Wilderness/expedition nursing

GilaRRT · Apr 8, 2008

Check the dive medicine and hyperbaric specialties as well. Very specialized areas. Mixed gas diving, saturation diving, and decompression is a very specialized field. In addition, many of these jobs will take you off shore. Flight nursing will help in that you should receivetraining in altitude/aerospace physiology, environmental physiology, gas laws, and basic survival.

I cannot offer much help in the way of "expedition nursing." I understand that many remote areas frequently explored have clinics and physicians. I think these positions are at a premium and it takes knowing somebody or being well known in the field to get an "in" with these positions.

You may consider working for client based service companies that have remote clinics. These companies focus on medical support for mine activities and oil companies who have projects in remote areas of the world. Africa for example.

Rio, ASN, RN · Apr 8, 2008

Wildernessgal,

Most big expeditions, especially in the Himalayas have team Physicians on board. It is very competitive and only a few slots for a lot of interested individuals, some serious and some just living a pipe dream. What expedition skills/experience do you possess? (Technical rock and ice, mountaineering, whitewater rafting/kayaking, canoe tripping, skiing alpine/nordic, sea kayaking, etc...) I presume you are already in excellent physical condition and are able to carry loads at high altitude. Have you done any climbing or trekking at altitude?

The best way to get your foot in the door is by networking. I have never seen an ad placed in any journals, “Seeking Doctor/Nurse/Paramedic for expedition must be able to suffer and work for food.” (Just joking but I have not seen any ads… really.)

Teaching is always a great way to get yourself noticed. (Its also is a great way to get into flight nursing.) Just my own opinion but I think RN/Paramedic would be an advantage. Here is a link to help you get started: http://www.wildmed.com

I entered the nursing profession via my work as a Ski Patrolman and raft guide/kayak instructor and currently work as a flight nurse. If you have any questions feel to PM or e-mail me. Good luck, sounds fun.

Rio, ASN, RN · Apr 8, 2008

Also check into NOLS, Outward Bound etc.. It may not be exactly what your are looking for but it is still networking.

Quickbeam, BSN, RN · Apr 8, 2008

My husband is a 30 year professional wilderness guide and mountaineer/climber/educator. It is an extremely hard field to crack, let alone make a living at. Being a nurse would give you a great resume point to gain admission. He does stress that you'd need to be proficient at the wilderness skills...everyone on trips has to be competent at the skills (ice climbing, mountaineering, kayaking, etc).

His suggestion is starting with a NOLS (National Outdoor Leadership School) class or an Outward Bound experience. Get climbing and high altitude experience. You'll need to find out if you get altitude sickness and you won't know until you've been there.

There is a certification available through Wilderness First Responder that's kind of like first aid in the wild. DH says the courses are very good.

There are great climbing/kayaking specialty programs all over the US.

While being a nurse would help your ability to get into these programs and gain expertise, wilderness trips are not falling over themselves to accommodate a nurse (I know this first hand!). Your key will be wilderness skills expertise.

CraigB-RN, MSN, RN · Apr 8, 2008

The other thing to keep in mind is that depending on the expedition/Venue you might have to get a union card. I applied to supply medical care to an eco-challenge and had to get a SAG union card. In the end, ti didn't happen.

Check out the different wilderness EMT type courses. Join the wilderness medical society, things like that. get lots of trauma training. When I was doing things like that, I worked as an agency nurse so I had the most flexibilty in scheduling.

wildernessgal · Apr 9, 2008

Thank-you everyone for your help with my dream. I was just feeling a little lost in what I needed to do and this helps

mtnmurse · Jul 22, 2008

Wildernessgal,

I am about on the same track as you. I am also a BSN student graduating this August. I am trying to start in the ER or ICU in a level I or II trauma hospital.

I have been researching how to break into the field of wilderness nursing. It is true that you need to be competent in all skills related to outdoors. Make a log of all you accomplishements. The flight nurse direction is good. There is also a RN to Paramedic bridge course offered at Crieghton University.

If you find any other information let me know. I think someone should start a masters program in this field. Good luck to you.

GilaRRT · Aug 18, 2008

Another route to consider is remote medical support. I recently started working for a company that provides remote medical solutions in various areas throughout the world. After a brief stay in Dubai, I am currently working out of a small compound in Afghanistan. We provide emergency and primary care to clients. Mainly contractors. (Security, communication contractors, building contractors, and the like.)

In addition, we provide Medevac services for clients who require subspecialty (or any specialty for that matter) care and stabilization that is not available in theater. Thus far, the experience has been incredible. Simple concepts we take for granted every day in the US are complex and time consuming over here. For example, you will learn all kinds of different medication names and indications. Who knew you could give Tramadol IV? Language and communication barriers are also difficult to work around and logistics is very complicated. Some stuff we buy in theater, some stuff is a quid pro quo drug deal, while other stuff comes from other countries.

Omnium_Gatherum · May 3, 2010

Getting your BSN and your CFRN is going to take long enough, without getting your EMS as well. Most Air Ambulances also require several years experience in the ER or ICU before they will let you fly, even if you have your CFRN.

I would work a few years in ICU and ER. Get your CCRN and/or your CFRN.

If you are interested, Barrow (Alaska) does a MedEvac course. Alaska is a

good place to break into 'remote nursing'. Most hospitals that are not road

accessible (Bethel, Nome, Barrow, etc) require you to train in MedEvac.

Before you do any of that you'll need your ACLS, PALS, NRP and TNCC.

As you can see... that all adds up to a lot of study and experience. You

really have to be focused and commited to the goal.

Raytheon (rayjobs.com) offer jobs for civilian flight nurses in the Antarctic.

Or, what about joining the Air National Guard as a Flight Nurse - that would

be the best kind of experience you could get as far as wilderness/medevac/

flight nurse experience goes.

Also, join your local 'Search and Rescue' volunteer group. They will put you

in touch with a wider range of people in the 'wilderness/survival' field.

You can also get your SAR Tech certification.

In the process of doing all or any of the above things you will most likely

come across an opportunity that opens itself up to you for what you are

looking for.

DareBear · Jul 31, 2010

check out http://www.gmrsltd.com/WemPro2.html - this course will show you if you can handle wilderness medicine. I'll give you the run-down, the course takes place 14 miles in the middle of the Belizian jungle. You sleep in tents on cots in 90-100 degree swamp weather and bathe in a swamp that hopefully doesnt evaporate by the 20th day in! wake up every morning for class (which is outside, there are no indoors here) and after about 4-5 hours of class they take you into the jungle for a scenerio that make last 1-12 hours.. you dont know because its the "expedition setting" and you may end up in one of hundreds of caves with bats, spiders, you name it, or some random swamp or mixture of swamp-cave depending on the time of year. The scenerios can be from basic rescue, to full on blood transfusion in the feild with a class members blood! obviously its not forced upon you, and they check for blood type and all that stuff. Who needs a OP, or NP, or even intubation in the feild? are you really going to carry all that stuff with you on an expedition? NOPE! you carry a airway kit thats the size of a soap dish, you need an airway? safety-pin the tongue to the cheeck! its life over limb out there and this course will show you if you can or cant handle it. I paid about $4k in 08, I dunno if things have changed but this course is well worth the $$. its for anyone with an EMT and up, I recommend anyone with at least ALS skills AT LEAST! let me know if you need more info on it. goodluck!

GilaRRT · Jul 31, 2010

Actually, I have found nasal airways to be critical for airway management in the remote setting. Typically take up less space, rather easy to place, better tolerated and harder to dislodge than their oral counterparts. I once managed a patient who had a prolonged episode of seizures followed by a prolonged episode of being unresponsive with a nasal airway for a couple of hours until he could be evacuated by aeroplane.

I would not recommend a safety pin through the tongue or cheek. If dislodged or compromised, you can expect copious amounts of blood in your airway and a significantly compounded situation. Nor do I suggest aggressive infusion of any fluid (blood or otherwise) until the source of bleeding can be managed. The literature on permissive hypotension and damage control resuscitation is rapidly changing that paradigm. I would also say that this literature comes from people providing health care to traumatic injuries in austere settings.