Most nurses have an adventurous tick. Patient care in itself can be an adrenaline rush. Whether it be managing a patient’s vitals, doing CPR or administering medication, it all boils down to the fact that this is a person’s life and health on the line, and managing such an important thing is stressful and it’s way exciting.
Every nurse that likes the ER has considered becoming a flight nurse. It is hard not to think… “that sounds like a really cool job…”
Mary Pitman knows emergency situations all to well. With many years as an ER nurse, then paramedic training, and finally working as a flight nurse, Mary has taken emergency to the next level.
We were lucky enough to get an interview with Mary regarding her career in nursing to shed some light on what it is really like to be a flight nurse, and what it would take to be successful in this industry.
Can you tell us a bit about your time in the ER as a nurse?
I went through a week orientation as a graduate nurse in 1981. It was optional. My thought was, “Eeyew! Blood and guts. But it will give me a better understanding of what they do and it will make me a better nurse and besides it’s only a week.” By the second day I was hooked. By the third day they were saying, “You’re not like the other graduates we get in here.” I was told I needed a year of experience on the floor. I was glad I did that. I used that time to perfect my technical skills like IVs, NG tubes, etc.
In traumas, I learned to dissociate the person from the injuries. This in no way meant I was insensitive to them as a person. But when someone’s is hanging to life by a thread, you need to focus on body systems. What is this person’s body telling you? That’s how you survive and do the most good for the patient.
My most memorable case was a child that drowned in my neighborhood who was 3, about the same age as my son. The medics were calling in and the ER doc said, “This kid’s dead.” I countered with, “No she isn’t she’s just cold stressed. We’ll warm her up and she’ll be fine.” He asked me if I had ever lost a child before. “No, and today’s not going to be that day.” The child came in and he basically let me run the code. “What do you want to give next?” He kept asking. I eventually realized what he was doing. He was letting me think that I had done everything possible. He wanted me to have no doubt that everything had been done.
I never forgot that act of compassion toward me.
What are some qualities that someone looking into becoming a ER nurse should have in your opinion to survive or become a great ER nurse?
It’s a great place for nurses with ADD!
There are 6 things:
• The ability to work under pressure
• The ability to prioritize
• The ability to think ahead
• An insatiable thirst for learning new things
• Confidence in your skills
• The ability to get over it. Under pressure, you may have things said to you that would not normally be said under less stressful situations. Don’t take it personally.
At what point did you decide to become a flight nurse?
I took a flight nursing course. A doctor I was working with was the medical director for a long-distance air ambulance company and knew I had that knowledge. He needed someone to go to London to pick up former screen legend Ava Gardner. I had a passport and the time off, but it turned out she was too sick to fly. The company began calling me after that.
What were some of the best thing you took away from Paramedic school? Did it help cultivate your skills in any way?
I didn’t go to Paramedic school. I was able to challenge the exam. I did that because the director of the paramedic program saw that I was really good with the students when they did clinical time in the ER. He thought I’d be a good clinical instructor. My students always got the best experiences! One group made me a badge that said “Dr. Mom.” I still have it.
Was there a big difference in ER nursing and flight nursing? What was the most difficult change for you?
Flight physiology and gas laws are the biggest differences. Positioning the patient in the aircraft to allow for G-forces makes a difference depending on their diagnosis. Small bubbles in the patient (and the crew) become big bubbles at altitude. And if you need to defibrillate, you have to be very aware of all the metal around you and how that might transmit energy. The Lear jets you fly in are not like corporate Lears. They’re more like cigar tubes with wings. Those are some of the major differences.
It only took one time of not checking the weather of the destination (Madison Wisconsin with a temp of 33 degrees, rain/slush and a wind chill of way-too-cold) for me to never make that mistake again. All I had on was scrubs. Other than that, it was really a pretty easy transition.
How hard is it to get a job as a flight nurse? Are there any “must haves” in order to get into an agency other then a nursing license?
Air medical companies use RNs, paramedics, doctors and respiratory therapists. You absolutely must have training in this because it is highly specialized. It’s less so if you’re doing the helicopter because you don’t usually get up high enough to have the changes that come with flying in a Lear jet at 45,000 feet. Even in a pressurized cabin, there are changes. You can get certified in this and that makes you more marketable. Being physically fit is also a plus. And get a passport.
You can’t be afraid to say “no” if they want you to do a flight that is beyond your skill level. The company wanted me to pick up a neonate in Dayton, Ohio with Tetralogy of Fallot (the aorta and vena cava were switched) and fly him to Boston. I said, “I don’t do neonates and I especially don’t do neonates that are that sick.” They replied, “We knew you were going to say that. The baby will be flying with a neonatologist and a respiratory therapist. They have the baby part. You know the flight physiology.”
It worked out.
If you were to give advice to someone that was looking to follow this career path what would it be?
Knowing what I know now, if I were to have it to do all over again, I would make the same choice. When I think of the tens of thousands of lives I’ve touched, often under the most horrific of circumstances, I am humbled beyond words. You’ll see things in the ER that you’ll never see any where else in the hospital.
There’s a certain level of status in the public perception that goes above and beyond just being a nurse. Their eyes get big when you tell them you work in the ER.
Even when the ER isn’t busy there’s a certain level of palpable adrenaline because you never know what’s going to come through the door.
You either love it or you hate it. There is no in between.