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What Is Flight Nursing?

Jun 18, 2020
Justin Bartlett RN, BSN, TNCC, NRP, PHTLS

Do you have an affinity for going fast, flying high, and saving lives (and being a badass)? Look no further, because flight nursing is for those medical professionals who have knack for high speeds, loud noises, and caring for the sick at 10,000 feet.

What Is Flight Nursing?

Essentially, flight nursing entails mobile care for a variety of patients in the field, under pre-hospital, emergency, and critical care conditions. This can be in civilian or military scenarios, and it usually involves some kind of airborne transportation, whether that be a plane or helicopter.

Flight nurses and emergency personnel are critical in transporting injured or sick patients in the shortest times possible, often making the difference of a few life-saving seconds.

Becoming a Flight Nurse

My name is Justin Bartlett, and I'm going to tell you how. I started flight nursing about three months ago and am currently working for Hawaii Life Flight out in the beautiful sunshine state of Hawaii. There is a little to know about me and my medical career, and it starts almost seven years ago in Maryland.

plane on runway with man justin bartlett RN flight nursing

I decided to pursue a career in nursing. I began working in the medical field as a certified nursing assistant at a nursing home, which soon turned into becoming an ER tech at the local Emergency Department. I then made the decision to go into nursing school and a couple years later, I became a registered nurse.

I spent about three and a half years as a nurse in the same hospital; one year as a med/surg nurse and two and a half years as an ER nurse. I received consistent experience at this ER caring for patients of all types, including trauma patients, cardiac patients, stroke victims, and a multitude of others.

The ER was not a trauma center, but we had our fair share of stabilizing trauma patients before being sent out. This is where I had the thought of one day becoming a flight nurse.

I can remember my first pediatric code, a little seven-year-old girl who went into cardiac arrest and DIC while having breakfast with her mother. The young child came to our ER, and we proceeded to care for the patient for an extended amount of time. Our plan was to have the patient flown to shock trauma in Baltimore, Maryland.

We worked with the child for hours as we waited for the flight crew to come pick up the patient. When they arrived, I could sense a change in the room as we felt elated that we finally could get this patient to an appropriate facility with people who knew exactly what they were doing.

Those nurses/medics seemed to know exactly what to do as well as the correct questions to ask. They had a sense of calm and badassness without being overtly arrogant. I thought that one day I wanted to do what they do. The child, unfortunately, had a bad outcome, but the attempt of everyone involved was one incident I will never forget.

Now that you understand when and where I decided I wanted to become a flight nurse, it’s time to tell you how I became one.

How I became a flight nurse

After my experiences at my local ER, I decided to get into the travel nursing game. I spent the next two and a half years traveling between ERs, working in trauma centers in places like New Orleans, West Virginia, and Phoenix as well as others. I was growing my resume at each place I went to, gaining more patient experience, learning new skills, and taking care of wide populations of patients.

tail of plane on runway flight nursing

I eventually came to an ER on the big island of Hawaii called North Hawaii Community Hospital. It was a small ER with about 12 beds and would stay relatively busy during the day and slow down at night. Here at NHCH, I became more familiar with flight nursing because any critical patient and/or specialized patient was to be flown to a neighboring island for care.

I became acquainted with the flight crews. One of the crew members, in particular, that worked part time as a nurse at the same ER I was in. At this point in my career I wanted to do travel nursing until I found a place that I wanted to stay long term. Eventually, if I stayed somewhere for an extended period of time, then I would have looked to pursue flight nursing.

On my last day of my contract at NHCH, the flight nurse whom I worked with in the ER told me that if I wanted to get into flight nursing, I should reach out to her in the future. I kept that in my mind as I left for my last travel contract in Tennessee. Fast forward a couple months later and I received a call; it was my old coworker at NHCH telling me that she had an opening for a nurse at the base station that services NHCH.

Requirements for becoming a flight nurse

At this point, I was given two options: continue my travel nursing or give flight nursing a go on a tropical island. Believe me when I say this it was a pretty easy decision. I applied to the position with Hawaii Life Flight, unsure if I would even get it (these positions are fairly competitive and require extensive experience). I didn’t think I was qualified enough because they looked for those with pre-hospital transport experience, multiple certifications that I did not have, and ICU experience that I did not have.

When I received my first interview, I was shocked by how some qualifications didn’t hold as much weight as I previously thought. I thought that I needed to be an ER nurse of 20 years with all that experience in Level 1 trauma centers and advanced trauma certifications. It would have been great to have all that experience, but they were more seriously looking for someone who was motivated, willing to learn and get all the necessary certifications, and someone who was a good cultural fit for the company.

I must have met all three of those requirements because I was hired a few weeks later and headed to Salt Lake City, Utah for eight days of training.

Among the requirements to be a flight nurse, there were some that I had to work on first. I initially had BLS, ACLS, PALS, TNCC, ENPC, and my BSN. I was told I needed to get my Neonatal Resuscitation Program (NRP), renew my TNCC, Prehospital Trauma Life Support (PHTLS), and within a year accumulate an advanced trauma certification like CFRN or CCRN.

plane on runway in front of rainbow flight nursing

When I arrived at orientation to learn more about what it is to be a flight nurse, I was told of the additional certifications/education I had to procure within a specified amount of time. I completed my NRP, while I was at orientation, completed my PHTLS weeks later, and recertified my TNCC shortly after that. Orientation consisted of basically advanced nursing school in eight days. It was an intense period, where I learned all about the cardiac and respiratory system in more depth then in nursing school.

I learned how to intubate a patient, start them on a ventilator and adjust their settings appropriately. I learned how to surgical cric a patient, I was taught how to place a chest tube and needle to decompress a pneumothorax in a patient. These were just a handful of skills and education I learned within these days of training. After completing the training, I was sent out to my base in Hawaii, and from there I would receive 16 more weeks of orientation training.

In these 16 weeks, I would fly with a partner and care for a multitude of different patients, but during this time, I had to prepare for the most intense testing I had ever completed, my Independent Studying Test. This test consisted of six-eight hours of testing my competency as a new flight nurse and included patient scenarios, showing my new found skills, reciting patient care guidelines and protocols, and even showing the testers around the aircraft and bags to ensure I knew where everything in and out of my aircraft was.

I had been studying since day one of orientation for this test and, luckily for me, I passed as of five days ago since writing this post. At this point in time I am currently studying for my CFRN exam at the end of the month to complete my certification requirements.

plane on runway man in front justin bartlett RN flight nursing

Looking back at my journey

At this point in my life, I have reached my goal of becoming a flight nurse. It was not easy, but very doable for almost anyone who has the determination to go and get what they want. My advice for someone who is looking to get into flight nursing is to clearly set that goal for yourself, and challenge yourself each and every day by being willing to put yourself into situations that may make others uncomfortable while striving to be the best healthcare provider you can be.

You may not get into the field right away, but don’t be discouraged and keep working toward this goal. I hope this post helps to share a little about the life of a new flight nurse and what it took to become one.

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