One RN is female, 27, an active-duty Army captain commissioned into the service right out of nursing school, who never intended to stay beyond the
initial experience she sought and seeing a little of the world. The other is male, 47, a former infantry sergeant and combat medic who gravitated to
nursing after leaving the Army where, "My job was to fire my weapon."

Different, yes. But military culture is at the foundation of both of their nursing careers and is reflected in the cadence of their words as they
discuss the combined duty of caregiver and leader, and their approach to working with staff.

Capt. Bethany L. Niccum, RN, BSN, discusses the Army's expectations and being more than head nurse at a family pediatric clinic in Würzburg, Germany:

"Not only are we expected to be competent as nurses, we are expected to be leaders and soldiers. We have a day-to-day mission to care for our patients, but we must always be training for our wartime mission as well. We are always
training, whether it be through unit in-services in the hospital or training in field hospitals.

"The military culture is incorporated into my everyday life and routine. I wear my camouflage uniform to work every day, reminding me that I am not only a nurse, but a soldier serving my country. I'm not just a nurse, I am an officer. I am a leader. I teach the soldiers under me not only nursing
skills, but to ensure that they are competent in soldiering skills as well. And I do my best to lead by example."

That means avoiding the management or leadership pitfall that knowledge kept private is power, Niccum said. "I have found that if you share information, others might have ideas the would help make things even better or that would help you out. There is no need to recreate the wheel when we all have the
same goal."

Former infantry Sgt. Patric Burke, RN, joined the ranks of civilian nursing in 1992 and practices at Heritage Oaks Hospital, Sacramento, Calif.

"When you're in elite combat units like I was, you want to accomplish your mission. You're focused on detail and sense of duty and pride. And I carry
that into my nursing career. You're not there for yourself, you're there for somebody else.

"When I go into my hospital that's what I'm focused on … The staff looks to you, as the RN, to be the leader. And I've never, ever shirked away from
that. I will take charge. I will direct and I will apply myself. When I'm on duty, it's duty, honor, country, and I firmly believe that. It may sound corny, but it's as simple as that.

"Military nurses are looked at as managers," Burke said. "A good military nurse will take his or her staff aside and explain not only what to do but
why you're doing it. That just reinforces trust.

"The corollary in the civilian world is that … if you're a smart nurse you'll trust your staff, you'll train your staff. If the core staff understands why they're doing something, they're much more apt to do it in a professional manner.

"It's knowledge, education and training that really wins out in the end to provide total and effective patient care."