Flight Nurses

Flight nurses provide care when speed and judgment are both paramount. They care for critically ill and injured patients during transport, working as part of EMS teams. Often the team consists of one nurse and one paramedic — and of course the pilot. (Flight nurses need a lot of skills, but flying isn’t one of them.)

Flight nursing is a competitive branch of nursing. There is a high level of responsibility involved in treating critically ill or injured patients away from a hospital setting. Strong candidates are those who have accrued quite a bit of experience working with critically ill or injured patients inside a hospital or ER setting – and who have taken the time to prepare themselves through study and certification.

Flight nurses may travel in helicopters or fixed wing aircrafts. Sometimes patients are taken directly from the scene by air. Often flight is inter-facility: The patient is being taken from one facility to another. The local facility does what they can to stabilize the patient and keep them alive until they can be taken to a facility that is better equipped to handle the level of acuity or the complexity of patient needs. Typically this is a Level I or Level II trauma center. Sometimes patients are infants or children on their way to facilities that can handle their acute needs.

Some flight nurses are hired by companies that do international flights.

Becoming a Flight Nurse

It takes multiple steps — and quite a few years — to become a flight nurse. A person must first become an RN.

Prospective nurses need to earn a degree in nursing and pass a licensing examination. While many RNs still enter the field with degrees at the associate’s level, the bachelor’s is the degree of choice for this specialty area. A nursing student can expect an introduction to a variety of nursing sub-disciplines. He or she can optimize nursing school experiences to be better prepared for critical care. One way is to try to secure a senior practicum in a high-acuity setting.

Ultimately, prospective flight nurses need some experience in emergency or critical care nursing. Employers typically want to see at least a few years of experience in that capacity.

While employers may specify three years of experience in either ER or ICU, these are separate specialties that appeal to different personalities. Critical care may be better. Having both types of experience can be an advantage.

Unlike emergency room nurses, critical care nurses work with a limited number of patients, but they work with them over an extended period of time. There are varying levels of specialization. An RN may work in a pediatric ICU, for example, or a cardiac ICU. Emergency room nurses see a wide variety of patients and often they need to assess situations very quickly. Many patients seen in these settings, though, do not constitute true emergencies.

Experience beyond the minimum can be a boon. Med Evac states that three years of ICU is their minimum, but the typical hire has seven to ten years of experience (https://www.medevacco.com/flight-team.html).

Flight nursing is a field that is clearly not for every nursing personality. Physical fitness is a consideration, as one 16-year veteran of the flight field notes; she states that on occasion, retrieving a patient requires climbing or even rowing (https://www.youtube.com/watch?v=PBu7zE3F4p0). A flight nurse will need situational awareness and the ability to make decisions quickly.

Flight nurses need to work more autonomously than nurses in most settings. Gypsy Nurse, an agency that places nurses in short-term assignments, has provided information about some of the skills flight nurses need to master – and need to utilize regularly to carry them out in difficult circumstances (https://www.thegypsynurse.com/blog/getting-flight-nursing/).

Flight nursing is a type of transit nursing. A person can get some sense of what it’s like to be involved with emergency services by becoming an EMT; the initial training is relatively low. A person who goes the nursing route will have different career options than a person who goes the paramedic route. And one who makes it onto the flight crew will typically enjoy a higher salary than his or her paramedic partner. Daily Nurse published the story of one flight nurse – a former EMT – and his pathway into the profession (https://dailynurse.com/one-step-at-a-time-a-nurses-journey-from-emt-to-flight-nurse).

Pediatric Life Flight

Some transit services are specific to neonatal and pediatric populations. The way to get a position in this sub-discipline is to work with similar populations on the ground. Again, the focus should be on emergency/ critical need. Some neonatal nurses spend some time in the NICU and some time in the air. Neonatal nurses need Neonatal Resuscitation Program (NRP) certification.

Professional Flight Nurse Certifications

Employers seek certification. There is one professional nursing certification specifically designed for flight: Certified Flight Registered Nurse (CFRN); it is granted by the Board of Certification for Emergency Nursing (BCEN).

Other related certifications can be considered during the transition period. Life Flight Network Kelso, for example, stated that the hire would need the CFRN within two years; it was strongly preferred that those who did not yet have the CFRN hold the Certified Emergency Nurse (CEN) or Critical Care Nurse (CCRN).

A flight nurse will need an advanced trauma care course. Flight nurses, and those planning to make the transition, report taking a lot of specialized courses. Among those that can prove useful are courses in obstetrics.

Resources

One can find links to many air transport services on the website of the Commission on Accreditation of Medical Transport Services (https://www.camts.org/services).

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