Flight nurse inside a medical helicopter

Flight nurses are by their side when patients must be transported to hospitals by plane or helicopter. They perform the same tasks as registered nurses, just thousands of feet in the air. Those who work on first-response teams may also specialize in trauma care.

Flight nurses are also called transport nurses. They provide direct medical care and support to patients transported to and from hospitals. In addition, they coordinate with paramedics, doctors, and other medical staff to ensure that the patient’s transition from the sky to the land goes smoothly. 

As some patients are in serious condition during transport, the flight nurse’s job is to ensure they remain stable and safely reach where they need to go. In addition, because flight nurses are often required to respond to severe accidents, they are accustomed to treating patients in critical care and providing life-saving treatment.

What does flight mean?

Flight nursing is nursing done on aircraft. Flight nurses don’t operate the aircraft but instead work on them with flight paramedics and flight physicians as they transport patients from scenes of accidents to hospitals or move them from one healthcare facility to another. 

All flight nurses are part of a medical evacuation team. They work alongside flight paramedics and pilots to provide rapid response medical care and life-saving treatment. Nurses and paramedics are not licensed to fly planes or helicopters. They work exclusively on board with patients. 

What is the difference between a flight nurse and a registered nurse (RN)?

Flight nurses are specialists in critical care and trauma care. They know how to provide life-sustaining procedures aboard aircraft and exclusively work with patients who are being moved via plane or helicopter. 

Registered nurses work in hospitals, medical clinics, and doctor’s offices, treating patients across various medical specialties. Flight nurses are also RNs, but they have additional training in flight nursing. Their focus lies in primary care and patient transport. 

Like RNs, flight nurses take vitals, assess patients, administer IVs, and administer medications. They can also intubate patients or provide life support during cardiac arrest or respiratory distress. 

While there are millions of experienced RNs, not all have the same level of experience and education in providing critical care or treating trauma patients. This is where flight nurses stand out.

What qualifications does a flight nurse need?

The minimum job qualifications for flight nurses are:

  • Associate’s or bachelor’s degree from an accredited nursing school program

  • A valid RN license in your state

  • At least three years’ ICU/critical care/emergency experience

  • BLS, CPR, ACLS, and PALS certifications

  • TPATC, TNCC, PHTLS, or ITLS certifications, depending on your state

Let’s take a closer look at what some of these qualifications mean. 

  • BLS = Basic Life Support

  • CPR = Cardiopulmonary Resuscitation 

  • ACLS = Advanced Cardiac Life Support

  • PALS = Pediatric Advanced Life Support

These are standard nursing requirements in many states, even for RNs who don’t work as flight nurses. Any nurse who wants to work with emergency or critical care patients will need to know basic and advanced life support practices for patients of all ages. 

Now, onto the actual qualifications for flight nurses. What certification do you need to be a flight nurse?

It depends. Some states have specific education requirements, but the most commonly recognized are:

  • TPATC = Transport Professional Advanced Training Course

  • TNCC = Trauma Nursing Core Course

  • PHTLS = Prehospital Trauma Life Support

  • ITLS = International Trauma Life Support

In addition to these requirements, you can pursue certification through the Board of Certification for Emergency Nursing as a Certified Flight Registered Nurse (CFEN).

Where do flight nurses work?

Flight nurses work aboard aircraft for hospitals, trauma centers, and emergency medical facilities. They can also work for the military, being dispatched to combat zones and flying with wounded soldiers as they’re transported to hospitals or back to the United States. 

You can also find some flight nurses in fire departments, part of search and rescue teams, and working for independent critical care transportation companies. 

What is it like to be a flight nurse?

Life as a flight nurse is fast-paced and demanding. During your shifts, you have to be able to get into the aircraft and be prepared to fly within minutes, and you never know what you’ll encounter when you reach your patient. 

In transport situations, you are with patients who are being moved from one facility to another. They’re often transported to trauma centers or surgical hospitals when their facility does not have the resources to treat them properly. 

Most of the patient's flight nurses treat are in grave condition, so they have to be comfortable working under a lot of pressure and stress. In most cases, someone’s life is literally in your hands. It can be exhilarating and rewarding but also tremendously stressful, leading to anxiety. 

Not everyone will want to be a flight nurse due to the physical and mental demands, but it's a gratifying job for someone who is committed to it. You know you’re the only person who can help your patients when they need it the most. 

How much do flight nurses make?

As trauma experts, flight nurses are entitled to higher pay than non-trauma nurses. Those with CFRN certification can earn even more. The national average salary for flight nurses is $89,579.22, though it isn’t uncommon for them to make over $100,000 annually.

Recommended Reading - How much do Flight Nurses make? 

Are there different specialties of flight nurses?

Not particularly. Flight nursing in and of itself is a specialization. Your specialties as a CFRN are critical care transport and trauma care. You can continuously pursue additional certifications, but since most of your patients will be in intensive care or require trauma support, these are the critical disciplines for flight nurses to focus on.

Advantages and disadvantages of a career as a flight nurse

Benefits of choosing a career as a flight nurse

1) Exciting work environment

You won’t be standing in a hospital for your shifts. Instead, you’ll wait to be dispatched and go onboard a plane or helicopter to retrieve patients from different destinations. Sometimes, you’ll respond to the scene of an accident. Then, you transport patients from one hospital or trauma center to another. 

There is always something happening, and for a nurse who enjoys the excitement of working above ground, being aboard aircraft is one of the most exciting aspects of the job.

2) High salary 

Flight nurses are critical care nurses with specialized trauma, air evacuation, and medical transport training. Their unique skills and knowledge qualify them for a higher-than-average nursing salary. 

3) Independence

Because they’re part of the first-response team in trauma situations, flight nurses have a great deal of independence. They are trusted experts who can intubate, insert chest tubes, and more. They always operate on protocol, but they may sometimes ask for permission to go off protocol from medical control. 

There is a great deal of responsibility in the job, and many flight nurses love using their skills and knowledge so extensively in their work. 

Disadvantages of choosing a career as a flight nurse

1) Unpredictable

Shifts vary greatly for flight nurses. Sometimes, they may be sitting around for hours at a time, waiting to be dispatched. Other times, they get a call for a severely injured or ill patient, and the next 8 hours are incredibly intense. 

Some nurses thrive off this schedule, but others will find it stressful and prefer greater structure. 

2) Competitive field

Becoming a flight nurse requires a lot of commitment. You must dedicate years of critical care experience and earn all your certifications. Getting your CFRN certificate is challenging. Make sure that you put effort into building a well-rounded resume before applying.

3) Trauma

Flight nurses themselves can experience trauma as they witness so many patients in life-threatening conditions. Sometimes, they won’t be able to save them, and they can often blame themselves even if they know the person’s situation was beyond their control. 

Working in critical care exposes nurses to people in the worst possible condition, so you must be able to handle what you’ll see. You’ll also have to be able to emotionally handle struggling to save someone and having them die under your care.

How to become a flight Nurse

After earning your nursing degree and becoming an RN, you have to gain experience in critical care/emergency nursing. Many flight nurse employers suggest getting a background in both because flight nursing combines emergency response and trauma nursing. 

You will also have to earn appropriate certifications to become a flight nurse. The most important one you will have to earn is your CFRN, which makes you a Certified Flight Registered Nurse.

Recommended Reading - How to Become a Flight Nurse

Frequently asked questions about flight nurses 

How long does it take to become a flight nurse?

From earning your degree to getting hired as a flight nurse, expect to spend around eight years earning all your qualifications and experience. In addition to becoming an RN, you must also gain several years’ experience in critical and emergency care and take numerous courses in trauma care and medical transport. 

What procedures can a flight nurse do?

A Certified Flight Registered Nurse can check vitals, administer medications, and perform various critical care/life support procedures. For example, they can intubate patients, insert chest tubes, insert central lines and IVs, manage airways, and more.

How do I get fight nurse training?

Most certifications, like BLS, ACLS, and PALS, are offered through service providers. Your current place of employment should be able to connect you with the appropriate resources. There are also flight nurse programs you can look for in your state that provide all the necessary courses and training material. 

You can explore the CFRN eligibility requirements for details on what you need and how to train to become a flight nurse. 

What makes a good flight nurse?

There are several qualities that every good flight nurse needs:

  • Ability to work well under pressure

  • Quick-thinking

  • Problem-solving abilities

  • A passion for learning

These qualities help flight nurses improve their skills and knowledge to serve their patients better. CFRNs will encounter patients with problems they’ve never seen, and sometimes, they may not even know the root cause. They have to be able to act fast and stabilize someone until they reach the hospital. 

How often do flight nurses work?

Most flight nurses work two 24-hour shifts per week. They must be on-call for those 48 hours to respond when patients need them at a moment’s notice. Some professionals spend their off-hours continuing education courses or working second jobs in healthcare. 

Who do flight nurses collaborate with?

Flight nurses collaborate with the pilot of the aircraft and the paramedic. They also have to coordinate with first responders on the ground and staff at the receiving facility. 

Can a flight nurse become a pilot?

Flight nurses are nurses, so they don’t receive any training to fly an aircraft. But if you attend an aviation school and train in air evacuations, you should eventually become a pilot for a medical transport team.