Critical Care Experience

[nyemt2005]

I know you need a few years of critical care experience before you would be considered for a flight position. My question is, does the size of the hospital you gain this critical care experience in matter? Will 3 years of ICU in a small community hospital be looked at with less value then 3 years ICU at a larger tertiary facility?

[astn]

Generally speaking, yes. Getting a flight job is more complicated then just that, but if all other things were equal, the experience gained from a tertiary hospital will be considered more valuable then at the community hospital.

However, for a larger hospital you need to consider what unit you'll work on, as you will potentially be a much less "well-rounded" nurse if you work in a specialty area. I would float or moonlight as much as possible if I worked in an area such as Neuro ICU, and would aim for Medical or Trauma ICU if my only goal was to work on the helicopter/airplane. I would also try to suck up to the ED manager to let me float/work down there as well.

Another minor factor, but worth considering, is 'where do all the cool kids work?' If all the flight people have side-jobs (or primary jobs) in a particular hospital, and you know you want to work for that service, get a job there. A lot of the world is who you know, after all.

[EmergencyNrse]

The answer can be found in another question:

How well do you work independently and make critical decisions on your own?

It's not just "experience". I know a bunch of people that are really good in the unit but put them out on their own without someone to ask, check their dose, mix their gtts... they're LOST!

There is no code button. There is no rapid response team. There is no doctor to turn to when your patient "tanks".

You might get to make cell phone call but what's going on with that patent while you're on the phone? You're on your own.

I know the appeal to getting out there. It seems like it's really cool but at what cost? You absolutely MUST be solid in your ACLS algorithms. You MUST be able to adjust to micro-drip concentrations that aren't standard for your floor/hospital. (They vary) You have to be comfortable to recognize when it's appropriate to give a bolus or start "pressors" on your own. Know how to mix your solutions, give medicines, and take appropriate actions by yourself. Intubation? Running a code by yourself?

One more thing to consider. Motion sickness.

I have worked with people with far greater skills than my own. I can only aspire to equal their skills and knowledge but they can't be in an aircraft blowing around. They can't be in the back of an ambulance riding backwards writing/charting... They blow chunks.

All-in-all transport really is a fantastic job. My suggestion is not to be too eager. It might bite yo in the end. Work on skills. You CAN do it. Good luck.

[Pneumothorax, BSN, RN]

The answer can be found in another question:

How well do you work independently and make critical decisions on your own?

It's not just "experience". I know a bunch of people that are really good in the unit but put them out on their own without someone to ask, check their dose, mix their gtts... they're LOST!

There is no code button. There is no rapid response team. There is no doctor to turn to when your patient "tanks".

You might get to make cell phone call but what's going on with that patent while you're on the phone? You're on your own.

I know the appeal to getting out there. It seems like it's really cool but at what cost? You absolutely MUST be solid in your ACLS algorithms. You MUST be able to adjust to micro-drip concentrations that aren't standard for your floor/hospital. (They vary) You have to be comfortable to recognize when it's appropriate to give a bolus or start "pressors" on your own. Know how to mix your solutions, give medicines, and take appropriate actions by yourself. Intubation? Running a code by yourself?

One more thing to consider. Motion sickness.

I have worked with people with far greater skills than my own. I can only aspire to equal their skills and knowledge but they can't be in an aircraft blowing around. They can't be in the back of an ambulance riding backwards writing/charting... They blow chunks.

All-in-all transport really is a fantastic job. My suggestion is not to be too eager. It might bite yo in the end. Work on skills. You CAN do it. Good luck.

this is why having prehospital skills (emt/paramedic ) is greatly helpful in developing autonomy, ICU is helpful for drips/meds familiarity. Med Control is always a phone call away. bc flight nurses/medics arent docs and still may need assistance ya know :)

motion sickness: see if your flight service does ride alongs...thats a good way to see if its for you.. you not only go up in the heli, but you can see what its like patient care and all..:) ive done it quite a few times and absolutely love it. i will tell u its not like anything else ive ever done hahah :)

[nyemt2005]

Thanks for the responses. I do have a lot of experience in the pre-hospital setting as an EMT although at the basic level. I have the opportunity to start as a new grad in a small ICU at a community hospital. I think I'm just going to start there and then move to a bigger hospital after a couple of years. I liked the manager for the unit and I sort of liked the idea of being able to float into the PACU and ED.

[Merlyn]

Thanks for the responses. I do have a lot of experience in the pre-hospital setting as an EMT although at the basic level. I have the opportunity to start as a new grad in a small ICU at a community hospital. I think I'm just going to start there and then move to a bigger hospital after a couple of years. I liked the manager for the unit and I sort of liked the idea of being able to float into the PACU and ED.

Good choice!

[Pneumothorax, BSN, RN]

sounds like a really good opportunity.. good luck :)