Flight Nursing: Behind the fancy helicopter

Flight Nursing: the career that literally every other nurse wants to pursue. Why is it such a popular field? Specialties Flight Knowledge


Flight Nursing: Behind the fancy helicopter

You are transporting a patient whose only hope is you and your team. Your limited space, the weight of your equipment, and the limited time you have to help your patient are all working against you, yet you do everything you can to defeat the odds. What does it take to be a flight nurse?


There are many misconceptions about this line of work, including a very good paycheck, getting paid to travel, and the perk of being able to work outside the normal working environment for a nurse. With so many reasons for becoming a flight nurse, why wouldn't everyone want to become one?

When working hard every day you go to work, you can hope for a good pay check to reward you for all the work you've done. Often, a lot of this work can be overlooked, including the hours beyond your normal load. Many flight nurses work on salary; this means that, in a way, there is no limit of the amount of hours a flight nurse may work in a week. Picture this: you're on a helicopter transferring a patient a hundred miles or more from where you're stationed. By the time you get back to the base, you have an hour left of your shift, and you get a call from an hour or two away. Are you just going to wait for the next shift to get it?

Flight nurses are considered the creme of the crop because they're willing to put patients' needs in front of their own.

Have you ever wanted to see the world but wanted to get paid to do it?

Many nurses believe that flight nursing is similar to travel nursing, which allows you to see new places and change your location frequently. Although this is true, flight nurses usually do not see anything besides the walls of a hospital when transporting patients. Since the patients that flight nurses transport have such a high acuity, they can't afford to waste time by sightseeing and checking out new places nearby; they must be ready to go when another emergency presents itself. When on the clock, flight nurses are consumed in the well-being of others, not play time.

The many areas of nursing can go on forever: hospitals, nursing homes, rehabilitation center, clinics, etc. Although the emergency department and intensive care units can offer the driven, adrenaline-hungry individual a place to "play," some nurses don't want to stay in a typical workplace for too long. The helicopter can seem like an exciting work environment; what many nurses overlook is the small quarters of the helicopter, which is occupied by the patient, the flight nurse, and often additional staff responsible for the patient. There are often restrictions on height and weight for flight nurses, which narrows the pool of applicants greatly. A flight nurse must be able to perform life-saving procedures without much room to roam.

Flight Nursing Challenges

With all the challenges of flight nursing, you may ask why my dream is to become one. When I think of flight nursing, I think of the ultimate sacrifices that these nurses are making. Rather than spending time with their family, they'll miss a birthday party to treat a dying patient. Instead of getting to bed on time, they'll spend two hours beyond their shift to transport a patient who would otherwise not make it if they'd waited for the next shift.

I want to be a flight nurse because I feel like it would be the ultimate job to be able to save a person's life. This patient could be someone's grandmother, mother, father, sister, or baby brother, and at the end of the day, I would know that I took a front-row seat to help them stay around a little longer. Although I know there's a chance that a patient may be lost, the possibility that I can impact a patient's life in such a large way makes me passionate about flight nursing.

Considering that not everyone can do it, flight nursing is a very challenging yet rewarding line of work. Although many sacrifices must be made in a nurse's life to become one, the many lessons and what you gain from this field are well worth it.

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A few things to add…

To be a competent flight nurse you need a minimum of 5 years in a high acuity ICU/ED, as you are making life changing decisions in regards to meds, and etc, so it is certainly stressful. Most flight teams consist of an RN/Medic or RN/RT pair, and the nurse is often times intubating. It is expected that your expertise in critical care will guide you to temporarily play the role of the physician when you are the highest educated member on board.

Although it is seen as the "dream nursing career" it does have an overlooked dark side, that helicopter crashes are more common than one would hope, and considering flight nurses are called to scene rescues which are sometimes dangerous, you place a big risk and trust in the pilot, who carries not only the patients life in his hands, but yours as well.

Overall it is thrilling and rewarding. Each nursing specialty presents its own challenges.

Specializes in Addictions, psych, corrections, transfers.

I actually had a nursing instructor that was a previous flight nurse. She broke both of her feet and ankles jumping out of the helicopter too early. She was never able to be a floor nurse again after that due to pain and ambulatory issues. She was the best instructor I ever had though.

Specializes in PeriOp, ICU, PICU, NICU.

Great post. I'm a ground transport nurse and although were not "cream of the crop" we sacrifice a lot as well. 24 hr shifts, long transport times, stand up 24's and when the choppers are grounded during bad weather, were it. ;)

Specializes in Peds/Neo CCT,Flight, ER, Hem/Onc.

I've responded to and deleted my response to this article three times now. I'm trying to figure out how to correct some really big errors without sounding snarky and I really don't want to tinkle in the OP's Wheaties but...

Flight nurses absolutely do NOT have a corner on the market in putting patient needs before their own. Yes, it does happen that sometimes the shift goes beyond regularly scheduled hours. Sometimes by a lot, but trust me the first thing out of most FN's mouths when they get toned out just before they're supposed to leave is definitely not "oh goodie I get to go save a patient". The normal response would be against TOS. You just do it because it's your job not because FNs are altruistic angels flying through the sky. Just like the Med-Surg nurse that stays over two hours to chart. It's the job.

Second. Good Pay. Ummm, not really. I made $27/hr with 20 years of experience. Now I make over $40/hr in a clinic! The reason for this is that for every position that opens there are hundreds of applicants. There's no incentive to pay well.

Third. It ain't all about saving lives. The VAST majority of patients being flown today could easily be transported by an ALS ambulance. Note, I'm not even saying a MICU I'm saying an ALS service. Sadly, many flights are done to facilitate getting rid of a patient as quickly as possible (GOMER syndrome) not because the patient needs an extremely high level of care. Flight services need to fly patients to make money so they will never refuse a mission. Even one that clearly does not need their service.

Fourth: Hands down flight nursing is by far the most dangerous nursing job there is and that fact is not to be taken lightly. Things that need to be considered are how will this affect your marriage and your family. There is a very good possibility that you could die. Flight programs are popping up all over the place. Not all of them put safety as their number one priority. in 2008 36 human beings lost their lives in HEMS related incidents. Think about it.

Fifth: just like in any nursing specialty there are good flight nurses and not so good flight nurses. Calling all of them the Creme [sic] of the Crop is a little generous. Flight nursing certainly has its cache. But I know some brilliant ICU and ED nurses too. And to the previous poster ground transport nurses function at the EXACT same level as flight nurses but for longer periods of time and without the cool suits. Don't sell yourself short. In fact, ground crews are more likely to go over their shifts by large amounts of time and they rarely refuse a mission due to weather.

To the OP. Continue working towards your dream of being a flight nurse. It's a wonderful career that will push you out of your comfort zone and teach you many things. Be mindful though that every nursing specialty brings something to the table and you can find brilliant people in all of them. Oh, and one more thing. Never, ever wear your flightsuit to the grocery store or the mall. It will make you look like a tool. ;)

Specializes in ICU + Infection Prevention.

This article is filled several pieces of incorrect information.

It is likely a result of the author failing to perform proper research/interviews and lacking the background, education, and experience to write the article.

This is a learning opportunity. Good luck with your future OP.

Specializes in Emergency/Cath Lab.

What are your credentials for speaking of what it is like to work on a helo? Sounds like you should have talked to scot before you did this fluff "article"

Specializes in Flight, ER, Transport, ICU/Critical Care.

Thank you FlyingScot - nicely said. I, too, have tried and failed to post a response. Your response is awesome. Spot on awesome.

I will repeat - the job is simply a job. The job is unique in that in can KILL you. I was scheduled to be on a helicopter that crashed in 2008. An extended medical leave kept me off work an additional couple of weeks unexpectedly or I would have died. Let that sink in. DIED. I lost a friend in that crash.

Saving lives & taking names - nah, just doesn't happen. If that's what you are looking for, I'm afraid you are going to be very disappointed. I did a lot more "lifesaving" as a medic. You are getting folks from "point A" to "point B". And your customer is NOT the patient is most every case. Disappointed yet? Yeah, me too.


Ideally, you SHOULD be well prepared. Now, that means high end nursing experience. Not because you are seeing the "sickest of the sick" everyday, but when you do, you want to be PREPARED. It will happen. 3-5 years of high acuity experience is essential. Now, does ER count or do you need high acuity SICU? if you have to ask - you already know the answer.

if you can run 4 code rooms by yourself, and take care of 3 ICU holds on a regular basis - yep, your ER experience counts. If you only work abdominal pain, ortho injury and the like - and can't manage a "really sick patient" - no, your ER experience is not enough. Sorry. Just not going to be well prepared.

But, can you get a job flying with only THREE (3) ER experience?

There is a proliferation of flight programs in some parts of the country and they advertise and hire with ----

"three years of ER or ICU nursing experience" so, the short answer is YES, you may be minimally qualified by that metric.

Additionally, they want ACLS, PALS, PHTLS (this is a field trauma course), NRP, and ICS/FEMA training.

After you are hired, training becomes a BIG part of your life. You will be expected to become an instructor in the above disciplines - in short, there is no place to hide in this profession. So, think carefully. For every hour I spent on the aircraft - I figured I spent well over 10 in preparation of some type.

So, while you could be hired with 3 ER years - and you "get your dream spot" - what if your partner is a medic with 3 medic years on a semi-busy truck - and you two get a really sick ICU patient. It happens. Will either of you really know what to do? Lifesaving sounds good, till you get out of an aircraft KNOWING you didn't know what the heck you were doing. But, hey, it's a dream job? My point - just because you can, may not mean you should.

If you want to do this job -- KNOW what it entails. PROFESSIONALLY. PERSONALLY. Be willing to do it right. Get the experience. Get the education. Set the standard for yourself. A personal standard.

The RISKS are real. Occasionally, you will be rewarded with a patient outcome that does bring a smile to your face - though they are rare. All in all, it is a JOB.

The money is marginal compared to hours worked. The amount of butt-kissing that goes on it that industry is astonishing (to be fair, I'm not currently flying) - it's a "you call, we haul" fly everything -- mother, jugs and speed at 1500 feet above ground at 150mph. If they have a hurt finger, infected toes, abdominal pain - you name it. It's out of control. No one tells the calling hospitals NO. We fly folks from medical floors, to medical floors -- not ICUs. Not worth risking your life for IMO. The referring hospital just wants the patient out.

Think carefully. Carefully look at any program you are considering going to work for -- also, consider how much competition that program has -- it will change the way all programs operate.

Good luck!

Specializes in Clinic, treatment nurse, skilled nursing.

Thank you for sharing

It's apparent the people replying with negativity are most likely not flying any longer due to "burn out". Those with the negative attitude should stay on the ground. If you are carrying this type of attitude in the air you are doing a disservice to your crew and your patient.

The majority of FNs ARE the creme of the crop, who have the skills and critical thinking required to perform autonomously under environmental, physical and mental pressure.

Working for a HELO service that puts crew safety and clinical education as top priorities is essential. These are the services that utilize resource management as it was designed. These are the services not doing point A to point B medical transfers. The majority of the transports are ICU to ICU or ED to ED or ED to ICU transfers as well as trauma scene calls.

FN are a special breed, who have proved they have what it takes to save lives, acknowledge the inherent risks, embrace education, know their limits and are doing it for the love of the job, not for a huge paycheck, ego building or getting off on time.

The success of a FN is equally proportionate to the caliber of the HELO service they work for. Choose wisely.

Specializes in Peds/Neo CCT,Flight, ER, Hem/Onc.
It's apparent the people replying with negativity are most likely not flying any longer due to "burn out". Those with the negative attitude should stay on the ground. If you are carrying this type of attitude in the air you are doing a disservice to your crew and your patient.

That's the biggest bunch of BS I've seen in a long while. Are YOU a flight nurse? The OP is an LVN with one year of experience in a nursing home. She doesn't have a clue what being a flight nurse is. Her "article" paints a Hollywood image of the specialty. I corrected her inaccuracies. I loved being a FN. I quit the year 36 people died and my company refused to provide NVG's for the crew. Guess what... I WAS part of that "special breed" and I was successful at it. No burnout here. I just didn't want to die in an ill-equipped aircraft. But hey, thanks for the judgmental attitude and personal attack.

No personal attack. Only stating there is no room for negativity or bitterness in the HELO. This a HUGE safety issue for the crew and patient. Choosing the right flight program is the major point. Education and safety will be their top priority. If the FN has the support they need, they are more likely to have job satisfaction. No program is fail safe. The opinions of FN from different types of flight programs are going to produce different perspectives concerning job satisfaction, job expectations and overall opinion. I fly for a great program that provides all the resources I need for success and safety. I'm not a glorified ALS provider in the sky. We rarely fly medical patients from A to B. We don't minimalize the specialized training of a FN and acknowledge FN are held to a high clinical standard. We acknowledge we have late calls and yes we like to get off on time, but duty calls and we leave our opinions at base and go do what we have trained for most of our nursing careers. At the end of the day, we have made a difference in a least one person's life. That's why we do what we do. It's all about perspective and what type of flight service you have worked for that molds your opinion. Again, choose the flight program wisely. It will make or break you. You made the right choice to leave a program that refused to have NVGs.