Not your usual questions

offlabel · May 22, 2018

"Most" medical transport by rotor wing do not merit that mode of conveyance, i.e. ground transport is appropriate and preferable most of the time.

PeakRN · May 22, 2018

1) Is it possible to get a job in a rural area instead of a city? I really want to move to a more rural area one day.

Our flight program rotates medics and nurses throughout all of the bases, most of which are in the city but there are a couple of rural bases.

2) How do you find companies that do a decent amount of scene calls? I miss my days of being a paramedic and even a few scene calls here and there would be nice.

You'll have to call and ask. Around here 80% transport is about the norm for all of the HEMS services.

3) How common are the totally unnecessary transports? I know it's part of the business, but some of you here, as well as someone I know that worked for a large hospital based company, made it sound like it was complete bull crap all the time. I know everyone has different experiences, so I'm curious what you all think about this part.

The vast majority of transport is either unnecessary or above the level needed. Most helicopter transport would have been stable for either ground or fixed wing. Most CCT could have been transported ALS, et cetera.

4) Is experience at a tertiary care center good enough, or is Level I trauma center experience really necessary?

This will also depend on the group. Ours prefers at least 2 years of critical care experience with one in the ICU or PICU for the general transport/911 spots, though on average nurses have at least 5 years of critical care experience when starting. We do not particularly care about level I experience, trauma is a small portion of what our crews respond to and is one of the easiest patients they can encounter.

Our specialty teams require experience within their area of expertise (NICU, Pediatric, and OB teams).

ScottMedicRN · May 23, 2018

How does rotating bases work? Do they just tell you that you have to drive far to work and you have to just suck it up and do it?

I'd imagine rural actually gets MORE unwarranted transports due to extended driving times alone, but rural living is something I want in life.

I get that HEMS gets abused a lot, I'm just curious HOW bad it really is. A guy I know worked for Johns Hopkins and made it sound like they were flying walking/talking people regularly. They also did 0% scene transfers. He eventually lost it and quit on the spot. Just wondering if that's an exaggeration.

I've done transport before and I know it's about the money, I just would hope to have a decent amount of interesting critical care cases here and there.

Just want to hear what it's really like. It seems 50/50 love/hate on this message board.

PeakRN · May 23, 2018

How does rotating bases work? Do they just tell you that you have to drive far to work and you have to just suck it up and do it?

I only work on a specialty team so I don't know the their exact bidding process, but they typically spend a few months at a base before they rotate. The nurses and medics can switch shifts with those at other bases if they wish. Specialty teams have a fixed base and with rare exception those nurses and RTs don't pick up or switch shifts at other bases. There are so many people who want to get in that they have to basically take what they get, the competing system does the same thing.

I'd imagine rural actually gets MORE unwarranted transports due to extended driving times alone, but rural living is something I want in life.

It depends on what you consider unwarranted transport. Does flying a IA candidate who is otherwise stable for a bus warrant the transport? Time can be a very legitimate reason for flight. Most of the patients that get flown into us should have been okay to stay at most hospitals, but are beyond the capabilities of critical access hospitals.

I get that HEMS gets abused a lot, I'm just curious HOW bad it really is. A guy I know worked for Johns Hopkins and made it sound like they were flying walking/talking people regularly. They also did 0% scene transfers. He eventually lost it and quit on the spot. Just wondering if that's an exaggeration.

Back when I worked in Fire we would fly out strokes if they could fly faster than I could have driven them in the bus. Those patients would have been fine with paramedic level care.

We do get quite a few fixed wing and flights in that I would never have flown, but the sending facility just wasn't comfortable with sending ALS or CCT bus.

I've done transport before and I know it's about the money, I just would hope to have a decent amount of interesting critical care cases here and there.

Just want to hear what it's really like. It seems 50/50 love/hate on this message board.

I hate flying, and my specialty team is ground based. We only fly if we have to, and we have a helicopter flown out to us on scene. Sitting in a burning hot or freezing helicopter and hoping we don't hit a power line just doesn't do anything for me. I would put myself more in the 'hate' category, but I also choose to not have it be my career since I work primarily in the ED of the hospital we are based out of.

ScottMedicRN · Sep 26, 2018

Since this post I've been collecting certs. By the end of this year I'll have everything I can think of. BLS, ACLS, PALS, NRP, PHTLS, STABLE, Paramedic, CCRN, ICS & NIMS courses. I have a job lined up for ground transport as well. I'm going to do ride along with local flight programs. My hospital also has a Flight Program, which means I could have a shot at a decent salary. I'm hoping all of this will up my chances. I'll have more questions for you all as I get more ICU time in.

Being in EMS for a long time, I do fear that I could experience burn out like I eventually did with EMS, but I feel like pre-hospital is my passion. I want to pursue it.

Honestly, my biggest concern is being able to find a rural service. I want to live in the country, even if it means relocating to a totally different region. I'm not a city person, haha. I guess I'll have a lot of research to do in that regard.

medic9872 · Nov 14, 2018

What state are you in? I'm in GA and most of the bases within about 75 miles of my house are rural. The trend here is to keep the helicopters in the places that the calls originate rather than sending them from the cities to the calls as it's a delay. They do a mix of scene calls and transfers. I would suggest that you ask the individual services about the specifics and talk to the crews. I have been missing my EMS days and I think this would be a good way to use all of my skills.

I actually had an interview today with one of the big flight services in my area. I have 7 years EMS (5 as a medic) and just under 5 years as a RN (primarily ER, some ICU in a small hospital). I aced the tests and I think the interview went well. I have my ACLS, PALS, BLS & BLS instructor, GA EMS instructor (I think this was a huge selling point), some of the NIMS courses (100, 200, 700, I think), and TNCC. I was a bit surprised that I got an interview and even more surprised at how well it seemed to go. Ultimately I think that experience and certs are how you get your foot in the door, but it's up to you and your personality from there. I think it also depends on how competitive your area is. For the services in my area, they prefer experience in education as they do a lot of community outreach and a lot of training. They also expect you to be customer service oriented (I know, we all hate that lol). I think this company is a good fit for me personally and I really hope they offer me the job. I should know something in a couple weeks.

RickyRescueRN, BSN, RN · Dec 5, 2018

Since this post I've been collecting certs. By the end of this year I'll have everything I can think of. BLS, ACLS, PALS, NRP, PHTLS, STABLE, Paramedic, CCRN, ICS & NIMS courses. I have a job lined up for ground transport as well. I'm going to do ride along with local flight programs. My hospital also has a Flight Program, which means I could have a shot at a decent salary. I'm hoping all of this will up my chances. I'll have more questions for you all as I get more ICU time in.
Being in EMS for a long time, I do fear that I could experience burn out like I eventually did with EMS, but I feel like pre-hospital is my passion. I want to pursue it.
Honestly, my biggest concern is being able to find a rural service. I want to live in the country, even if it means relocating to a totally different region. I'm not a city person, haha. I guess I'll have a lot of research to do in that regard.

It sounds like you have most of what is required for a Flight position. I would recommend a Trauma Course as well (Transport Provider Advanced Trauma Course -TPATC is the one which is CAMTS approved presently).

I have been a flight RN for a very long time and have seen volume at all programs generally decline. A lot of this has to do with the numbers of helicopter bases that are popping up all the time , diluting the actual call volume in any given area. Many of the rural areas transport pretty low acuity patients as they cannot afford to have their ground ambulance out of the area/ county for an extended period of time so turf it to the local air ambulance (which is a complete misuse of an expensive resource) .

If you speak to RNs at most flight programs you will find that the larger percentage of their call volume are IFTs and 911/ scene work can be limited. Personally , I find the really acute IFTS a lot more challenging and critical than the majority of seen calls that I go on.

Please let us know how you progress and when you get a transport/ flight RN position.

Best of Luck!

ScottMedicRN · Apr 20, 2021

An update:

I’ve since been working ground critical care transport for a very large hospital. We routinely have critical patients. I have even done a flight or two with our flight team in an emergency, but typically flight is a different company from us.

Added trauma cert. done airways labs. All of that stuff. I personally think I could get a flight job with my resume, especially the ICU and paramedic experience, but here’s the kicker.

Im not really interested in flight anymore. Im more leaning towards NP school. I’m not sure what happened. The helicopter itself is cool, but the patient care just isn’t exciting me anymore. And I’m not sure if I want to do two 24 hour shifts PLUS training and on call. I highly value my free time, and I’m just not as gung ho about flight like other guys I know who are just dying to get in, but don’t have my experience. I don’t have ptsd, but I’m not even sure I want to see traumatic scene calls anymore.

yet a base just opened near me, and part of me wants to apply, yet the other part lacks the motivation I feel like one should have for orientation as a Flight RN. Not just another job, but that’s how I feel it would be.

I've thought about applying, but I’m not sure what to expect with hours either. Two 24’s is the max Time I could give