ER or ICU to Flight Nurse?

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    I live in Austin, Texas. I'm a 3rd semester ADN student with about 7 months to go until my RN. I'm also about 2 months out from completing an EMT-B program. Originally when I was choosing my path I was interested in becoming a paramedic. Someone convinced me that I should go for my RN instead. At this point in my education, i have been fascinated with ER work because I felt that it was the closest to what paramedics would be dealing with. From everyone that I have networked with, or just had a chance to ask questions about flight nursing, it seems that most people say that an ICU nurse has a better transition into Flight/Transport nursing than an ER nurse.

    WHAT SAY YOU! ??

    I talked to a flight nurse this week and she told me that in our area we have CC ambulances that roll out with an RN and a EMT-P. Should i can my ideations of ER nursing and go straight for ICU?

    In my area it seems that ER's seldom hire GN's, but ICUs will. Opinions welcome! thanks in advance!


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  3. 16 Comments...

  4. 0
    You can check some of the other threads as well.

    IMHO, solid ICU experience is always a good bet when it comes to a potential flight nurse position. You see, as a nurse, you bring a different education and skill set to the table. Many places fly RN/PM. The PM will usually bring scene and field related experience to the table. While, the nurse brings critical care and facility experience to the table.

    Many will argue and flame me; however, ER is a mixed bag. You may have really sick patients and you may not. I have a friend who works a level I ER and says all he does with a cardiac is get a XII lead, give some O2 and NTG, and send them up to the cath lab. However, solid ICU and CCU experience will give you a skill set that will complement your medic partner nicely.

    Not to say pure ER RN's cannot make it in flight. I happen to be a ER RN; however, I had a big learning curve.
  5. 1
    I am also an ADN student looking to fly one day. I haven't heard that either way is better, but I'm interested in seeing what the community says as well.
    8jimi8ICURN likes this.
  6. 1
    I second everything GilaRN wrote.

    I've been a flight medic for some years now. When I became a nurse, my RN partner really got on my case because I went to the ER (my comfort zone) instead of ICU. I've learned a lot in the ER; but as stated the really solid critical care skills are what the nurse brings to the team. As it is, the 'field skills' won't be learned in the ER. Nurses in the ER don't do many of the skills that paramedics do outside; that's for the MDs (intubations, darting chests, running a code, etc.). A flight nurse usually learns the field skills only after already being hired for training by a flight organization.

    Go talk to the guys at Austin/Travis EMS; they'll likely tell you the same thing.
    8jimi8ICURN likes this.
  7. 0
    I had my 4 hour rotation down in the PICU yesterday. While I was there I was able to talk to one of the transport nurses. It looks like I am going to have to just go for the ICU. Thanks everyone for helping me tweak my plans! I've been volunteering with the fire department, so I'll just have to get my small taste of pre-hospital with the SHFD and my little EMT-B cert I know flying is still a few years away, but I have a definite plan now. I'll try for the ICU, go through TNCC, Keep my ACLS and PALS up, get CCRN and hopefully I'll be able to float the ER some as well on my way to the chopper Hopefully they will be holding ITLS in my area soon. Has anyone heard anything about SLAM in their areas? It hasn't been held in Dallas in a few years and the transport nurse I talked to yesterday wasn't sure if it would be coming back.
  8. 0
    Sounds like you have a pretty good plan. Don't rush it. There is no substitute for education and experience. Good luck!
  9. 0
    Really? SLAM moved? It was always taught at the chiropractic school. Mr. Rich must have relocated?

    Agree, do not rush yourself. You need at least 3-5 years of solid experience. I started flying after the four year mark, and had a steep learning curve.
  10. 0
    Well, I am planning on certifying in ICU as well as ER. There is a 2 year Acute Care Nurse Practitioner that lets you specialize in Flight Nursing at Case Western Reserve University in Cleveland that I am looking at attending once I have enough experience. I definitely understand how much learning there is ahead of me... i still have 7 months of nursing school! It is just important to me to have a plan. I've got plenty of CEU's to look forward to as well.

    I have a question: Has anyone heard of Case Western? Does anyone know of a better or more reputable NP/MSN school to go to?

    Would it be better to start out specializing in cardiac ICU, or a regional level II trauma ICU? I am very very interested in cardiac, but I am not sure if being at the Larger busier hospital is better for the variety of traumas. I realize I will have to do it all eventually, but I might have earned myself a little extra credit points at one of our cardiac magnet hospitals in town.

    I heard that we cannot challenge the paramedic exam in Texas anymore. Does anyone think taking EMT-I or possibly eventually EMT-P would be of any help while I am still building my resume? I still must admit that riding in an ambulance is an enticing dream to me.
  11. 0
    Legitimately enough, you have a lot of questions!

    I've heard only good things about Case Western. In general, it is a good school. I wouldn't go there only for the flight segment, though. Anything you need to learn to be a flight nurse isn't much in addition to the usual ACNP skills. It can all be learned in short time. BTW, there is little extra role in the industry for NPs over other flight nurses at this time. Just the way things are set up. I worked a critical care job with a Chief Flight Nurse who is an ACNP. He almost never got to use his advanced skills, though it was comforting to know he had them. He had to work in the ER to stay sharp. If you go to FlightWeb and do a search, you'll find some threads discussing this.

    Once you are licensed and settled into work, you may like paramedic school. I would wait at least a year, so you don't burn out doing too much all at the same time. I still love being a paramedic. I think working outside the hospital is more fun than inside. I do both to stay happy. It is NOT a requirement nor an advantage for most flight nursing jobs.
  12. 0
    No doubt about it... ICU. ED just won't prepare you for those 6 drip, ABG interpreting, MODS, SIRS, ARDS nightmare transfers.

    As an ICU nurse, your expertise begins at the edge of your medic partner's comfort zone.

    Lastly, do not be in a big hurry to run out and be an NP. If you want to fly you don't need it. Does nothing for you in the air. You want to someday be the chief flight nurse administrator person - go for it. Further, I personally would discourage any newbie nurse from jumping right in to a NP program. Don't underestimate the importance of experience and how do you even know you want the NP if you haven't worked next to one.

    My 2 cents, do what you want and be psyched about it.

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