flight positions

Shamira Aizza · Nov 20, 2006

Yawn.

All that to make an inaccurate generalization that flying is dangerous business.

It's simply not true based on anything you've said. If you do anything long enough, including inherently safe activities, you can encounter a dangerous situation. The fact that you might encounter something dangerous if you do it long enough does not make it a "dangerous business." It makes it an occupation or pasttime where something dangerous can happen. You can experience this anywhere, including manufacturing and clerking a convenience store. You clerk a store long enough, you are going to get robbed. It doesn't make clerking a convenience store inherently "dangerous."

Here's what's dangerous; swatting a hungry bear with a short stick. Running across a mine field. Forgetting to pay your date before dropping her off at Ponce De Leon. Those are dangerous...all likely resulting in bad outcomes.

Flying rarely results in a bad outcome, including EMS flying.

I wasn't going to even address the rest of your post because it's not really relevant, but I thought I'd point out that the majority of EMS crashes are pilot error (usually weather), and the reason helicopter insurance is higher is because a 1997 Honda costs $3500 to replace and a 1997 EC135 costs about $3-4 million.

teiladay · Nov 20, 2006

In regard to my insurance statement. I was encouraging you to write aircraft/pilot insurers so they could inform you the often large differences between fixed and rotary premiums.

Aircraft insurance is directly tethered to the *dangers* and *complexities* of aircraft, their weights, typical flight profiles, even aircraft in the same "type", "catagory", as well as, but not limited to, pilot experience (actually a lot different than how auto insurance premiums are figured).

My only reason for mentioning auto ins. was so you'd understand that you'd probablly have to write away for data vs. simply calling and getting a quote like you can with auto ins. (getting aviation quotes are more in-depth).

I thought you'd surely understand that I didn't mean compare premiums between a motorcar and an aircraft.

If you truly wish to actually learn something; Boeing (or any other aircraft manufacturer for that matter), the FAA, the NTSB, virtually ANY aviation insurer, the military (safty office and office of statistical data, Ft. Rucker, AL), and most dual rated pilots will relate to you that helicopters are inherently more dangerous to both fly, and fly in, compared to airplanes.

1. Many job positions (to include many flight nurse slots) in the civilian sector receive "hazard" or "danger" pay.. People who are actually knowledgeable about aircraft and the associated complexities and hazards, don't have to wonder why its commonly called "hazard", "danger", etc., pay.

(no offense to flight nurses, but typically a flight nurse knows very little about the totality of flight hazards associated with cruise and terrain or NOE flight compared to a rated pilot). The aircraft/hazard knowledge would be like comparing a Student Nurses Aid to a seasoned CRNA.

2. Life insurance premiums are most often raised if you inform your insurer that you're a pilot. Because insurance companies consider it (flying) a "hazardous" occupation.

3. I'd like to hear from a dual rated PILOT (not a nurse), Aviation Insurer, FAA designee, or even a Life Insurance Agent, to state that flying isn't considered "hazardous" ((chuckle)).

I sincerely think you're equating your flight experience as a *nurse* and or passenger to that of an experienced pilot in both aircraft and helicopters, civilian and military... and I really don't think the former is as qualified to get as specific about the dangers of flight.. Specifically, the increased risks associated with piloting or simply flying in a helicopter. Simply put, most flight nurses are not well versed in aviation past their nursing duties...

Its not a slap in the face to flight nurses, its just true. Just like most pilots don't have the skills of a nurse, even though they may have flown with nurses.

I'm sure at least the original poster would be able to, at this point tell a difference..

When you obtain your Commercial Instrument (license/rating) for fixed and rotary, a few thousand hours flight time (actually piloting the aircraft, as opposed to riding in it and or performing nursing duties), military and civilian flight experience as a pilot (not a nurse), and have been licensed for just under 20 years.. then get back to me about the dangers of flight..

Rio, ASN, RN · Nov 20, 2006

here is my 2 centavos:

1. I'm a nurse, not a pilot, not an actuary.

2. When it comes to aviation or medicine, apathy is dangerous.

3. Crew resource management.

4. Situational Awareness.

5. Sterile Cockpit when appropriate.

6. "Three to say GO, one to say NO."

7. Weather minimums are relative.

8. In HEMS, CFIT is the leading cause of catastrophic events.

9. IFR, NVG, Dual Pilot AC are not safety panaceas. (includes 3,4 & 5)

10. I FEEL safer working in a helicopter than I do flying as a passenger on a commercial airline.

11. When I go to work and we brief, EVERYONE is on the same page.

If I don't like the weather, there is a vibration I didn't feel before, there is a strange smell and no one will fess up, or a chip light flickers in a way I don't like:

I have the authority(as does the medic) to abort the mission.

Shamira Aizza · Nov 20, 2006

here is my 2 centavos:
1. I'm a nurse, not a pilot, not an actuary.
2. When it comes to aviation or medicine, apathy is dangerous.
3. Crew resource management.
4. Situational Awareness.
5. Sterile Cockpit when appropriate.
6. "Three to say GO, one to say NO."
7. Weather minimums are relative.
8. In HEMS, CFIT is the leading cause of catastrophic events.
9. IFR, NVG, Dual Pilot AC are not safety panaceas. (includes 3,4 & 5)
10. I FEEL safer working in a helicopter than I do flying as a passenger on a commercial airline.
11. When I go to work and we brief, EVERYONE is on the same page.
If I don't like the weather, there is a vibration I didn't feel before, there is a strange smell and no one will fess up, or a chip light flickers in a way I don't like:
I have the authority(as does the medic) to abort the mission.

Well said. There are more, but this is good, even though I think there is no shortage of folks who would argue until the next conference that they think IFR and NVG's are the answer to all that is safe in air medical EMS. I think they are good additions, but as of yet they really haven't been studied to prove their value.

Shamira Aizza · Nov 21, 2006

Look, you can label any issue in any way relative to it's comparison to something else, but it's disingenius. A '77 Pinto is more dangerous than a Lexus LS 430 with side impact airbags in a smashup derby, but the Pinto is more safe than a 5 hp gocart. I suppose that in general simply makes gocarts dangerous to ride...based solely on the comparisons and context of a smashup derby, right?

I understand your position based on insurance, etc, but you are using the data from a for-profit agency to prop up a subjective statement (this is not a slam against for-profit activity, I am pro-capitalist). I, however, trust insurance companies far le$$ than I give them annually.

Let's make this comparison; who do you think is engaging in a more dangerous occupation, an unarmed Army nurse on a 3 year assignment in Baghdad or an RN working in any hospital in any city in the USA...you pick the hospital.

Now, I'm not a pilot, but I do know that it's simply not true that being a flight nurse is more dangerous than being any other kind of nurse. 2/3 of all hospitals are in areas with average or above average risk of violent crime activity. Additionally, about 2/3 of of the estimated 1,000 homicides and 1.5 million assaults which occur within a workplace happen in a health-care setting. Since the majority of helicopters are no longer based in these urban settings, it seems as though you've got a tough sell.

You've got a lot of great numbers that are all correct to prove one point or another, but they don't support your claim that being a flight nurse is a dangerous activity for a nurse to pursue.

I don't live in a bubble; I've got two siblings that are pilots. One is a rotor pilot and the other is an FAA District Safety Program Manager. I'm not even remotely as wise as them about aviation, but I've spent a bit of time living and flying and don't need an insurance company looking for a bigger premium to try and tell me that they've determined that in$urance premium based on some altruistic and objectively-obtained number which shows that flying is inherently dangerous.

Until you can show me something which shows that becoming a flight nurse is somehow more dangerous than some other relevant activity, we'll simply disagree.

58flyer · Nov 27, 2006

Shamira and Teila, I can see both sides of the discussion. As a pilot (comm-instrument, airplane and helo) I do agree that flying is safer than driving. You are more likely to be injured or killed driving to work than you are while flying at work. Is it more dangerous than other types of work? Of course it "depends." Years ago I worked for a police agency and when I was assigned to the air unit, one of the guys tried to get us extra pay because of our "hazardous" occupation. THe union wouldn't even present it to the city council because the numbers didn't add up. Beat cops were far more likely to get injured on the job than pilots. I know in my own experience when I rode a beat I was injured an average of twice a year in the line of duty, and none of these were car wrecks. Now with 8 combined years in police helicopter flying I have yet to be injured at all.

Are helicopters more hazardous than airplanes? Absolutely they are. For all the reasons that Teila mentions. Then you add the fact that EMS missions are flown under what is generally regarded as hazardous conditions, like landing in tight quarters in unimproved areas, sometimes at night, and weather is often a factor as well.

I have had an inflight engine failure in both an airplane and a helicopter. With the airplane, the engine just quit, that's all it did, and it became a glider. I landed it safely on a road. With the helicopter, I wish the engine had "only" quit. My life would have been a lot easier. First, the front bearing in the compressor failed, which caused the compressor wheels to become uncontained. That's a nice way of saying that high speed metal fragments went flying in all directions, doing major damage to vital helicopter components. A very dear component, the driveshaft, was severed at the k-flex coupling, right below the compressor. The other end of the shaft was still attached to the transmission, and began flailing about making wicked and expensive sounding noises, not to mention causing a awful vibration that made the instruments impossible to read. Ever heard of autorotation? That's where when the engine fails you can lower collective and the blade pitch flattens out and allows the air coming up from below to turn the rotor at the right RPM which will allow the pilot to make a safe landing, if he does everything right. Well.........if things weren't complicated enough at this point, the autorotation thing was turning the transmission but in the design of the helicopter I was flying the tail rotor driveshaft doesn't run off the transmission. It runs off the engine gearbox. Now recall the severed driveshaft, it was not able to drive the engine gearbox, which meant that I lost the tail rotor. To spice up the already considerable fun and games, the flailing driveshaft was dragging down the rotor RPM, which caused an audible warning to come on, adding to the excitement. I managed to thread the eye of the needle in getting it into a really small area. Had I been any lower, I wouldn't have made it. Had I been any higher, there would have been less rotor RPM at the final pitch pull, as it was I pulled max collective to cushion the touch down. I can honestly say that I didn't do any more damage getting it down than the helicopter had already done to itself. Oddly, the loss of the tail rotor did not present a problem as the helicopter pointed itself straight during the final pitch pull, but it sure added some stress.

I didn't mean to give such a long winded account of my experience, but it does illustrate that when things do go wrong in a helicopter, it can get dramatic in a hurry. In flying, dramatic means hazardous. In the big picture though, helicopters are quite safe, major failures are relatively rare. If I didn't think they were safe, I wouldn't be flying them still.

BTW, Shamira, you said that NVGs haven't been studied to prove their value. I can assure you that in military and law enforcement flying, NVGs have proven to be a significant safety enhancement. I won't fly at night without it. I just wish the EMS community would buy into it more.

Shamira Aizza · Nov 27, 2006

I didn't say that NVG's aren't good additions, because they very well may be essential additions. However, no-one has conducted any kind of evaluation to see if EMS programs have statistically improved their safety with the addition of NVG's.

I really don't know what point you were trying to make about your rotor story. Here's what I got; an engine quit on an airplane, and you landed without injury. An engine quit on a helicopter, and you landed without injury.

Does this somehow support a claim that working as a flight nurse is somehow more dangerous? Is 'drama' statistically relevant to danger?

I don't mean to be argumentative, I just think statements should be qualified and kept in perspective...that's all I'm doing.

58flyer · Nov 28, 2006

I know what you said about NVGs. The point I was trying to make about NVGs and EMS is that EMS, for whatever reason, has been slow to get the ball rolling with NVGs. I know a fair number of EMS pilots, in fact my NVG instructor is a full time EMS pilot and also flies in the National Guard. He is baffled as to why his employer specifically forbids NVGs even if he provided his own. In my discussions with him and other EMS pilots we have concluded that it is all about cost. A new pair of Gen 4 Anvis 9s costs 10 to 12K. That's when you can get them, as the present war in Iraq is consuming the production runs. Then they have to be maintained and then there's training and recurrency. As far as studies are concerned, there are enough studies from the military and LE to conclude NVGs are a safety enhancement. I am not personally aware of any specific EMS NVG study, but I will be sure to ask when we pilots get together again as a group. We have a helo convention coming up soon so I will have that opportunity.

So you don't know what my point was with my "story." OK, let's take it a step at a time. The OP was asking about flight positions. By post #6, the question was asked about hazards and crashes and so on. That's fine, because posts tend to meander around a bit. Then you, Shamira, and Teiladay went back and forth about the relative safety of EMS flying, helicopters, fixed wing, insurance, being a flight nurse, being a pilot, and so on. My point was this: As a pilot speaking from the pilot perspective, I happen to agree with Teiladay that helicopters are inherently more dangerous to fly than fixed wing aircraft for reasons already expounded upon. I simply related a couple of my experiences to illustrate my position. As an experienced pilot in both fixed and rotary wing aircraft, with 26 years flying fixed wing and 12 years flying rotary wing, and a few thousand hours, I feel qualified to contribute an opinion. It is very much in perspective and in continuity with what has already been said. This a forum where people discuss ideas, vent, get information, pass along information, suggestions, and so forth. That is what I was doing. So sorry if we don't always agree, but that's just life. Too bad that flew (pun intended) right over your head.

Shamira Aizza · Dec 1, 2006

So sorry if we don't always agree, but that's just life. Too bad that flew (pun intended) right over your head.

So now you have to start using indirect insults? Nothing flew over my head; you are simply straying from the discussion that was made without qualification and you failed to prove that working as a flight nurse is dangerous.

BTW, an EMS pilot cannot simply use NVG's just because he has a pair at home. The FAA requires training specific to the aircraft he is using and that the cockpit be configured for NVG flying. So not only are the goggles expensive, so is the mandatory training by the FAA, and the required cockpit modification. Again, I am an advocate of goggles, but as of yet, no-one has shown any proof that using goggles in the EMS environment has done anything to reduce the crash rate. Personally, I believe any program that has already made a financial commitment to goggles probably has had a long-standing aggressive and progressive safety program in place and has not had a problem with crashes. Additionally, I would speculate that the majority of crashes that have occurred would not have been avoided even if there were already a goggle program in place. Not to get too far off the mark, but it's reasonable to reply to these claims.

So if you think helicopter flying is safer, see what (News Article - Slack & Davis, L.L.P. www.slackdavis.com) has to say; in this data, the fatality rate for fixed-wing air ambulances is higher per crash than rotor wing air ambulance.

So like I said, I saw a lot of claims suggesting that being a flight nurse is somehow dangerous, and this is simply untrue. Then you shared two stories of having engine failures in both FW and RW aircraft, both which exhibited the same outcome...no injuries. You definitely have the privilege to make comments with all the experience you have, but you have to have more than an opinion...you have to have a point, and you have to qualify your belief's with more than just 'I've been flying since the Wright brother's franchised their bicycle shop.' You have to show some kind of validity to the simple claims that working as a flight nurse is somehow 'dangerous' or more dangerous than working as any other kind of nurse.

Still, no-one has shown support for this claim.

rn/writer, RN · Dec 1, 2006

Please concentrate on the thread topics and leave the personal comments out. We're all for lively debate, but sarcasm, snide remarks, and insults violate the TOS and don't add anything positive to the mix.

teiladay · Dec 4, 2006

Of these 55 EMS aircraft accidents, 41 were helicopter EMS accidents, 16 of which were fatal, resulting in a total of 39 fatalities and 13 serious injuries; 14 were airplane EMS accidents, 5 of which were fatal, resulting in 15 fatalities and 6 serious injuries. Since the initiation of this special investigation in January 2005, 9 additional EMS aircraft accidents have occurred, resulting in 8 fatalities.

((sigh))

2 licensed pilots on this thread with helicopter and fixed wing experience agree that helicopter flight is more dangerous than fixed wing flight.

Can you find me one single EMS pilot, who is licensed to fly fixed and rotary wing, who will disagree that flying in a helicopter engaged in typical rotary wing flight profiles (hovering, langing in confined spaces, typical EMS terrain flight, etc.) is generally more dangerous than fixed wing aircraft typically engaged in EMS fixed wing flight profiles? I seriously doubt it..

*More specifically, a flight nurse flying in a helicopter generally faces greater danger (simply due to flight profile(s) of an EMS helicopter), than a flight nurse on a fixed wing EMS platform. Please find me one EMS PILOT (not nurse) that will disagree with that statement.

I think that most (if not all) pilots would agree, that a flight nurse (no matter how experienced in his/her nursing field) is hardly qualified to speak about the totality of relative dangers, and how they contrast, between fixed wing and rotary wing flight.

Licensed nurses are experts in their field, and are awesome experts!

That said.. they are still nurses and not licensed pilots, with the knowledge and expertise that comes with years of experience flying BOTH airplanes and helicopters.

Lastly, I think your interpretation of the above statistic(s) as a "nurse" is a bit different than how we would interpret such as pilots. Reading the stats above, I'd rather be a flight nurse on an airplane any day of the week (as far as a chance of injury is concerned), as opposed to a helicopter.

A pilot licensed as early as last night, could probably tell you that heavy icing enountered above 10,000 ft (that can't be cleared), is more likley to kill 5 onboard an airplane, compared to a helicopter whos tail rotor clips a hardwood at 30ft AGL... but which is LIKELY to happen more often? Fatal icing in an EMS fixed wing, or a crash due to terrain, natural feature and or man-made structure impact in an EMS helicopter?

I think all EMS **PILOTS** would state the latter.

Lets hear what more actual dual licensed PILOTS have to say, as licensed pilots are without doubt, a more reliable source of information on aviation hazards than are licensed nurses.. :lol2:

I think I'm starting to see why men (especially those with a college degree) are more likely to gravitate to PA and med schools vs. entering the nursing profession.

((very cordial poke in the ribs))

Shamira Aizza · Dec 5, 2006

Some people will convolute and dilute the discussion in any way thinkable to cover up what may have been a mis-spoken sentence. I'm not trying to be disrespectful, but you can only expect people to take original comments at face value.

You said, "Flying is dangerous business."

That's what you said. You then told us to ratchet up the 'danger factor' if it was a helicopter.

I did NOT disagree with you about FW vs. RW...even though you chose to repetively focus on this diversion about FW being safer than RW. So what, who cares?

What I disagree with is your blanket statement saying "flying is a dangerous business" in the context of being a flight nurse. I'm suspecting that you believe this simply because if something goes wrong, someone could get killed. I view this claim academically and subjectively, meaning, statistically the activity should actually reflect how dangerous it is instead of subjectively supposing how dangerous it appears to be. The mere fact that something could happen does not create an elevated level of danger, because the reality is that something fatal could happen in hundreds of nursing venues; infection from a needle-stick to assault by a patient or co-worker.

Bottom line; I worked as a manager in a flight service, and more of my employees were involved in accidents traveling too and from work than were involved in accidents while at work (which would be ZERO...unless we count the time they wrecked one of the company cars or were involved in an accident in the ambulance).

For that reason, factually so, the most dangerous part of being a flight nurse is the drive to and from work.

What is so inaccurate about my statement?