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The Q Word Podcast

“So You Want To Be A Flight Nurse”

Lisa: Hello, Nyssa! How are you today? 


Nyssa: Hi, Lisa! I'm good. 


Lisa: How are things in Georgia?


Nyssa: Hot. So, so hot.


Lisa: Really? I'm so surprised to hear that.


Nyssa: And humid. Are you surprised by that also?


Lisa: I'm sorry. But the weather here in Boston has been per-fect for the

last week. 


Nyssa: Yeah, call me in February.


Lisa: Alright. Well, before we get to February, let's talk about something new today. What's on our docket for today's episode?


Nyssa: I thought we would talk about “So you want to be a flight nurse?” I get this question a lot. There are a lot of ER nurses and ICU nurses out there who- and even nursing students- who kind of have their eye on working their career toward becoming a flight nurse. And so I get asked the question a lot about, “What do I need to do? How do I need to poise myself in the next, you know, two to five years so that this is an achievable goal?” And so I thought we would just review it.


Lisa: Can you tell me or remind me how you got to the idea that you wanted to be a flight nurse?


Nyssa: So I was the educator in the emergency room. And as part of that, I was in charge of doing all the helipad safety training for the emergency room staff, nurses, and techs- anybody who was going to go and retrieve a patient from the helipad. So the end of my little spiel about helipad safety was to let everyone know that there's an opportunity to do a third ride; you can go and do a fly long. You know, “I have the contact info if you guys want it,” whatever. And people always seem to have two reactions to that: “Oh, no, I like my feet on the ground!” or, “Oh, my gosh, I would love to do that! I want the phone number immediately.” In all the years that I gave that little spiel, only two people took me up on the offer to actually go and do it. So when the rubber hits the road, finding the time to go and do it did not- even though it sounded super cool, and fun and interesting- there were really only two people who actually followed through, went, and did it. And I gave one of these little spiels, and I was walking back down from the helipad thinking a lot about, “Why have I never done a fly along? Like, I should probably go and see what this is about that I'm offering to everyone.”


Lisa: So you're, like, selling a pizza that you've never actually eaten? 


Nyssa: Exactly.


Lisa: Mmm… that's really bad.


Nyssa: So I went and did a fly along. I hung out with the crew for the daylight hours and we flew and it was amazing. And they said, “You should just throw your hat in the ring, you know, you should just apply.” And I did it on a whim. And it was a very, very good decision. I love my job.


Lisa: Okay, so for people who are not doing it on a whim, but who have thought it out... What is your advice to them?


Nyssa: I get this question a lot. There are about four air medical companies- really large ones. And I did a little bit of research. I know, of course, what my company requires so I looked and researched what the other companies require- the minimum requirements- to apply, and they are virtually identical. So I'm going to go through those with you right now and tell you what the websites say. But then I'm going to give you like the real deal behind it. Some bonus info about how to really make yourself competitive, your resume, and how to stand out so that you will get an interview. The first requirement on all of these: you have to be a graduate of an accredited nursing school. And that's kind of obvious. You also have to be licensed in the state that you are applying for. That's something that you can do retrospectively. You can get a nursing license, but just know that that those are two obvious requirements.


Lisa:I keep thinking about those kids who posed as doctors... “Yes, I'm an accredited nurse. Can I get in your helicopter?”


Nyssa: They require three years of critical care experience. And most of them define critical care as ER or ICU. I would say it needs to be a high volume, high acuity ER or ICU. I would also say that it's probably more like five years for you to really get your resume recognized. We do hire people at the three year mark, and they are successful, but the vast majority of people are closer to the five year mark of their nursing experience.


Lisa: What is the distinction in terms of experience? That just those extra two years make you a more seasoned, salted, delicious nurse?


Nyssa: Absolutely more delicious! It's just that much more foundation that you have. When you're in the back of the ambulance and putting a patient in a helicopter, you don't have an ER physician there with you. You don't have an intensivist there with you. You have you and your partner and your protocols. So it's an environment where you do a lot of independent thinking, a lot of critical thinking, and in a rapid fire way. So you need a good foundation so that you can make those decisions in the best interest for the patient. 


Lisa: And I assume also not be sidetracked or distracted by the cramped spaces, the shift in altitude, the loop-de-loops that the pilots probably often have to perform when

flying in the air- as Airwolf kinda helicopter piloting stuff. 


Nyssa: That's right. 


Lisa: That's a deep dive... Kids ask your parents about Airwolf.


Nyssa: Yeah, and I'm going to tell you how to figure that out; figure out whether or not that's something that you can do as you're going through this process. You have to have basic life support. You have to have advanced cardiac life support. You need to have pediatric advanced life support. If you happen to be an adult only ICU nurse, you probably need to get a little bit of a comfort level with some peds so try to vary your experience. Get a little bit of pediatric exposure and definitely pediatric advanced life support. They also like it if you have an advanced trauma course. So, trauma nurse core curriculum, which is put out by the Emergency Nurses Association, or the advanced trauma course for nurses which is put out by the Society for Trauma Nurses. Those are required within six months of hire, but the real deal is you want to have already had those. In fact, for your ACLS, your PALS, and one of these advanced trauma courses, if you can go to those classes and just absolutely crush the class, and be invited to be an instructor, and then get your instructor status and teach these courses to where you have a comfort level with them and an intimate knowledge of them that’s past just the student who passed the test... that much more advantage to you, your resume and your future patients! So that's always my recommendation: strive for instructor status and teach these courses.


Lisa: So far, you seem to be recommending a little bit more than what the basic requirements are.


Nyssa: That's right. So this is a highly desirable field. So when a position goes up, they may get 30 to 50 applications. You could probably assume that the majority of them have these minimum requirements. So you need to have something above and beyond the minimum that gets your resume pulled from the stack. So an advanced certification is not required. It says that you need to have it within two years of hire. So that's your certified emergency nursing certification, your critical care nursing certification or your certified flight nursing certification. The real deal is: you need to already have it. You need to go ahead and have that. They say it's not required for hiring and that you should have it within two years of hire... My recommendation is that you go ahead and have it. So your CCN, your CCRN, and your CFRN. There's a couple of other advanced certifications. One is the Certification for Pediatric Emergency Nurses- CPEN. And then there's a newer certification that's a couple years old that's Trauma Certified Registered Nurse. Both of those are very good to have. They do not fulfill this requirement of the two year hire. What's recognized really is CEN, CCRN, CFRN. I will let you know that there are a lot of nurses in the flight industry that are double and triple certified. So think about that when you're trying to get your resume pulled from the stack. And the neonatal resuscitation; that's one that they require that you have within six months of hire- and that is really and truly legit. You do not have to have that ahead of time; certainly helpful if you do, but I wouldn't go out and pay for it if you're not going to use it in your daily job. Just let the company cover you in those first six months. So that one really is truly something you can wait.


Lisa: For the lay people out there like me: these certifications- they’re courses that take a month? Six months? A year? How does it work?


Nyssa: So the trauma courses are a weekend. You can take TNCC in a two day period, you can take ATCN in a two day period. At the end of the course, you are required to pass a test and a megacode. And then you have those certifications. You do have to renew them. I think they're both every four years. For the CEN, the CCRN- that's just a big, fat, hairy test that you're going to take. One hundred and 75 questions and you need to pass the test.


Lisa: I'm sorry. I'm envisioning a big, fat, hairy test being airlifted in a helicopter to a hospital for a nurse to take it.


Nyssa: That’s exactly what they do. So the website says that a bonus is if you have your bachelor's in nursing- I would say that's true. And then also if you have any flight experience or any pre-hospital experience. So if you were a medic before you were a nurse, they love that. If you were a respiratory therapist before you were a nurse, that's also a huge bonus. If you have both ER and ICU experience, that's a bonus. So those are good things. Another requirement one of the companies listed, straight out in black and white, the other companies didn't but probably do have this requirement, is around the 215 to 220 pound weight mark. So this is one of those jobs where, you know, it does benefit you to be smaller. For every 10 pounds of weight that a crew member does not have, that's 10 pounds more weight of a patient that we can take. The mark, though, is about 215 to 220 pounds.


Lisa: That's still pretty... healthy...


Nyssa: Generous. Yeah, it's generous.


Lisa: Generous. That's a good word.


Nyssa: Yeah. When you are looking into these, you also need to know if there are any state specific requirements. My state doesn't have any state specific, but there are a handful that do so your responsibility is to know what those are. So those are kind of the basic things that you need to be working towards at the three to five year mark, to just get you started. I have some additional recommendations that I want to make and I kind of want to just discuss for a minute a little bit about the industry so that you know what you’re getting into. The company that I work for is obviously the one that I can speak most intelligently about. We are in 48 states, we have about 300 bases nationwide. You need to know that there is a difference between being a hospital based program and a community based program. So some hospitals, especially specialty hospitals- like children's hospitals- they will have one helicopter and they will have their own crew. Now their requirements might be very different than these that I just addressed; so you need to know if that's what you're going to do. Hospital based- it’s just like it sounds. It's affiliated with a specific hospital. The community based are set out in usually a rural area to serve those underserved communities.


Lisa: And you're in a community based one?


Nyssa: I am in a community base. That's right. You also should know that for flight nurse, there is a distinction between rotor wing and fixed wing. So you might be applying for a position on a helicopter, you might be applying for a position on an airplane.


Lisa: Oh!


Nyssa: Those are a little bit different as well. The helicopter generally does shorter flights, obviously. The airplane is going to cross state lines more frequently. So you may cross 2, 3, 4 states- so much longer distances. The airplane in general can also manage larger patients; so heftier patients and the airplane does almost exclusively inter-facility flights. So that's what I want to talk about next. There's two types of flights that you will be called on to do as a flight nurse. One is a scene flight where EMS has called you directly to the scene of a car accident or a fall. It could even be someone's house that's having a stroke. You're picking them up directly out of the scene and taking them to a larger facility with resources that they need. 


Lisa: Presumably, there are restrictions- you can't land in a very wooded area, you can't land in a rocky or hilly area, you have to have enough clearance... Who is it that knows whether or not summoning a helicopter is an effective method?


Nyssa: Yeah, it's all ground provider discretion and judgment. So we really, really rely on the guys and gals in the ambulance- those medics and EMTs- to make a judgment call and decide, “This patient needs to fly,” because we're way too far out or they're way too sick, or the local hospital cannot provide what they need. We do some training with them. But by and large, these folks are really, really great. Then, in addition to that, the fire department and sometimes even sheriff or state troopers are the ones that secure the landing area for us. So sometimes we land on the interstate, sometimes we land on a highway, a farmer's field, a soccer field, a church parking lot, and they are the ones that clear that area for us and make sure that we're going to be safe. There's no overhead power lines or road cows.


Lisa: What's the coolest place you've ever landed? 


Nyssa: The interstate.


Lisa: Really? Like seeing traffic blocked off on either side? 


Nyssa: Absolutely, yeah.


Lisa: That’s kind of cool. Must feel very powerful.


Nyssa: Karma has also had me sitting in traffic when a helicopter is landing. And, yeah, I feel your pain. 


Lisa: What goes around comes around!


Nyssa: That's right, that’s right. So the second type of call is an inter-facility, where a small hospital, a critical access hospital, or even a community hospital that doesn't have the highest level of resources will call us to take their critical care patient to a higher level of care. So we may be taking them to a trauma center, a stroke center, a cardiac center, a specialty pediatric hospital, a burn center... So we will go to the facility and it's a physician or nurse who's called for us at that point. If you're on a fixed wing, they do almost exclusively inter-facility calls. So those are a few things that you need to know about the industry before you get into this. So you are working towards this goal and there are some things that I want you to think about. One, is there is some inherent risk, so you need to understand that. I did understand that in a general way. The first time it hit me was after I had been to new hire orientation at corporate, we came back for our local area orientation and we were filling out a packet of paperwork. What's your phone number? What's your address? What's the best way to reach you? What time of day is... you know, that kind of new hire paperwork. And I remember it said, “Can you provide your dentist’s name, address, and phone number?” And I'm sitting in the room with five or six other new hires, and I say, out loud, “Huh, I wonder why they want my dentist’s number and not my doctor.”


Lisa: Ohhhh… dental records!


Nyssa: The light bulb went on and we all went, *frightened gasps*. Wow. Okay. So it's not to see if I get my cleanings every six months, I can tell you that. It was a very poignant moment for me and my career where I realized they're asking me for my dentist in case they ever need my dental records.


Lisa: Yeah, I can tell you that both Michelle and I, we had to stop thinking about the fact that you get into a helicopter every day.


Nyssa: We do have really tight, tight safety restrictions and we do have a lot of very serious weather minimums that we have to have or we won't take flights. And we have a policy that I really love that's very important to us; that is three to go and one to say no. So if for any reason I step outside, and I look at, you know, maybe the the forecast is fine, but I see something I don't like, or I see something on the aircraft that I don't like, or I just have a weird feeling in the pit of my stomach or the hairs on the back of my neck. It does not have to be something that I can explain. I can pull the plug on the flight and say, “Guys, we're not going.” And it is pretty sacrosanct. I don't have to give rationales for it. I can just say, look, something's not right. And I'm pulling the plug on this flight. So I really appreciate that culture of safety that we have. So I had the dentist moment- as you continue to fill out the form it asks you things like, “If something bad were to happen, who do you want us to notify first?” And, “Who would you like to notify?” So obviously mine is my husband. I want him to be notified first. And I'm thinking about this thing about who do I want to notify him of some really bad news that has happened? I'm like, “I don't know, like, could you get Halle Berry? Because that might soften the blow. He's always had a crush on her.”


Lisa: Really? Didn't know that about Roy.


Nyssa: I didn't have,you know, I didn't know my co workers yet. I didn't know my base manager very well yet. So it was a little bit of a curveball thrown at me like I don't know who to say, for you to go and give this bad news. But yeah, so it's different than any other new employee form I have ever filled out. And that's when the safety issue really is driven home. And we like to say that you take more risk driving on the interstate on your way to work than you do when you actually get in the helicopter. But you just need to be aware that there is an inherent risk. And so that's something that needs to be pointed out. I will say that I recommend what's called a third ride fly along. And this was kind of alluding to what you were talking about earlier. So some companies- not all- offer for you to come and spend the daylight hours with us on the aircraft and if we get a call, you go along with us in the middle seat, and see firsthand for yourself what we do in the back of the ambulance and what we do in the small facility and taking them to the larger facility and how we care for patients. It gives you the opportunity to recognize what you were saying; these are very restricted scenarios where you have minimal resources, you have a time constraint, it's a tiny, little environment so there's no personal space issues. If you have claustrophobia, this is not going to be a good idea for you. If you have issues with heights, obviously, not going to be super great for you. And then motion sickness can be an issue as well. So I know at least two co-workers who mapped out their whole life's plan based on this idea of becoming a flight crew member and then when they actually got in a helicopter, they vomited every single time. You know, they did the job for several years, but after a while your body's just getting hammered and if you're feeling terrible, I'm not sure about how great the care is that you can provide for a patient. So that's something you want to know before you put all your eggs in this flight crew basket and map out your whole career on this. So I recommend definitely doing the third ride. In fact, I would say do it a couple of times. The heat of the summer is a good one. Because it's miserable. The winter is a good one. That's mandatory for me. And when you can go into your interview and say that you've actually done a fly along a couple of times, I think that gives you quite an edge. I have two partners who've been doing this a really, really long time and both of them say that they have never gotten nauseous. Not one time. I can tell you in the four years that I've been doing it, there have been a handful of times in the winter when it's very windy, or when I was really, really hungry and also really, really hot that I've gotten a little queasy. I've never vomited. I have had third riders vomit on me. And it was really important for them to know that your body's not going to love this job, probably. 


Lisa: Alright. 


Nyssa: So that's a recommendation. I also want to mention what the interview process is like. So you have built this robust resume, you've spent a lot of time and effort in doing these things to get your resume noticed and now it's been pulled out of the stack of 30 or 50 and you've been contacted by HR. You are going to now be asked to take a critical care exam. It's like an entrance exam. It is quite difficult. This is something that you need to prepare for. And it can best be prepared prepared for by using the certified flight registered nurse exam prep materials. So there's a couple of books that I always recommend. The first one is a book called Back to Basics, and it's by Orchid Lee Lopez.


Lisa: That's a pretty name. Orchid Lee. I like that. 


Nyssa: So you can buy that on Amazon. It's very inexpensive. It's about 24 bucks. One great thing is you can get it on your Kindle. So I've had many, many times when people have called me and said, “Hey, I test in three days. What do you recommend?” And like, hmm, with three days you can't even get it shipped to you prime for that, but you can get it downloaded on your Kindle in real time. So that's a great, great thing. I don't recommend that you spend three days studying. You need a little bit more time than that. The drawback to her book is that it was published in 2011. So it's a little bit dated. A better option for what's current is CFRN Certification Exam Review by Flightbridge. That one is much more current. It's a little higher, it's about $55. It's not Kindle downloadable, so you need to give yourself some time to get it. Both of these books are going to provide you with an outline of topics. So if you know what your weakest topic is, you can go straight to that section and study it. They also give you practice questions with extensive rationales that you need to be learning.


Lisa: Okay. 


Nyssa: The reason why I tell you this is you're going to have a good foundation from your three to five years or more of experience. But there are things on this exam that you're probably not going to have had a lot of exposure to that you will in the flight environment. So for example: high risk OB. We fly high risk OB patients, but in the ER, we had the privilege and luxury of just scooting them on up to labor and delivery and letting those experts handle it. Well in the flight environment that's not an option so we do have to learn about high risk OB. That could be on your interest exam. There could be some questions on there. This exam is designed to weed out folks. So that's why it is difficult and that's why there are things on there that they know you have minimal exposure to. They're also testing your critical thinking skills and your testing skills. Another thing that's going to be on there is principles on rapid sequence induction for intubation. So this is something that all nurses have assisted with in the hospital, but the intubation itself was done by respiratory or by a physician. Well in the flight environment, guess what? It's going to be you, your medic partner, or you and your medic partner together. 


Lisa: I see. 


Nyssa: So there are questions on that on the exam and it will be a role that you are not familiar with. It's a different role than what you did in the hospital.


Lisa: Is it different than what you were taught when you are a student in nursing school? Like, did you encounter this as a student and then just never… No? You're you're shaking your head and sticking your tongue out, so I'm assuming that…


Nyssa: Yeah, so there's very little in nursing school that touches on these kinds of advanced and critical care. You may have gotten a paragraph in your book and maybe a mention, but a deep dive, no. 


Lisa: Okay. 


Nyssa: Then the other thing that kind of pairs along with that is ventilator management. So again, in the hospital, nurses take care of vented patients all the time, but it's in conjunction with a respiratory therapist and a pulmonologist. And generally, they're the ones running the show and you're just passing along the vent settings to the next nurse. That's pretty much the extent of what we do with vents with some few exceptions. But in the transport environment and the flight environment, it's you, again, you and your medic partner that are initiating the vent settings in a field intubation- managing it, troubleshooting it, and making decisions on it. So that was a huge learning curve for me because that's not something we ever did in the hospital environment. Those questions might also be on  your entrance exam. So you need to have at least breezed through those chapters on the book and familiarized yourself with a few of those things. So just don't be surprised when you see things on the test that you're like, “We don't do this in the hospital.” That's kind of the whole point. And that's one of the reasons why they put that on there.


Lisa: Right. Because you're kind of in a mobile emergency room. And it's just you and one other person and whatever you have at hand.


Nyssa: Right. And you are fulfilling the roles of sometimes four or five or six other people- the two of you. So you take your exam and you do well. So on this exam, you have to reach a certain threshold in order to continue in the process. I do know people who have not made the benchmark number and have retested again in three or six months. So you do have the opportunity of retesting, going back, studying, and then reapplying and if your resume gets pulled again, you will have opportunity to retest again. So all is not lost if you don't pass it on the first time. 


Lisa: How many times can you retest?


Nyssa: I don't think there's a number. But I know you get at least another stab at it, just from knowing what people that I've seen going through this process But let's say you are successful on the test, then the next step is going to be coming in for an interview. And this interview is going to be different than any interview you've ever done before. It's three part, at least three parts, maybe more. So you will sit down with the panel and they will interview you and they will ask you the traditional questions. What are your strengths? What are your weaknesses? Tell us about yourself? Why do you want to be flight nurse? What do you know about our company? Kind of the standard Interview Questions? And then they will always end the interview with what questions do you have for us. And I always recommend that people have some intelligent questions to ask back. Please don't say when can I start? Please don't say what's the pay rate, those are not appropriate in an interview and they make you look unprofessional. So have some good questions prepared. 

Lisa: What's a good question? Give me an idea of a good question or two.

Nyssa: So if I were on a panel, which I am just a line flight nurse that has not been on an interview panel in this role, I've interviewed people in other roles in nursing that I've done, but I would want to hear you say something like, what does my orientation look like? Who will be my preceptor? How will I know if I'm on track, where you want me to be? How will I get feedback about my performance? You could say: you know ventilators are not my strength.  How will I get training on ventilators? What will that look like? You could say: where would you ideally want to see me one year from now, as a good employee? What would it look like a year from now? What do you guys think makes a great flight nurse? You know, what are your definitions of a great flight nurse? Those are all questions that make you sound engaged, thoughtful. Like you're planning out how to succeed in your orientation, how to succeed in your first year and beyond that, right? So those are the kind of questions that I would want to hear if I were on the hiring end, which again, I'm not.


Lisa: But no, those are very helpful. And actually some of those are great for regular interviews except for "What would I do with a ventilator?" But I could see myself asking those questions and interviews of my own when they asked me if I have any questions.

Nyssa: So you've rocked your interview. And then the next thing that they're going to do is you're going to go through some mega codes. So at this point, you will be familiar with mega codes, because you've done them at the end of ACLS, you've done them at the end of PALS, you've done him at the end of TNCC and ATCN. So what a mega code looks like: you're going to go into a sim lab with a high definition basically, it's a robot mannequin, okay, that can talk to you. It has vital signs, it has heart tones, we have adult ones, we have ob ones that have a little baby inside that can actually be delivered, we have pediatric, neonatal. So you will be with this high fidelity mannequin, and you will be given a scenario. In general, you are given one medical scenario and one trauma scenario, I can guarantee you that you will be intubating this mannequin. So the idea is that you walk into a hospital or you walk into the back of an ambulance. And here's your patient, and they want to see how you are going to do the hands on piece of the care of the patient and what you know and how your assessment is and what your thought process is and what kind of tests you want or questions you're going to ask and resources that you're going to use and need. And do you know how to use those appropriately? So you do need to be prepared for at least two mega codes, they may even put you through three or four if they're going to use the peds and neonate and so forth. So that's one of the reasons why these courses are so important for you to go through and have that experience.

Lisa: So when you do these mega codes, are you in an environment that simulates the inside of the helicopter?

Nyssa: No, it's going to look more probably like a like a hospital room.

Lisa: That's not fun. It would be so cool if it was actually one of those like little kind of like an astronaut and like the G forces are hitting you then what are you going to do? How do you make this patient while you're negative five G's I don't know what G's are but that would be really cool. 

Nyssa: I know! I hope my educators aren't listening to this because they will totally get ideas.

That interview process is super intense. And I was whipped by the end of the day. That is your brain is fried and scrambled. It was very, very stressful and very, very nerve wracking. But you can see why it's such a competitive field. And they're trying to find the strongest candidate to fit with the position, there's a couple other little pieces of advice that I want to end with. One is I want you to find a mentor, I want you to find someone in the flight industry, if you can, that will mentor you through this and help you along the way, giving you some of these tips or when you bump up against a roadblock,  some creative ideas on how to come around that.

Lisa: And your're volunteering yourself to all of our listeners to be that mentor for each and every one of them? 


Nyssa: Absolutely, yeah. Just hit me up.


Lisa: And I'll give you her personal cell phone number.

Nyssa: Okay, wonderful. That's exciting. The last thing that I want to mention is to ask yourself a question, How bad do you want this? And the reason why I asked that is because (or you need to ask yourself that) is because there are some ways to break into this industry, if you really, really want this. So as we have talked about a lot of these bases, the majority of the bases that we serve, serve rural communities, which means that the base is oftentimes in a very remote area, a very small town with not a lot of exciting things to do on the weekends. And so a lot of people don't want to live in those environments and be in those places. The more remote and the more rural the base is, the more difficult it is to staff because of those things that I just mentioned. So people end up commuting long ways because they want to be in a little bit bigger city. And so they'll commute an hour or two hours to work is not uncommon.

Lisa: I mean, you commute like 45 minutes to an hour, right?

Nyssa: Yeah, I commute about an hour. Uh huh. And it's not bad because we do 2-24 hour shifts a week. And so it's not the same as commuting an hour to a 12 hour shift in an ER, which I probably would not do. So if you want to break into the industry, there are some bases that are in some very rural and very remote states and very remote areas that are difficult to staff, if you are willing. And if your life circumstances make it so that you can relocate to one of these places, you can get a position there. And then once you are in the company and in the door and you're getting flight experience, and you've put a year or 15 months under your belt, and a position comes open in at the base or in the area where you really want it to be, then you get first dibs on an inner company transfer. So you can sort of work your way back to where you wanted to be originally. So if you're more on the three year end of experience, or you're willing to do whatever it takes to get into this industry, and you have the flexibility of picking up and relocating, this is a really good option for you.

Lisa: So what are the benefits to being a flight nurse as opposed to being a regular ER nurse? And I fully understand that this may be a personal preference thing, but sell it to me, Nyssa.

Nyssa: So what I love about it and when I was looking for when I went into this is I was looking to push my skills and my critical thinking forward. There's a lot of independent thinking in this, you know, as we've mentioned several times, it's you and your medic partner making decisions for the patient, in the back of the ambulance or in the helicopter. I love the challenge of that. I love the increase of knowledge that I have gained from learning things like ventilators and being able to intubate, which we don't do in the hospital, as registered nurses in the ER. So it's just was a way to push my practice even further, to another level.  You know that I love ER nursing, and I haven't given that up, I still work in an ER. And this is a way to take it even further outside the hospital and into the community. So I just find it to be another level of challenge.

Lisa: I'm going to ask the question, you said that I shouldn't ask my first interview. How much money do you get paid? I don't want a dollar figure but is it a more lucrative nursing career? And part of that question is, does it have an earlier expiration date than an ER nurse would you say in terms of being able to continue in that position?

Nyssa: What I will say, again, is from my experience, my company, my market, and what I will tell you is that the pay rate that I make is very, very comparable to what I made in the hospital. So as far as the expiration date, that sometimes sends people away because they can get paid higher in the hospital environment. We lose people to the same reason that people are lost in the hospital: they want to go on to be, you know, be masters prepared. And so they go on to become a nurse practitioner or CRNA.  People relocate. And then sometimes people just burn out. You know, working and not sleeping at night sometimes gets old. Sometimes your body doesn't tolerate it anymore. Because there is a physical aspect to flight nursing. There is in the ER as well. Being on your feet for 12 hours a day is no joke physically.

Lisa: Plus, you're also like staying in a dorm with the people who are also on the shift with you and you have to eat microwave food and it's not home, you're not going home.

Nyssa: Well the base becomes your home for about 25% of your life. You spend it there. So it's true that at your base, crew members become a type of a family; you eat three meals a day with them. And you see them at two in the morning and you see them on Christmas day and you spend a lot of time with them. And so one of the attributes to being a successful flight crew member is you have to be a team player. You don't have to, like hang out with these people outside of work. But you've got to be able to get along with folks 24 hours a day. We don't leave the base unless it's for a call. We don't run up the street to grab something from the grocery store. We don't leave and go to McDonald's. So you are with these people for 24 hours a day. If you are a loner or you like your privacy, this may not be something for you.

Lisa: I wonder why there isn't along with Chicago Med and Chicago Fire something like Chicago flight nurses because that sounds like a really interesting setting. It could see a lot of really high drama.

Nyssa: You are on fire with the ideas today.


Lisa: I am. I totally am. Again, pitching this to all the Hollywood producers that are listening to this. I will volunteer my services as a writer for, I don't know, a billion dollars an episode.


Nyssa: Yeah, that sounds reasonable.


Lisa: Yeah. Okay, so do you recommend it? I mean, let's just put it down to two nuts and bolts.

Nyssa: I mean, I love it. I know it's not for everyone. But it's definitely for me.

Lisa: Well, I'm glad that you're flying the skies. And I know that whenever I get into trouble on the side of the road, I'm just gonna beep you. Right?

Nyssa: Yes. So if you have more questions about what it takes to be a flight nurse, if there's something that you're thinking about that I didn't touch on, please feel free to hit us up. We are on all the social media at The Q Word podcast. We are also

or you can email us at theqwordpodcast@gmail. com.


Lisa: And we'd also love it if you would rate us on your podcast app of choice, be it Spotify or iTunes or Stitcher. Give us a five star review so that we can rise up in the ranks of podcast fame and get a few steps closer to our goal of taking over the world.


Nyssa: Right. With your billion dollar paycheck you'll be able to do that. If you don't want to miss an episode be sure and subscribe.

Lisa: Absolutely.




flight nurse, ER, hospital, patient, helicopter, questions, ventilators, nursing. interview, resume, base, certification, fly, environment, medic

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