DEPARTMENT OF THE AIR FORCE PRESENTATION TO THE COMMITTEE ON APPROPRIATIONS SUBCOMMITTEE ON DEFENSE UNITED STATES SENATE SUBJECT: MEDICAL READINESS AIR FORCE NURSING SERVICES STATEMENT OF: MAJOR GENERAL MELISSA A. RANK ASSISTANT AIR FORCE SURGEON GENERAL NURSING SERVICES AND ASSISTANT AIR FORCE SURGEON GENERAL MEDICAL FORCE DEVELOPMENT April 16, 2008 NOT FOR PUBLICATION UNTIL RELEASED BY THE COMMITTEE ON APPROPRIATIONS SUBCOMMITTEE ON DEFENSE UNITED STATES SENATE
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Statement Air Force Nursing Service SC-02 Surgeon General, Nursing Services, Office of the Surgeon General, Headquarters U.S. Air Force, Bolling AFB, D.C. MAJOR AWARDS AND DECORATIONS
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DEPARTMENT OF THE AIR FORCE
PRESENTATION TO THE COMMITTEE ON APPROPRIATIONS
SUBCOMMITTEE ON DEFENSE
UNITED STATES SENATE
SUBJECT: MEDICAL READINESS AIR FORCE NURSING SERVICES STATEMENT OF: MAJOR GENERAL MELISSA A. RANK
ASSISTANT AIR FORCE SURGEON GENERAL NURSING SERVICES AND ASSISTANT AIR FORCE SURGEON GENERAL MEDICAL FORCE DEVELOPMENT
April 16, 2008 NOT FOR PUBLICATION UNTIL RELEASED BY THE COMMITTEE ON APPROPRIATIONS SUBCOMMITTEE ON DEFENSE UNITED STATES SENATE
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U N I T E D S T A T E S A I R F O R C E
MAJOR GENERAL MELISSA A. RANK Maj. Gen. Melissa A. Rank is Assistant Air Force Surgeon General, Medical Force Development, and Assistant Air Force Surgeon General, Nursing Services, Office of the Surgeon General, Headquarters U.S. Air Force, Bolling Air Force Base, D.C. As Assistant Air Force Surgeon General, Medical Force Development, she establishes new and appraises existing personnel policy and enhancement actions for more than 34,000 active-duty officer and enlisted medical personnel. She collaborates with Department of Defense agencies and Air Staff directorates to establish and meet future staffing needs. Her directorate is also responsible for all medical force education and training programs. As Assistant Air Force Surgeon General, Nursing Services, she creates and evaluates nursing policies and programs for 19,000 active-duty, Guard and Reserve nursing personnel. She interacts with major commands, the Air Staff, other military services and the Joint Staff on nursing services matters to ensure the highest caliber of nursing care and personnel. General Rank was born in Frostburg, Md., and earned a Bachelor of Science degree in nursing from the University of Maryland at Baltimore in 1975. While attending the University of Maryland full time, General Rank was employed as a senior registered nurse at Baltimore City Hospitals in the Medical-Surgical Trauma Intensive Care Unit, as a public health nurse at Johns Hopkins Medical Institutions, and clinical nurse researcher at the Center for Disease Control. Her Air Force career began as a staff nurse at Dover AFB, Del., and she has held a wide variety of clinical and supervisory positions at medical facilities in the United States, Germany and Japan. The general previously served in the Office of the Surgeon General as Executive Management Fellow for Services, Chief of Plans, Policies and Programs for Nursing Services in the Directorate of Work Force Management, and Deputy Assistant Surgeon General for Health Care Operations. She also served for one year as the U.S. Air Force Surgeon Chair to Air University, Maxwell AFB, Ala. General Rank has commanded an aeromedical evacuation squadron in Southwest Asia, a medical operations squadron and two medical groups. EDUCATION 1975 Bachelor of Science degree in nursing, University of Maryland at Baltimore 1980 Nursing Service Management Course, School of Health Care Sciences, Sheppard AFB, Texas 1982 Flight Nurse School, School of Aerospace Medicine, Brooks AFB, Texas 1984 Squadron Officer School, Maxwell AFB, Ala. 1984 Air Command and Staff College, by seminar 1990 Master’s degree in nursing administration, University of Texas at San Antonio
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1999 Master’s degree in strategic studies, Air War College, Maxwell AFB, Ala. ASSIGNMENTS 1. February 1978 - February 1982, staff nurse, Obstetrics and Gynecology Unit, and charge nurse, OB/GYN Clinic, Dover AFB, Del. 2. February 1982 - May 1984, charge nurse, Minimal Care Unit; clinical nurse, Intermediate Care Unit; supervisor, Outpatient Nursing Services, Chanute AFB, Ill. 3. May 1984 - May 1987, staff nurse, Pediatric Unit; night supervisor and Chief Nurse, 18th Aeromedical Staging Flight, Wiesbaden Regional Medical Center, Weisbaden, West Germany 4. May 1987 - October 1991, charge nurse, Neurosurgical Unit; clinical supervisor, Surgical Units; and quality improvement and risk management coordinator for the Division of Nursing, Wilford Hall Medical Center, San Antonio, Texas 5. October 1991 - September 1994, officer in charge, In-flight Nursing Care; assistant Chief, Nursing Services; and Chief, Nursing Services, 9th Aeromedical Evacuation Squadron, Yokota Air Base, Japan (October 1992 - January 1993, Commander, 1611th Aeromedical Evacuation Squadron (Provisional), Southwest Asia) 6. September 1994 - September 1996, Commander, 22nd Medical Operations Squadron, and Chief Nurse Executive, 22nd Medical Group, McConnell AFB, Kan. 7. September 1996 - July 1998, Executive Management Fellow for Services, and Chief of Plans, Policies and Programs for Nursing Services, Directorate of Work Force Management, Office of the Surgeon General, Bolling AFB, Washington, D.C. 8. July 1998 - June 1999, student, Air War College, Maxwell AFB, Ala. 9. June 1999 - July 2000, U.S. Air Force Surgeon Chair to Air University, Maxwell AFB, Ala. 10. July 2000 - July 2002, Commander, 20th Medical Group, Shaw AFB, S.C. 11. July 2002 - July 2004, Commander, 99th Medical Group, Nellis AFB, Nev. 12. July 2004 - July 2005, Deputy Assistant Surgeon General for Health Care Operations, Office of the Surgeon General, Bolling AFB, Washington, D.C. 13. July 2005 - present, Assistant Air Force Surgeon General, Medical Force Development, and Assistant Air Force Surgeon General, Nursing Services, Office of the Surgeon General, Headquarters U.S. Air Force, Bolling AFB, D.C. MAJOR AWARDS AND DECORATIONS Legion of Merit with oak leaf cluster Meritorious Service Medal with four oak leaf clusters Aerial Achievement Medal Air Force Commendation Medal with oak leaf cluster Air Force Achievement Medal with two oak leaf clusters Air Force Outstanding Unit Award with two oak leaf clusters Combat Readiness Medal Southwest Asia Service Medal PROFESSIONAL MEMBERSHIPS AND ASSOCIATIONS Sigma Theta Tau International American Nurses Association Kansas Nurses Association Association of Military Surgeons of the United States EFFECTIVE DATES OF PROMOTION Captain Feb. 1, 1980 Major May 1, 1987 Lieutenant Colonel May 1, 1993 Colonel March 1, 1999 Brigadier General Jan. 1, 2005 Major General Oct. 1, 2005 (Current as of December 2005)
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Mister Chairman and distinguished members of the committee, it is an honor and gives
me great pleasure to again represent your Air Force Nursing team. As we vigorously execute our
mission at home and abroad, Air Force nurses and enlisted medical technicians are meeting the
increasing challenges with notable professionalism and distinction. The Total Nursing Force is
comprised of officer, enlisted, and civilian nursing personnel with Active Duty, Air National Guard
(ANG), and Air Force Reserve Command (AFRC) components. Serving alongside Brigadier
General Jan Young of the ANG and Colonel Laura Talbot of the AFRC has been my distinct
pleasure. I look forward to serving with Colonel Anne Manly who was recently appointed in the
AFRC Corps Chief position replacing Colonel Laura Talbot. Together we are a powerful total
force nursing team directly supporting the Secretary and the Chief of Staff of the Air Force’s top
priorities to Win Today’s Fight, Take Care of our Airmen, and Prepare for Tomorrow’s
Challenges.
Expeditionary Nursing
Air Force Nursing is an operational capability and Air Force Nursing Services remain at
the forefront in support of the warfighter. A heightened demand has been placed upon military
nursing for highly complex clinical skills and our total nursing force is meeting this challenge.
Every member of the Total Nursing Force team has told me that their deployments, caring for
America’s most precious sons and daughters, has been the most professionally rewarding
experience of their lives. For instance, Captain Shelly Garceau is an emergency room nurse at
the 332nd Expeditionary Medical Group (EMDG) in Balad Air Base, Iraq, one of the busiest trauma
centers in the world. The emergency room treats 23 patients a day on average, 11 of which are
trauma cases. In a 24 hour cycle, the facility’s operating room staff typically handles more than a
dozen cases and performs more than 60 procedures. In the past year, nursing was critical to the
successful treatment of over 10,000 injuries. The hospital currently holds a 98 percent
survivability rate for wounded Americans who arrive at the 332nd EMDG. Colonel Norman
Forbes, 332nd EMDG Chief Nurse, states, “In a four month period, the facility’s statistics match or
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exceed activities at the R. Adams Cowley Shock Trauma Center in Baltimore, where many of our
staff nurses were trained.”
Behind every case and helping every patient who arrives at their doorstep, is the nursing
staff of the 332nd EMDG. From the moment a wounded soldier arrives at the hospital to the time
the patient lands in Germany or is medically evacuated to the United States, a nurse and
technician are there to care for the wounded patient. The pride that erupts from the members of
this medical group is felt and seen when you look at even just one situation: Two Marines were
transferred out of the Balad Air Base emergency room with partial thickness burns to the face as
a result of an explosion; Captain Garceau (332nd EMDG) stated, “That guy couldn’t even see me.
He wouldn’t be able to show you who I am if he saw me. But he’d recognize my voice. And
when he said thank you to me, it was like nothing else. There’s nothing like the ‘thank-you’s’ you
get here—nothing at all.”
Bringing wounded warriors home is mission #1 for our fixed-wing aeromedical evacuation
(AE) system. AE is a unique and significant part of our Nation’s renowned mobility resources. Its
mission is to rapidly evacuate patients under the supervision of qualified AE crewmembers by
fixed-wing aircraft during peace, humanitarian, noncombatant evacuation operations, and
joint/combined contingency operations. The Air Force Reserve Component owns approximately
88 percent of the total AE force structure, with the remaining 12 percent distributed among four
active duty AE squadrons. During November 6-7 2007, active duty and reserve subject matter
experts met to hold a capabilities review and risk assessment on the AE system. As a result of
this meeting, the Air Force AE patient care information management and in-transit visibility
modernization plan evolved. The recommendations for a new electronic patient medical record
and the ability for combatant commanders to know where, when, and how their injured troops are
doing, will bring AE to the leading edge of technology.
A major advancement in aeromedical evacuation system of the Afghan National Army
(ANA) Air Corps is the work being done by individuals like Major Mical Kupke, Captain Marilyn
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Thomas, Master Sergeant Brian Engle, and Technical Sergeant Janet Wilson who opened a flight
medicine clinic in Kabul, Afghanistan. These Airmen are using all local resources available to
perform work, including loading patients onto MI-17 helicopters, coordinating with the Czech
Republic field hospital and working with the medevac unit located nearby at Bagram Air Base,
Afghanistan. As Sergeant Engle stated, “The ultimate goal is for us to be able to step away as
the ANA becomes self-sustaining.” Sergeant Wilson stated, “The fact that we’re able to bring
something to their Air Corps and help the Afghan National Army build up their structure is very
positive; it makes me proud that I can contribute just a tiny portion to that.”
Our aeromedical staging facilities (ASF) provide critical support to the aeromedical
system. The 79th ASF at Andrews AFB, Maryland is the busiest in the continental United States.
Since January 2007, the staff has launched and recovered 699 missions, and facilitated the
transport and care of 7,895 patients to Andrews, Walter Reed Army Medical Center and the
National Naval Medical Center. The 79th ASF staff includes 31 permanent and 33 deployed
active duty and reserve nursing and administrative nursing personnel. Army, Navy and Marines
liaisons also work in the ASF assisting their patients with transition back to the United States.
The patients have a wide variety of injuries and illnesses, including those from improvised