By Tom Clegg
Working on a patient in critical condition can be stressful for any nurse. But imagine working on that same kind of patient in the middle of the street shortly after a motorcycle accident, or inside a cramped medical transport helicopter with limited supplies flying at night at 120 mph.
Being a flight nurse isn’t for everybody, but it is for Debbie McIntyre, RN, CFRN, air medical base manager of PHI AirCare 2 in Fredericksburg, Va.
“It does take a little getting used to,” said McIntyre, who has been a flight nurse for the past 28 of her 33 years in nursing. “It’s definitely different than being in a hospital where everything is kind of controlled.”
Not to mention there’s no threat of a bird strike in the ICU. McIntyre won’t soon forget the day last year that a crane flew into the path of the AirCare 2 helicopter and crashed through the pilot-side windshield during a flight out of Washington D.C.
“There’s a few seconds where you kind of go, ‘OK, what’s going on?’” McIntyre recalled of that nerve-wracking flight. “We’re in the back, and in our particular aircraft you can’t see the pilot. We know something has jolted the aircraft, and we’re looking at each other like, ‘Are we OK?’
“[The pilot’s] not talking to us right away because he’s assessing his situation. He’s just taken a bird into the face. He had his visor down, which really saved him.”
Fortunately, the pilot suffered only a lacerated chin. There wasn’t much left of the crane.
As much as McIntyre enjoys the unpredictability of her job, she said the best part is the teamwork required. Each flight typically consists of only three people: a flight nurse, a paramedic and a pilot. The bond formed between the paramedic and nurse has to be close.
“It’s not like going into a trauma center where you have 20 people,” McIntyre said. “It’s just the two of you. So you really have to count on your partner, and if you don’t partner well, you won’t do well in this job.”
McIntyre said about 60% of the AirCare 2 calls are for hospital flights, which usually involve transporting a patient in need of a higher level of care from one hospital to another. The other 40% involve such things as motor vehicle accidents or shootings, where care is performed on the street before the patient is flown to a trauma center. Also becoming increasing common in recent years are flights for patients who have suffered heart attacks or strokes, where time is of the essence.
In addition to working on flights, McIntyre is in charge of hiring at AirCare 2. Requirements to become a flight nurse there typically include a minimum of five years of critical care or emergency medicine experience. They also must hold numerous certifications, such as pediatric advanced life support, cardiac life support, trauma life support and flight nursing.
Extensive, continual training also takes place for established flight nurses and paramedics to keep up with the latest changes and advancements in care.
The setup at Children’s National Medical Center in Washington, D.C., is slightly different. There, the transport team may be called upon for either air or ground transports of patients.
One of those team members is flight nurse Gwenn Greer, RN, CNPT, CCRN, CPEN. Although she is capable of doing ambulance ground transports, Greer mostly takes part in air transports. She said the reactions of the young patients who are picked up by Children’s National’s red-and-black SkyBear helicopter range from being “terrified” to “absolutely in awe,” but most fall into another category.
“I find that most children are lulled to sleep by a helicopter,” she said. “I call it the world’s most expensive rocking chair.”
It didn’t take long for Greer, who has been a transport nurse for eight of her 11 years in nursing, to realize it was the specialty for her. “It took me five minutes of transport to know that that’s what I’m going to do,” she said. “I love transporting.”
But the biggest reason this mother of three children enjoys being a flight nurse is the love for her patients and the work Children’s National does for them. Greer said she is amazed by the bravery and resiliency of children, such as the case of a teenage girl who was being coded for a ruptured arteriovenous malformation when Greer’s team picked her up.
“I was terrified of what her outcome was going to be, and she actually walked out of this hospital and went to her prom,” Greer said. “There are certain things that you get to do here that I just don’t think you would see at other places.”
Tom Clegg is a freelance writer.