History of Flight Nursing
Posted on November 16, 2010 by flight nurses
History of Flight Nursing
Nursing is a noble profession which is engaged in taking care of not only the sick but also
those who are well. It is one of the many professions that has blossomed and branched out to
a variety of specialties and practiced in different settings. One of the many nursing specialties
that has become popular among nurses nowadays is flight nursing.
So what is flight nursing? Flight nursing is a nursing specialty where registered nurses
provide comprehensive emergency care to clients, who are critically ill during aeromedical
evacuation and rescues on board a helicopter and propeller aircraft or jet aircraft. Flight
nurses are highly trained registered nurses because they need to provide intensive care to
clients in disaster and combat scenes. Flight nurses are classified into two: Civilian flight
nurses and Military flight nurses. Civilian flight nurses are those who work in hospital, local
and government agencies, fire departments and private emergency offices responsible in
evacuation and rescues. Military flight nurses in the other hand refer to nurses serving the
military who are responsible in the care and transport of their wounded colleagues in times of
battle.
Flight nursing history is traced way back in the year 1925 when the U.S. Army Corps had
established a medical division where a plane is used in their missions. Back then, flight
nursing is usually associated with military nursing. In 1930, United Airlines has hired its first
flight attendant, who is also a registered nurse by profession. This started the idea of civilian
flight nurses.
It was during the World War II (1942) that marked the widespread use of flight nursing in the
U.S. Military. This is the era of military flight nurses. The first military flight nurses are those
who are members of the U.S. Army Nurse Corps in World War II. They are responsible for
the care of their colleagues at war while they are rescued aboard a helicopter or a plane. The
presence of these nurses in the battle field had significantly reduced the mortality rate of
soldiers dying in the battle. In history, flight nursing has significantly aided a lot of soldiers
not only in World War II but also to conflicts such as that of Korean, Vietnam and Gulf War.
It was just in 1993 that the first Certified Flight Registered Nurse (CFRN) Exam was
conducted among those who are interested in the field of flight nursing. Currently, in order to
qualify to become a flight nurse, he must be a registered nurse with several years of
experience in critical, intensive and emergency care experience and certifications in
Advanced Cardiac Life Support, Certified Emergency Nurse and Certified Critical Care
Nurse.
The National Flight Nurses Association (NFNA) established on 1980’s was later on changed
to Air and Surface Transport Nurses Association (ASTNA) on 1998. It is a non-profit
organization which aims to advance the practice on patient care and transporting them from
one place to another.
Indeed, flight nursing has come a long way. It is one of the nursing avenues where the young
ones can try for themselves and see whether they are apt for the challenge of becoming one.
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.
Linda Himmelbaum
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