UNITED STATES AIR FORCENURSE CORPSFully Qualified Nurse Clinical (NC) & Nurse Specialist (NCS), Nurse TransitionProgram (NTP), Health Professionals Scholarship Program (HPSP)INFORMATION BOOKLETBRANDON A. KLINE, MSgt, USAFHealth Professions Recruiter, 342 RCS4600 SE 29th St, Ste 356, Del City, OK 73115-3430Cell:(405) 448-2101, Office: (405) 670-1986, Fax: (405) 672-2332,Email: [email protected]: as of 4 Feb 2013)

Table of Contents Air Force Nursing Nurse Responsibilities Air Force Benefits Nurse Specialties Educational Programs Assignment Locations Officer Ranks Pay & Entitlements Career Progression Frequently Asked Questions Commissioned Officer Training Nurse Transition Program Health Professions Scholarship Program BSN / MSN School Affiliates Qualifications Applications Process Required Documentation

Air Force NursingRespect and Prestige: You’ve set high goals for yourself, so why settle for anythingless? You can be part of the best healthcare program in the world. With our on-goingresearch and new technology development, you’ll join the Air Force’s top-notch medicalteams in providing the highest quality care to your patients.As an Air Force Nurse, you’ll gain the respectof your civilian colleagues and your military coworkers. You’ll become a vital member of ourmedical team. Whether you’re in collegepursuing your nursing degree or currentlyworking in nursing, you decided to enter thisprofession because you care about peopleand want to make a difference in the world.It’s those very same skills and compassionthat Air Force Nursing needs today. The AirForce can help you achieve your goals, followyour dreams and exceed any expectations you may imagine for yourself.In caring for their patients while also serving as Air Force officers, our healthcare teamslive by the Air Force’s core values of Integrity First, Service Before Self and Excellencein All We Do. In return, the Air Force offers unique challenges, career growth, andeducational opportunities. We’re also committed to providing you a quality of life andstable work week that lets you devote more time for yourself, your family and yourfriends.Lifestyle: Being an Air Force Nurse is a rewarding lifestyle. You’ll get to provide healthcare to active-duty members and their families using some of the most advancedequipment available. You’ll get a great feeling knowing your skills are highly valued as avital member of the Air Force healthcare team. Our medical teams are passionate andcompassionate about what they do. Not only will you get to practice your profession,you’ll also get to shape your future as a leader while developing and using your skills asa commissioned officer and healthcare professional. You’ll also have the satisfaction ofworking with some very talented officers and enlisted members who care about theirpatients as much as you do.The world and different cultures await you. Your quest for adventure will take youplaces. While many of your civilian counterparts are stuck in a routine job withpredictable hours, you can volunteer for assignments that include Europe and the FarEast. Or, you can apply for jobs in Alaska to enjoy its hunting and fishing opportunities,or even Washington, D.C., for its great museums, intellectual forums and the historicalsites of our nation’s beginnings. And the best part, as many Air Force people agree, isthe lifelong friends you’ll make along the way in your military career, be it four years orthirty.A comprehensive history of Air Force Nursing ps/public/documents/afms/ctb 039988.pdf

Nurse ResponsibilitiesWithin the Air Force, the practice of nursing by a registered nursing professional meansassuming responsibility and accountability for these and other nursing actions: Diagnosing and treating human responses to actual or potential healthconditions. Providing healthcare services in collaboration with other health servicepersonnel, including carrying out diagnostic and therapeutic regimens prescribedby duly licensed practitioners authorized to order such regimens. Teaching healthcare practices. Making a nursing diagnosis that identifies the needs of anindividual, family, or group. Administering a nursing treatment regimen throughselection. Performance and management of proper nursing practices. Administering, supervising, delegating, and evaluating nursing and medicaltechnician actionsOur health professionals will tell you that participating in humanitarian missions brings asense of personal fulfillment and satisfaction in their lives. Whether providing medicalare to survivors of a natural disaster, airlifting medical supplies to a third-world countryor responding to an emergency request from a foreign government, Air Force medicalpersonnel are ready to help wherever and whenever needed to save lives.

Features & BenefitsAir Force Nurses enter the military as officers with the same rank as physicians, leadingto a more team-oriented environment. Besides a great job, education, and training consider these benefits:Pay and compensation: Who doesn’t need a good income these days? The Air Forcestrives to provide salaries that are competitive with those in the civilian sector. As youprogress in your career, getting promoted and adding years to your military service time,your pay will increase. In addition, all military members may earn annual pay raisesapproved by Congress and the President. Your experience and education determineswhat rank you’ll enter the Air Force. Add in monthly food and housing allowances andyou’ll make a comfortable living. Don’t forget the free medical and dental benefits you’dpay for in the private sector for you and your family members.Earn 30 days of vacation with pay each year: Beginning your very first year! You’llhave lots of time to enjoy your off-duty time with family and friends at home or inanother state or country. There are some really great vacation destinations too, likebeach time at the Hale Koa Hotel in Hawaii, or skiing in Garmisch, Germany or golfingat Shades of Green in Orlando, Florida.No loss of seniority when moving to other hospitals or clinics: No matter whetheryou serve stateside or overseas, in a small clinic or large hospital. Air Force nurseshave that advantage over their civilian counterparts. You can see the world and stillearn your promotions and pay raises just like other Air Force personnel in nonhealthcare professions. It’s that simple.Tax-free housing and food allowances: Most ofthe time, you can choose to live on base or in thelocal community. If you live in base housing, you doso rent free. If you live off-base, the Air Forceprovides you with a monthly housing allowance.You can still continue to use the on-base facilitiessuch as restaurants and the grocery store no matterwhether you live on base or off.Comprehensive medical and dental care: Unlikethe private sector, you won’t have to wait for monthsto start using all facets of our medical and dentalcare the Air Force provides for its military membersand their families. Think of the monthly savingsyou’ll enjoy by not having to pay those veryexpensive healthcare premiums that your civiliancounterparts, friends and neighbors have to dealwith.Insurance: You can purchase life insurance policiesup to 400,000 for up to about 30 per month. If you are temporarily disabled due toillness or injury, you’ll still receive a salary.

Live, work and travel overseas: What an opportunity it would be for you and yourfamily to see the world; maybe even live in a foreign country, and experience differentethnic cultures together! The Air Force can make it happen.Home loans: As an Air Force member, or as a veteran, you’re eligible for low-costVeterans Administration backed home mortgage loans.Thrift Savings Plan: TSP is a Federal Government-sponsored retirement savings andinvestment plan. It’s optional and is completely separate from the military pension. Theplan offers the same type of savings and tax benefits that many private corporationsoffer their employees under ―401K‖ plans. You get a choice of investment funds andyou contribute from your own pay. The amount you contribute and the earningsattributable to your contributions belong to you, even if you don’t serve the yearsneeded to receive a military retirement.Discount shopping at on-base grocery and department stores: Our commissarieshave a variety of fresh, frozen and packaged foods just like off-base supermarkets. Ourbase exchanges have the latest in clothing, electronics, jewelry, and household items,just to name a few. We even have gas stations on base too!Family care while you’re at work: There are on-base child care centers for infants,toddlers and young children. For near-teens and teens, the youth center has a variety ofactivities and regularly-scheduled programs to keep young people busy.Recreation: Air Force bases have a variety of morale, welfare and recreation programs,including sports and fitness activities, to enjoy all year long. In recent years, the AirForce has made exercise and staying ―fit to fight‖ a top priority. Our fitness centershave top-of-the-line exercise equipment, swimming pools and weight room plus wehave tennis courts, golf courses, campingareas, and varied fitness classes for theentire family. Most bases also havebowling alleys, movie theaters, youthcenters and even discount ticket officeswhere you’ll get reduced prices foramusement parks, live theater andmovies.Retirement: While civilian pension plansare falling by the wayside or being totallycut, our retirement plan is still one of thebest programs around. Plus, while you’re earning your pension, there are no payrolldeductions for the Air Force’s retirement plan. With just 20 years of service with the AirForce, you’ll be eligible for retirement. You could be as young as 38 years old and still, ifyou choose, have another 27 years or more to do something else! Of course, you canstay in the Air Force past 20 with the potential to retire at 75% base pay.Morale, Welfare and Recreation (MWR) Activities: Provide conveniently located, lowcost, professionally managed activities and entertainment. You and your dependentsreceive significant savings when you participate in programs that include golf, bowling,child development center, clubs, arts and crafts, outdoor recreation activities, equipmentcheck-out, libraries, youth activities, hobby shops, recreation centers, aero clubs, etc.Space Available Travel: Members on leave may travel on military aircraft at no cost.

Nurse SpecialtiesEntry Level46N1TNurse Transition Program (NTP)- Two tracks only: Med/Surg or OBFully Qualified (FQ)46N346F3*Clinical Nurse (Med/Surg)Flight NurseFQ Nurse Specialists (NCS):46N3D*46N3E46N3F46N3G46N3J46P346S3Clinical Nurse Staff DevelopmentCritical Care NurseNeonatal Intensive Care NursePerinatal Nurse- OB / GYN / LD / PPEmergency (ER) /Trauma NurseMental Health NursePerioperative (OR) NurseFQ Advanced Practice Nurses (NCS- APN):46Y3C*46Y3G46Y3M46Y3A46Y3B46Y3H46Y3PAdult / Acute Care Nurse Practitioner (ACNP)Nurse MidwifeCertified Registered Nurse Anesthetist (CNRA)Women’s Health Nurse Practitioner (WHNP)Pediatric Nurse Practitioner (PNP)Family Nurse Practitioner (FNP)Psychiatric Mental Health Nurse Practitioner (PMHNP)Nurse Corps Health Professions Scholarship Program (NC-HPSP):46G146M146N1B46N1C*46N3A46N1H46P1ANurse MidwifeCertified Registered Nurse Anesthetist (CNRA)Pediatric Nurse Practitioner (PNP)Adult / Acute Care Nurse Practitioner (ACNP)Women’s Health Nurse Practitioner (WHNP)Family Nurse Practitioner (FNP)Psychiatric Mental Health Nurse Practitioner (PMHNP)Note: * Very limited Availability

Nurse Specialty DescriptionsAcute Care Nurse Practitioner (ACNP): is an advanced-practice registered nurse whoprovides care to patients who are experiencing acute, critical, and complex episodicillnesses or injuries. The ACNP's scope of practice encompasses trauma, critical careand emergency service, as well as hospital-based specialty practices such asorthopedics, cardiology, neurology, oncology and infectious disease. The ACNP hascompleted a graduate-level program of specialized study that includes both didactictraining and a minimum of 500 supervised clinical hours. National board certification andstate licensure are subsequently required to begin independent practice. The ACNP'sscope of practice includes: conducting a comprehensive history and physical exam,diagnostic reasoning, ordering and interpreting the full range of diagnostic tests,performance of invasive procedures, and prescriptive authority. The ACNP collaborateswith the patient, family members, and other members of the health-care team to reachthe best possible outcome for the patient.Emergency Room (ER) Nurse: Emergencynursing crosses multiple dimensions and includesthe provision of care that ranges from birth, death,injury prevention, women's health, disease, and lifeand limb-saving measures. Unique to emergencynursing practice is the application of the nursingprocess to patients of all ages requiring stabilizationand/or resuscitation for a variety of illnesses andinjuries which occur in a variety of settings,including during a contingency or natural disastersetting. These may require minimal care to lifesupport measures; patient, family, and significantother education; appropriate referral and discharge planning; and knowledge of legalimplications. The emergency room nurse is a focal point at the crossroads of primary,secondary, and tertiary care, and on the wellness illness continuum. Emergency roomnurses triage and use assessment skills during contingency operations as well aspeacetime, to save life and limb. ACLS, BLS, required, Trauma Nurse Course highlyencouraged.Critical Care Nurse: A critical care nurses manages complex critically ill and injuredadults to children. As a critical care nurse, you will use state-of-the-art equipment on theground and in the air and assist with transport of critically injured soldiers during acontingency. Advanced cardiac life support (ACLS) and basic life support (BLS) arerequired. Advanced education is encouraged throughout your career.Family Practice Nurse Practitioner (FNP): Air Force Family Practice NursePractitioner manages all ages of patients from infant to geriatrics. They work incollaboration with physicians and a multidisciplinary team to benefit the militarypopulation and their beneficiaries and practice as an independent practitioner with anormal caseload of patients with complex multisystem medical issues, as well as routinehealth maintenance.

Medical Surgical (Clinical) Nurse: Clinicalmedical surgical nurses are indispensablemembers of Air Force medical teams. As amedical surgical nurse, you plan, implement andevaluate nursing care for both outpatients andinpatients along the health continuum. You willcollaborate with all members of the team toensure your patients and their families receivethe finest state-of-the-art health care. A variety ofassignments await you from working in a full sizemedical center including research, to workinginterdependently with medical providers in a small clinic. Medical surgical nurses areinvolved in every aspect of healthcare from bedside nursing, community initiatives,leadership, research, education and disaster preparedness, including deployment.Medical surgical nursing offers the widest variety of opportunities within healthcare.Mental Health Nurse: Mental health nurses are crucial to the recovery of their patients.In this assignment, you will provide services to promote and maintain optimal mentalhealth, manage mental and physical disorders and diagnose and treat humanresponses to actual or potential mental health problems. You will work with individuals,families, groups and communities to assess mental health needs, develop diagnosesand plans and implement and evaluate nursing care. You will also monitor patientsundergoing detoxification from alcohol and drugs, assist in planning, providing andevaluating comprehensive mental health services and support, conduct and use nursingresearch to improve health-care delivery. As a mental health nurse you may manageinpatient care units, provide case management, and work with members in the deployedsetting.Neonatal Intensive Care Nurse: An Air Forceneonatal nurse is a medical surgical nurse whoworks primarily in the neonatal intensive care unit(NICU). As a neonatal nurse, you will assess,plan, supervise and ensure that quality care isgiven to neonatal patients (ages 0-30 days) withmultiple pathologies, including medical andsurgical diagnosis. You will attend high-riskdeliveries, as well as perform all functions of amedical surgical nurse while managing resourcesduring multiple admissions and discharges.Depending on the NICU to which you are assigned, you may care for infants on highfrequency oscillator ventilators or extracorporeal membrane oxygenation and assist inneonatal aeromedical evacuation (transport) missions. You will be responsible for usinghighly specialized equipment; assigning duties to subordinates; and providingpsychological, social and educational support to parents and family members. All AirForce neonatal nurses must acquire and maintain certification in basic life support (BLS)and the neonatal resuscitation program (NRP).

Nurse Anesthetist: (CRNA) ensures that alloperations and surgeries are as painless aspossible. In this role, you will administer anestheticagents to patients and monitor their reactions toanesthesia and surgery. You will also provide orsupervise postoperative recovery care. Yourresponsibilities will include the management of theanesthesia department. You will provide orsupervise services in support of patients withrespiratory care requirements. You will also assistwith the training of personnel in venipuncture andintravenous therapy, respiratory care, cardiopulmonary resuscitation and anesthesiaunder the direction of a medical officer. Your responsibilities include performingpreoperative evaluations and preparations, administering anesthetics and advising theanesthesiologist of adverse reactions necessitating nondelegated medical decisions.Nurse-Midwife: On the front lines of women's health in the Air Force is the certifiednurse-midwife. The certified nurse-midwife provides comfort, support and expertise inmedical-midwifery care during pregnancy, labor, delivery, and postpartum. Functioningin this role you will independently manage women's health care with emphasis on thematernity cycle and practice in collaboration with an obstetrician/gynecologist or familypractice physician.Operating Room Nurse: The operating roomnurse is on the front line of the most complexlifesaving procedures. You will be responsible forplanning, directing and coordinating activities ofthe operating room department. An operatingroom nurse provides professional nursing care topatients undergoing surgery, prepares andmaintains the operating room for all surgicalprocedures and assembles the type and quantityof materials and special equipment needed fordaily procedures and possible emergencies. Youwill conduct both preoperative and postoperative visits with your patients. You will alsocoordinate with other hospital units, which may include recovery room, intensive care,obstetrics and nursing units, to ensure your patients' progress.Psychiatric Mental Health Nurse Practitioner: (PMHNP) provides comprehensivepsychiatric mental health care to the adult military population, retirees, and theirsignificant others between the ages of 18 and 65. The PMHNP interfaces andcollaborates with other professional to insure appropriate and coordinatedmultidisciplinary patient evaluation and treatment. PMHNP functions independently andin collaboration with credentialed health providers. Also serves as a role model andconsultant to staff in the provision of psychiatric care, education, and research.

Pediatric Nurse Practitioner: PNP) is aprivileged provider in the specialty of Pediatrics.PNPs are registered nurses who have obtainedadvanced education, training, and certification topractice independently and collaboratively toprovide primary health care to pediatric clients.PNPs provide medical assessment, treatment,education, health promotion, and prevention toindividuals, families, and the community. PNPspractice independently and collaboratively withphysicians providing comprehensive healthcarefor well and sick children from birth to adolescence and are an integral, active memberof the pediatric healthcare team, caring for neonates, infants, children, and adolescentsup to age 21 yrs. Education requirements include graduation from an accreditedbaccalaureate degree program in nursing (BSN) and completion of an approved andaccredited Master's Degree (MSN or MS) prepared pediatric nurse practitioner program.Licensure is required as an RN from at least one US jurisdictions. In addition, nationalcertification through the Pediatric Nursing Certification Board (PNCB) or the AmericanNurses Credentialing Center (ANCC) is required. Basic Life Support and PediatricAdvanced Life Support certifications are also a requirement.Perinatal (OB/GYN) Nurse: You assess, plan,implement, supervise and evaluate quality caregiven to obstetrical/neonatal patients and families.Assignment opportunities exist both in the Statesand overseas. Depending on the unit to which youare assigned, you may care for high risk OBpatients, level II nursery patients, circulate forcesarean sections, or add medical-surgicalpatients to your OB duties on a single unitinpatient care ward. OB nurses are integral partsof OB care teams and work with certifiedmidwives, physicians, neonatologists, pediatricians, medical surgical nurse specialistsand others to provide management of acute and chronic illnesses as well as low riskobstetrical care. All Air Force Obstetric Nurses must acquire and maintain certification inBasic Life Support (BLS) and Neonatal Resuscitation Program (NRP).Women's Healthcare Nurse Practitioner: (WHNP) is an advanced practice medicalsurgical nurse who works in the ambulatory care setting. As a WHNP, you will provideprimary health care to both obstetric and gynecologic patients from menarche throughtheir life cycle. Your privileges include obtaining medical histories, performing physicalexams, and establishing medical diagnoses; ordering and interpreting diagnosticstudies; initiating appropriate treatment, to include drug therapy, within privileged scopeof care. Also perform comprehensive family planning counseling, cancer screening, STIcare, and procedures (if credentialed to do so, such as IUD insertion, colposcopy, andbiopsies of the vulva, vagina, cervix, and endometrium). The practice setting the AirForce WHNP ranges from solo practice in a clinic to group practice in a medical center.

Educational ProgramsNurse Corps Programs: The Nurse Corps annually provides Air Force Nurses with avariety of opportunities to receive graduate education at civilian institutions sponsoredby the Air Force Institute of Technology. Typical degrees awarded include a Master ofScience in Nursing Disciplines which has nurse practitioner programs and clinicalspecialties.Professional Growth: From day one and throughout your Air Force career, youachieve professional growth and development through leadership experiences, on-thejob training (OJT) and continued education. The Air Force places a very high priority oncontinuing education and training. You’ll have the opportunity to meet your goals andfurther your career. If you’re still in nursing school and have student loans or you’rewondering how you’ll pay for your master’s degree, we’ve got that covered too.Nursing Service Fundamentals: Introductory level correspondence course designedto prepare nurses to deal effectively with day-to-day situations encountered in Air ForceNursing units. Additionally the course facilitates and awareness of the nurse managerrole. Some components include cultural diversity, sexual harassment, followership,mentoring, manpower and duty schedules, ethical decision-making, and delegation.This course is a prerequisite for selection to Nursing Service Management.Flight Nursing: Trains nurses pre-selected for flying assignment as a member of themedical crew in aeromedical evacuation units. At Brooks AFB, TX, this 5 ½ -weekcourse includes principles of aerospace medicine; altitude physiology; specializedtechniques necessary for safe and efficient transportation of patients by air in peacetimeand wartime environments; life support principles, procedures, equipment, andtechniques, and survival skills. Provides the knowledge and skills required formanagement and nursing care of patients in flight.Post 9/11 GI Bill: Up to 48,000 for use toward your education while on duty or up to15 years after you leave or retire from the Air Force. And, it is transferrable to yourspouse or your children. Certain rules apply.Clinical Hyperbarics: Provides training necessary to function as a hyberbaric medicinenurse, emphasizing management of total patient care for critically/chronically ill patientsselected for hyperbaric oxygen therapy. Attendees participate in all phases of clinicalhyperbaric medicine including wound care, in this 7-week course at Brooks AFB, TX.Students gain experience in emergency practice to include treatment for decompressionsickness, air embolisms, carbon monoxide poisoning, and gas gangrene. Four weeksof job qualification is then mandatory at the selectees’ clinical hyperbaric site before thenurse is considered fully qualified.Nursing Service Management: This residence course at Sheppard AFB, TX providestraining in the knowledge and skills needed to perform the duties associated withnursing management positions. Topics include regulatory agencies, standards ofpractice, responsibilities, management tools, quality assessment/improvement, riskmanagement, duty scheduling, and performance evaluations. Completion of NurseService Fundamentals is mandatory before selection to attend Nurse ServiceManagement.

Health Professions Education and Training Course: This 4-week course held atSheppard AFB, TX, prepares both officer and enlisted members for various roles ineducation within the Medical Group. Attendees make several oral presentations andaccomplish various individual and group projects. Content focuses on initial orientationof medical group personnel, in-service education, and continuing education, assessinglearner needs, teaching adult learners, planning and implementing educationalprograms, evaluating effectiveness of educational endeavors, and management ofMedical Group Education and Training.Operating Room Nurse: Provides training to enter the operating room nurse careerfield from other nursing career fields. Course consists of 2 weeks of didactic trainingand 10 weeks of clinical experience under direct supervision of the course supervisorand approved preceptors. Emphasis is placed on development of the preoperative roleand ability to function effectively and safely as a surgical team member. Creation of anoptimal surgical environment, utilizing the principles of aseptic technique and infectioncontrol practices is stressed. Operating room nurses responsibilities during ORemergencies, peacetime disasters, and wartime medical readiness are alsoemphasized.Nurse Anesthetist: Selected RN’s participate inselected universities, which are fully accredited byAnesthetists. The didactic instruction involvesphysiology, physics, chemistry and various Air Force Medical Centers.a 2-year master program throughthe American Association of Nurseareas such as general anatomy,The clinical phase is accomplishedNeonatal Intensive Care Nurse: This 10-week course provides training to enter theNeonatal ICU career field from other nursing career fields. This course provides trainingin the knowledge and skills necessary to perform the duties of a clinical nurse in a level2-3 neonatal ICU. This course will include emergency response to newborn deliveriesand concepts of neonatal transport. Instruction is geared toward providing the basicknowledge and hands on training needed in assessing, planning, implementing, andevaluating care of the neonatal patient.Perinatal Nursing: This 6-week course, taught at Langley AFB, VA or Lackland AFB,TX provides training for new perinatal nurses in the knowledge and skills necessary toperform duties as a staff nurse in an obstetrical unit, including labor and delivery,postpartum, and newborn nursery. Instruction is geared toward planning, implementing,and evaluating care of antepartum, intrapartum, postpartum, and neonatal patients.Continuing Education Contact Hours: The Air Force Nurse Corps supportsprofessional growth and development through continuing education programs. Severalfunding sources exist to send nurses, expenses paid, and educational offerings such asnational conventions of nursing specialty organizations and other local and nationaleducation conferences and courses. In addition, the NC continues its tradition ofcommitment to education through its Continuing Educational Approval and RecognitionProgram (CEARP). Contact hour activities, approved through CEARP, are often heldright in the workplace and are possible because the NC is an accredited approver unitof the American Nurses Credentialing Center Commission on Accreditation (ANCCCOA). The Air Force requires 60 contact hours every 3 years. The Air Force contactrequirement usually meets or exceeds individual state requirements; however, eachnurse is required to maintain their states contact hour requirement.

Uniformed Services University Health Sciences (USUHS) Graduate School ofNursing: The USUHS Graduate School of Nursing focuses on preparing health careprofessionals at the graduate level for practice and research in federal and militaryhealthcare.Sponsorship for Graduate Study: Thr

46Y3G Nurse Midwife 46Y3M Certified Registered Nurse Anesthetist (CNRA) 46Y3A Women’s Health Nurse Practitioner (WHNP) 46Y3B Pediatric Nurse Practitioner (PNP) 46Y3H Family Nurse Practitioner (FNP) 46Y3P Psychiatric Mental Health Nurse Practitioner (PMHNP) Nurse Corps Health Professions Scholarship Progra