Flight Nurse: A Life of Training and Trauma

This is a paper written by John C. Lee, Jr., SRN from the east side of the country. I am grateful that he shared it with me, because he captured the desire to become a flight nurse and quite a lot of useful information for those interested in the field. Reprinted with permission.

Flight Nurse: A Life of Training and Trauma.

As I have yet to begin my formal training for a nursing career, reflecting on a specific role within nursing is a guilty pleasure. However, I realize that in today’s world, it is never too early in an educational pursuit to think about long-term career goals. Without any experience in the field, this exercise is very much a reflection of what I currently feel based on my own thoughts and research knowledge. As with all things, life is dynamically fluid, and my future experiences will bring opportunities and changes in my career. For now I will let my mind fly toward the blue skies of a flight nurse.

Every few weeks, I pull into the parking area at CMMC to view the rays of sun dancing on the smooth shinny metal body of the Lifeflight helicopter. One day I was lucky enough to see the blades of the chopper slowly turning, getting faster and faster as I smelled the jet fuel and heard the wind whistle past my ears; out of the hospital, running past me were the nurses and paramedics in their blue jumpsuits and helmets. They hopped aboard, then flew off at top speed in their fully equipped flying emergency room, ready to land on the road or in a field to pick up a trauma patient in desperate need of care. I knew that both the helicopter and nurses would be operating at top speed to get the patient stable in the crucial “Golden Hour” and beat back death. The chance to fly, be a part of a highly trained team, along with being able to help stabilize and give a trauma patient the chance to live, seems like a career I would love. In my exploration into the world of a flight nurse, I found it to be a career built around a life of training and trauma.

The field of flight nursing was born out of trauma: the need to get critically ill patients to a hospital quickly in order to offer the best chance for survival. More specifically, World War II created this new career for nurses. According to Lambert & Lambert (2005):

When the war began it was thought that only cargo or bomber aircraft would be used to transport sick and wounded soldiers. Thus since enlisted men in the Medical Corps were taught first aid, it was not considered necessary to assign nurses to accompany the wounded while being transported in an aircraft. However this policy quickly changed with the establishment of a Nursing Division in the Air Surgeon’s Office for the development and special training of flight nurses. (pp. 34 -35)

Through each subsequent war, the need for flight nurses grew. Around 1971, the creation of emergency medical services, established the need for civilian flight nurses to transport the most critically ill and provide top-notch medical service in flight (Air & Surface Transport Nurses Association (ASTNA), 2007).

I quickly realized that a flight nurse is a lot more than just being a nurse, wearing a flight suit, and looking cool. Flight nursing combines the skills of intensive care, critical care, and emergency nursing. According to Scally (2002), “Some might argue that even more so than in other types of nursing, [in flight nursing] continuous training and experience matter” (p. 1). Flight nursing involves caring for the 10 percent of the most critically ill or injured patients across all specialties of medicine and disease process. Instead of just maintaining the patients during transport, flight nurses make onsite diagnoses and treatment decisions, providing care before the patients get to the hospitals (Scally, 2002). This requires an intense amount of training.

Requirements to be a flight nurse vary from state to state and program to program but nationally, all flight nursing programs require RN’s to have two to three years of critical care experience and advanced cardiac life support and pediatric advanced life support certificates. Other requirements may include a neonatal resuscitation program, a nationally recognized trauma program, and transport nurse advanced trauma courses. Certifications such as critical care registered nurse, certified emergency nurse, or certified flight registered nurse may also be required. Some states also require nurses to be paramedics or at least emergency medical technicians (ASTNA, 2007).

To meet my goal of becoming a flight nurse will require hard work, a huge time commitment, much training, and exposure to trauma. Aside from the possible adrenaline rush, what draws me to this career is the opportunity to learn so many varying and broad based skills. Through my short time being a lowly EMT-B, I have developed a great desire to continue to learn life-saving techniques and trauma skills. Along with the typical protocols, I will be forced to make diagnoses that will impact the patient for good or bad.

On a broad based level, I am already on a flight path toward my goals. As a voluntary EMT-B, I realize just how important it is to keep learning and moving forward with continuing training. In the next month, I will be taking a course in pre-hospital trauma life support for EMS providers. I am currently involved with volunteer work at Tri-Town Rescue, and have had exposure over the past several weeks ranging from traumatic motor vehicle accidents to working on a patient in full cardiac arrest. This summer I may even train for my EMT – intermediate level certificate.

In the short-term, I will focus my education in these areas along with graduating with my BSN. In the long-term, I will look for opportunities to meet the requirements needed in the critical care unit to learn and hone my technical skills along with my interpersonal skills. Through all this, I will continue to train and train and train toward my goal of applying for and securing a job as a flight nurse. This will not be an easy task. According to the ASTNA (2007), there are about 3,000 civilian flight nurses in the United States. There are more nurses wanting to be flight nurses than there are jobs. According to Scally (2002), “Turnover in most flight nursing programs are very low. However, you can find a job as a flight nurse if you’re willing to move to any area of the country as jobs become available, be persistent, and continue to obtain more advanced training” (p. 2). I am finding out that anything worthwhile in life is a process of persistence.

Once I reach this highly specialized goal, what kind of money can I command? Research from Salary.com (2007), shows that the median expected salary is $56,326 for a flight nurse. The range is from a low of $52,184 to a high of $64,804. In comparison, the median expected salary for an emergency room nurse is $56, 226, with the range at a low of $51,106 to a high of $61,644. Initially, I was shocked to see that at the median range the salary difference is approximately a hundred dollars. All this extra training for what seems such a small amount of pay? This can be attributed to two factors. The first is that in general nursing salaries are low compared to other high-end professions, and the second is the simple theory of economics: supply vs. demand. With so many willing nurses and so few slots available, the market controls salaries. In the end, it is not the appeal of money, it is the professional challenge that draws many nurses to flight nursing.

I know for me it is the overall challenge of nursing that draws me toward the profession, with a long-term horizon of critical care flight nursing. Hudson (2001) states, “Flight nursing has the intensity of ICU with the urgency of an emergency department. It is the ultimate challenge, the relationships formed are professional, yet intensely intimate at the same time” (p. 230). I can think of no other job that allows room for both professionalism and intimacy. This is why I can allow my mind to fly toward the skies of flight nursing. Whatever my career in nursing brings, I am sure it will bring challenges, relationships, professionalism, and intimacy. I can only hope that time and persistence will bring a flight helmet and jumpsuit to me.


Air & Surface Transport Nurses Association. (n.d.). ASTNA answers frequently asked   questions. Retrieved February 19, 2007, from http://www.astna.org/FN-FAQ.html

Hudson, J. (2001). Trauma junkie: Memoirs of an emergency flight nurse. Buffalo, NY: Firefly Books.

Lambert, V. and Lambert C. (2005). The evolution of nursing education and practice in the U.S. In J. Daly, S. Speedy, D. Jackson, V. Lambert, & C. Lambert. (Eds.), Professional nursing: Concepts, issues, and challenges (pp. 34-35). New York: Springer Publishing Company.

Salary.com. (n.d). Salary.com nursing salaries. Retrieved February 19, 2007, from http://www.salary.com/sitesearch/layoutscripts/sisl_display.asp?searchtextvalue=ed+nurse&Image1.x=0&Image1.y=0

Scally, R. (2002). Flight nurses: Nursing’s high altitude calling. Spotlight on nurses. Retrieved February 19, 2007, from http://www.nursezone.com/student_nurse_center/default.asp?articleId=9674

  1. Hey bud sorry to burst your bubble but I have been a trauma and an ICU nurse for 13 years. I make 51,000 a year plus differential. You as a new grad on day shift will be making about 37k for a couple9(4-5) of years. I now am going back to transport and what you will find is that flight teams pay like shit for all the experience they demand. You will start most likely at 22 dollars an hour or around 39k…plus differential. Not really all that great for the risk and responsibility. I have already known 2 nurses in my career who have crashed and died. My suggestion to you is to pick a career that will give you the monetary and respect benefit down the road because when the glory wears off bud and you have family to take care of its not so great anymore.

  2. In response to Johns oh-so positive post: I’m not sure where he lives, but I fly full time, work a little ER to keep my hand in, and will make somewhere around 80k this year. That full time flying job… 7 24 hour shifts a month. Not bad in my opinion. New grads around here, in ER/ ICU will start at about 55k a year. More depending on the deal you work and the hospital. Flying isn’t about glory, or saving the world. It’s about the challenges of taking care of patients that need it…and doing it while you get to fly. It’s an awesome side of Nursing. To the original poster: Keep the faith….the struggle is worth it.

  3. I agree with Steve. I am a part time flight nurse. I work full time in the hospital. Flight nursing is an awesome side of nursing. You do have to look at the money side of it of course, but it’s not all about the money. It’s not all about the glory and saving the world either. I fly in Western Kansas where there are not trauma centers every 50 miles. So our flying out here is about the challenges of taking care of patients that need it and getting them to the trauma centers that are sometimes an hour or more away. It’s about living your dream! Not everyone can say they have lived their dream. Obviously John hasn’t lived his dream yet!

  4. Im a senior in High school an have been thinking about pursueing a career as a flight nurse I want to know is this the right job for me. I read that Flight Nurses get paid about the same salary as a regular emergency room nurse, is this true and if so what are your suggestions for someone looking to pursue a career in the medical field specifically as nursing position?

  5. I’m not a flight nurse, or even a nurse for that matter, but an ED Social Worker in a large medical center. If this is something in your life that you want to do…DO IT!!! The adrenaline rush that one gets when traumas come in, the interaction with the patient as a team, and the need to “play detective” in some cases to identify a patient and their family is great, but I think that being a flight nurse would be awesome!!!! Hang on to your dream and persue it head on!!

  6. I’m a flight nurse after deciding that’s where I wanted to end up in life after serving in the Army as a medic. To Daniel: it’s not so much about the money as the comaraderie and challenge of the job that make it worthwhile. Nursing is probably the most mentally exhausting profession without that realization. A big paycheck will never relieve the daily stresses of the job. As for the salary quote from salary.com, that can almost be taken with a grain of salt. I’ve seen new grads start in hospitals in California at $37/hr. I have a buddy from the Army I went to nursing school with, he started in Montana at $18/hr.

  7. Liz, Kelli, and Steve;

    I would like to thank you for your inspiration. I am a new nurse going on 3 years, 2 of which have been in the OR. I have a background as an EMT-I and ever since then I can remember watching the military MAST helicopter coming to pick up the patient from the scene. As dorky as it may seem I would hear the theme from M.A.S.H. in my head as the bird landed. It also gave me a huge sense of pride for the work that I was doing. I unfortunately never got a change to fly with any patient to the hospital. It was something that I always wanted to pursue. As I am going through the motions of my RN experience in the OR I am also pursuing my MSN and I find it funny that I continue to look up into the blue sky and ask myself “what am I waiting for.” I know that it’s a long and difficult road to gain all the required training for flying but in the end I think it is well worth it. I just wanted to thank each of you for your positive words of encouragement. I wish you all the best and my the Lord keep you all safe.

  8. Hello, I am in the 8th grade and doing a reserch project of what career i want to do and since i was little i always wanted to do something with medical flight. Now that i am older i have desided to do something about flight nurse, and i was wondering if this is good career for me in the future. I know it is alot of work to be one and take alot of training and all but to me i think its what i want to do, because i like to help people out when they are sick and things like that. So is this a good career pick for me?

  9. I have always had an interest in flight nursing. I think nursing alone is very rewarding, although never pursued flight nursing. I have recently been asked if I was interested in doing 3/24 hr shifts a month as a flight nurse and am very apprehensive since I am a nurse in a rural hospital and we ship our traumas out. I feel that I have much experience in rural nursing, ED, Med-Surg, LDP, and we are required to have the typical TNCC, BLS, ALS, STABLE, PALS. I also have a couple other certifications but nothing to do with flight nursing. What are some things I can brush up on to pursue this flight nurse part time career? As I watch the flight crew come into our hospital I am very excited to see them and very in awe over their talents. What an awesome feeling watching there dedication gives me….

  10. Wow, that was a piece of art! Thank you and Congrats on you paper. I am studying nursing and EMT just so I can have the skills and training to care for others, as it’s my passion. I have a 6 year old who has had the privelege of watching many life flights through his window. He urges me to help him with the oxygen mask only so he can get a closer view of the landing. His big sister was also rescued from a highway trauma scene and we were all very impressed by the quality of work they can give. to many of us, they are heroes! All to say, my son is healthy now and he dreams of being just like “those cool guys in the helicopter and bring them to you mommy so you can help them more and sissy can be their doctor”. I praise him and encourage his dreams, just like I would anyone’s, regardless the pay.

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