Episode 15: Inside the World of a Flight Nurse

Cara Lunsford (00:48.948)
First of all, Bob. Bob, I love that hat.

Bob Bacheler (00:57.058)
People would not know what I look like without it.

Cara Lunsford (00:59.928)
I wish I had, you know, I wish I had my hat. Like I would, I would go and put a hat on just, just for this interview. You know, it's so funny that you say that is that my father growing up always, always had a cowboy hat on.

Bob Bacheler (01:18.966)
Okay.

Cara Lunsford (01:20.143)
And so much so that when he took it off, he had like a permanent indentation on the side of his head where the hat would sit. Like in his hair.

Bob Bacheler (01:31.758)
I wouldn't doubt that I probably do. I probably do that.

Cara Lunsford (01:35.623)
Do you have that? Do you sleep in it? So you just don't know.

Bob Bacheler (01:39.022)
No, I don't sleep in my head. I run the joke that I woke up next to a woman and she started screaming, are you? And I put my hat on and she said, oh, you're my husband. Okay.

Cara Lunsford (01:50.638)
that's so funny. love that. So funny. Okay, well, Bob Batchelor, I'm really excited to have you on the show. I can't tell you. I really we tracked you down.

Bob Bacheler (02:05.017)
good, well thank you. think that it's a little scary, but you know.

Cara Lunsford (02:10.687)
It's a little scary. It's a little stalkerish. we, my, the podcast coordinator, Rhea, she really wanted an episode on this very subject.

Bob Bacheler (02:19.821)
Mm-hmm.

Cara Lunsford (02:26.673)
you know, which is basically she wanted to know about flight nursing. She thought it was a fascinating field. I agreed with her. I had found your organization, reached out to some person just literally cold called and was like, hi, is there anyone over there that would be interested in talking to me on the podcast? And then of course life happens and it worked its way to you eventually. And here we are Bob. 

Bob Bacheler (02:32.846)
Mm-hmm.

Bob Bacheler (02:58.964)
I'm excited to be here.

Cara Lunsford (03:01.459)
I'm excited to have you. Bob, tell me a little bit about just yourself. Like how did you get started in this? How did you just get started in the healthcare field to begin with? And then like how did you make your way into this area of healthcare?

Bob Bacheler (03:23.278)
So, nursing was kind of a second career for me. I was only 30 at the time. I knew if I wanted to have a family that I needed to have some kind of stable backup income. was a serial entrepreneur prior to going into nursing. as you well know, failure is often at the point of that. And I said that if I'm gonna have a family, I wanted something as a backup.

that I could do in the event that one of my businesses didn't work out. I never expected to make a career out of it. And I went to Community College of Philadelphia in 1989, graduated in 93, wound up working in an ICU, trauma ICU, right out of nursing school, which I was very excited. And I said, this is fun.

So, you my path in the beginning...

Cara Lunsford (04:23.037)
Such a typical dude. have to say, like, such a typical dude. Like, so many, so many of, like, the men that I know are, like, trauma. They're like, I'm going into trauma.

Bob Bacheler (04:34.452)
And I hate to be a stereotype, but I am going to be that stereotype. I did trauma, I did burn, I did ICU, I did all of the guy things, if you will, and I love that. I moved, I worked as a contract nurse soon after my two years were up.

at the hospital I was staff nurse at and I would just work all over the city of Philadelphia in all the trauma units and all the I worked in all three of the burn units here in Philadelphia and I thought it was I had a I had a great time doing it it was a lot of fun

Being the guy, the dude, if you will, well, you I wanted to be a flight nurse. That's that was kind of like the be all, do all, end all of what guys want to do. Well, the problem that I had is I live in Philadelphia and we're a major metropolitan area and there's just not that many flight nurse positions, you know, when you have, you know, five level one trauma centers within a five mile radius.

If you want to move out to Walla Walla, Washington or some rural area like that, again, no disrespect to Walla Walla, Washington, but if you want to live in a rural area, the opportunities for rotor wing nurses are much better. But on the other side, the helicopter nurses are referred to as rotor wing. That's what it's referred to in the industry.

Cara Lunsford (06:05.457)
Is that what they call them? Rotor, rotor wing?

Bob Bacheler (06:17.134)
But I do happen to live close to Philadelphia International Airport. So I guess it was way back in 2004, a friend asked me to fly his grandfather from Sarasota, Florida up to Toronto, Canada. And I said, well, sure, I'm a nurse. And as many people who work with the dementia crowd know, which I didn't realize at the time,

you know, lot of folks with dementia respond better to caregivers than they do to family. So that was one of the reasons that the family didn't want to do it themselves. So I said, sure, I'm a nurse. I can do this. And I flew down to Sarasota. And he was a cantankerous old cuss. I picked him up. We got him on an Air Canada flight.

and took off. I'm sitting there in first class because I said we're going to fly in first class. And this was the first time I had ever flown in first class in my life. I thought this was really cool. Patients sitting next to me. I'm reading Skymall, having a grand old time. That'll date me. And all of sudden, he stands up. Help, help, I'm being kidnapped. I'm being kidnapped. Well, and you have to keep in mind that this was not that long after 9-11. And nobody had a sense of humor.

on airplanes anymore. I mean, it's just, you know, it's funny. So I did what any good ICU trauma dude nurse would do. How'd all, how'd all right through the pant leg. Boom.

Cara Lunsford (07:44.603)
You gave him some Thorazine.

Bob Bacheler (07:51.662)
pop. Well, I think I think any of your listeners are going to think the same thing sedation and and and that's what I did. You know, five milligrams of haldol right through the pant leg. Boom. He sat down. I just said, Grandpa had a bad dream. He's fine. Sound asleep. And he was sound asleep for the rest of the trip. Taking him off the plane. He was sound asleep. Wheeling him through the airport. You know, it was fine. I handed him off, you know.

Cara Lunsford (07:58.066)
Yeah

Bob Bacheler (08:18.558)
the facility and I was like, yeah, he's really tired. He had a long flight. And I was like, wow, this is what I want to do for my career because I've always loved aviation. I've always loved airports. You know, I love, I love patients.

Cara Lunsford (08:33.363)
First of all, let me just tell you, there's plenty of people out there that are not in need of this type of service but would welcome someone sedating them on the plane. you know, people who are afraid of flying, like they're like, hey, they're like, I can call Bob, Bob will just cut.

Bob Bacheler (08:45.165)
Mm-hmm.

Bob Bacheler (08:54.354)
We get more of those requests than you imagine, and that is a concern. 25 % of our patient population post-COVID are dementia patients, cognitively impaired patients. And when we're transporting anybody who has the potential to become aggressive or potential for agitation.

Cara Lunsford (09:06.163)
Yeah.

Bob Bacheler (09:17.538)
you know, we're going to want to make sure we have that sedation of last resort. And there's, always trying to manage the patient. We're always trying to keep the patient calm, you know, orals, you know, we're always kind of giving some kind of, you know, proactive oral sedation and try to give them oral sedation through the, through the flight, you know, but we always kind of want to make sure we have that last, you know, last resort if we need to do it. And, know, over the course of the last 20 years,

Cara Lunsford (09:21.851)
Yeah, of course.

Bob Bacheler (09:44.906)
mean, maybe half a dozen times. So it is a very, very rare event. And we never plan for that. If somebody is combative, we're not taking them on a commercial airline. So it's one of those that has to go into the planning and the operations of things.

Cara Lunsford (10:01.797)
I you know, it's we joke because we're nurses. So that's what we do. Right. So we we joke. Yes, we have a very morbid sense of humor. But, you know, candidly speaking, even a lay person who's listening to this podcast episode, you know, if you're a parent, how many parents out there have like medicated their

Bob Bacheler (10:06.26)
Mm-hmm. We joke very darkly.

Cara Lunsford (10:31.714)
child with Benadryl and like tested it out beforehand to make sure they didn't have some sort of paradoxical reaction and then you know after you know

Bob Bacheler (10:32.65)
yeah.

Bob Bacheler (10:37.827)
Mm-hmm.

Cara Lunsford (10:44.692)
that they use that because they're like, I don't want my two year old like screaming on the plane. You know, so I think all of us have had those moments where we're like, how are we going to how are we going to control this with medication?

Bob Bacheler (10:51.694)
Mm-hmm.

Bob Bacheler (10:59.98)
Yes. You know, yes, absolutely. And it's funny, my daughter travels with her dog, you know, and the dog is a comfort animal. And she sedates the dog too. I mean, before she travels.

Cara Lunsford (11:12.753)
Yeah. for sure. For sure. I mean, I was just on a flight with someone who had a cat and the cat was like, you know, you can't see my face on this podcast, but I'm basically like squinting my eyes and and and and literally just looked stoned. mean, like completely stoned. And I was like, what? What? Give your cat.

Bob Bacheler (11:20.492)
Mm-hmm.

Bob Bacheler (11:27.31)
You

Bob Bacheler (11:32.782)
You

Bob Bacheler (11:37.57)
Can I have some of that?

Cara Lunsford (11:38.758)
Yeah, right. So yeah, I mean, I think that that it is just fascinating. I'll tell you, Bob, this is so it's kind of surreal. But today, I got a message that like one of my longtime clients who I've been with for like 10 years, once a year, he will hire me to transport him. So he flies me out first class.

Bob Bacheler (12:07.138)
Mm-hmm.

Cara Lunsford (12:07.571)
which is always amazing, puts me up and then I fly back with him private from like Europe.

Bob Bacheler (12:18.2)
Okay.

Cara Lunsford (12:21.235)
only because there's been a situation where he aspirated 30,000 feet in the air years ago. And so now my job is really just to make sure that his head of bed is elevated when he's sleeping on the plane. You know, I tell him that he can't eat, you know, two hours before and he listens to me. So because

Bob Bacheler (12:28.888)
Okay.

Bob Bacheler (12:39.576)
Mm-hmm.

Cara Lunsford (12:51.142)
very similar to what you just said is that he listens to caregivers. But if his son or you know, one of his sons was to tell him this, he'd be like, I'm not doing that, you know, but because I'm on the plane with him, he listens to me and we get him home safely and he doesn't aspirate and you know, all is good. Right. So so that being said, like I, you know, I totally understand the whole like companion

thing, the flight companion thing, and I think it is a great gig for nurses who are looking to do this. do you, so for your, tell us a little bit about your company. Okay.

Bob Bacheler (13:22.318)
Mm-hmm.

Bob Bacheler (13:33.614)
Okay. So what we do is we have nurses and doctors all over the country. Now for the, for the last couple of years, all of our nurses have been per diem 1099. What we've discovered is we have, you know, the old 80 20 rule where you have, 20 % of the nurses doing 80 % of the flights. So, you know, we're kind of transitioning, you know, to, to an employee model this year.

where our nurses are actually, you know, our W-2 employees. Yeah, we have about 70 doctors and nurses all across the country who fly for us. All of our nurses are, you know, minimum of 10 years ICU critical care experience.

We're looking for that critical thinking background. It's gonna be one nurse and a patient at 35,000 feet. And you need somebody who has really good critical thinking skills and good clinical skills in general.

we make sure that our staff are well vetted. To be fair, most of our nurses are seasoned nurses. I would probably say the average age of our nurses is around 50 to maybe 55. So, this is kind of a second career. Nurses can make more money.

working in the ICU. I did per diem work for a good portion of my career and I know what a nurse can make doing a 12 hour shift in the ICU. And I know what some of these contracts, remote will pay. I mean, they pay an awful lot of money, which is terrific for nurses. I don't get me wrong.

Bob Bacheler (15:22.958)
One of our early podcasts, people were talking about getting paid, you know, $8 an hour, you know, when they started nursing. And I think I started around 14 when I started $14 an hour. And I thought at the time I was like, well, I'm big cheese. But most of our nurses who fly for us, again, have kind of raised their kids, you know, their kids have moved out. And now they're saying, you know, I want to do something that is fun, that's enjoyable.

And, you know, to be fair, I think what we do is the most amount of fun that you can have as a nurse. You know, you're, you're doing one-on-one patient care. Uh, you're getting somebody where they need to go in, in, know, what could be a, a, a, I don't want to say crisis, cause again, we're not an emergent service, but you know, I, you and I, share a passion for hospice, you know, um, we transport a lot home.

in their final days or you know when they know that they're going to pass and you know they want to pass at home. We're often of great service to the Indian diaspora here in the United States because

they want to die at home. As any hospice nurse will probably tell you better than I can, I just wish they didn't wait so long until things were so close to the end for us to transport them because we're transporting some people who you know you get them there and you know you hear 24 48 hours later that they passed and that always kind of you know gives us that that that's

Cara Lunsford (16:59.463)
That's a little like Weekend at Bernie's, Bob. I'm just saying like that's a... That's pretty close to propping him up.

Bob Bacheler (17:06.158)
That's pretty close. And we do some low Glasgow Coma Scale patients, traumatic brain injuries and stroke patients that may very well fit into that criteria, especially transporting people overseas. We're having a grand old conversation with them, talking to the whole way. And I know they're Glasgow Coma Scale 3.

We're not getting any response. Yes, Weekend at Bernie's is a good way to describe that.

Cara Lunsford (17:46.846)
Yeah, I think that if you have, would say that what has really prepared me and for...

for things like flight nursing or private duty concierge, where you're in situations where you don't have everything available to you. I've found that sometimes nurses that come right out of the hospital are definitely used to having a med room and everything available and supplies. it's definitely a transition.

Bob Bacheler (18:06.062)
Yeah.

Bob Bacheler (18:23.02)
Mm-hmm.

Cara Lunsford (18:31.099)
right over to that kind of way of thinking.

Bob Bacheler (18:38.67)
Mm-hmm.

Cara Lunsford (18:39.252)
One of the things that definitely helped me was going into home health. So working in home health, working in hospice, realizing like there's only so much I have available to me, like in this home, in my bag. I can't just call to the pharmacy and have something tubed up to me. you know, and also mission work. So working, working missions. So medical missions. I worked in Haiti. Talk about

Bob Bacheler (18:44.864)
Absolutely.

Bob Bacheler (18:49.742)
Mm-hmm.

Bob Bacheler (19:04.718)
Mm-hmm.

Cara Lunsford (19:09.285)
not having anything. Like you just you just don't have the stuff that you're accustomed to having. So I would say that anyone who's interested in going into this field should definitely probably like I don't know if you agree with me, Bob, but like moonlight in some of these areas like of home health or hospice or doing a mission or something like that, because it helps you get a little bit more into that MacGyver mode than

Bob Bacheler (19:10.922)
austere conditions.

Mm-hmm.

Bob Bacheler (19:36.899)
Mm-hmm.

Cara Lunsford (19:39.141)
than sometimes what we're used to in the hospital.

Bob Bacheler (19:43.022)
Absolutely.

I often have conversations with our friends in the air ambulance industry. know, when I was an ICU nurse, you would go into the hospital and it really didn't matter what your patient was. It didn't matter whether they were vented. It didn't really matter if they were on ECMO 15 drips. That's fine. You're as you identify, you're in the hospital setting. You have everything you need. In the air ambulance world, they have every, their planes are configured. They have their ventilators. have the drug box.

they have everything they could possibly want for a patient. So what the patient is doesn't necessarily matter a whole lot. They can be doing ECMO at 35,000 feet if they have the right equipment. When we're transporting a patient on a commercial airline, to your point, no, we don't have a med room in the back of the airplane. I had a patient a couple of years ago, I was transporting to Hong Kong, and he had a gastric fistula.

and they had decided the day before he was going to go to Hong Kong to start feeding him and he had some fried chicken and some hamburgers and I'm about an hour and half into this 14-hour flight to Hong Kong and all of a sudden he starts erupting through his gastric fistula. Now, fortunately, he wasn't in any catastrophic distress, but, you know, we had, you know, I had some dressings to pack him and keep him clean.

Well, I wound up using those dressings in about the first hour of this flight. So, okay, I'm down to 12 hours, you know, and I've had this guy erupting. Well, I realized that they have feminine products on this airplane and we were on a 747.

Bob Bacheler (21:28.426)
So I wound up going over the course of the next 10 hours, I was in every single bathroom on that plane taking out all the feminine supplies and I was using them to pack his fish. Now I always, to be fair, I always left one or two in every bathroom. But whoever had to restock that plane when they were done is probably like,

They emptied all of the bathrooms. mean, this is a 747. There's a lot of bathrooms on a 747. So I went through a lot of product there. But as to your point of MacGyvering, yes, that's what it takes. It takes sometimes being creative to get what done, done.

Cara Lunsford (22:07.287)
That's that's amazing. I was on a concierge private duty thing in South Africa and and I was talking to a bodyguard and he was like, I carry I carry tampons because if I get shot, I'm going to stick the tampon in the bullet hole wound. And I was like, what I had I

Bob Bacheler (22:16.417)
Okay.

Bob Bacheler (22:28.074)
Mm-hmm. Yep. Mm-hmm. Yeah, they're sterile. Mm-hmm.

Cara Lunsford (22:36.25)
Yeah, and they expand, they expand like and they create like pressure in the area to like stop the bleed. And I was like, that is fascinating. And they even have an applicator so you can like stick it in. I was like, that is that's amazing. And there's so many. Actually, do you have any other like stories like that? Because I think like this is like such a good learning experience

Bob Bacheler (22:49.89)
Mm-hmm. Mm-hmm.

Cara Lunsford (23:06.133)
for people thinking about going into the field where it's like you had to get, or maybe one of your nurses or doctors had to get resourceful.

Bob Bacheler (23:15.466)
we have it all the time. In many cases, we'll have flights getting changed or flights getting delayed. Years ago, we had a patient who was flying a patient through Moscow.

Not that we've done that for the last couple of years, but they had a mechanical problem and they had to take the patient off the flight in Moscow and check him into a hotel for the night and stay with the patient at a hotel overnight. There are any number of cases where, you know, our patients who have had traumatic brain injuries, you know, that we're having conversations with.

on the flight, it's making the flight crew come around, do they want anything? Hi John, do you want anything to drink? No, he doesn't want anything, he's fine. You know, nobody is more, is the.

knows any better. that's fine. We have had episodes where we've kind of had to improvise just to make sure the patient got to where they needed to go. Patients who are mobility impaired. Just last week we had a flight we were going to do with a gentleman who had a leg fracture and we were told in our intake

when I was talking to the nurse that the patient could bend their leg.

Bob Bacheler (24:50.446)
and our nurse gets down there the day before the flight and they're like, Bob, this guy is six foot four. He has a leg extender on and he is not bending his leg at all. Now, normally somebody like that we'd put in a first class seat, but you know, if you imagine somebody who is very, very tall, no, we're not getting him into a first class seat if he can't bend his leg at all. So we just kind of improvised. We went up, you know, getting a full row of coach seats on the same flight. We just put him in a, we put him in a full row of coach

and you know everything went fine. So I was little improvise and adapt on the fly there.

Cara Lunsford (25:28.434)
That is a great solution. if you can't bend your leg and if you have, and if they have, obviously, you know, the people that are hiring your company have some level of means so that they have the financial ability to hire an escort to come with them.

Bob Bacheler (25:30.51)
Mm-hmm.

Bob Bacheler (25:39.726)
Mm-hmm.

Bob Bacheler (25:48.686)
Some of them do. To be fair, a lot of people were transporting the $10,000 it costs to get, let's say, get somebody across the country. That is every penny in the world to them. And a lot of times people are reaching out to us because they talk to an air ambulance company, which is definitely can be a simpler way to go.

you know, but the air ambulance company quoted him $50,000. Well, that $10,000 that I'm saying is what it's going to cost, you know, sounds like a lot until you compare it to, you know, $50,000 for an air ambulance crew. We did a transport to India a number of years ago and the family called me up and they said, we need to get, you know, grandma back to India. What's it going to cost? And I said, well, about $30,000. And the response was, is that all? I said,

Well, yes, let me guess you were talking to an air ambulance company. Yes, they talked to an air ambulance company that told them it going to cost them $300,000. So $30,000 sounds like an awful lot of money, but if you're comparing it to $300,000, it's pretty realistic.

Cara Lunsford (26:59.635)
Well, and I think that there's so many situations, right? And you mentioned this a little bit earlier about how people kind of wait until the last minute to start thinking about where they, you know, where they want to die or where they want their parent to die or grandparent. And that sometimes it's in their hometown. Sometimes it's getting them closer and

Bob Bacheler (27:25.731)
Mm-hmm.

Cara Lunsford (27:29.983)
We know that people spend the majority of the money that they're going to spend on health care, they spend it in the very later later stages of their life. And so I think some of that.

Bob Bacheler (27:39.661)
Mm-hmm.

Cara Lunsford (27:46.652)
you know, should be around like, where does some where will somebody be the most comfortable? You know, if you can save some money on medical treatments that you know are going to be maybe futile and you can start having the end of life conversation a little sooner and you can say, hey, you know what? I'd really love to have my parent who is back east. I want them to be out here.

Bob Bacheler (27:53.005)
Yeah.

Cara Lunsford (28:16.705)
with me. I can care for them better here. I can even save some money being able to care for them as opposed to paying caregivers who might be back east. And you spend that money to get them out. Then you have that quality time with your loved one.

Bob Bacheler (28:20.631)
Okay.

Bob Bacheler (28:26.605)
Mm-hmm.

Cara Lunsford (28:37.94)
And you can actually make them more comfortable in the later stages and end of their life. So I mean, to me, $10,000 to get somebody out safely to wherever you need them to be so that they're closer to their family, that I think is just invaluable.

Bob Bacheler (28:51.651)
Mm-hmm.

Bob Bacheler (29:01.43)
And a lot of these folks are paying an awful lot of money in facility fees, if they're in a skilled nursing facility. I mean, we're talking thousands and thousands of dollars a month. It's not uncommon for people to say, well, we want to get grandma out on the 31st.

because we're paying for this facility in this special needs skilled nursing facility in California and we want them to be with us in Boston, but we're trying not to pay a month where we're paying $4,000 here and $4,000 here. So in many cases, we're kind of...

Cara Lunsford (29:36.756)
Yeah, and you're lucky if it's only $4,000. My grandmother was at a local assisted living and she didn't even have a lot of medical needs or medical care and she was paying $6,000 a month.

Bob Bacheler (29:46.51)
Mm-hmm.

Bob Bacheler (29:52.799)
wouldn't doubt a member. A lot of memory care facilities can cost a can cost a small fortune.

Cara Lunsford (29:58.621)
Yeah.

And she didn't even need memory care. She literally was just there because, well, she was 90 at the time, like 94 at the time. And she had she had injured her hip. She didn't completely break it, but she fell and she injured her hip. And then she kind of got stuck there during 2020. So then we wanted to get her out at some point. But yes, six thousand dollars a month.

Bob Bacheler (30:08.504)
Okay.

Bob Bacheler (30:14.498)
Okay.

Bob Bacheler (30:18.03)
Mm-hmm.

Bob Bacheler (30:26.956)
Mm-hmm. Yes.

Cara Lunsford (30:30.048)
And yeah, you could totally save that and then spend that quality time, especially if you know that your loved one is approaching end of life or is a candidate for hospice or something like that, that being able to do that closer to home is such a better option, in my opinion, of course, that's my opinion.

Bob Bacheler (30:51.308)
No, I completely agree. I completely agree with you. you know, that's what we love about what we do is, you know, we're providing that service and we're providing that ability to get somebody, you know, to their family when, you know, the family just has no idea how are they going to do this? And they reach out to us and they say, well, we have this and this and this and this and this. And that's fine. We're, you know, I don't want say we've seen it all because every, every day is something new. There's always some new challenge and every transport is unique.

in its own way.

But a lot of these problems we've seen before and we have resources and the ability to overcome them and get people where they need to go. And they're very happy about it. one of the things that I'm just very excited about are what people have said about us on Facebook and Yelp and Google. mean, hundreds of people have just said wonderful things about them that just humbles me and makes me feel very good about the service that we're

providing. It's so much more than other positions where you just go and you do a job. We have a true passion and we're doing a true service.

Cara Lunsford (32:06.077)
Yeah, and you know, it's so nice when you can, I know you said earlier, you can pick up an ICU shift and you can make a nice amount of money, especially if you're working registry or you're traveling or something like that. There's a huge need, obviously, in the ICU. But that's a lot of work. It's really hard, right? It's hard work, OK?

Bob Bacheler (32:14.317)
Mm-hmm.

Bob Bacheler (32:17.933)
Yes.

Mm-hmm.

Bob Bacheler (32:25.006)
Mm-hmm.

Bob Bacheler (32:33.326)
It is hard work. I wouldn't want to it sound like flying with a patient on a commercial airline is easy, but again, in comparison, I think it's a little bit more relaxed than working a 12 or 16 hour shift in an ICU, which I've done many, many times in my career.

Cara Lunsford (32:46.755)
I would agree.

Cara Lunsford (32:51.877)
Yeah. I mean, I guess it depends, right? Like it depends on the patient. It depends. There's a lot of I've I've worked some private cases where if I was stuck with them on an airplane for 10 hours could be very challenging. But.

But that being said, is that like there you're you're in, you're out, you know, like you're and probably like, I would guess maybe not the same amount of charting requirements as I mean, I don't know what your charting what your charting requirements are like, but I imagine not is not not like the hospital.

Bob Bacheler (33:16.686)
Mm-hmm.

Bob Bacheler (33:29.358)
I mean

No, it's not nearly as much as what we did in the ICU. I kind of grew up in that document by exception kind of phase where, I mean, you're doing details, but I tell our nurses, if you've written a half a page, you're starting to push too much paperwork then.

Cara Lunsford (33:52.914)
Yeah.

Yeah, so which is also really nice because I found that doing jobs where I was really able to show up for the patient and really do the patient care. Those were the things that were just so satisfying and and soul fulfilling. And you feel like, this is what I signed up to do. Like, this is the type of work like actually doing patient care and being with a patient and being

Bob Bacheler (34:04.269)
Mm-hmm.

Bob Bacheler (34:08.343)
Yes.

Cara Lunsford (34:23.436)
present is so it's it's so nice like even just being able to sit with someone and talk about things like talk about their life talking we've lost that art I think a little bit in the acute care setting just because of time and

Bob Bacheler (34:41.069)
Mm-hmm.

Cara Lunsford (34:44.816)
other stressors and things like that, that you don't necessarily always have that ability to sit down with a patient and just talk about their life. And that in and of itself is so healing for a patient, even somebody who has dementia. If you've worked with a dementia patient before,

Bob Bacheler (35:00.706)
Mm-hmm.

Cara Lunsford (35:11.315)
You know that like sometimes just going along with the story is is the best like not going no we're we're not you know we're not in your house right now. We're actually on a plane just kind of going with it and being like yeah so what would you like to do you know while you sit in your recliner you know like just playing into the story right because when you

Bob Bacheler (35:17.132)
Mm-hmm.

Bob Bacheler (35:24.558)
Mm-hmm.

Cara Lunsford (35:41.262)
fight them on it, sometimes that creates more agitation and all of that. So I think utilizing those parts of ourselves as nurses that we've learned is just, it's incredibly invaluable, I think.

Bob Bacheler (35:55.758)
Well, if my wife taught me anything, it's never argue with a woman. And I've taken that to heart when I'm transporting dementia patients. I tell people, never argue with your patient. Whatever your patient says is right. And in their reality, that's the way it is. And we've had the great opportunity. I've, you know.

flown on hundreds of flights and you're quite literally sitting next to somebody for hours on end and to your point and as you say, know, yes, they're just opening up to you and you know, it's very heartwarming and to have that one-on-one interaction and I think that is really why most of us got into this profession to start with, you know, to heal somebody whether that's physical or emotional.

Cara Lunsford (36:46.431)
Yeah.

Yeah, and so so many times that emotional healing can translate into physical healing. And that's the magic, right? That's the magic of of health care and and and and well-being. I think that sometimes we think it's intervention or we think it's specific medication or we think it's, you know, some other type of, you know, medical intervention.

Bob Bacheler (36:56.205)
Mm-hmm.

Cara Lunsford (37:17.319)
But oftentimes you can see really magical things happen. I imagine there's been times when I've been with a patient and I didn't really do anything quote unquote medical, right? I wasn't bringing in a new medication or scheduling them for a surgery. But after spending, you know, a few shifts with them in their home,

Bob Bacheler (37:32.929)
Okay.

Cara Lunsford (37:47.016)
their family starts saying, you know, my mom seems so much more lucid and she's doing things that she wasn't doing before. what are you doing? And I was like, taking an interest? I was like, that's it. Like, I'm just spending time with them. And...

Bob Bacheler (37:57.635)
Mm-hmm.

Bob Bacheler (38:04.206)
Mm-hmm.

Cara Lunsford (38:10.579)
One time I brought like a VR set to a client's home and I was taking care of her husband actually, but she had dementia and like kind of early stages of dementia. And so I started like bringing these this VR set to the house and letting her have these experiences where she was like surrounded by nature and she's like, my gosh,

Bob Bacheler (38:15.424)
O- Okay?

Cara Lunsford (38:40.506)
there's a bunny over there and there's a there's a deer. there's a deer. You know, she got so excited. She but her memory actually improved through using the VR, which I can't explain it. I you know, her family was like, what what do you do? I was like, I don't know. I just I brought the VR. I thought she'd really enjoy it. She did. And now she wants to do it kind of daily and

Bob Bacheler (38:41.774)
Hahaha

Bob Bacheler (38:56.238)
Fascinating.

Bob Bacheler (39:04.494)
Mm-hmm.

Cara Lunsford (39:10.457)
and she was showing some signs of improvement. And so I think that we have those unique opportunities when we spend time with people. And that's exactly what you're doing and what the nurses and the physicians are doing when they get to spend time with these patients, which I think is amazing.

Bob Bacheler (39:26.286)
Yes.

Bob Bacheler (39:30.094)
It is. Again, I've said before, but I think what we do is the most fun a nurse can have in nursing.

Cara Lunsford (39:40.062)
Yeah, for sure. So is there still opportunities for nurses or physicians to come and work for you? Do you still have like a per diem list that you're going to kind of keep in the event that you need someone and your regular staffs are not available?

Bob Bacheler (39:41.795)
Mm-hmm.

Bob Bacheler (39:57.162)
We do, but I hate to break anybody's heart. The staff we have have never left. I think I've had two nurses kind of retire and leave us. And I wish I could hire every nurse who applies to do this. And I wish I could share the experience that we have.

you know, with all nurses. be fair, you know, that we have the staff that we have and we need. mean, we probably hire one person a year, you know, maybe two people in a year, you know, as we continue to grow. You know, the population is aging, so, you know, we've done more flights year over year since we started, well.

I think there was that one hiccup back 2020 when things got a little squirrely in the aviation industry. But other than that, it's been steady growth. it's one of those, it's hard to get into just because people who are in the profession just stay.

Cara Lunsford (41:04.722)
Well,

You know, it's kind of like OB, right? Like people always want to go into OB, but no one ever leaves. And so it's it's tough. It's tough to like, especially if you come right out of nursing school, getting into OB like good luck there. They're they're hiring people who have a lot of experience in OB or they're just not hiring. And I think that that's a testament to the type of work that that nurses feel like they get to do.

Bob Bacheler (41:10.414)
Mm-hmm.

Bob Bacheler (41:31.981)
Mm-hmm.

Cara Lunsford (41:35.318)
in those types of industries. Clearly the nurses that are working for you are really enjoying that work. It probably doesn't even feel like work to them. And that's what we all hope for, right? We all hope that we can find that job that doesn't feel like a job.

Bob Bacheler (41:37.602)
Mm-hmm.

Bob Bacheler (41:48.983)
Yes.

Bob Bacheler (41:53.796)
that classic line of, you love what you do, you'll never work a day in your life.

Cara Lunsford (41:58.204)
Yes.

Yes, absolutely. And hopefully, you know, even through this podcast and spreading awareness about your organization, Flying Angels, is that nurses are sometimes the best evangelists of a good thing. Right. So many times you've got a nurse who's probably listening to this podcast or a doctor who's listening to this podcast. We have a variety of people that listen to

Bob Bacheler (42:15.936)
Mm-hmm. Yes.

Bob Bacheler (42:27.17)
Mm-hmm.

Cara Lunsford (42:28.816)
this podcast, I'm sure, but obviously a lot of nurses and a lot of just healthcare professionals. But they're in a unique, you know, advantage to be able to talk to patients, right? They're at the bedside with somebody who does need to be transported, but isn't really a candidate for air ambulance or something like that.

but they are right there at the bedside with the family members having these conversations. And hopefully they'll hear this podcast episode and they'll think, you know what? Now I know that there's this option and what nurse doesn't want to be able to give their patients all of the options, right? And being able to say, Hey, you you should look into flying angels because I

Bob Bacheler (43:15.095)
Mm-hmm.

Cara Lunsford (43:21.359)
listened to them on this podcast and it seems like a really good option for your family. Who knows Bob? You might have to hire more people because after all the nurses start going, you should use flying angels. All of a sudden you're going to be like, shoot, we got to hire more people.

Bob Bacheler (43:37.282)
I would hope so. My running joke is if I had a nickel for every time I was at a conference and somebody said that I didn't know this service existed, I could retire. The only problem is I'd spend all my time counting nickels. So, you know, I'm going to Denver tomorrow for a hospice conference, the American Academy of Hospice Providers. I probably missed a letter in there to share, you know, what we do with them.

So that when they have their clients who are at end of life and say, you know, I want to return to Boston or I want to return to California or I want to return to India, but I don't know how to get there, you know, that, you know, we can share that, hey, this is an option, you know, for you. And perhaps we could be of service getting their clients home at the end of life.

Cara Lunsford (44:29.415)
Yeah, absolutely. Are you familiar with ELNEC? End of Life Nursing Education Consortium?

Bob Bacheler (44:33.07)
what?

Bob Bacheler (44:37.642)
No, I've not heard of that before.

Cara Lunsford (44:41.148)
I can definitely make some introductions for you. think it's an organization that you should probably be connected with and they should know about your services because they do so much educating of healthcare providers about end of life and around options. And so I think that that would be such a good

Bob Bacheler (44:49.196)
Okay.

Bob Bacheler (44:57.367)
Okay.

Cara Lunsford (45:07.995)
opportunity for you to get in front of some more healthcare providers as well so that they can extend that message out to their patients.

Bob Bacheler (45:18.61)
I am forever learning about new organizations that I hadn't heard of before. I want to be in front of them. want them to know that we're there as a resource for them and for their clients.

Cara Lunsford (45:33.106)
Yes, absolutely. And I think El Neck is a good one. It would be a good one for you. So I'll for sure make that connection. One of my superpowers is connecting people. Well.

Bob Bacheler (45:40.696)
Okay.

Bob Bacheler (45:49.964)
That's a good superpower to have.

Cara Lunsford (45:52.243)
creating a strong network and then connecting people within that network. So I, maybe that's why I'm VP of community.

Bob Bacheler (45:56.044)
Mm-hmm.

Bob Bacheler (46:03.374)
Well, maybe that's why you do what you do.

Cara Lunsford (46:05.777)
Yes, absolutely. Probably why I do what I do. Exactly. Well, okay. So if anyone wanted to reach out, learn more about your organization, whether it's because they want to be one of those one to two people that you might hire per year, or because they have a

client, they have a patient, have someone that they think would be a good candidate for this or a family that they're working with. Where should they go?

Bob Bacheler (46:36.483)
Mm-hmm.

Bob Bacheler (46:43.212)
The easiest place to go is our website. We have a lot of information. We try to be very transparent about our service, what we offer, how it's done, what it costs. And that's just flyingangels.com. That is the way to go. Just www.flyingangels.com. What I do encourage people to do is Google Flying Angels Philadelphia because then you're not just seeing what we're saying.

But you know that's going to take you to to Google's reviews of us and Yelp's reviews of us and Facebook's reviews of us and and people have very graciously shared their stories and any number of clients have said well I was going over those and I saw that this family had you know the exact same situation that we did and you know the the experience is wonderful and Grandma got to where she needed to go and and that's what that's we want you to do for us so

because I care a lot more about what others say about us than what I say. I'm only going to say glowing things about flying angels. What makes me very happy is when other people say flying terrific things about flying angels.

Cara Lunsford (47:54.099)
Yeah, mean, having that kind of endorsement from families and you can't you can't buy that. And it is a testament to the type of care that your nurses and your physicians are giving to those to those those clients as they're in transport. So I I'm I'm going to definitely be an evangelist for for your company, for anyone.

Bob Bacheler (48:09.143)
Mm-hmm.

Cara Lunsford (48:24.093)
that I can think of that potentially needs that. And I'm just I'm so grateful that you took the time today to come on, talk with me, share some some fun stories, have a little bit of that morbid sense of humor with me, which I always appreciate. And wearing that awesome hat.

Bob Bacheler (48:43.788)
Well, thank you. Again, people would not know what I look like. I was at a conference with a woman who worked for an air ambulance company and she had a terrific hair job with multiple colors, you know, and that was her trademark. you know, people recognized her from across the room. And we used to joke, I have a much easier job. I just put my hat on.

Cara Lunsford (49:08.295)
Yeah, I many people know what I look like at this point. In fact, I've had people come up to me at conferences and they're like, you're the host of the podcast because I have a very distinct look. You know, have piercings and I have tattoos and I have like a mohawk and a very long mohawk. But so I definitely have a very distinct look that people recognize when I'm out and about. So I always appreciate a defined

Bob Bacheler (49:11.981)
Mm-hmm.

Bob Bacheler (49:21.805)
Mm-hmm.

Bob Bacheler (49:33.227)
Mm-hmm.

Bob Bacheler (49:39.426)
Well, people will never see me without a hat. So if you see a guy at a hat with a conference, that's probably me.

Cara Lunsford (49:46.952)
Got it, got it. Well, Bob, thank you so much. I am incredibly grateful for the time that you've spent with with me today. And for anyone who's listening, flyingangels.com or just Google Flying Angels Philadelphia, like you said, and you'll get a you'll be able to see all the amazing reviews. And I'm just thank you so much.

Bob Bacheler (50:08.909)
Mm-hmm.

Bob Bacheler (50:12.524)
No, thank you. It's been my honor and pleasure to be on your podcast.