A flight nurse (also known as aero-medical nurses) is a highly trained registered nurse who provides emergency medical care to all types of patient’s while they are being transferred to the hospital via aircraft.
Rescue operations and/or aero-medical evacuations may take place aboard various aircraft’s such as jet aircraft, propeller aircraft and/or helicopters.
During these situations an aero-medical nurse may be accompanied by an emergency medical crew or critical care air transport team to provide the patient(s) and on-board nurse with additional medical support and expertise, however in some cases these on-board nurses may also work alone on flights that do not require a medical team and/or additional medical support.
A medical support team may include various medical specialists such as flight paramedics, flight physicians (aka flight surgeons) and/or respiratory practitioners along with the primary aero-medical nurse, pilot & co pilot.
Aero-medical nurses are often used during rescue operations or on aero-medical evacuations when medical ground units (such as an ambulance) are unable to respond to a call or emergency within a respectable amount of time due to long travel distances.
They may also be used in situations where terrain, weather and/or other obstacles may make it difficult or impossible for ambulances and/or other ground vehicles to reach a patient or a group of patients in need of immediate emergency medical care such as after an earthquake, on icy terrain, in areas surrounded by mountains, hills, trees, and water or during times when a traffic jam may prevent an ambulance from gaining access to injured people involved in a major car accident.
Aero-medical nurses are in charge of providing in-flight management and medical care to all types of patients and play a primary role from the beginning of the evacuation until the patient reaches the hospital.
During aero medical evacuations these nurses are responsible for facilitating proper patient care and providing their patients with a comfortable experience while ultimately insuring their safety as they are being transferred to the hospital.
In addition to evacuating patients and providing them with a comfortable transport they will evaluate the individual needs of the patients on board, monitor their vital signs, provide patients with Intravenous therapy (IV’s), dress wounds, apply splints to broken and fractured bones, request the appropriate medications, supplies and equipment for each patient based on their medical needs and initiate emergency medical treatment to patients in the event that a flight physician is absent or unavailable.
In some cases they may also be responsible for the planning and preparation of aero-medical evacuation missions and will coordinate plans with the pilot and medical crew to expedite the process and ensure that proper procedures are being taken.
Flight nurses are on call 24 hours a day 7 days a week, however to avoid burnout and fatigue most flight nurses work in shifts that are determined by the hospital or health care center they work for.
In many cases flight nurses end up working 6 – 10 24 hour shifts per month.
While flight nurses may be on duty for a 24 hour shift they aren’t always operating on a rescue mission, in fact some flight nurses end up having a lot of down time where they aren’t rescuing people from emergencies or traumas.
When a flight nurse first arrive for his or her shift they go over their standard check up routine which involves doing a shift briefing where they cover any issues that may occur such as possible weather forecasts, safety issues, possible maintenance issues with the aircraft, and any issues or problems that may have come up in the last few days.
After going over the basics the flight nurse then goes through an aircraft check up, checking to make sure all of the (90 +) medications are in good condition and haven’t been used or tampered with, the equipment is charged and is in working order, and all of the equipment is in the correct place in the aircraft so that can be easily accessed and so that the crew will be ready to go at a moments notice in case of an emergency.
Once everything has been check and/or replaced the flight nurses then follow-up with any patients they’ve transported over the last few days to ensure that everything is ok, follow-up with the doctor regarding any procedures that were taking while on the rescue mission and will discuss with the crew any information they have received and go over any lessons, training or learning that has occurred from their previous missions and discussions with doctors/patients.
When not on a mission flight nurses spend a lot of time doing research, training and learning, however they always remain ready to operate at a moments notice if they get an emergency call.
The knowledge and experience flight nurses have acquired through years of training in emergency situations has prepared them to provide the best possible care to patients who are suffering from an illness or injury.
They are educated, fast paced and always focused on ensuring their patients get the best care possible.
Being a flight nurse not only requires a high level of education and training, but the ability to act quickly and decisively, stay calm under intense situations and make effective decisions as a leader.
Flight nursing is just as much about being able to control your emotions and thoughts as it is about being highly educated, trained and in good physical shape.
Because of the intense situations flight nurses are in when they are working in the field they have to consistently be aware of what’s going on in their environment and be able to assess the condition of their patients as quickly as possible if they want to be effective and save lives in the this line of work.
All flight nurse have several things in common when it comes to the mental aspects of their work:
Ability to remain positive under critical/stressful situations
Because of the emergency and trauma situations flight nurses are put into no two situations are the same and no two patients are the same either.
Flight nurses must be able to assess the condition and emotional aspects of their patients as well as the physical.
Patients who are suffering from a trauma may not be completely conscious of their behavior or condition and may even be mentally/emotionally unstable due to trauma they are suffering from.
Flight nurses must be patient, caring, even-tempered and calm in order to keep the situation under control and ensure their patient that everything will be o.k.
Ability to provide top notch care
During flight missions flight nurses are in charge of getting to their patients quickly, determining their ailment, stabilizing their condition and getting them to the hospital or health care facility ASAP where they can receive further medical assistance.
Once they arrive to the scene of the emergency these nurses will question the patient to get a better understanding of their ailment, assess the patients condition, provide any necessary medications, treatments, splints and/or dress wounds, if necessary use a wheel chair or stretcher to get the patient on the aircraft and into a comfortable position, monitor and record the patients vital signs and gather any information on the patient that may be of use to the medical team at the hospital.
Effective leadership and Communication
Flight nurses must be able to communicate effectively with their medical transport team and flight crew members which may include paramedics, physicians and/or respiratory practitioners.
In many cases (such as the absence of a flight physician) flight nurses may be responsible for leading the team in how to provide proper care to the patients while they are being transferred to the hospital.
Education and confidence are extremely important for effective communication and leadership.
Individuals who work in this field have been required to take continuing education courses and certifications to ensure that they can properly assess, communicate and treat patients under various conditions.
Ability to act quickly and effectively
When faced with emergency situations flight nurses must be able to act quickly and effectively in order to ensure their patients get the treatment they need.
A large part of this training comes from their experience working in a critical care setting for several years before becoming a flight nurse and is a vital trait for ensuring the patients survival and recovery.
No two situations are the same when it comes to emergencies so experience is vital.
It is not something that can be read about or watched on a t.v. and it can only be acquired through years of training in the field.
These are just four of the mental traits flight nurses must posses, but they are vital for good communication and proper patient care.
Registered nursing background
When it comes to training flight nurses are highly trained registered nurses who have acquired years of experience and training working in a critical care setting before operating in the aero-medical field of flight nursing.
In fact all flight nurses are generally required to have at least 5 years of experience as a registered nurse in a critical care setting, and all potential candidates must take a number of continuing education courses and certifications before being considered for a position as a flight nurse.
Due to the highly demanding and challenging work flight nurses often encounter while on the job the level of experience, training, expertise and mental aptitude required in handling and caring for patients in need of critical care is of the utmost importance, and hospitals and organizations that are looking to hire flight nurses to work for them are looking for those who can provide their patients with the highest level of care while on the ground and en route to the nearest health care facility.
When it comes to the training and certification that’s required of those looking to work as flying nurses some of the training and certification registered nurses may be required to take before becoming a flight nurse may include working for several years in an emergency care field, gaining several certifications in emergency, trauma and respiratory care, taking aero-medical courses and gaining certification as a certified flight nurse.
The more experience and training a registered nurse is able to acquire during the years in the emergency care field the better.
In addition to passing a number of training and certification courses flight nurses must also be excellent communicators, think on their toes, be able to diagnose and treat patients suffering from traumas, be proficient at operating medical machinery, have a team oriented mentality and be able to respond quickly to unpredictable situations involving emotional, psychological and physical trauma.
All potential/operational flight nurses must be physically fit and able to maneuver easily in all types of environments including the often small medical cabin space that exists within the aircraft itself.
Flight nurses have been known to operate in variety of environments including mountainous regions, at the scene of an accident, in stormy weather and in war zones among other environments so they must always remain in peak mental and physical condition in order to keep their patients, team and themselves out of danger and focused on providing the patient with the proper care he or she needs.
Flight nursing is a very challenging and rewarding field to work in and those who are able to perform at the highest level stand the best chance of being hired for this type of special care work.
Types of aero-medical transport nurses
There are two primary classifications or positions for registered nurses looking to obtain a position as an aero-medical nurse.
While both of these aero-medical nursing types perform many of the same medical tasks, treatments and procedures that are standard among all qualified aero-medical nurses the locations they work in, the application of the medical treatments they perform and the types of rescue operations they are involved in may vary dramatically because of varying roles, responsibilities and circumstances among the two classifications.
Civilian fight nurse
As the name suggests civilian flight nurses primarily operate work for local hospitals, the Government, Federal and State organizations, fire departments, private medical firms and a mixture of other private and Government agencies.
These nurses generally begin their nursing education at a local college or university where they enter a nursing program and study for several years to earn their bachelors of science in nursing degree and pass the national licensing exam.
From there they spend several more years working as registered nurses in an emergency or intensive care setting where they gain the knowledge, training and certifications they need in order to obtain a job in the aero-medical care field.
Military flight nurse
Military flight nurses work for the United States Military and are members of the aero-medical evacuation crew.
These nurses are responsible for the planning and preparation of aero-medical evacuation missions to ensure mission success and provide proper patients with proper medical care and comfortable environment while maintaining ultimate safety standards.
Military flight nurses may or may not operate in hostile environments where they are responsible for extracting patients and providing medical aid to wounded soldiers who are operating in the battlefield.
These nurses may also perform regular routine check ups and medical tests to ensure that soldiers aren’t suffering from any medical conditions/ailments and are able to operate in peak condition.
Other flight nurse positions
Flight nurses play a vital role in aero medical evacuations and rescue missions by ensuring that their passengers receive the medical treatment they need and by making sure they arrive at the hospital safely and in good hands, however flight nurses aren’t alone and are generally accompanied by a team of other medical specialists dedicated to assisting the flight nurse in performing his or her job effectively and efficiently.
Everyone on board is just as important in making sure the aero-medical evacuation goes as planned and that everyone works together cohesive to create a good working environment.
Other medical specialists found on board these types of missions include flight physicians, flight paramedics, respiratory practitioners and the flight crew (pilot/co-pilot).
A flight physician is essentially a doctor who works on board an aircraft.
When a flight physician is present he/she plays a central role in ensuring that critically ill and/or injured patients receive proper medication and treatments while in flight and if necessary will perform emergency surgical operations while on board the aircraft.
These specialists are highly experienced and trained to perform surgery on patients who have suffered from many different types of traumas.
Before becoming a flight physician they have had years of experience working in the emergency room of hospitals or health care centers.
Flight physicians are extremely helpful in bringing their surgical expertise into situations where a patient is in need of emergency treatment due to an accident or trauma which can not wait till they get to the hospital.
Flight paramedics are trained to respond to immediate medical emergencies and can provide basic/advanced medical care to patients suffering from shock, heart attacks, seizures and a host of other trauma and medical emergencies while transporting them to the hospital where the patient can receive a higher level of medical care.
Flight paramedics may perform many of the same tasks as flight nurses such as responding to and treating ill patients, handling patient medications, dressing wounds and providing basic and advanced life support to patients in transit to the hospital.
While they do perform many of the operations flight nurses perform their experience and training is considered as in-depth so they often end up working under an experienced flight nurse on aero medical missions/evacuations.
Respiratory practitioners play a vital role in making sure that their patients aren’t suffering from any heart or lung problems and are experienced in assessing, treating and monitoring those who are suffering from respiratory issues.
These medical experts are in charge of maintaining proper airway management in situations where patients are having difficulty breathing.
Respiratory practitioners may administer drugs or gasses such as oxygen, asthmatic gasses, anesthesia, sedatives and other oxygenated medications in order to provide the patient with breathing assistance and keep their airway clean of debris and other respiratory complications.
Having a respiratory practitioner on board can be extremely helpful, especially during missions that involve patients who are suffering from respiratory issues or individuals who have been rescued from a fire or other similar sort of environment that may inhibit proper breathing.
Finally the flight crew which contains the pilot and co pilot.
While it is pretty self-explanatory without a flight crew there would be no way to operate the aircraft and transport patients to the hospital.
In many cases the flight crew isn’t really talked about or mentioned that much online or in the health care industry however they are vital to the success of the mission.
They have to be able to take the aircraft into locations that are difficult for other mobile response vehicles to gain access to and have to be highly experienced in flying aircraft in environments that aren’t always friendly or easy to navigate in.
Unlike most emergency response vehicles such as ambulances that operate on the ground flight nurses operate in the air so they require a different mode of transportation for getting patients transferred to and from a hospital, health care facility and/or the scene of an accident.
Flight nurses are often called upon when ground units are unable to respond to an emergency a certain amount of time.
In order to provide emergency patients with the quickest route to and from the hospital flight nurses operate on board a variety of fixed wing and propeller or jet operated aircraft such as jet aircraft, propeller aircraft and/or helicopters.
Flight nurses who operate on helicopters are often used for aero medical evacuations and rescue missions where they can fly into a location such as at the scene of a car accident, flood or earthquake , provide immediate extraction for the emergency patient and return to a hospital or emergency health care facility so that the patient can receive proper treatment.
Helicopters are ideal for getting into tough locations that fixed wing aircraft cannot get to and are often found in cities where ground transportation may have difficulty responding to an emergency because of traffic, street lights and/or a number of other factors that would inhibit a timely rescue.
Helicopters may also be found in rural locations where ground vehicles may have difficulty traversing the landscape such as mountainous terrain, forests and snow-capped mountains.
Flight nurses who work on board fixed wing aircraft such as jets are responsible for transporting patients from one facility to another and while they aren’t able to land in a large variety of locations the way helicopters are able to they are the quickest mode of transportation for getting from one facility to another.
In these situations fixed wing aircraft is often used when one health care facility doesn’t have the necessary equipment or staff to provide proper medical care to an on-site patient who is in need of emergency care.
Health care facilities that have air strips and can facilitate fixed wing aircraft may also rely on these vehicles to get patients, emergency equipment, medicine and donor organs where they need to go as quickly as possible, especially when extended travel such as state to state transportation is necessary.
In addition to working for hospitals and health care organizations flight nurses also operate in the miliary where they provide soldiers and other military personnel with all of the same medical attention and may also provide physical exams, check ups and minor medical care to those operating in the field.
Requirements and certifications (Education and Training)
All aero-medical nurses have previous experience as registered nurses and have post-graduate training as emergency medical nurses and/or intensive care nurses.
In terms of flight preparation and training these nurses are experienced and trained in hemodynamic support (support of the movement of blood in the body), vasoactive medications (medication used to increase or decrease blood pressure and/or heart rate), mechanical ventilation (mechanically induced or forced breathing), and a variety of other skills related to intensive care, and are trained and certified in several other areas related to emergency care such as:
- Critical Care Registered Nursing
- Certified Emergency Nursing
- Certified Flight Registered Nursing
- Basic Life Support
- Advanced Cardiac Life Support
- Pediatric Advanced Life Support
- Pre-Hospital Trauma Life Support
- Neonatal Resuscitation
- CPR Certification
- EMS Certification/Licence
Additional training and certification courses potential flight nurses may (or may not) be required to take:
- Trauma Nurse Core Course
- Advanced Trauma Care for Nurses
- Advanced Trauma Life Support
- Commission on Accreditation of Medical Transport Systems
- Transport Nurse Advanced Trauma Course
- TNATC Advanced Provider Course
Hazardous Material Training:
- NIMS Training IS 100, 200, 700, 800
In order to qualify for a position as an aero-medical nurse registered nurses are not only required to have developed these skills and certifications, but in many cases registered nurses must generally have at least 5 years of experience working in a hospital or health care setting that specialize in intensive care.
Note: To find out what types of training and certifications may be required in order to get accepted for a position as an aero-medical nurse it is recommended that you contact several professional aero-medical nurses and hiring organizations in your area or the location you would like to work in so that you can get a good understanding of what types of training, education, experience and certifications these organizations require and are looking for when they are interested in hiring a potential nurses to operate on their plans.
You can also speak with your local hospital or the hospital you work for (assuming they have an aero-medical pre-hospital team) and consult the nurses working in that department or contact your human resources department for additional information and help.
Age & health factors
While there are no specific age requirements for those who are looking to start a career as a flight nurse there are a lot of education, training and certifications involved in order to become certified as a flight nurse which can affect how young a potential flight nurses is when he/she apply’s for a flight nursing position.
Because of the training and certifications needed to work in this field most registered nurses that apply for a flight nursing position tend to be in their mid 20’s to early 30’s.
For starters all potential flight nurses are previously training registered nurses who generally have at least 5 years of experience in a critical care setting.
Due to the advanced education and training required to perform effectively and efficiently in this type of field all potential flight nurses must have at least a bachelors in nursing.
Most bachelor nursing programs can take an average of 4 – 5 years to complete.
Those looking to get accepted into a college or university nursing program may have to first complete a number of prerequisites and maintain a certain GPA standard before being accepted into a nursing program.
Once a registered nurse obtains his/her bachelors degree in nursing it is highly recommended that he/she take as many continuing education courses as possible related to the fields of critical care and flight nursing.
It is also important that he/she obtain any certifications that are related to critical care and flight nursing, and find out what requirements have to be fulfilled in order to become flight nurse certified.
For a list of some of the required flight nurse certifications check out: Flight Nurse Training and Certification
When you take into account the education, training and certifications one must possess before being able to work as a flight nurse it is easy to understand that most flight nurses aren’t even eligible until they are in their mid 20’s or older.
The speed at which one may become eligible to obtain a position as a flight nurse is largely determined by his/her level of focus and dedication in the field, and his/her ability to complete the training needed to become a flight nurse within a specific time frame.
On the other end there are also cases of registered nurses who have applied to become flight nurses while they are in their mid 40’s.
While there is no specific age limit cap on becoming a flight nurse (certain health care organizations may/may not hire nurses do to their age) the level of physical/mental health a candidate needs to be in to work effectively in this field may limit older nurses from applying or getting accepted into this field due to the physical/psychological requirements needed to be an effective flight nurse.
Even with the experience, training, certifications and mindset that a registered nurse brings to the flight nursing field it is still possible that an individual may not be able to become a flight nurse due to certain restrictions.
Some of the most common reasons a potential candidate may not be able to become a flight nurse include:
Being overweight – While there is nt official bar for how much a flight nurse can weigh before losing eligibility of becoming a flight nurse certain health care organizations and hospitals may place a limit on a flight nurses total weight because flight nurses must be able to maneuver comfortably with their medical team in an often small airplane with lots of medical equipment.
If a nurses weight interferes with his/her ability to safely operate on board an aircraft he/she may not be able to be hired for a position as a flight nurse.
Being too tall – Another reason for not being eligible to work as a flight nurse is due to the fact that the applicant is too tall to comfortably operate on board an aircraft without affecting the patient, medical team or his/her own safety and comfort.
Nurses who are extremely tall may not be able to provide patients with the care and comfort they need while on board an aircraft due to the lack of cabin space that is available on the airplane or helicopter.
Age, health, size – While being small isn’t generally considered a problem for those looking to become flight nurses (in fact it may be a good thing in some situations) it’s worth noting that if being small negatively affects a nurses ability to lift and handle patients and/or equipment while on board an aircraft it may affect an organization or hospitals decision in hiring that nurse.
Maintaining a healthy and strong body is essential for providing proper care and being able to lift patients and equipment, therefore nurses suffering from debilitating conditions or going through rehabilitation may not be the best candidate for a flight nursing position, at least not until they recover their health.
While age may not affect a flight nurses ability it is a known fact that as we get older our body becomes less capable of handling the demands we are capable of at a younger age and at a certain point our age can and will affect our ability to perform our job functions, especially those that require lots of physical movement.
As a side not it is important to understand that each of these factors are simply potential reasons for not being hired as a flight nurses and may not apply to all positions.
The demands required of the potential flight nurse and the aircraft they expected to operate in may play more of a significant role in deciding the best candidate than his or her physical characteristics and some flight nursing positions may be better suited for the applicant than the one they are applying to.
The importance of flight nurses
Flight nurses have proved over and over again how vital they are to the medical industry and the important role they play in the survival of the lives of others.
Flight nurses play an important role in ensuring the rescue, care and survival of patients/civilians and military personnel who are facing life threatened trauma’s, illnesses or injuries in area’s that are difficult to access on foot or by ground transportation.
The advantage flight nurses have over ambulances or other medical mobile units is in their ability to quickly get into and out of hard to reach area’s such as large car accidents/pile ups and traffic, mountainous regions, frozen territories, forests and countless other environments.
They are also able to easily get to and from medical centers at a much faster pace than ground transportation vehicles can because they are able to avoid lights and traffic which can slow ground vehicles down significantly.
Nurses who work in this field take pride in knowing that what they are doing is saving the lives of patients who otherwise may not have survived due to a lack of medical intervention.
Having a flight nursing staff is not only extremely important for hospitals but for military forces throughout the world.
In the military flight nurses are often used in aero-medical evacuations and rescue missions to rescue injured soldiers who are trapped in locations that may not be easily accessible by other methods of transportation.
Having a crew that can fly in, rescue a soldier and fly out within a matter of minutes has saved the lives of countless soldiers on the battlefield.
Why become a flight nurse nurse?
Becoming a Flight Nurse not only provides a great opportunity for career advancement and increased pay but also provides nurses with a deep sense of accomplishment and satisfaction in their career.
The internal rewards of playing a critical part in the safety and transportation of patients in need of emergency care is one that few people will ever have the opportunity to experience.
By working together with a small and often limited medical team where you need to consistently think on the fly and adapt to new environments and situations you’ll gain vital skills that go well beyond just helping sick patients.
As an aero-medical transport nurse the unexpected challenges you face on a daily basis help you acquire new skills, gain a new perspective on what it means to be a nurse and gives you the tools you need to become a better medical operator in all medical situations.
The skills, training, knowledge and experiences these nurses obtain in their careers will help provide them with the education they need to become effective and successful in all areas related to the medical field and will provide them with better opportunities for career advancement in the future.