How to Become a Flight Nurse in the USA

By ShiftMed Team//Nursing Profession
Flight Nurse helicopter

A Flight Nurse is a specially trained medical practitioner who provides air-transit care, unlike an ambulance paramedic who travels by road. A Flight Nurse mainly works on board a rescue aircraft during emergencies. 

As a Flight Nurse, your main job is to keep your patients safe and stable in the emergency helicopter or rescue airplane until you get to a good hospital. Nursing is a gratifying job if you thrive in challenging situations, are comfortable in the air, and most importantly if you want to save lives. 

This guide explains how to become a Flight Nurse, from what to study to how to advance in your career. 

What Are The Duties Of A Flight Nurse? 

Your duty as a Flight Nurse is two-fold: in an emergency and a non-emergency situation. During a rescue emergency like a fire, accident, natural disaster, or armed conflict, a Flight Nurse must assess the patient's illness or injury, make plans for their treatment in transit, and get them to their destination safely. 

You should be a quick thinker: give first aid, ventilation, or resuscitation, secure the gurney, unload the patient safely, and inform the receiving staff about the patient's condition on the ground. 

When off-duty, a Flight Nurse must update patient records, monitor medical supplies and equipment on the emergency aircraft, and assist the pilot when necessary. This means that despite being on call, you should stay on top of your administrative tasks. 

Recommended Reading - What is a Flight Nurse?

What Are The Steps To Become A Qualified Flight Nurse?

To qualify as a Flight Nurse, consider what your future employer would want from their medical team. 

You’ll need nursing education certificates, licenses, and experience as a registered nurse in emergency or trauma care. 

Here are the steps to becoming a qualified Flight Nurse: 

Earn a High School Diploma or GED

Start with your high school diploma or GED to get into nursing school. You'll need the best grades in maths and sciences. 

Earn A BSN or an ADN Degree

Next, choose to study for a Bachelor of Science in Nursing (BSN) or Associate Degree in Nursing (ADN). Most employers prefer Flight Nurses with BSN qualifications since it includes clinical hours as part of the curriculum. 

However, a BSN takes four years to complete, while an ADN takes two years. If you already have a bachelor's degree in another field but want to become a Flight Nurse, you can study an Accelerated Bachelor of Science in Nursing (ABSC). The course takes about 12 to 18 months from an accredited school. 

Note: In addition to these requirements, it's also helpful to have other nursing credentials, including:

  • Basic life support (BLS)

  • Cardiopulmonary resuscitation (CPR)

  • Life support (pre-hospital trauma, pediatric, advanced cardiac)

  • Advanced trauma care

These certifications make you a more competent Flight Nurse and improve your career prospects. 

Pass the NCLEX-RN Exam

NCLEX-RN stands for the National Council Licensure Examination Registered Nurse. You should take this exam six weeks after completing your nursing degree. 

The NCLEX-RN tests your knowledge in nursing basics, medications, patient behavior support, and much more. If you miss or fail, you can retake your NCLEX-RN after 45 days. 

Obtain Your Registered Nurse Licence for the Particular State You Intend To Work In Initially

Once you pass your NCLEX-RN exam, applying for your nursing license is next. Check with your state's Board of Nursing to see the qualifications. These usually include:

  • A pass in your NCLEX-RX 

  • Your education transcripts 

  • Your fingerprints for a background check

  • A license application fee (varies by state)

Gain Experience in the ICU or ER

You're now a trained and registered nurse, but you need some work experience before you board an emergency aircraft. Go for job placements that put you in emergency departments, intensive care units (ICUs), or trauma units. 

This is the kind of work you'll be doing as a Flight Nurse. Get at least two years of emergency care experience to qualify for the job. 

Become a Certified Flight Registered Nurse (CFRN) From the BCEN

BCEN stands for the Board of Certification for Emergency Nursing. This organization issues the Certified Flight Registered Nurse (CFRN) qualification. Any registered nurse with an unrestricted license can apply for the CFRN exam. Once you pay the exam fee, you'll receive an email confirming your eligibility for the CFRN exam. 

All you need to do is book your exam date, study the provided CFRN materials, and sit for your exam. If you do your CFRN exam at a testing center, your results will be available in a few days. But if you do it online, you'll see your test results on your screen. 

Note: The CFRN exam fee is $370, but if you're a member of a professional nursing association, you'll only pay $230. 

Can You Become A Flight Nurse Online?

You can obtain specific nursing credentials through online classes and exams. However, you need hands-on training and experience to be a successful Flight Nurse. 

What Is The Difference Between A Flight Nurse And A Registered Nurse?

A Flight Nurse is a registered nurse (RN) with specific experience and qualifications. A Flight Nurse also has slightly different roles and duties simply due to the mode of transport. 

This means that on top of RN responsibilities, a Flight Nurse needs to:

  • Maintain radio communications with the pilot

  • Get patients in and out of the aircraft

  • Secure patients for the duration of the flight

  • Maintain aircraft medical equipment and supplies 

In addition, Flight Nurses have a wider range of employers outside hospitals and clinics. A Flight Nurse can work in a: 

  • Fire department

  • Search and rescue team

  • Military agency

  • Private medical evacuation company

  • National park service

These are different emergency environments compared to the hospital's ER or trauma wing. However, RN experience in a hospital is necessary for a Flight Nurse. 

What Positions Can You Progress To From Being A Flight Nurse?

As a Flight Nurse, your career progression can be promising in the following ways: 

Choose a nursing specialty: 

Critical care is a significant asset for a Flight Nurse, but you could also specialize in neonatal and pediatric care to provide emergency care to children. 

Study an advanced degree: 

A master's in your nursing specialty is good if you'd like a more administrative role. Work your way up to the director of nursing, where you can coordinate training programs, lead a Flight Nurse team, or even start a private emergency evacuation company. 

Note: You can also choose to work as a military Flight Nurse and make your progress up the ranks. Every military branch has active Flight Nurses, not just the US Air Force. Even the reserves, the Navy, Marines, and National Guard need Flight Nurses. If you choose this career path, you will most likely work with active American troops in different countries. 

Do Your Flight Nurse and RN Exam Qualifications Expire?

Generally, RN qualifications in the US all have a renewal date, but it depends on your state's requirements. 

For example, you may renew your Flight Nurse and RN certification every two or four years. 

Either way, you'll have 30 and 60 days to renew your licenses. In addition, in some states, you don't have to retake any Flight Nurse or RN exams if you provide proof of continuing education. 

You'll also need to renew your other certifications, such as: 

  • Certified Flight Registered Nurse (CFRN)—every four years

  • Certified Transport Registered Nurse (CTRN)—every four years 

  • Emergency Nurse Practitioner (ENP-BC)—every five years 

  • Critical Care Nurse (CCRN)—every three years 

  • Advanced Burn Life Support (ABLS)—every four years 

  • …and many more. 

Note: You'll sometimes need to renew your Flight Nurse qualifications if you move to another state. That means resitting nursing exams even if your qualifications are still valid. 

How Much Do Flight Nurses Make? 

As of April 2022, the mean salary for a Flight Nurse in the US is $89,578.22 per year. The top 5 Flight Nurse salaries are in New York, New Jersey, Connecticut, California, and Massachusetts, which register over $100,000 per year. Conversely, the lowest 5 Flight Nurse salaries are in Oklahoma, West Virginia, Wyoming, South Dakota, and Mississippi, at just under $82,000 annually. 

Recommended Reading - How much do Flight Nurses make?

Some Frequently Asked Questions about Becoming a Flight Nurse

How Long Does It Take To Become A Flight Nurse? 

It takes 2 and 4 years to gain your education and license qualifications. You may need an additional 5 to 9 years of critical care experience to become a Flight Nurse. 

Recommended Reading - How Long Is Nursing School in The USA?

How Tall Do You Have To Be To Be A Flight Nurse?

The average Flight Nurse's height limit is 6'2". However, ask your prospective employer for their physical requirements. Their height limit is tied to the size of the aircraft. 

How Can I Become A Civilian Flight Nurse?

To work as a civilian Flight Nurse, follow the steps explained above: get your high school diploma or GED, a nursing degree, and a pass in the NCLEX-RN exam. But if you're a military Flight Nurse looking to enter civilian practice, you can indeed find work as a Flight Nurse veteran. Check with your state's Board of Nursing to know if you can transfer or renew your certifications. 

How to Become a Flight Nurse for the US Air Force?

To become a US Air Force Flight Nurse, you still need your nursing degree and license, but you have to be physically qualified to fly. Your additional qualifications include: 

  • A flying class medical exam, which includes an ECG for your heart, a hearing test, and an eye test

  • Maximum age of 47 years

  • At least one year of experience as a critical care nurse

  • Acceptance by the Air Force Reserve Surgeon General and the Medical Unit Commander

  • 5.5 weeks of training as a commissioned officer 

What Skills Does A Flight Nurse Need? 

Besides your educational and emergency experience, Flight Nurse needs different skills to succeed in their careers. 

These include: 

  • Good leadership skills

  • Good communication skills

  • Problem-solving skills

  • Stress management skills

  • Time management skills to handle shifts and 24/7 on-call rotations

  • Ability to work in tight or confined spaces 

  • Physical fitness and stamina to handle the job

  • Empathy to make patients receptive to care

Note: It is worth noting that flight nursing is a stressful job, often more challenging than hospital ER or trauma ward nursing. With these skills, you can better adjust to emergencies, put your patients' lives first, and maintain your physical and mental wellbeing. 

What Are The Safety Risks Of A Flight Nurse? 

A Flight Nurse's job is to get right into emergencies to airlift patients out of dangerous environments. 

Here are some examples: 

  • A Flight Nurse must ensure that the crash site is safe from gas or leaks, fires, and debris in a vehicle accident

  • A Flight Nurse may need to rescue hikers, researchers, or film crews in remote work. You should have ready, proper clothing and communication options on top of medical supplies to survive remote rescue locations. 

  • Emergency medical aircraft also fly through dangerous weather, such as thunderstorms and fog, anytime of day or night. Poor visibility and turbulence make a Flight Nurse's job even more challenging. 

All Flight Nurses and pilots receive the best occupational health and safety (OSHA) training to do excellent work in emergencies. 

Get Started with your Flight Nurse Career Today

As you can see, becoming a Flight Nurse takes time and dedication. Emergencies can happen anywhere and anytime, so this is a vital healthcare job. The most important thing is to airlift your patients to safety as efficiently as possible to save their lives. 

If you desire to become a Flight Nurse, start planning your career right now. For more resources about your career path as a Flight Nurse, sign up with Shiftmed today.