astn

Sorry to be the bearer of bad news, but HEMS is currently in a "bubble." As an example, you look at Philadelphia (where I'm from) and you'll see 6-7 helicopters all covering the same territory, based on a 10(!) minute flight time. If you were to open that up to a more reasonable 20 to 30 minute response time, there would be over a dozen helicopters (probably 16-18) all vying for the same territory and business. This is for an area where you can spit and hit a trauma center or burn center, either adult or pediatric. That level of "service" isn't viable. Out in the sticks, there is more of a need, but it is harder to support the service, plus you have a more "rural" attitude towards emergencies. People who live 90 minutes from the nearest town tend to accept that it's gonna take a while to get to the hospital. The problem though is that these areas can't support a flight service based on call volume. Prehospital response can't support a helicopter, and there isn't large enough interfacility need in the country. If a helicopter doesn't make money, it isn't in business (medicine is a for-profit venture, y'know.) The problem is, most of the HEMS interfacility transports are unnecessary, and largely for the conveience of the hospital rather then a need for urgent transportation (as strangely, some of the most critical cases aren't stable enough to go by air). Insurers (and patients,) who are getting stuck with ridiculous transportation costs, have already been paying close attention to reimbursements, and while they haven't really pushed back yet, you can feel it hanging there. With ObamaCare, a lot of changes are going to occur with insurers (as they will likely get more power then they currently have over the practice of medicine) and HEMS will take a hit (it's inevitable). That's going to mean a lot less jobs for flight nurses/medics, and lower pay as well (as people would do it for free if you let them). It's not a career field I'd want to aspire to. Ground critical care, on the other hand, may become a big deal, but that's another post, and not at all sexy.

There are a lot of threads on this, so it's worth searching. The best place to find the specific requirements of the position is via the service's page, as they all lay out both their requirements and preferences. In general though the short answer is you need to get a job in the ICU and work there for 3 years. Pick up every alphabet card you can get your hands on. Try to get your paramedic card. I'd try to float into the ED if I could, or get a per diem/overtime in the ER at the hospital you work. You may also want to consider some other options, as there is the strong potential for a major realignment in the next 5 years with regard to flight services. There are currently too many helicopters in some areas, troubling safety records, and some significant problems with finances. Once you lump in nationalized health care (assuming that exists after the Supremes get done), heli-EMS is going to be around, but hurting.

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.

Your intrepretation is correct, but it doesn't matter, as the rule is bipolar as hell. If you are "on call on the employer's premises" you are "working while "on call"", and need to be paid for those hours. However, DOL doesn't care what you get paid, they only care that your total income is greater then minimum wage. So long as you are compensated at a rate greater then $7.25 (or your state's minimum wage) when including the overtime calculation, you're going to lose the fight. If you make more then ~$380/week, DOL is satisfied. Technically speaking, I believe there is case law that would support you being paid your full rate for the on-call working hours, but the hospital can simply adjust your base rate to make the weekly pay work out the same, which ultimately hurts you as now you make less when on legitimate overtime. You have no options aside from the potentially destructive (union, quit, or "blue flu"). Sorry.

Never in one of your classes, but we move in the same internet circles. I've seen your name either directly on indirectly on several mailing lists I am on, and I know people who've taken your reviews in Dallas.

Deep breath, Rio.. Mark is actually a "known" quantity in the world, as has all the alphabets because his primary(?) source of income is education--and it's hard to teach a review course if you can't show people you've passed the test. It's also a reasonable question to ask: There is no central clearinghouse for jobs (aside from flight web, which isn't comprehensive) and he did state that looking at all the different individual companies is cumbersome, so I'm not sure how it's "slothful" or you're "spoon-feeding" him information that he already clearly stated. Short answer--there isn't a clearinghouse that I know of. ADAMS Atlas & Database of Air Medical Services is what it's called, which could be helpful for your jobseekers, so they know what services exist in their target area.

I'm very late to the party, but I don't come here much. I would recommend making a new plan. Limited motion sickness is an acceptable thing, but not so much that you need medication. I start to get queasy during long-rides in the back of the ambulance when there isn't a patient (as the RN where I am typically moves from truck to truck depending on the run) but once there is something to think about (the patient) I've never been motion sick. Now, I just tell whoever is in the front-right to get in the back when we're going to/from the transport (RHIP) and then I never have to deal with it. As far as making yourself more marketable, working peds is probably one of the more valuable things you can do, as there are more open jobs with pediatric transport services in my opinion, but if you have both peds and adult, you're golden. I wouldn't worry about the background check, as it is no more stringent then another hospital employee (and if you work for a private service, usually much less).

EPIC will never be the "best" system, but it is highly configurable which is why hospitals seem to love it. That said, it's only as good as the people implementing it, and since they are usually bean counters or people so far removed from actually doing work--it generally sucks. The -BEST- thing you could do for yourself and your department, is convince as many members of your staff as possible to get on the working committee (if they have one) so that you can trial it and lobby to have it set up "well" for the ER. Many times, the folks upstairs are the only ones who have any input (ER doesn't seem to participate in these things, I've noticed) so it's marginally usable for someone on a floor, but completely unusable for the "treat and street" life in the ED. Since they sunk in a lot of money, you spent your time ******** about the fifteen screens of data you have to input, as your time is the least valuable commodity the hospital has.

Exactly as she says. You could have the log tattooed on your ass, and HIPAA wouldn't care. HIPAA cares about who you disclose the information to, not what information you keep. You would have to take reasonable precautions to prevent an accidental or unintended disclosure though (meaning you should keep it secured somewhere). However, as Debby says--your hospital probably has a policy against this behavior as part of their HIPAA compliance plan, therefore while it's not a de facto HIPAA violation, it would be against policy and could subject you to discipline if someone at your place of employment felt it was inappropriate. It would also be discoverable if there was some sort of legal action.

This isn't going to make you feel any better, but from my job search several years ago, I remember a very nice HR rep advising me that if I didn't get a job 6 months out, I wasn't going to. Once the next class graduates, you move to the bottom of the list. You've got the exact same knowledge as the newer people, but it's fresher in their brain. You may want to consider either moving to an area where they are desperate for help, going back to school for a higher degree in nursing, or if neither are an option, an alternate career field. Either way, good luck, and sorry.

It's a pretty boring but generally easy job. Most of the time you're just doing routine transports that aren't in any way "critical care". Since you're in New Jersey, which (so far as I know) doesn't allow Paramedics to do ALS transfers, you're going to do even more BS then an average transport nurse. I have heard that in northern NJ either they are trialing or have allowed paramedics to do some ALS transfers, but since it's new for the state, I'm sure there will be teething problems. Most of the peds tend to go by a pediatric transport service affiliated with a major tertiary care center instead of via the regular service, though since I don't know which service you're talking about it's possible you'd have to do both. You're almost entirely on your own, and have to exercise a lot of independent medical judgement, as there isn't anyone or any time to get orders or instructions from medical command once you've taken the transport. You also don't have the help that you're used to from working in a hospital. I haven't had a lot of patients code on me during transport (maybe I'm just that good) but when it does happen, It's just me, or I may be assisted by a paramedic. It's a different job. Most of the people I know who are successful are former paramedics (or at least EMTs) and used to working on their own without the resources of a hospital, but I do know several who had no prior "street" time and know of many more.

Many hospitals are going that way, though RNs are normally wearing either Navy Blue or white. Not all hospitals in Philly have implemented this though, and I know even less about the surrounding sub-/ex-urbs. For what it's worth, since no one is replying.

Travel and agency nurses, from what I can tell, is a pretty raw deal regardless of where or who you're working for. Competition was pretty fierce when I was talking to recruiters, which drove rates down well below regular per diem rates. In fact, some open positions paid less hourly then my staff position. The highest agency/travel position I've seen advertised locally is "up to $40/hr" which is around per diem rates locally, and at best marginally better then a benefitted staff position (much less overtime). It -seemed- to me that a lot of the agency people I bumped into were doing so while they were trying to get a staff position (as the job market still isn't very good). I do see some travel positions posted (actually quite a few of them for the region) but I don't have much more to offer. Personally, I would recommend AGAINST looking for travel work in the Philly/Camden area. Outside of the metro area, it might be better, but I don't know. It would be very easy to get screwed here if you don't have local knowledge, and the money isn't worth it.

I rode a motorcycle to work every day, unless it was going to rain on my way in (then I would beg my wife to drive me). In the *ssh*le of Texas, it's 100°F+ throughout the summer. I didn't have any problems, but I don't wear safety gear in the summer, and I don't have much stop and go. If you're 'all of the gear, all of the time', stop 'n' go, or in a very hot and humid place, it's going to be a consideration. My biggest complaint was riding -home- in the rain, but eh.

While it's unlikely you'd ever see this done, it's even less likely at a "real" trauma center. It's an ATLS skill solely for the sites that don't have ultrasound (much less CT) available. That said, as far as a diagnostic skill goes it it pretty worthless. If there is a high suspicion of an ABD bleed, you'd be better off sending it out anyway as once you perform a peritoneal lavage, you've just killed those other two tools (which will give much better, more complete information anyway.) From a historical standpoint, however, it's an interesting skill. It makes you appreciate the technology we have now.