Every aspect of nursing has its own level of uniquity and transport nursing is no different.  Whether it’s by ground (ambulance), fixed-wing (airplane), or rotor-wing (helicopter), this field is challenging, rewarding, and sometimes taxing. Nevertheless, it’s the best job in the world. Okay, admittedly, I’m biased, but stick with me. Let’s explore five things I love, and what you should know if you’re interested in transport nursing.

“Team on Three:  Ready?  Break!”  

Most transport programs function in teams of three: a pilot or vehicle operator, and two critical care providers. There’s some variety in the team of providers—registered nurses, paramedics, respiratory therapists, and physicians—depending on a program’s mission profile. But the most commonly seen crew mix is a nurse and paramedic. 

Together, this team focuses on a central goal: manage the care of critically ill or injured patients while safely transporting them to their respective destinations. Patient condition and needs, distance, weather, and weight are just some of the factors the team must consider when accepting and preparing for transport. 

As the team begins planning the best course of action, other key players are also at work. For flights, a well-trained communication specialist is a crucial component. These team members typically have a medical background and coordinate the entire transport while tracking the team’s movements from beginning to end. Maintainers or mechanics also ensure our vehicles are safe and fully operational before ever departing on a transport.  

Flight nursing is inherently dangerous, requiring constant teamwork and communication. To honor those we’ve lost, we remain vigilant, as a team, to accomplish the goal safely, efficiently, and effectively.  

Variety: Not Just a Magazine

Having started my career in public safety, I’ve always enjoyed a fast-paced, unpredictable environment. From learning and understanding aspects of aviation, working in confined environments with limited resources, and being prepared for anything, flight nursing embodies variety. 

Transport nurses must be prepared to handle a myriad of situations. At a moment's notice, you may be requested to an intensive care unit (ICU), emergency department (ED), or a major interstate for a car accident. Each transport request and each patient has individual challenges the team must manage.  

It’s not just what’s in front of you, but the utilization of critical thinking skills to predict and plan for things to change, and how you’ll address that issue, should it arise. The job demands preparedness to handle diverse situations, in austere environments, with sometimes seemingly unsolvable situations. It’s problem-solving at its finest.  

Mirror, Mirror…

One of the traits that makes a successful transport nurse is the ability to be self-reflective — it’s a world that mandates continued growth. But growth, both personally and professionally, requires you to ask yourself, “What can I do to improve?”  

This is asked not only of yourself, but also of the team. After each transport, teams debrief the trip: what went well? What could we have done differently? Are there opportunities for us to grow? 

As noted above, you have to be prepared for a wide variety of clinical situations.  Diligence, self-motivation, humility, and flexibility — all traits that contribute to the success of a transport nurse. 

Nurses:  It’s NOT What’s For Dinner

Name a career that eats their young more than nursing. I’ll wait. 

It’s the adage that never seems to slip our profession. I don’t believe it’s laced with bad intentions, though. We, as a profession, hold and expect high standards. It’s a good thing, as long as we approach with clear, meaningful intentions.  

As a transport nurse, I’m given the opportunity to interact with a wide variety of people: the public, students, fellow nurses, physicians, and EMS providers. The transport nursing role allows you to teach, educate, and mentor during those interactions. 

In turn, I’m also afforded the opportunity to learn from them. There’s no one person or role who is the end all, be all: it’s one of the things that is so great about the nursing profession. Imparting wisdom and experience on the rising stars of our profession is the greatest gift we can leave.    

The Ripple Effect

The most common question I receive as a flight nurse is, “What’s the craziest thing you’ve ever seen?” It’s the one question I really don’t want to answer.  

Why?  

Because we see things in one shift most people shouldn’t see in a lifetime. However, this isn’t exclusive to transport nursing.  Many nursing roles expose us to situations that are sad, hard, frustrating, and sometimes downright depressing. 

So why do I still love transport nursing after 20 years? It’s the chance to have an impact on others. In many situations, we meet people on the worst day in their lives, and the end result isn’t always positive. But given the opportunity to help, I want to contribute in giving the best that I have to make an impact in their life.  

Whether performing a clinical treatment/procedure, being calm and kind, holding their hand, or allowing family to see them one last time before we depart: never forget that what you do in the moment makes an impact, even if you don’t recognize it at the time. It’s the Ripple Effect.  

Don’t fool yourself, though — the emotions are still there…and it’s normal. It’s okay. New nurse…veteran nurse…no one is immune. Don’t ignore your feelings. Find someone who will listen. Although we’re out of time to explore this deeper, I’ll leave you with this: You are NOT alone. There IS help.

If you’re interested in learning more about transport nursing, or have questions, visit the Air & Surface Transport Nurses Association at www.astna.org.

Kevin Kissner, MSN, FNP-C, RN, CEN, CFRN, NRP, has been an active flight nurse/paramedic in the private sector for more than 20 years.  In addition to his transport role, he currently serves on the Board of Directors for the Air & Surface Transport Nurses Association (ASTNA), with a passion for education, safety, and mentorship.