Flight nurse training in the spotlight

A team of researchers from Case Western Reserve University’s Frances Payne Bolton School of Nursing in the US has called for new competencies and training for flight nurses, as the number of flights and complexity of cases handled continues to increase. Andrew Reimer, a flight nurse, and Shirley Moore, associate dean of research at the University’s School of Nursing, have outlined their goals for new training in the Journal of Advanced Nursing in an article entitled Flight Nursing Expertise: Towards a Middle-Range Theory.
In the article, the researchers propose a theory that takes into consideration the unstructured medical environment and the need for fast thinking that being a flight nurse entails, and claim that some medications and practices used in emergency rooms are either ineffective or cannot be performed inside an aircraft, with care often relying on visual clues and patient patterns.
Reimer said that as flight nursing is still a relatively new discipline, “the knowledge about what works is limited.” In order to develop new theories of flight nursing, Reimer combined a review of research literature with his own experiences. He found that flight nurses need different skill sets from those used in hospital settings in order to access a patient’s vital signs – for example, nurses may have difficulty hearing a patient’s heartbeat in a helicopter due to the noise, and could have difficulty distinguishing a pulse from the vibrations of the rotor blades. Flight nurses have learnt, on the job, how to combat such obstacles, but Reimer said they should have the knowledge before they board the aircraft. As such, the researchers have called for more training that focuses on the uncertain environment of the patient and crew.
Reimer also believes that practising in simulated environments, where fast assessments and quick decision-making is needed, is essential to prepare flight nurses for the pressure they are put under during urgent missions. He concluded: “You can take an ICE nurse with 20 years of experience and put them in the helicopter to care for the patient, and the learning curve will be similar to someone with only two years of experience.” He believes that targeted training would shorten the learning period for flight nurses.

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