Re: ER or ICU to Flight Nurse?
Not the case at all, worked in a small US/Mexico border town ER off a major interstate. The amount of trauma we saw was staggering. It was not uncommon to do a couple of RSI's per shift. The experience was second to none because of limited staffing and relatively high volume. For example, at night, we had one RN, one LPN, and our physician. The physicians ranged from internists to pediatricians. Some of the docs relied on us heavily for assistance.
There was no competition with residents or students. We often did not have specialty staff such as RT, and had to manage intubated patients with multiple drips and critical problems until the flight team would extract the said patient. In addition, the docs allowed us to have a significant amount of autonomy within facility policy and BON SOP of course.
After only a year, I had been directly involved with countless codes, RSI's, and saw stuff that I did not even see in Afghanistan. I remember having a patient present in a complete heart block and being the only other person assisting the doctor with the placement of a temporary transvenous pacemaker. We had mass casualty incidents from 20+ vehicle pileups on the highway with our spring dust storms to a HAZMAT incident where multiple contaminated factory workers were staged in our makeshift parking lot decontamination stations. I learned how to transduce my first invasive line from an old battle axe nurse when one of our docs placed a central line in the femoral artery. Some people would have lost the plot, she simply stated, "now we have an art line, may as well transduce it."
The experience I gained along with developing the ability to improv my way through difficult situations served me well. ER nurses who excel in a rural high volume setting with limited resources are a special breed. However, you still need a solid critical care skill set to excel in most flight environments.
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