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Flight Nurses: A Career Above the Clouds

by Katie Street

The majority of nurses deal with life threatening decisions, clinical procedures, crisis management, overextended hours and emotional, physical and mental stress on a daily basis. But could you imagine handling those challenges while providing critical medical care aboard an aircraft with unpredictable weather conditions and often without the direct supervision of a physician? That is the role of a flight nurse — providing a continuum of care while a patient is being transported to a hospital.

A brief history – covering battle zones

Flight nursing has its origins in World War II when medical air transport provided life saving response to wounded soldiers. Patients could be air lifted off battle zones to medical facilities with an increased chance of survival. Female flight nurses were once a part of the military, and endured the same dangerous combat situations in World War II as did the men. In addition to their nursing skills, these women were also taught basic military survival and some combat skills. As a result of their heroic efforts, hundreds of wounded soldiers were saved.

Today, flight nurses maintain an active role in the military. From World War II, to Vietnam and Operation Iraqi Freedom, nurses are routinely deployed to combat areas. As both medical and aircraft technology advance, so does the chance of patient survival. Flight nurses are not just restricted to the military now either. Civilian hospitals and healthcare organizations routinely use air medical transport as part of their medical programs.

What are the requirements?

The idea of air travel as a means of fast response to trauma situations also applies to the skills and experience of the on-board flight nurse. Flight nurses must put their critical thinking skills to the test — automatic response is key. Think fast. Act fast. In addition, flight nurses receive aviation training, physics and physiology. These areas aid in understanding how air transport could affect a patients’ condition. An intensive background in the following areas is also extremely valuable: emergency, trauma, neonatal care, pediatrics, cardiac, and obstetric care. There are also physical demands on the job, such as working in extreme weather conditions, heavy lifting, high noise level, and altitude changes. In addition, some programs have weight and height restrictions.

Flight nurses always work in a team environment that includes the pilot and an additional medical crewmember. The team maintains in constant radio contact with a physician and/or hospital. Since physicians are often not on board these medical transports, flight nurses routinely perform advanced medical procedures such as ventilator management, central line placement, chest tube insertion, pain management, intraaortic balloon pump management, administration of anesthetic medications, and intubation to name a few. Requirements do vary from program to program, so it is important to check with potential employers before applying.

National Requirements:

• Licensed registered nurse
• 2-3 years critical care experience
• 2-3 years emergency experience
• ACLS advanced cardiac life support certificate
• PALS pediatric advanced life support certificate

Additional Requirements:

• NALS Neonatal resuscitation program
• Trauma programs such as BTLS Basic Trauma Life Support or

FNATC Flight Nurse Advanced Trauma Course

• 2-3 years emergency wing experience (ground transport experience helpful)
• Certifications such as CCRN Critical Care Registered Nurse, CFRN Certified Flight Registered Nurse and/or CEN Certified Emergency Nurse
• An EMT certification is also helpful, but not required

The skies the limit.

If you are considering making the career move, remember the broader the skills and experience, the better. Don’t lock yourself into one specialty or department. While there certainly is a high level of autonomy with flight nursing, you must be confident in your decision-making skills and act fast. With each crisis is an opportunity to use your critical care skills and provide a program of care. A flight nursing career has unlimited challenges and rewards—the skies the limit!

For more information on a career in flight nursing, contact these organizations/publications:

Association of Air Medical Services (AAMS)
526 King Street, Suite 415
Alexandria, VA 22314
Phone: 703-836-8732
Fax: 703-836-8920
E-mail: information@aams.org

Air & Surface Transport Nurses Association
9101 E. Kenyon Avenue, Suite 3000
Denver, CO 80237
Phone: 800-897-6362
Fax: 303-770-1812
E-mail: astna@gwami.com
www.astna.org

Emergency Nurses Association Headquarters
915 Lee Street
Des Plaines, IL 60016-6569
Phone: 800-900-9659
www.ena.org

www.flightweb.com

Hudson, Janice. Trauma Junkie: Memoirs of an Emergency Flight Nurse, 3 March 2001.