Air Transport

ED to ICU would probably be my personal preference, based on my own experience.

IMHO, most people never completely step out of the mindset ingrained in them as new nurses, whatever environment that might be. Again, this is just my own personal experience, but I have seen a large number of ED nurses successfully transition to the ICU, but ICU nurses tend to hate the ED chaos/lack of control with a burning passion and never fully integrate into the ED.

Ideally, you'll look for a Level I trauma ED which has oriented new grads before, and is willing to provide you with an orientation of 16 weeks or longer, including substantial class time in EKG interpretation, trauma care, critical care concepts and other topics.

Good luck to you. :)

Fixed-Wing or Rotary Aircraft? Both?

Most companies that hire require you to have RN and Paramedic licenses to work.

There is also a flight physical so you have to meet certain health requirements.

BCEN/CEN, CFRN, TNCC, ENPC, ATLS, often not required right away are just icing on the cake.

http://nursingschool.org/nursing-careers/specialties/flight/

Here's another reference to give some guidance:

http://www.astna.org/

(They have a bunch of neat acronyms to put by your name as well.)

Just stay away from the tail-rotor rookie!

Fixed-Wing or Rotary Aircraft? Both?

Most companies that hire require you to have RN and Paramedic licenses to work.

There is also a flight physical so you have to meet certain health requirements.

BCEN/CEN, CFRN, TNCC, ENPC, ATLS, often not required right away are just icing on the cake.

http://nursingschool.org/nursing-careers/specialties/flight/

Here's another reference to give some guidance:

http://www.astna.org/

(They have a bunch of neat acronyms to put by your name as well.)

Just stay away from the tail-rotor rookie!

Good websites for reference.

However, in my area, most are not both RNs and paramedics (though my state does recognize PHRNs - pre-hospital RNs). Flight crews usually have at least one of each flight nurse and flight medic. OP should see what's typical in his/her region.

EmergencyNrse -- I would prefer to end on rotary wing, but I would be just dandy on fixed wing. The agencies around here start you out on fixed wing and you have to earn your way up to rotary. We have a lot of mountains around us so I would eventually like to be on the hoist rescue team... but that would be a long way off. Thank you for the web sites, I'll check them out on one of my many needed breaks from studying. :)

Altra -- Good point about going from organization to organized chaos. I can see habits of the first few years after school being so engrained that they may never be overcome. In my area the flight team on rotary wing is a pilot, flight medic, and a flight nurse. That being said... I'm sure all the fancy letters after your name might look good on a resume. The fixed wing has a little more support with it but I think it depends on the case. I know they have physicians that are on the team too, but I'm not sure if they go on every flight or if they are just on call for the sketchy ones. (ha... as if they aren't already skectchy to begin with.)

Solid ICU experience would be your best bet. Many of the paramedic/RN teams assume that the nurse is well versed in "critical care." While ER experience is good, you do not typically receive comprehensive experience in the ER such as comprehensive ventilator management, managing invasive lines such as intracranial and pulmonary artery modalities, and managing critical post-surgical patients who may have balloon pumps and other complex modalities in place.

As an ER nurse who transitioned to flying, I was at a significant disadvantage even though I had a fair amount of basic ventilator and basic haemodynamic experience. Solid critical care experience would have made my transition much easier.

As an ER nurse who transitioned to flying, I was at a significant disadvantage even though I had a fair amount of basic ventilator and basic haemodynamic experience. Solid critical care experience would have made my transition much easier.

You play with more toys in the "Unit" that's about it.

For critical decision making and prioritization skills give me an

experienced nurse in taking care of "emergencies" or someone

that's been "on the bus". Especially if your bird responds to 911 calls!

Critical Care Transport work is okay for those that receive patients that

have reasonably been stabilized to make the trip. For these assignments

the ICU people are okay.

It has been my experience that ICU nurses are ones that I see refuse to

transport certain cases for one excuse or another. Can't handle the possibility

of "controlled chaos" during the trip. 1st time I heard of someone refusing to

transport I was like "whaaat???'' Happens all the time. Amazing.

You play with more toys in the "Unit" that's about it.

For critical decision making and prioritization skills give me an

experienced nurse in taking care of "emergencies" or someone

that's been "on the bus". Especially if your bird responds to 911 calls!

Critical Care Transport work is okay for those that receive patients that

have reasonably been stabilized to make the trip. For these assignments

the ICU people are okay.

It has been my experience that ICU nurses are ones that I see refuse to

transport certain cases for one excuse or another. Can't handle the possibility

of "controlled chaos" during the trip. 1st time I heard of someone refusing to

transport I was like "whaaat???'' Happens all the time. Amazing.

You failed to take my post into it's proper context. My response was related to a typical paramedic/RN team. It is reasonable to expect that the paramedic will be an expert in "emergency" medicine and manage the "911" calls. However, when paired with a nurse, it is reasonable to expect that nurse to be well versed in managing "critical care" patients (Balloon pumps, pulmonary artery catheters, ICP monitoring and so on). It is the marriage of the paramedic and nurse that allows such a team to provide care to a diverse patient population. An emergency room nurse without a solid critical care skill set brings little to the team.

Some ER nurses do cross train or have a critical care skill set, but this is not the rule. I stand by my statement that a solid critical care skill set will be the greatest asset in such a team.

Regarding turning down a mission. There are many complicated factors such as the safety, aviation environment, access to the patient and so on that go into making a "no-go" decision. It would be mypoic of me at best to make a judgment of ICU nurses versus ER nurses and judgement calls based on anecdote.

I've done ED, critical care and flight for 20 years. I went from critical care to flight, then ED later. I effing despise the ED, UNLESS it is a level 5. Most of the crap that rolls through ED doors these days is level 2-3 nonsense and I can't stand it. I want to hit them over the head with something so they really WILL have something to complain about!

That said, I think you could go either way. In my part of the country now, flight nurses also have to be EMT-P, check your area. If that is the case where you are, critical care and paramedic exp ought to do the trick. If not, I'd start in ED and move on to CC. Going the other way is very frustrating! Make sure your ED exp is at a trauma center or it isn't going to be very helpful when push comes to shove. Life flight doesn't pick up many people with back pain.

I'm just teasing you a little. "Lighten up Francis"...

I figured if you've tasted what regurgitated charcoal tastes like

and clean blood & puke off your shoes as much as I have you can

take a little joking here and there. If we are nothing we share the same

Type-A personality that allows us to do what it is we do.

Thank you all for your thoughts. :)