Becoming a flight nurse?

gregemt · May 17, 2011

You need around 5 years experience as an RN in ED/critical care, even better if its at a level 1 trauma hospital. A BSN looks good, as well as certs like CCRN, CFRN, CEN, ACLS, PALS, NRP. Getting your paramedic license does look good, though is usually not necessary.

getoverit, BSN, RN, EMT-P · May 17, 2011

Is there a local/regional flight program you're interested in working for? If so, introduce yourself to them. A great opportunity to do this would be when you're taking a course like TNCC, ACLS, etc. Learn what kind of aircraft they use and do some research on that model. In interviews I've always been impressed when an applicant says "How do you like the xxx?" It usually shows they've done some homework.

Get as much critical care experience as you can. ICUs, CCU, etc. The clinical experience as well as learning how to use all the hardware. You may be flying with a partner who doesn't have the critical care knowledge and when you're in an ICU picking up a ventilator, IABP, invasive hemodynamics, 7-8+ vasoactive drips, etc....you want to know what can be d/c'd for the flight as opposed to what absolutely needs to be continued.

Like GregEMT posted, a paramedic license may help. It may not. Or it may be required within a certain amount of time from your hire date. Find out what program you want to fly with and then learn their requirements. It sounds like a cop-out answer, but it's true. Each program is different, they have different aircraft, differing mission profiles, crew configurations, etc.

and all the "bells and whistle" certs you can get. CEN/CCRN, etc. ACLS, a trauma course (TNCC, PHTLS, something along those lines), a pediatric course (PALS, PEPP) and probably neonatal resuscitation too. Look into taking the Critical Care Transport Program, it was developed by Univ. of Maryland and they hold 2 week seminars at various hospitals and community colleges around the country.

Hope this helps. Email me if you want. and I read your post about your brother...my thoughts and prayers go out to you. I hope he gets better soon.

getoverit, BSN, RN, EMT-P · May 17, 2011

While I agree with the rest of your post, I take exception to the following (and I quote):

"The CCEMTP is designed for people who have had no or very minimal exposure to critical care and most of it will be a very basic review for an experienced ICU RN. Seek out training programs designed to improve the knowledge of the critical care RN with hands on time demonstrations with various equipment."

#1 The course is practical for people who have little exposure to critical care and many course participants rarely ever work in a true critical care environment. but that doesn't underscore the value in a review of things we do everyday and with a group of peers who broaden our horizon of knowledge.

#2 It is a review of hardware and parameters, treatment modalities and machine settings...but it exposes providers to them in a vehicle (air or ground) and the different risks inherent with each. and not only to a comfort level with how to use things as simple as locking mechanisms on a stretcher mount but more importantly to a better, more well-rounded understanding of disease and injury pathology, and more specifically how it applies to CCT.

#3 The class had many hours of, as you say "...with hands on time demonstrations with various equipment." This is valuable and the course would have been lacking without it. I don't remember the exact hours but I would guess 20+ clinicals either in a truck or ICU/cath lab/OR. Of course it would be of limited value to the student who had absolutely no prior exposure to the material. But what about when that medic goes on a call and finds a patient with an injury/illness pattern that they remember from taking the class? It influences the way they treat the patient and get a more positive outcome. How can anyone argue against that?

I took my class in 1998 and have been doing flight/CCT/ICU nursing since then. I know my experience is limited to the past 13 years (and 6 before that if you count riding 911 calls in an ambulance all day and night!) but look on any of the websites you linked us to and tell me how many jobs list CCEMTP as either required or preferred.

The course is well worth the time for even an "experienced ICU RN" and I would bet on my colleagues feeling the same.

getoverit, BSN, RN, EMT-P · May 19, 2011

You make a few good points.

but I am not "bragging" about my experience and connections--which happen to be my co-workers, I don't think it's out of line to offer their opinions on the topic, you may be upset because I've not encountered anyone that shares your viewpoint--although I'm sure they're out there...somewhere.

I only mention them because in your posts (this thread and others) you have often refused to acknowledge things that were presented as opinions based on personal experience.

Also you make inferences about other postings that are incorrect and I'm trying to limit that here.

PMFB-RN, RN · May 19, 2011

Our flight service runs with an RN / paramedic team. We only hire experienced SICU nurses. We want nurses with a lot of open heart experience as well as trauma. We do not hire nurses with only ER experience.

TraumaSurfer · May 19, 2011

Plain and simple:

Work towards your BSN (preferred although not always mandatory)

CFRN, CCRN and CEN are the big certs for RNs

These weekend certs are of course required but they also should be if you have worked in the ICUs and ED:

ACLS, PALS, NRP

Preferred certs along with the others:

STABLE, PEPP, PHTLS, TNATCC, TNCC

3 - 5 years of experience in high acuity critical care units: SICU, CVICU, CCU or whatever combination of ICUs that will get you the most experience with many types of patients, technology, medicated drips and hemodynamic monitoring with a thorough understanding. Peds and maybe Neo ICU would also be highly recommended if the service you are interested in does a mixture of patients.

The CCEMTP is good for Paramedics (or RNs) who have NO experience at all in an ICU. However, for an RN, you would be very, very scary if you relied on that minimal overview for critical care training. The courses that are offered for RNs in prep for the CCRN and ICU classes that are focused on very specific components may last 2 - 3 days instead of attempting to squeeze all the info in a couple of hours. In an earlier post I outlined some of the specific equipment or types of patients you might need to be familar with. There are also many excellent review classes on line once you get some working knowledge of ICUs. Examples would be some of the ventilator companies and Datascope or through SCCM. Critical care nursing associations also offer excellent courses either through their websites online or at conferences. In the ICUs you will have contact with experienced RNs, probably flight services bringing or taking patients, physcians and respiratory therapists who will offer you much more indepth information critical care education.

Air and Surface Transport Nurses Association offers excellent information and has the textbook you need to get you started for the CFRN.

You also will need to be familar with CAMTS or at least what it does for the industry.

TraumaSurfer · May 19, 2011

getoverit said:

You make a few good points.
but I am not "bragging" about my experience and connections--which happen to be my co-workers, I don't think it's out of line to offer their opinions on the topic, you may be upset because I've not encountered anyone that shares your viewpoint--although I'm sure they're out there...somewhere.

I only mention them because in your posts (this thread and others) you have often refused to acknowledge things that were presented as opinions based on personal experience.

Also you make inferences about other postings that are incorrect and I'm trying to limit that here.

I'd like you to answer my question: What is your education/job title? and when did you take the CCEMTP course?

Much of the information on an anonymous forum is based purely on personal experience, either fact or fiction, and rarely do the posters provide concrete information or links to back up their statements as the truth and whole truth.

I prefer to direct people to credible sources for them to get the information first hand.

It you have good information with links to the sources to post which will be of use, there is no need to put up a bunch of alphabet soup or brag about personal tales on an anonymous forum. The OP can easily join a professional nursing associations and get advice on their forums where the posters are not anonymous. Usually they may offer personal contact information to those seeking real advice.

getoverit, BSN, RN, EMT-P · May 26, 2011

PMFB-RN said:

Our flight service runs with an RN / paramedic team. We only hire experienced SICU nurses. We want nurses with a lot of open heart experience as well as trauma. We do not hire nurses with only ER experience.

I'm sorry. I intended to respond to your post earlier but got distracted. I wanted to ask about your program hiring CCU/Medical ICU nurses?

I've found that these nurses are just as familiar with art lines, CVCs, vents, gtts, IABPs etc. At the risk of getting flamed, I believe that in an the prehospital setting, there is very little an ER nurse is going to do immediately to stabilize a patient that a paramedic would do as well.

PMFB-RN, RN · May 26, 2011

getoverit said:

I'm sorry. I intended to respond to your post earlier but got distracted. I wanted to ask about your program hiring CCU/Medical ICU nurses?
I've found that these nurses are just as familiar with art lines, CVCs, vents, gtts, IABPs etc. At the risk of getting flamed, I believe that in an the prehospital setting, there is very little an ER nurse is going to do immediately to stabilize a patient that a paramedic would do as well.

*** Actually all of the flight nurses have been hired out of one hospital's SICU. The windows of the SICU look out over the heli pad. Driect ICU admits only have about 50 yards to go from helocopter or ground ambulance to the SICU. The SICU nurses and transport nurses are very well known to each other.

While we have some excellent MICU/CCU nurses they do not get the same kind of exposure to gtts, swans, LVADs, IABPs, etc. that the SICU nurses do. However trauma is the big difference. In our ER when there is a level I or II trama activation it is an SICU nurse who comes down to the trauma bay and acts and the trauma nurse. The ER nurse documents and runs to get things. Our SICU nurses must have TNCC or ATCN, PALs, either ENPC or neonatal recesation course. Those who are planning on applying for the transport service usually try to take the trama pager more often and get the most trauma experience. SICU nurses are also on the code team and act as the alternative code team leader until the ER physicians arrives, if he arrives (not always the case as there can be multiple code on occasion or something urgent in the ER prevents them from responding to codes).

These experiences are felt by the manager of the transport service to well prepare an RN for transport work.

One thing I just realized. All of the transport nuses are well known to me as I am an SICU nurse and am casual on the transport service (ground). Only one of the full time transport nurses has a BSN. We also have a couple casual nurses who are advanced practice nurses, one NP and two CRNAs.

getoverit, BSN, RN, EMT-P · May 27, 2011

thanks for replying.

That's interesting about your hospital and the SICU nurses. Where I work, it's the same thing but for MICU nurses. True, the swans and LVADs are more common in SI, but to be honest I've never had to fly someone with a swan. things like vents, gtts, hemodynamics, IABP, etc are much more common for us. also, the MI nurses carry code and rapid response pagers.

and about the education thing...I see this debated so much. I don't think that associates vs bachelors or higher makes much difference in this line of work. for a managment position, I can understand; but for a clinical nurse, the degree isn't as important to me as their understanding of pathophys and "getting it from your head to your hands". There are exceptions but some of the sharpest RNs I ever worked with had gone to a diploma program; and some with master's degrees were definitely not the ones you wanted helping in an emergency.

thanks again and take care!

PMFB-RN, RN · May 27, 2011

getoverit said:

thanks for replying.
That's interesting about your hospital and the SICU nurses. Where I work, it's the same thing but for MICU nurses. True, the swans and LVADs are more common in SI, but to be honest I've never had to fly someone with a swan. things like vents, gtts, hemodynamics, IABP, etc are much more common for us. also, the MI nurses carry code and rapid response pagers.

and about the education thing...I see this debated so much. I don't think that associates vs bachelors or higher makes much difference in this line of work. for a managment position, I can understand; but for a clinical nurse, the degree isn't as important to me as their understanding of pathophys and "getting it from your head to your hands". There are exceptions but some of the sharpest RNs I ever worked with had gone to a diploma program; and some with master's degrees were definitely not the ones you wanted helping in an emergency.

thanks again and take care!

*** It is not uncommon for us to transport a patient with a swan. Usually a cadiogenic shock patient we are taking from an outside hospital's MICU to our hospital SICU for heart surgery.

Speaking as somone who serves as a preceptor in my hospitals Critical care Nurse Residency program (9 month program to turn new grads into SICU, MICU, PICU, NICU, PACU, or ER nurses) I have not been able to predict how well a new nurse will do in critical care based on their initial nurse education. However only ADN new grads are hired into the SICU nurse resdiency as the new grad BSNs were not finishing their two year contracts before going off to CRNA school. Even when the contract pay off was raised to $15K they left after a year or so vs 100% of ADN grads finishing their contracts (so far).