Maj. Gen. Rank retires Published Jan. 7, 2009 WASHINGTON -- -- Imagine that you are leading an aeromedical evacuation crew and need to get several pilots out of harm's way and to the hospital. The pilots had unknowingly hit landmines that had been covered by sand. They are badly hurt. Your problem: there aren't any C-141s scheduled for a routine mission for another week into Southwest Asia. Maj. Gen. Melissa A. Rank was in that position when she was the 1611th (Provisional) Aeromedical Evacuation Squadron Commander at a base in Southwest Asia. With cooperation from the line of the Air Force and Air Mobility Command, a KC-10 that had just landed was used. She and her team immediately reconfigured the plane for aeromedical evacuation mission to get the pilots out of danger and quickly to Landstuhl Regional Medical Center in Germany. It was an extraordinary rare occurrence to use a KC-10 for an aeromedical evacuation in the early 1990s'. Yet, today a wide-range of aircraft are used to move patients in and out of combat situations. When General Rank was growing up in Frostburg, Md., there were only three career options for women: secretary, teacher or nursing. With her mother's guidance, she chose nursing. Her dad also had a tremendous impact on her career choice. While she was growing up, she saw her dad overcome adversity by finding a way to serve his country even though he had severe polio. He worked as a civilian rocket scientist for the Navy. "I think when it's all said and done as I'm reflecting on my career, I was serving for him," said General Rank. She also learned perseverance from her dad. As General Rank reflects upon her 32 year-career, she spoke about finding herself exercising her strength of character by taking a stand on important issues on behalf of nursing and her patients. She overcame challenges while she was a group commander of the 20th Medical Group at Shaw Air Force Base, S.C. During her tenure at Shaw, the obstetrical unit faced great adversity in maintaining currency in delivering safe patient care to expectant parents and their newborns. During the resolution of this challenge, she learned a few things. First, staff look up to you as their leader. They need a leader to shore them up during times of crisis. Second, training is of utmost importance. The more you train, the more you're able to do the procedure second nature. Third, young staff should not be afraid of channeling up concerns for fear of retribution. Despite a whirlwind of inspections during this time, her medical group endured and was highly successful. "We pushed ourselves harder than we ever thought possible," said General Rank. Their hard work and perseverance paid off. Throughout her career, General Rank worked hard to increase the quality of life for the staff and the quality of care for the patients. The "3 Minute Difference" was one of the recommendations she made to the nursing staff, encouraging them to sit down with their patients while talking to them. "Nursing research has borne out that patients feel like their nurses care when being asked a series of questions while the nurse is sitting down rather than standing up," said General Rank. Over the course of her career, General Rank is proud of the changes made to take care of Air Force medical personnel - officer, enlisted and civilian, and ultimately, the patients. The nurse transition program, critical care nurse fellowship program, nurse enlisted commissioning program, implementation of the AFMS flight path where all corps can achieve command, and the new Medical Education Training Campus at Ft. Sam Houston are a few of the items that she's proud of. To resolve a dire shortage of critical care nurses, a one-year critical care nurse fellowship program was begun in the National Capitol Region, spring boarding off the already successful nurse fellowship program in San Antonio. This program educates a clinical nurse in critical care. After seven months, the fellows are able to deploy. While deployed, they are mentored and watched over by a fully qualified critical care nurse. When their deployment is complete, they finish up their fellowship and attain the status of a fully qualified critical care nurse. General Rank also advocated a nurse enlisted commissioning program. This program allows the Air Force to grow its own nurses. Previously, over seven years, the recruitment of nurses had been steadily decreasing. The Air Force was been able to reverse this decline by implementing the nurse enlisted commissioning program. There are 73 candidates currently in their nursing programs who will achieve their Bachelor's of Science in Nursing over the next two years. Of the 73 candidates, 50 percent are from the Air Force Line (non-medical) and 50 percent are medics. "This proves that there is interest beyond the enlisted health care professions to become nurses," said General Rank. She worked with other offices within the office of the Air Force Surgeon General to ensure that this program will continue to "grow" 50 nurses a year well into the future. The Nurse Transition Program (NTP) takes a nurse who has graduated from nursing school and places them in military treatment facilities, not only to introduce them to the military way of life but provide them additional clinical time in obstetrics or medical surgical nursing. With assistance of the Office of the Surgeon General, Air Education Training Command, the Air Force Medical Service initiated a relationship with the University of Cincinnati Medical Center to begin a Nurse Transition Program in a civilian medical institution for the very first time. The University accepted its first Nurse Transition Program students in Oct. 2008. Each class will last between nine and 11 weeks and will enable each nurse to become fully qualified. Further, once the program is complete, the nurses will go onto military treatment facilities and medical centers. An additional Nurse Transition Program platform is expected to be created in 2009 between Luke Air Force Base, Ariz., and civilian medical facilities in the local area that will offer a similar rich clinical experience as the University of Cincinnati provides new Air Force nurses. General Rank is also proud of collaborating with the other Services to establish the Medical Education Training Campus (METC), to be located at Ft. Sam Houston. She was a flag officer member and lead of an 18-member steering committee. METC will bring the enlisted from all three Services together in a University setting to acquire their medical education and training experience. However, each of the enlisted will continue to have components of its medical education and training that are Service-specific curriculum. General Rank is famous for discussing the ability to receive 'instantaneous feedback' via e-mail 'from nurses in Balad, Iraq and Bagram, Afghanistan'. When asked if a particular item was an impetus in changing nursing policy or starting a program, she stated, that about two and a half years ago, she received a forwarded e-mail from an Air Force Captain in Balad, Iraq. His e-mail described the Iraqi children he was taking care of and how humbled he was to serve in the military and care for our troops. This e-mail and subsequent e-mails, energized General Rank to work harder to increase promotion opportunity and timing and acquire more field grade billets for nurses. She also appealed to nurses and technicians to share their stories in hopes that it would help them rebound from the tragedies they saw in Iraq and Afghanistan. General Rank offered the following advice to future Air Force officers, enlisted, and civilians: "They should live by the core Air Force values; have accountability up and down the chain as well as laterally; and above all else, to thine own self be true," said General Rank. In retirement, her 9-year-old daughter, Katelin, has high hopes for her mom. She wants her to help teach language, math and science to her fourth grade class. Her mom will also help her to be a stiff competitor in sports such as swimming, softball and karate.