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Becoming a Flight Nurse Update

Many, MANY of you have sent me emails and posted comments asking for more information about becoming a flight nurse.

I have read every single one of them, and have realized how important it is for me to finish my “Becoming a Flight Nurse” venture.  Your questions are adding a new level of depth to the content, so please keep asking!  I promise it will not be for naught.

As I keep plugging away at that part of my blog, and resume a more regular blogging schedule, (if ever I had one), please be patient as I work to respond.

If you are interested in getting email updates from me when I do update “Becoming a Flight Nurse” please leave me your email addy in the comment section and I will put you on the list!

What is a Flight Nurse, Exactly? Part I: General Job Description

Parti
I’m in the flight nurse’s seat, so now what?

Before delving any more deeply into the nuances of the flight nursing profession, I think it would be wise to discuss the basics of what a flight nurse is. In my mind, describing the flight nurse role should be broken down into three parts, and thus three posts:

Part I: General Job Description—official definition and my definition
Part II: The Cool Factor—where the rubber meets the road
Part III: Personality—the most important component

Part I: General Job Description

As with any job, someone, somewhere has been tasked with writing an “official” job description. As I prescribe to the mantra, “Brilliant people copy, geniuses steal,” when possible, the following comes from my actual job description:

Registered Nurse, Flight

“The Registered Nurse, in accordance with [ORGANIZATION blah blah blah,] collaborates with other members of the health care team and uses clinical judgment skills to diagnose and treat the patient responses to actual or potential health conditions. The RN assesses, monitors, detects, plans and takes appropriate action to prevent potential physiological complications associated with specific health problems and / or medical treatment.”

As you can see, this description could cover any RN position in existence. The interesting bits and bobs are actually in our addendum with one specific sentence being important:

“Able to function effectively in and out of hospital environment with limited supportive equipment and personnel.”

I will not beat a dead horse by rewriting what is easily written. Other general flight nursing job descriptions can be found at the following links:

Air & Surface Transport Nurses Association FAQ
Nursing Spectrum, Students’ Corner: Flight Nurs
ing
Have You ever Thought About Becoming a Flight N
urse?
NursingLink: Flight Nurse

What is My Definition of a Flight Nurse?

“A Registered Nurse, licensed and certified to their eyeballs, who is confident but not arrogant, assertive, but not an ass, experienced but able to learn new tricks. The RN has to have awesome assessment skills, be in tune with their own intuition, able to be productive in the face of extreme chaos, be a politician and tactful when necessary or just plain mean when needed. They must be self motivated, and detail oriented to the point of being anal retentive. The RN has to be a team player. A dark, sick and somewhat twisted sense of humor is preferred. They must also be courageous but maintain balance in their risk taking behavior. Above all, the nurse must keep the safety of themselves, their fellow crew members, and the patient their primary focus. They should also look cool in a flight suit.”

Although there is quite a bit of humor (duh) in the above paragraph, there is also a lot of truth to it as well. Flight Nurses must be able to care for the patient, the patient’s loved ones, the ground crew/hospital staff, as well as his or her self.

The rest simply boils down to the desire to become a Flight Nurse, and the capability to love being on the edge.

Becoming a Flight Nurse—-Overview

Adrenaline, chaos, stress, excitement, emotion—-

There are endless adjectives associated with the world of flight medicine.

“I’ve always wanted to be a flight nurse, but . . .”

This has been repeated to me endless times. Flight nursing is a profession many want, but few are willing to pursue. The job requirements alone are enough to weed out the “wannabe” riff-raff. I personally believe many of the rest, who would actually be amazing at this very specialized segment of nursing, give up the dream because they simply can’t visualize the path. I was one of the lucky few who were gifted with both opportunity and incredible mentors. The path was lit brightly.

What you will find in my words, hopefully, is a guide. An in, into one of the most rewarding, but simultaneously one of the most physically, intellectually and emotionally demanding profession in existence. Not only are the lives of our patients at stake, but those of the medical crew are as well.

My DUSTOFF MEDEVAC unit had a motto:

“So Others May Live”

It was a shortened form of the unit’s original Viet Nam motto:

“We Die, So Others May Live”

Last year this reality came close to home when a Survival Flight organ procurement team gave their lives on a flight to collect lungs for a man who needed them. Pulling life from death.

One of the team was and acquaintance of my best friend Ben who was working at the Ann Arbor VA. The aviation community is small. Very small.

A few days after the accident, without a word, Ben greeted me with an all enveloping bear hug. I knew he saw my mortality a bit more clearly, as did I.

——–

This is not an all inclusive guide. It is also not a finished product. It isn’t meant to be. It is more of a living, evolving work, meant to encourage, inspire and put a recognizable face on flight nursing. Yes, it is a profession of the elite. No, it is not a club of pre-madonnas. We need the best, we want the best, we expect the best.

Our patients’ lives depend on it.

My life depends on it.

This is also not a work of all encompassing views. These views are mine, and mine alone. Although I am supported by my employer, Aero Med, in my blogging venture, all mistakes are my responsibility and I will conscientiously strive to represent Aero Med, my co-workers and my patient encounters in a professional manner. HIPAA is always at the fore front of my mind. Be certain that the stories are changed accordingly. No good story is ever worth breaching a person’s privacy.

I welcome and encourage questions. I rely on my coworkers and readers to keep my writing content accurate and appropriate. One of the beauties of blogging is an unlimited number of editors and proofreaders, making a much better product.

For those of you who hope to earn a place in the flight nurse’s seat, I hope this will be of use. For those of you simply curious about what goes on when we fly over your house and rattle your windows——welcome.

Be sure, however, that your life will never be the same.

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.

References

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

Luck is Where Preparation Meets Opportunity

This page, part of crzegrl.net, is a chronological collection of posts titled: “Becoming a Flight Nurse.” Flight Nursing is a unique specialty in the nursing world as there is no one way to get there. Each flight nurse brings a unique set of experiences and skills with them on each mission. Although openings for flight nurses are coveted and rare, they do exist.

I approached my quest to be the one in the flight nurse’s seat believing that, “Luck favors a prepared mind,” and “Luck is where preparation meets opportunity.” I also knew that, “the squeaky nurse (aka–the PIA nurse with creds and the right personality) gets the job.”

It is my hope that my experiences and the information I present will inspire you in your quest to become a better nurse, because that is what being a Flight Nurse is about, becoming the best of the best. I also hope to encourage you to approach Nursing as a profession instead of just a job. When I was a new flight medic, I asked one of my sergeants if he still got scared when the mission bell rang.

He stopped and purposefully turned, looking me in the eye, “Emily, the day you are no longer afraid is the day you need to quit.”

Being a professional is about the quest to always be better, respect your skills, but know your limitations.

I’m still scared.

Thank You

Patrick—for always encouraging my crazy ideas. Mom—for picking me up, over and over. B.J.—for keeping me sane by being insane. The Club—for reminding me why I do what I do. SFC Rodriguez—for not just wearing both EFMB and Aircrew Member badges, but lighting the torch in a young impressionable PFC. Ben, Sarah & Kate—for giving me reasons to move home. My Aero Med Family—for supporting this even though I am ‘the new girl.’

I could never be me without you all.

Introduction

USAAA

Introduction

One day in 1998, I called my mom, as I still do, the morning after my first bad flight as a Medic in the U.S. Army. The training accident made the Associated Press ticker and the front page of at least two papers as far away as Florida and Michigan.

He was 19 years old, engaged and a father. I was left alone with him as another flight medic and the flight physician prepped to transfer him to the ER at a level one trauma center in San Bernardino County. His heart, beating strongly about 85 times a minute, sped up to the mid 100s and almost instantly slow down to nothing. The monitor squiggles stopped.

At the time I didn’t realize that was the classic response for a heart no longer controlled by the brainstem. His brain herniated. The young soldier died right in front of me and there was nothing I could do.

I will never forget that afternoon as long as I live.

Lansing State Journal

Lansing State Journal, 20 June 1998

“Emily, you need to never do anything else with your life,” was my mother’s response. At 24 years old, I understood to my soul that she was right.

Orlando Sentinel

Orlando Sentinel, 20 June 1998

Seven years passed between my last mission as a flight medic and my first mission as a flight nurse. Never once during those intervening years did I lose track of what mom said to me that morning. Never once did I forget that soldier, my first patient.

Over the past four years, sharing my life through this blog has been a natural extension of who I am. Being able to now write about my life as a flight nurse has brought everything full circle.

Thanks to the many of you whom have taken the time to ask me about becoming a flight nurse. Your questions have motivated me to attempt another long term goal, writing a book. For now, it will be saved here as part of my blog: a multi-media version of both who I am and what being a flight nurse is all about.

“Becoming a Flight Nurse” is Live!

After much work, I am happy to announce that “Becoming a Flight Nurse” is up!  Many of you have written to me asking great questions about what it takes to become a flight nurse.  Surprisingly there just isn’t much written on the subject.

What is “Becoming a Flight Nurse?”

It is part blog, part website, part book.  It is a work in progress.  A collection, if you will, of stories, photos, videos and more information about being a flight nurse than you can shake an ET Tube at.

Patrick, thanks for not laughing at me when I told you I was going to write a book someday.

B.J., it has begun.

So, without further adieu:

Becoming a Flight Nurse