Destined to Be a Flight Nurse

[skorupar]

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.

[traumaRUs, MSN, APRN]

Moved to Flight Nursing

[Wuzzie]

13 hours ago, murseman24 said:

I choose the drug, dose, timing, route, and I love it. You can't do that as an RN, you can just try to understand why someone else asks you to do something. 

Au contraire my friend. I did just that as a flight nurse and without somebody to back me up in the next room if things went south.

[murseman24, MSN, CRNA]

13 hours ago, klone said:

My lord, you're still a baby.

The hubris, to think you've learned all you can learn as an ICU nurse after 3 1/2 years.

LOL, you can have the same learning experience for 15 years straight or you can push yourself to grow in the time you have. I chose to do the latter. If you want to take baby steps for your entire career that's your choice. I wanted a bigger challenge

[WestCoastSunRN, MSN, CNS]

3 minutes ago, murseman24 said:

LOL, you can have the same learning experience for 15 years straight or you can push yourself to grow in the time you have. I chose to do the latter. If you want to take baby steps for your entire career that's your choice. I wanted a bigger challenge

Just being honest here, and I will say this kindly, -- I'm sure you're smart - but you don't learn everything there is to know about ICU nursing in 3.5 years -- regardless the size of your steps. I do not know medical providers who would make this claim. Either you are a genius (and I would still doubt you had capped your learning), or you are overestimating yourself and underestimating others -- which, incidentally, is not necessary to prove yourself worthy of CRNA school/ambitions.

[murseman24, MSN, CRNA]

14 minutes ago, WestCoastSunRN said:

Just being honest here, and I will say this kindly, -- I'm sure you're smart - but you don't learn everything there is to know about ICU nursing in 3.5 years -- regardless the size of your steps. I do not know medical providers who would make this claim. Either you are a genius (and I would still doubt you had capped your learning), or you are overestimating yourself and underestimating others -- which, incidentally, is not necessary to prove yourself worthy of CRNA school/ambitions.

I never said I knew everything, I said I felt like I hit a ceiling and that my knowledge wasn't going to improve my scope of practice. If I had done trauma, ER, CVICU, flight, there would be definite learning opportunities. (Even med-surg would teach me things I never focused on in the ICU). I wanted to improve my ability to help patients and act on the knowledge I can obtain. I could never choose the med or intervention as a nurse (you need an order from the physician), and my hands on procedural skills were more limited than advanced practice allows me. I wanted much more control over my own practice.

[murseman24, MSN, CRNA]

3 hours ago, Wuzzie said:

Au contraire my friend. I did just that as a flight nurse and without somebody to back me up in the next room if things went south.

Never done flight, plenty of my colleagues have and they said they liked it. I liked rapid response for the same reasons (more autonomy), but it was still largely protocol based on standing orders.

[Wuzzie]

2 minutes ago, murseman24 said:

but it was still largely protocol based on standing orders.

You do realize who wrote the standing orders and protocols don’t you?

[rn409, BSN, RN]

Regarding your ICU experience (because I’m guessing you’re a CRNA now? Idk.) since I cannot speak to your experience or thoughts since then:

You know what makes the best THE BEST? Self awareness- the ability to look past your ego, see your flaws. I can see that there’s no changing your mind about this whole “ceiling” theory. Your lack of learning further is ON YOU. What you are saying is in no way true. But hey, I’m done trying to give another perspective thinking you might be able to see that trajectory. I’m just a dumb ICU nurse who only learns new things because I wasn’t smart enough to get them in the first place.

I truly hope no patient ever suffers due to your ego. And I hope, whatever you are doing now, that you see the endless knowledge to gain in that area (since ICU didn’t).

From someone who has been practicing about 6 years (and more who have practiced longer, saying the very same things).

[frozenmedic]

On 4/10/2019 at 7:37 PM, murseman24 said:

ACLS is a logarithm, there isn't anything inherently difficult in following it.

First off, this is a logarithm:

This is an algorithm:

There isn't anything inherently difficult about understanding the difference.

To the OP- you have already received lots of good advice; but however you decide to proceed, I would add a few points. If you really want to be a flight nurse, once you settle into a (preferably high acuity ICU) unit, make your focus physiology and prioritization for the ultra critically ill. Understand why your providers choose to make certain actions, and why they choose NOT to. Your goal is to be able to understand how physicians think and work through a differential. Once you have only one patient to fly at a time, your time management skills become almost irrelevant. That means there will be days you have to choose to spend 15 more minutes listening to a consulting service rather than catching up on charting about your tasky pair.

Your attitude is also essential. By their nature, flight crews are huge PR representatives for the hospital/agency they fly for. Those hiring for flight positions are not just looking for people who are clinically excellent. They want those who can also be called upon to make a positive impression at a terrified rural facility managing their first critical patient in months and a girl scout camp show-and-tell. This means you need to be known as the person on the unit who wants to do the best possible job regardless of the situation (helping your coworkers clean poop, precepting the "difficulty" orientee, etc); not the person who is only engaged when they have the sickest patient on the unit.