level of patient care required--intensive
care, intermediate care, and minimal care. There is normally a nursing service control
team and a centralized materiel service section. Figure 3-2 illustrates the organization
of the nursing service in a combat support hospital (TOE 8-123). Compare this
organization to the Department of Nursing described in paragraph 2-7i and illustrated in
figure 3-3. This hospital, like most TOE hospitals, has additional nursing personnel
assigned to organizational elements other than the nursing service. An operating room
head nurse is assigned to the surgical service control team and a nurse anesthetist and
an operating room nurse are assigned to each of the four in-patient surgical teams.
3-42. THE CLINICAL HEALTH CARE TEAM IN ARMY HOSPITALS
The clinical health care team is the group of individuals who work together in the
care and treatment of patients. In normal usage, it refers to the medical officers and the
professional and paraprofessional nursing personnel who are directly and continuously
employed in the care and treatment of patients in hospital nursing units.
MD0004
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