Staffing shortages continue to plague the U.S. military's flagship hospital in Bethesda, Maryland, leading to the disruption of services this month in the nephrology infusion clinic at Walter Reed National Military Medical Center.

A Walter Reed spokeswoman said Thursday that two nurses at the clinic, which provides infusion services for kidney, some gastroenterology and other department patients, went on emergency leave, forcing hospital leaders to shift staff from other areas of the hospital to support clinic operations.

Ricardo Reyes, a public affairs officer at Walter Reed, said no appointments were canceled and "all patients scheduled for this week have been rescheduled."

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A patient said that late last week they were notified by staff that the clinic would be closed for two weeks and told to make alternate arrangements.

The patient said they were shifted to Fort Belvoir^[2] Community Hospital, which also has a limited number of staff to support infusions and is a 90-minute drive during most times of the day from Walter Reed.

"We are working to make sure next week's scheduled patients are covered," Reyes said in an email to Military.com on Wednesday. "This is a temporary situation, and we expect to be back to normal operations later this month."

An April 2024 Defense Department report to Congress said that the facility was staffed at just 79% of its authorized number of personnel, with nurses having the lowest staffing rate at 68%.

To address the issue, the Defense Health Agency launched an effort with the medical commands of the military services to develop a Human Capital Distribution Plan, or HCDP, to determine the requirements at all medical and dental facilities to ensure that the facilities were adequately supported by military personnel as well as civilian and contract staff.

In its report to Congress on Walter Reed, Defense Health Agency officials said the HCDP would give the facility the means to fill its empty jobs.

"The HCDP ... will provide Military Health System leaders a way, and the means, to provide military and civil service authorizations filled by the right person, at the time they are needed, achieving great outcomes for our beneficiaries," the report stated.

The Defense Department awarded contracts worth up to $43 billion in May 2024 to 11 health care staffing companies to provide contract medical staff as well as support at military treatment facilities and other federal hospitals and clinics in the 50 states, District of Columbia, Puerto Rico and Guam.

According to the Defense Health Agency, under the agreements, known as the Medical Q-Coded Support and Services Next Generation contracts, the companies are to provide dental, nursing, physician and medical support staff to augment DoD civilian employees and military personnel at those hospitals and clinics.

Last year, Karen Ruedisueli, director of government relations for health affairs at the Military Officers Association of America, noted that staffing shortfalls at Walter Reed "could reverberate" across the military health system because not only is it considered a premier medical center, it is responsible for training the next generation of military doctors, with 53 graduate medical programs for the Army^[3], Navy^[4] and Air Force^[5].

"MOAA supports the DoD's revised strategy to stabilize the military health system^[6] and improve MTF [military treatment facilities] staffing so MHS [the military health system] can fulfill both readiness and beneficiary care missions," Ruedisueli wrote.

In an opinion piece published earlier this month^[7], acting Assistant Secretary of Defense for Health Affairs Dr. Stephen Ferrara pledged to work with department leadership to ensure that the military health system has what it needs to serve patients and train physicians.

"Military medicine is a no-fail mission. I'm confident that our success will continue to reinforce the strength that sustains the peace. But should the peace be broken ... our preparation will ensure we break the Walker Dip streak," Ferrara wrote, referring to the decline in combat medical skills following the end of a period of war.

Walter Reed is undergoing a multiyear renovation and expansion project, with a new five-story, 533,000-square-foot facility that opened this spring to house operating rooms and ambulatory procedure rooms, women's health, the Mother Infant Care Center and Neonatal Intensive Care Unit, dentistry, and dozens of other clinics and services.

A new building, slated to open in 2028, will house optometry, patient transport, the American Red Cross and administrative offices, according to facility officials.

Related: Pentagon's Top Doc Defends Military Health System Budget, Lays Out Plans for Improvements^[8]

Defense Secretary Pete Hegseth has ordered the military to take steps to encourage troops to consider being part of the agencies that handle immigration enforcement and border security though a new policy unveiled Thursday.

In a memo made public Thursday^[1], Hegseth ordered the Pentagon to "prioritize and broadly advertise" opportunities troops who are nearing separation or retirement from the military have with either Customs and Border Protection or Immigration and Customs Enforcement as part of its SkillBridge program.

SkillBridge is a program that is intended to allow troops to take part in real-world job experience while in their final 180 days of military service. The idea behind the program is that it enables a smoother transition to civilian life and allows troops to be more competitive in their chosen industries or fields.

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"Recognizing the importance of leveraging talent and furthering our commitment to work with DHS [Department of Homeland Security], the department is expanding opportunities for transitioning service members to support southern border activities," Hegseth wrote in his memo, which was signed two weeks ago.

While troops have long had access to SkillBridge opportunities with CBP and ICE, the new policy would give those agencies greater emphasis, and commanders are encouraged to approve requests to work with either agency "to the maximum extent possible."

SkillBridge is a training program with no explicit promise of a job after a service member gets out of the military, but there is also a broad understanding that it is meant to act as a gateway to a position with the chosen company or agency.

A defense official told Military.com on Thursday that the current training opportunities with DHS include jobs like paralegal, program management and intelligence research specialists. The official added that none of the training opportunities includes law enforcement at this time.

Top Pentagon spokesman Sean Parnell called the move "an exceptional opportunity to ensure the best of America can continue to serve and defend their country."

The move is just the latest push that Hegseth has made to enable the military to more closely support the Trump administration's growing emphasis on security on the southern border and deportations of people they claim to be in the country illegally.

Nearly two weeks ago, Parnell also announced that Hegseth signed a memo that allowed Pentagon civilians to be detailed to the Department of Homeland Security -- the agency that oversees both CBP and ICE -- to better support "border security efforts, as well as interior immigration enforcement."

The defense official said that, while the civilian effort is still being worked out with DHS, the military branches can begin prioritizing troops taking advantage of SkillBridge immediately.

The memos are now two moves the Trump administration has made to more closely integrate the military with law enforcement as a way to expedite the widespread removal of immigrants on American soil, a move deemed alarming by legal and military experts.

Mark Nevitt, an associate professor at Emory University School of Law, said it was "odd" that Hegseth would put this memo out and that it raises a multitude of questions as it relates to integrating the military with immigration enforcement.

"What capacity are they working through SkillBridge?" Nevitt said to Military.com in an interview Thursday. "Hopefully, there's some sort of deep, deep, deep thought being put into that. And if the military member is still on an active-duty status, you would hope that they're very limited in what they're doing with SkillBridge other than more observing."

The announced deployments^[3] of the National Guard^[4] and Marines to support Immigration and Customs Enforcement agents amid protests in Los Angeles this week mark another mixture of those two agencies. Active-duty military forces are not allowed to conduct law enforcement activities under the Posse Comitatus Act, but the Trump administration has worked to push those legal boundaries.

Although Guardsmen in Los Angeles have been pictured doing traditional law enforcement-related tasks, like carrying riot shields and securing perimeters behind police tape, U.S. Northern Command has claimed on social media that troops "are not conducting civilian law enforcement activities."

Nevitt said another recent trend is that National Guard units, such as those in Texas and Florida, have partnered under "287g" Immigration and Customs Enforcement agreements, which allow them to perform certain immigration officer-type actions while under state orders.

"SkillBridge is part of this larger integration, and there's just a strong, strong desire in this administration to use every tool at their disposal to enforce immigration law," Nevitt said.

Related: Hegseth Suggests LA-Style Troop Deployments Could Happen Anywhere in US 'if Necessary'^[5]