flight positions

npingeorgia · Dec 5, 2006

hi,

Just wanted to agree with the Army pilot that stated that if you fly long enough eventually something will happen. Look at it like this ,statistics can and will work against you at some point. I flew as a flight nurse for 4 years and flew with some of the most experienced pilots in the field. You can't imagine the situations that you may have to face that no amount of training would have ever prepared you for. As a flight nurse you are first and foremost a crew member and then a nurse. It's interesting that you point out that the company that you worked for has never had a mechanical failure that resulted in an injury, is that because of the crew that was on board and their fast actions to correct a problem or a pilot that was able to land quickly and safely or any number of other things that just happened to have gone right at the time and not result in an injury? My motto as a flight nurse is "Live to fly another day". Things can and will happen.

Good luck in your search for a job.

check out airmethods web site.

npingeorgia · Dec 5, 2006

Also after reading all the threads posted here I wanted to add this piece of food for thought. I have been a nurse for 15 years,ER and flight combined. I would like for all of those folks reading this that may have an interest in flight nursing to know that I have never been involved in a preshift safety briefing while working in the ER, but as a flight nurse it was done with the am pilot and again with the pm pilot. I did not make sure my last will and testament was done until I was instructed to do so by the company I worked for as a flight nurse, never has a hospital suggested that this be done. I am never worried about updating my coordinates with my charge nurse in the ER but I would love to be found on a cold night if I happen to be out in the middle of nowhere while working as a flight nurse. Oh yea, I always make sure I have an updated survival kit on board when I do daily check offs, in the ER we are worried about what we are ordering for dinner. I would think all of these things are in place because there is an inherent danger to being a flight nurse, or atleast being a part of a flight crew. Also, as far as the insurance thing goes, my life insurance would not pay off to my family if I were to die as part of a flight crew, killed in the ER?? oh yea paid fully.

58flyer · Dec 5, 2006

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.

You have already provided the answer for us. In the Slack & Davis article you linked earlier: 55 EMS aircraft accidents- 41 were helicopter and 14 were airplane. 39 fatalities/13 serious injuries among the 16 fatal helo accidents. 15 fatalities/6 serious injuries among the 5 fatal airplane accidents.

Obviously, the 2 dual rated pilots on this thread are not going to convince you that there is an elevated danger of flying helicopters versus fixed wing.

Most anything you do has a certain element of danger to it, starting with getting out of bed in the morning. Just how much danger an activity has to have in order to be labeled "dangerous" is subjective.

In aviation we manage the danger in a number of ways: Proper training, recurrency training, refresher training, train, train, train. Then there's maintenance and inspection of the aircraft itself. Pre and post flight inspection. Maintenance of equipment. Time/cycle life of components. Attention to weather and Notams. Flight helmets and Nomex suits. Flotation gear. Instrument competency. FARs and AIM. Professional associations and safety seminars. Safe refueling procedures. Crew rest requirements. Just to name a few, you could add a lot more to this list.

We do this because we recognize the dangers associated with flying. We learn from the mistakes and experiences of those who paid the ultimate price. And those of us who fly helicopters know that the greater complexity of the machine elevates the recognized danger to a higher level. Therefore, we take the appropriate precautions. That is so recognized danger doesn't become an actual danger.

My point, since I have to spell it out, flying does have a certain element of danger and risk, helicopters all the more so. But proper management of the risks and dangers reduces the risks and dangers to an acceptable level.

Shamira Aizza · Dec 6, 2006

Obviously, the 2 dual rated pilots on this thread are not going to convince you that there is an elevated danger of flying helicopters versus fixed wing.

Sigh.

It's because they don't need to. How many times do I have to say that I don't disagree with that. I never have disagreed with that. It never was the isssue I initially addressed? So why do folks keep going back to that? Maybe I should simply start pounding on an element of this discussion on which we both agree as if you didn't agree with me...would that make any sense to you?

Is anyone paying attention?

In the other posts, the comparisons are simply convoluted. The fact that you don't have to conduct a safety briefing or provide routine coordinates during an ER shift does not somehow make the job 'more safe.' It's a different environment with a different set of concerns and functions. In comparison, there has never been a police standoff with hostages on an EMS aircraft, and you don't have to hire armed security guards to accompany you on the aircraft...it's because the safety environment is different, requiring different methods. It's not because one environment is more dangerous than the other. Life insurance comparisons and the difference in payoff also have nothing to do with it; I would like you to challenge your insurance company to show you any statistical reason why they cannot justify a payoff if you would die while working as a flight nurse. They are a business willing to capitalize on stereotypes such as the ones suggested in this thread, and to use those stereotypes to improve their profits. They don't look for reasons to pay, they look for reasons to keep their money, and they are not objective philanthropic agencies...they are businesses with more concern for the expectations of shareholders than premium-holders.

And saying that something will happen if you fly long enough does not add any merit of credibility whatsoever to any position. There are thousands of activities we can engage in that will result in an unfortunate outcome if we simply do them long enough. Bad outcomes can come of what seem completely benign activities; for example, going to Disney would never be labeled as a dangerous activity, but over a dozen people have died, some as a result of malfunctions, and some simply because of an inability to tolerate the activity. Does that make it dangerous because something fatal could happen if one simply waits long enough for it to happen? Keep in mind that the number one audience of Disney is our children...doesn't make sense at all.

You do not "manage" danger. "Recognized danger?" There is no difference between recognized danger and actual danger. Additionally, statistics do not "work against" anyone, because they are not capable of prejudice or any kind of dynamic activity. They are static elements which simply display facts, and the facts do not show that working as a flight nurse is more dangerous than delivering pizza or filling candy machines.

Hey, look, if you want to say that working as a flight nurse is dangerous, feel free to do so. I'm sure it brings a bit of "ooh-aaah" to the dinner discussion and some self-gratification, maybe even pride. However, I believe you are obligated to show data to support your claim, otherwise you are only being subjective and attempting to display flight nursing in a manner that is based exclusively on drama and appearance, not facts.

The fact is that it's simply disingenius to make the blanket comment that working as a flight nurse is "dangerous" based on impression and stereotype...the "most dangerous jobs" in the world are not chosen based on assumption, but on NUMBERS and FACTS, and that is the same benchmark that should be used to qualify nursing as a dangerous, and that is one thing that no-one has brought to support their claim. The word 'dangerous' has a definition, and flight nursing as an activity does not fit the definition (i.e. unsafe, perilous, likely to cause harm).

BTW, thanks to whoever wished me a successful job search. I don't know where that came from, but I have a job. I left aviation after a good SAFE run of 7 years.

58flyer · Dec 6, 2006

Sigh.

OK, let's leave it at that. Have a nice day...:)

npingeorgia · Dec 7, 2006

Oh, the wish for a successful job hunt goes out to the person that started this thread, the first post, they were looking for a way to find available jobs within the air medical industry. You,shamirra aizza, turned this thread in to a discussion that quickly got off the mark. Also read the fine print of your insurance policies regarding your participation as a flight crew member, my insurance did not make this up when I asked about it, it was in the fine print. I know from personal experience that losing a flight crew to a crash is an experience that forever changed my life. So you'll never change my mind that there are inherent risks to being a flight nurse. I suppose we will agree to disagree.

Shamira Aizza · Dec 8, 2006

I did not divert this thread.

I responded directly to a clear comment made before mine.

I don't carry life insurance because I use alternative investments that won't question the reason for a payout. If I did choose life insurance, it wouldn't matter what the fine print said because the decision made by your insurance company to refuse payout in the event of death in an aircraft crash is not based on evidence, but rather sentiments such as can be found here.

I also know the first-hand pain of having colleagues perish in an air medical crash Memorial. I worked in that aircraft with these fine people...so if that adds some kind of credibility to the discussion, I ask not to be dismissed. But since I have siblings who are RW pilots and ASI supervisors (FAA), and I worked as an FN for 7 years, and held management positions before changing careers and returning to grad school, I believe I bring substantial experience and rational exposure to the discussion.

Here's what I've done here; I've merely asked that some kind of evidence be shown that working as a flight nurse is 'on-it's-face' dangerous. No-one has done that. I never said there weren't inherent risks, but when comparing the job of "flight nurse" to any other occupation, there is no academic, scientific, or statistical evidence to support the flat claim that working as a flight nurse is "dangerous." There are "inherent risks" to thousands of jobs, but loose application of that phrase does not make a job more dangerous than another. One way to qualify (or disqualify) such a claim would be to make comparisons to the rest of the work force; what you will find is that OSHA, NIOSH, NTSB (or any other data-gathering agency) specifically defines a dangerous occupation based on science and calculations. I think it's entirely reasonable to define occupational danger with objective terms instead of implying it's dangerous simply because of the complexity of the machinery.

I only ask one thing; someone show clear, objective, academic, scientific, statistically supportable evidence to qualify a general claim that working as a flight nurse is "dangerous." It's comments like that which may discourage some fine clinical talent from applying (and I know that it has), when the truth be known that the industry does not need to be handicapped by false stereotypes by spreading subjective opinions that working as a flight nurse is any more dangerous than working in any other less-glamorous nursing fields such as home-health or interventional radiology...and more.

pfitz1079 · Dec 8, 2006

"The risk helicopter EMS poses to flight crews, including pilots,

paramedics, flight nurses, and physicians, is palpable. During the

same 22-year study period, there were 144 crew deaths. Still, the

22-year average annual odds of a helicopter EMS crewmember

experiencing a fatal crash were 1 in 1,158.5 Incidentally, The Book

of Risks7 has published a number of activities that generate a 1 in

1,000 risk of death. By their numbers, 33 hours of helicopter EMS

flight time compares with 25 hours of rock climbing, 50 hours of

skydiving, and 55 hours of riding a motorcycle.5

The dedicated crewmembers of the air medical industry do

expose themselves to an appreciable level of risk in their

profession, greater than that of any other profession tracked by

the National Safety Council. And many have lost their lives in

the line of duty. We owe them a debt of gratitude on behalf of

the patients for whom helicopter EMS makes a difference."

Souls on Board: Helicopter Emergency Medical Services and Safety, Annals of Emergency Medicine, Volume 47, Issue 4, April 2006, Pages 357-360 Alexander P. Isakov

"Based on estimates of the numbers of crewmembers and crew deaths during 1995 to 2001,2 the death rate of helicopter EMS crewmembers was 75 per 100,000 person-years, 16 times the occupational injury death rate of 4.6 for all US workers during this period (emphasis mine). Wright reported an average rate during 2000 to 2004 of 1.8 fatal helicopter EMS crashes per 100,000 flight hours. At this rate, a helicopter EMS pilot or crewmember flying 20 hours per week during a 20-year career would have a 37% chance of being in a fatal crash"

EMS Helicopter Crashes: What Influences Fatal Outcome?

Susan P. Baker MPHa, Jurek G. Grabowski MPHb, Robert S. Dodd ScDa, Dennis F. Shanahan MD, MPHa, Margaret W. Lamb JDa and Guohua H. Li MD, DrPHa

Center for Injury Research and Policy, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD

Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.

Annals of Emergency Medicine

Volume 47, Issue 4 , April 2006, Pages 351-356

I don't think the work's dangerous, but clearly there are risks involved which are not typical of the nursing profession. I don't think anyone should be discouraged from entering into flight nursing because of the dangers, but I understand those who chose not to because of the risks. One should enter into this job with both eyes wide open, and a fair hearing should be given to all sides before making a decision.

Good luck with the job search.

Merry Christmas,

Pete Fitzpatrick

RN, CFRN, EMT-P

Writing from the Ninth Circle

Shamira Aizza · Dec 9, 2006

Finally some numbers.

I would like to point out that I read the Hopkins article before, and it is some of the most flawed data construction I have ever read.

They shared several examples of air medical accidents involving helicopters, but when they assembled their numbers, they included fixed wing data as well without clearly identifying the impact on the conclusion.

They also made the conclusion that someone who flew 20 hours per week for 20 years had almost a 40% chance of being involved in a fatal crash.

I'd like to meet that flight nurse with 21,000 hours of actual airborne time.

pfitz1079 · Dec 9, 2006

SA,

Why did you expend so much energy demanding numbers only to ignore them? This study has some unsettling conclusions, but it has survived peer review and has been published. Sorry, unless you're a Republican running for president, you can't ignore science.

I can't argue with your tactics. If one can't win an argument ("show me numbers"), one should change the argument ("those are bad numbers").

For the OP: Try flightweb.com, or individual program websites for jobs.

Pete Fitzpatrick

RN, CFRN, EMT-P

Writing from the Ninth Circle

Shamira Aizza · Dec 9, 2006

Maybe I should've revisited this publication before.

But since it's been brought, could I please review the article?

1. The conclusion was that fire and decreased visibility increases fatality rates, not that being a flight nurse is dangerous.

2. No potential bias was identified.

3. I doubt an FN could be found who has 21,000 hours of flight time. This statistic needs to be displayed in a manner truly reflective of the industry during the times evaluated. For example, the average flight nurse is airborne X number of hours per year (i.e. 200 hours). This is roughly how much time I spent airborne each year the last few years I flew, and I was one of the busier nurses. Alleging 20 hours of flight time per week is simply ridiculous. Hey, for discussion sake, I'll double that...let's say the average nurse flies 400hours per year, and that is being EXTREMELY generous. That means it would take 52.2 years to accumulate the amount of flight time equal to 20 hours per week at 20 years...and thereby expose themselves to the 37% chance of being involved in an accident. Do you see why I take this publication with a grain of salt? It also says that the amount of pilot flight time was not related to crash outcome...do you believe this? And 25% of all medical helicopters will crash over a given 15 year period. I cannot apologize for seriously questioning the validity of these numbers.

I theorize that the average nurse flies about 200 hours per year (some fly more, some fly less), and the average nurse would have to fly 105 years to expose themselves to the 37% chance of being involved in a fatal accident (not necessarily an accident that kills them, just involves a fatality). Looking at the numbers in the manner presented here, I can boldly claim that the average flight nurse has a 100% chance of dying before ever seeing retirement. But more realistically, I would theorize that the average flight career of a flight nurse is 10 years (I full expect that I could be years off the mark, but more than likely I overestimated the average flight career). This would make the estimated flight time about 2,000 hours...91% less than the 20hr/wk, 20 year nurse. I would like some help on the math here (I used the same formula as Baker did in the published study), but it seems to me that this means that the average flight nurse has around 3.5% chance of being involved in a fatal crash. Compare this to a statistic from the NTSB which says that the average American has about a 30% chance of being involved in a fatal crash involving an impaired driver during their lifetime...that's just the impaired driver and doesn't include the non-intox age-impaired (teen or elderly), weather-related, or sober folks who simply made a bad decision. That's why I say the most dangerous part of the job is the drive.

4. I recognize the comparison made to all occupations; that means they compared flight nurses to everyone from au pair to zoologist. It's too easy to make something look dramatically dangerous when you make a broad comparison like this.

I'm not ignoring the science, I am asking that it be presented realistically. BTW, the published conclusion did not at all report that EMS operations are dangerous, but that additional research will be required to determine cost-effective ways to reduce the fatal crash rate, and improve crashworthiness to avoid post-crash fire and avoid flight into IMC. As far as peer review (especially related to trade journals), when looking for articles of interest to it's readers, it does not always 'weed out' unsound research.

Personally, I think this research is extremely relevant, but naive in it's construction of the data. Sound science is reproducible (and I'm not aware of anyone who has visited this topic in this manner), but one study cannot be the basis for scientific conclusion or modification of practice.

npingeorgia · Dec 11, 2006

I just wanted to add that the figures quoted here by pfitz are more than a little unsettling for me too. I am glad to see the numbers and that you were so diligent to find the data to report here. How can anyone argue with data that shows that this profession is at a 16 time greater risk than the rest of the U.S. population for loss of life or injury?? Now getting back to the research studies, I do agree that sometimes numbers can be made to reflect the hypothesis that you initially set out to prove or disprove. However, it's kinda hard to argue with numbers that are not a part of a research study such as provided by OSHA and as quoted by pfitz above. 16 times that of all other U.S. workers. WoW!!

Way to go there pfitz.