Flight Nursing

by DidiRN Asst. Admin

3,229 Views | 7 Comments

Flight nursing is nursing care of patients during transport via aircraft or helicopter. This is an area where highly skilled individuals are an absolute must and is not a place for the inexperienced. Flight nurses many times must make quick life or death decisions calmly and accurately. This article explains the duties, responsibilities and other important aspects of flight nursing.

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    Flight Nursing

    Flight nurses require a Registered Nurse license with several years of experience in critical care and/or emergency nursing. Some RNs may already be required to have or plan on obtaining paramedic certification/license. Certifications in BLS, ACLS, NRP (Neonatal Resuscitation Program), TNCC (Trauma Nursing Core Course) and PALS (Pediatric Advanced Cardiac Life Support) are usually required. Other certifications that may be mandatory are Basic Trauma Life Support, Pre Trauma Life Support, and Transport Professional Advanced Trauma Course, CCRN and/or CEN. Certified Flight Registered Nurse (CFRN) often required within one year of hire. Hazardous material training is beneficial due to the occasional landing sites near accidents or large scale spills of hazardous materials.

    Work Environment

    Flight nurses work outdoors when arriving at an accident scene or a scene of a disaster. Exposure to inclement weather may be possible, although many flights have criteria to not operate in certain types of weather. Flight nurses work close to moving mechanical parts which and must be aware of potential flight turbulence. They will also be traveling to inpatient facilities for inter-hospital transfers that may require rapid transport. There are challenges while working inflight that include cramped surroundings and loud noise from the aircraft. Noise is such a problem that many employers require intermittent hearing tests and all flight crew are required or strongly encouraged to wear hearing protection.

    Skills / Qualities


    The ability to quickly adapt to different working environments is important. Nurses must be skilled in many different areas such as managing IV medications, ventilation management, advanced life support and cardiac monitoring. Understanding of pre hospital and emergency care on top of critical care is vital. Quick life and death decisions are frequent, so nurses must be comfortable in the management of the critically ill. Excellent interpersonal and communication skills and the ability to work in high pressure, rapidly changing situations is highly valued. Some employers may even have height and weight restrictions.

    Duties / Responsibilities

    Flight nursing has numerous responsibilities which include:

    • Rapid and thorough assessment/triage of patients with conditions such as trauma, cardiac, respiratory and other critical illnesses.
    • Management of pediatric clients
    • The ability to work closely with other flight nurses, flight paramedics, advanced practice nurses/physicians
    • Airway and ventilator management
    • Initiation and management of intravenous medication, fluids, and blood products
    • Maintaining patient safety before, during and after flight
    • May be required to participate in community and outreach and other educational events
    • May be required to participate in preflight liftoff checks and/or assist other flight personnel.
    • Initiation of emergency care in the absence of a physician
    • Management of patients during aircraft problems such as rapid decompression, wheels-up landings, and other aircraft emergencies

    Job Outlook

    Flight nurses typically experience a low rate of turnover so openings are not as abundant. Employers include private companies, hospital systems, or are members of the military.

    Salary

    Salaries are typically higher than average for flight nurses due to the extensive required experience. Some websites have quoted an average salary of $55,000 per year to up to $96,000 per year.

    Resources

    Air and Surface Transport Nurses Association


    Association of Air Medical Services


    Medevac Foundation International
    Last edit by DidiRN on Dec 2, '13
    ICUman, FLTRN70, Esme12, and 5 others like this.
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    DidiRN joined Apr '03 - from 'Midwest'. DidiRN has '25 plus' year(s) of experience and specializes in 'ICU, step down, dialysis'. Posts: 8,338 Likes: 1,173; Learn more about DidiRN by visiting their allnursesPage


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    7 Comments so far...

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    Nice and informative article. Pretty accurate in my experience. I wonder at the required experience ICU/ER. Our service does not hire ER nurses. They only hire adult ICU nurse who are then sent to be trained and work in PICU, NICE and L&D before being fully qualified for transport. Our service has both ground and air service. Usually nurses rotate between working ground ambulance and the aircraft.
    nicurn0213 likes this.
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    I am a flight nurse and our company also runs ground ambulance and air (FW & RW) transports. The flight team consist of a nurse (CFRN) and EMT-P (FP-C). Paramedics in Oregon are licensed with an associate degree. EMT-P's must have at least 3 years ground experience before going to the flight team and then obtain their FP-C within 18 months. RN's must have at least 2 years experience in either ICU/CCU or ED. RN's (BSN referred) must be ACLS and PALS certified and obtain PHTLS, NRP, and STABLE after hire plus obtain CFRN within 18 month of hire. RN's go through a 6 week ground academy that includes ground calls followed by a 3 week flight academy upon starting on the flight team. I was hired with prior pre-hospital EMS (EMT-P and MICN), ICU-CCU, post surgical and ED experience. Flight Paramedics and Flight RN's alternate patient care with the RN providing addition support in critical care and the Paramedics providing additional support in emergency skills. Bottom line, after working as a team over time there becomes little difference if any between the two professions in the level and capability of patient care!
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    Quote from fltRNKen
    I am a flight nurse and our company also runs ground ambulance and air (FW & RW) transports. The flight team consist of a nurse (CFRN) and EMT-P (FP-C). Paramedics in Oregon are licensed with an associate degree. EMT-P's must have at least 3 years ground experience before going to the flight team and then obtain their FP-C within 18 months. RN's must have at least 2 years experience in either ICU/CCU or ED. RN's (BSN referred) must be ACLS and PALS certified and obtain PHTLS, NRP, and STABLE after hire plus obtain CFRN within 18 month of hire. RN's go through a 6 week ground academy that includes ground calls followed by a 3 week flight academy upon starting on the flight team. I was hired with prior pre-hospital EMS (EMT-P and MICN), ICU-CCU, post surgical and ED experience. Flight Paramedics and Flight RN's alternate patient care with the RN providing addition support in critical care and the Paramedics providing additional support in emergency skills. Bottom line, after working as a team over time there becomes little difference if any between the two professions in the level and capability of patient care!
    I see you are from Grants Pass. I love that area and more or less grew up there. I went to North valley out near Merlin.
    Interesting that your service has BSN preferred. Our service here in Wisconsin has no preference either way and ADN, BSN and MSN are not even considered in the hiring process.
    Our service is the same in regard to there being little difference in the two professions in capability. Some differences in L&D drugs and of course the huge difference in pay with RNs making 30-50% more than the medics on the same service. Many of our RN are former medics who went to nursing because of that.
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    Wow what a small world! We have lived in Grants Pass for 13 years and in Merlin. We just sold our home off Potts Way in Merlin and built a home in Grants Pass off Redwood highway; actually off South River Rd along the river. You probably guessed that I work for Mercy Flights in Medford. The Paramedics get paid quite well compared to the rest of the industry, about a 2/3rds of what the RN's make. Although there is a medical director for Mercy Flights as a whole, the flight team still has more liberty with use of universal guidelines outside the general set protocols and like the RN's flight paramedics are equally able to give any and all appropriate medications accordingly. What brought you to Wisconsin and what company do you work for?
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    Quote from fltRNKen
    Wow what a small world! We have lived in Grants Pass for 13 years and in Merlin. We just sold our home off Potts Way in Merlin and built a home in Grants Pass off Redwood highway; actually off South River Rd along the river. You probably guessed that I work for Mercy Flights in Medford. The Paramedics get paid quite well compared to the rest of the industry, about a 2/3rds of what the RN's make. Although there is a medical director for Mercy Flights as a whole, the flight team still has more liberty with use of universal guidelines outside the general set protocols and like the RN's flight paramedics are equally able to give any and all appropriate medications accordingly. What brought you to Wisconsin and what company do you work for?

    My parents and I lived in a house on South River Rd back in the 80's before we moved to some property outside Merlin.
    I came to Wisconsin because I could become an RN in only 9 months here after I got out of the army. When I lived in Oregon the economy was based on timber and Grants Pass had a number of very large mills. Most of them closed down, there was no work at all and nearly all of the men in my class ended up in the military. I never moved back because that area of Oregon changed so drastically. It wasn't farming / timber town I grew up in. The cost of living rose dramatically. Every now and then I look at real estate listings in the area and am absolutely shocked at the dramatic increase in real estate, especially compared to the relatively low pay for nurses there. I stayed here because the cost of living is very low and the nurses pay is very high in comparison. A few years ago we bought 43 acres in the country with an almost new 4 br, 2ba house. We have fields, woods and a stream all for less than $100K. I work for a heath system where I can make well over $100K/year without working any OT. I live in a wonderful small town full of good working people with strong community ties. Perfect place to raise my kids. I have here what I had as a kid in SW Oregon.
    I don't do full time transport nursing anymore. That was my last job but I remain casual there. Currently work as full time rapid response nurse in a large hospital. It's a lot like transport nursing in that I have tons of protocols and standing orders and can handle many thing things myself. It's hard for me to imagine an RN job with more autonomy than transport or my current job.
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    Well sounds like Wisconsin was a great move on your part! We moved up from Redbluff, California to get away from the heat and high cost of living and have lived in Grants Pass now for 14 years. We love it here and plan to live here for our remaining life. Just built our dream home to retire in:-) Great sharing stories with you and I wish you all the best? Merry Christmas and a prosperous new year!
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    Quote from fltRNKen
    Well sounds like Wisconsin was a great move on your part! We moved up from Redbluff, California to get away from the heat and high cost of living and have lived in Grants Pass now for 14 years. We love it here and plan to live here for our remaining life. Just built our dream home to retire in:-) Great sharing stories with you and I wish you all the best? Merry Christmas and a prosperous new year!
    I bet you fit right in then since nearly everybody else who lives there now is also from California! Where you live along South River Road was all dairy farms and hop farms when I lived there. Was a great place to hunt. I spend many days wandering the area with a shotgun or 22 in my hand. Are there any farmers left? I can't imagine there are.
    Merry Christmas to you as well!


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