Destined to Be a Flight Nurse

[skorupar, BSN]

About eight months ago, I decided that I would like to be a flight nurse. I currently have a BSN and am BLS, ACLS and PALS certified. I was a CNA for 10 yrs and have been an RN for almost six yrs in April. I worked at an LTACH for four yrs, brain injury/general rehab for one yr, and just got my foot in the door in MS/Neuro ICU in October 2018.

I had an extended orientation in the ICU because I needed to improve my prioritization and time management skills. With three weeks left in the said "extended orientation," my manager and supervisor decided that I should transfer to a Med Surge/Progressive Care unit to work on the aforementioned skills and then see if I would like to rejoin the ICU team (~6 months).

With that said, I respect their professional feedback, but feel like if I would have had the opportunity to complete the remaining orientation, I would have improved those skills. My preceptors had told me they could see the improvement since I started orientation. A few also told me that it took a long time for them to build a routine.

So, I will interview for a position on the progressive care unit, which I shadowed. But, with wanting to be a flight nurse, I know I have a lot of work ahead of me and have many questions on which route I should pursue. I need critical care experience and am wondering if I should apply for an ED position or a different ICU position at another facility?

I know that different FFL companies require different certifications and having them increases your chance of qualifying for a position; so, should I try to complete some of them now (e.g., Paramedic)? Should I go back to school for my MSN? If so, which program? Is there one that is geared towards flight nursing? I do not know what I should do or where I should start with so much ahead of me. Any feedback or personal experiences would be greatly appreciated.

[Sour Lemon]

I have a relative who was a flight nurse, but she had about 17 years of critical care experience before she was selected for that position. And it wasn't always flying, sometimes it was traveling by ground. She still worked the floor some shifts, too.
What is it about flight nursing that you feel destined to do?

[Been there,done that, ASN, RN]

You need to put that dream on hold. You have to prove yourself in critical care first. Your current employer is bending over backwards to provide the experience and education you need.

Best wishes.

[Wuzzie]

Generally speaking ED experience is not optimal for a flight position. Some flight programs will take nurses with a minimum 2 years of experience in a high acuity CVICU, SICU or ICU. I won’t share my opinion on that. A large percentage of programs require 5 years or more in the same types of units. If I were you I would follow the plan your current hospital has for you. They sound supportive and you would continue moving forward. If you move to a different ICU and the same thing happens you will have set yourself back and there’s no way to tell if they will support your growth or just kick you to the curb. Don’t rush this.

[skorupar, BSN]

Thank you for the feedback. I do feel that my employer is very supportive and they are aware of my goal to be a flight nurse.

I would like to be a rotor fight nurse. I am aware that I will be on ground and fixed wing as well.

[KatieMI, BSN, MSN, RN]

Leaving alone the question about being "destined" into something, I would say that trying for another ICU might be not a bad idea.

As a former LTACH nurse, I would dare to say that after 4 years in that environment - providing it was "acute" LTACH - one should have same or better "prioritization" skills than an average med/surg nurse. And it is a well-known fact that some (and in fact quite a few of them) ICU nurses feel somehow way superior to those working long term acute without any perceptable degree of knowledge about what it implies.

'Been there, had that, done that, saw ICU floaters getting pale-faced when facing assignment of four vents, two of them simultaneously trying their best to catch Jesus' bus then and there.

Get to any acute care floor you can now but keep your options open and CV updated.

[NICU Guy, BSN, RN]

1 hour ago, skorupar said:

I had an extended orientation in the ICU because I needed to improve my prioritization and time management skills. With three weeks left in the said "extended orientation," my manager and supervisor decided that I should transfer to a Med Surge/Progressive Care unit to work on the aforementioned skills and then see if I would like to rejoin the ICU team (~6 months).

Flight nurse positions are very autonomous positions. A hospital/company would be looking for quick learners that have excellent critical care skills and very good critical thinking skills. It will take a minimum of 5 yrs of critical care experience before you begin to have the skills required. There are very few flight nurse positions and you will be competing against very good ICU nurses.

You had an extended orientation and when you were getting close to the end of your extended orientation, instead of keeping you in ICU, they are sending you to a Med/Surg floor with the possibility to come back (not guaranteed) to ICU in 6 months. It seems to me that they do not feel that you currently have what it takes to be an ICU nurse otherwise they would keep you in ICU after your orientation ends. It might be possible after a few years in Med/Surg to get back into ICU. You are looking at least 7-10 yrs before a flight nurse position is a possibility.

[Emergent, RN]

I think you should modify your plan. Becoming a flight nurse is like becoming a rock star. There are a lot of great musicians who will never attain that dream. But, they love music, and find great joy and satisfaction in it.

Start by becoming a good musician. Keep practicing and refining your skills out of love of your instrument. See where it takes you.

[ruby_jane, BSN, RN]

16 hours ago, KatieMI said:

And it is a well-known fact that some (and in fact quite a few of them) ICU nurses feel somehow way superior to those working long term acute without any perceptable degree of knowledge about what it implies.

'Been there, had that, done that, saw ICU floaters getting pale-faced when facing assignment of four vents, two of them simultaneously trying their best to catch Jesus' bus then and there.

And the choir says AMEN, KatieMI.

OP - you'll have to decide if a delay of six-ish months is a deal-breaker. A delayed position in the hand may be worth more than a position out in town with no guarantees. Good luck!

[RickyRescueRN, BSN, RN]

I feel I have to weigh in as a 22yr RN with 17 of those years being in Flight. No one is destined to be a Flight nurse.It's a nursing super speciality like so many others. One works hard for a long time to get into this field. You need solid ICU experience if you are to make a good flight nurse practitioner, and I mean 5-10years in the ICU. Patients that are flown deserve the best when it comes to ones experience and skill. CV ICU and high acuity SICU is what I recommend as you learn to care and manage patients with numerous invasive pressure lines, Mechanical Circ Support (Impella, LVAD, ECMO, IABP) and on numerous inotropes, pressor and other infusions. Most ICU managers and educators have a fairly good understanding of what is required from Flight and CCT RN's in terms of practice, so I would take their advice and get the experience you need on a tele floor. Rather do this than risk being told when you apply for a flight job that you are not experienced enough. Remember , it is a super specialty of nursing, with your experience built in Intensive care nursing and to a lessor extent in Emergency nursing. The road to attain this is a long one and for good reason. Check out the Flight Nursing Specialty section . Lots of good advice there from other flight nurses for nurses in the same position as you are. Good luck. Don't give up.

[rn409, BSN, RN]

I don’t think your MSN is going to help you here, but I don’t know what the flight companies you’re looking at have their expectations set at. Theirs must be different from what I’ve heard. I’ve known several people to become flight nurses, some have only ICU experience and some were ED experience. The ones who typically got the job the easiest were ones with a combination of both or RN ICU experience and EMT/paramedic experience. Have you talked to any recruiters about the best route?

[rn409, BSN, RN]

On 2/10/2019 at 6:36 PM, KatieMI said:

Leaving alone the question about being "destined" into something, I would say that trying for another ICU might be not a bad idea.

As a former LTACH nurse, I would dare to say that after 4 years in that environment - providing it was "acute" LTACH - one should have same or better "prioritization" skills than an average med/surg nurse. And it is a well-known fact that some (and in fact quite a few of them) ICU nurses feel somehow way superior to those working long term acute without any perceptable degree of knowledge about what it implies.

'Been there, had that, done that, saw ICU floaters getting pale-faced when facing assignment of four vents, two of them simultaneously trying their best to catch Jesus' bus then and there.

Get to any acute care floor you can now but keep your options open and CV updated.

As an ICU nurse, I do not feel superior to anyone unless they make no effort to be an effective caregiver. I just wanted to applaud you for your work, I know it’s tough (I’m definitely aware of how difficult some of the long term patients can be, and oh my goodness having more than 2 would be very difficult to manage). Thanks for what you do (or did)!