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So, You Wanna Be A Flight Nurse… The Future Flight Clinician’s Unofficial Guide to Human Maintenance (Part 1)

Posted in Flight Nurse, So You Wanna Fly, Uncategorized by

Also known as “all the things no one told me about becoming a flight nurse and I was too afraid to ask.”

If you spend enough time around flight medicine, you’ll notice something interesting: we spend a tremendous amount of time preparing people for the clinical side of the job. We teach ventilators. We teach hemodynamics. We teach advanced airway management, critical care pharmacology, blood administration, flight physiology, and the thousand other things required to keep very sick people alive in very inconvenient places. You know… important life saving stuff.

What we don’t teach is how to actually live this job. When I became a new flight nurse nobody sat me down during orientation and explains what happens when you’re eight hours into a humid summer shift, your flight suit has become a personal bog, you’ve consumed enough caffeine to qualify as a controlled substance (basically when you start to hear colors), and dispatch sends you to a hospital two hours from anywhere that resembles civilization before you had a chance to pee. I had to learn all of it through trial and error essentially.

Nobody teaches the proper technique for surviving a gross ER patient bathroom in a nomex onesie with someone’s unlabeled urine specimen looking at you sideways from the sink. Nobody discusses the emotional significance of finding the crew-room shower full of Tribbles (your crew mates’ hair) in the drain after a 20-hour day and something crusty/unidentifiable is chilling on your forearm.

Me hanging out with everyone’s hair clumps in the work shower, 2026

Nobody explains why every experienced flight clinician owns an oddly specific collection of chapstick, anti-chafing or -stank ass products, backup socks and under roos (most likely unmatching, potentialy with holes), emergency snacks, phone chargers, more pain-relievers than Walgreens, and enough caffeine to knock you both into and subsequently out of V-tach.

Most flight crews eventually learn these lessons the same way they learn everything else in medicine: through a combination of observation, suffering, and poor decisions. The reality is that flight medicine as whole isn’t just a job but rather a lifestyle. For some of you that life is 12-hour shift where you go home afterward, sleep in your own bed, and maintain a reasonably healthy connection to society. For others (like moi)….it’s a 24- or 48-hour assignment where you essentially move into a base with a group of coworkers who slowly transition from colleagues to roommates, family members, and occasionally hostage negotiators at 3am.

Either way, there are survival skills nobody teaches: the practical stuff, the weird stuff, or the “I wish someone had told me this three years ago” stuff. NEVER FEAR! I got you! Consider this your Unofficial Guide to the Activities of Daily Living in Flight Medicine*!

*A field manual for moisture management, sleep preservation, strategic snacking, flight-suit bathroom logistics, communal living, and maintaining a small shred of dignity while spending your high-speed career in a helicopter.

Part 1 of this series will include dressing for the weather, hydration and cooling solutions, and navigating the bathroom situation.

Dressing for Success (and Mitigating Inevitable Swamp Ass)

Flight medicine exposes you to a truly impressive variety of climates, often within the same shift depending on where you work. You may start your morning standing on a frozen highway shoulder in March, spend the afternoon in a hospital that appears to refrigerate its patients as if theyre preparing them to go to the morgue, and end the day baking in a different hospital that is hot enough to punish Satan for his transgressions. Through all of it, you’ll be wrapped in a flight suit that somehow manages to be simultaneously too hot, too cold, and slightly uncomfortable at all times because the crotch wants to greet your internal organs.

One of the biggest surprises for new flight clinicians is how much energy gets devoted to managing the environment inside the flight suit itself. We spend years learning how to manage ventilators, but almost no time discussing how to manage the small ecosystem developing between our skin and our onesie. Skin flora really do love a moist girlie.

Most programs require cotton base layers, which is great for fire safety and considerably less great for comfort. Cotton absorbs sweat like it’s trying to set a world record and once it’s wet, it remains wet. Eventually it begins clinging to your body with the determination of an emotionally needy ex— at least I assume thats the analogy because my ex’s stay away with good reason. Since most of us don’t get much say in the matter the goal then becomes learning how to strategically manage the suck.

For me, that starts with keeping everything as lightweight as possible. Compression shorts are one of the greatest contributions modern science has made to flight medicine. Good socks are worth spending money on, even if it feels ridiculous to hand over twenty dollars for something that lives inside your boots. Backup underwear should be considered mandatory equipment. And ladies, this is wear you sacrifice sexy for comfy and embrace the cotton granny life (“one of us, one of us”). No seriously, there are few morale boosters more powerful than changing into a fresh pair halfway through a shift that has gone sideways. It’s amazing how quickly your outlook on life improves when you’re no longer marinating in your own poor decisions. Also for my bra-wearing cohorts say it with me, “sports bra, burn underwire.”

The opposite problem occurs in cold weather. New flight clinicians often assume they need the thickest layers possible only to discover that flight medicine consists of repeatedly transitioning between freezing and sweating every thirty minutes. My least favorite thing in winter was having my layers to survive the single digit outside and then having to spend hours packaging in the Tropics of NICU. Thin layers work better than bulky ones especially ones you can shed. Hand warmers stuffed into random pockets are worth their weight in gold and seriously don’t sleep on footwarmers. Finally…wool socks,which continue to prove that sheep solved a problem we never quite figured out ourselves because being cold is baaaaad. I’ll see myself out.

Now… if you like to live dangerously… all natural fibers are the safest things to wear in flight. However, I’m going to be very blunt and candid on this next part. I have always worried more about hypo/hyperthermia in our work environments moreso than getting burnt and seran-wrapped by synthetic fibers. I personally do wear synthetic clothing designed for hot or cold environments because the likelihood of me getting injured from those things is higher than the fire in the cockpit. Please use your best judgement on this and lean into your programs for guidance. I’m not going to be the one to tell you to break the rules.

THAT ALL BEING SAID: Eventually, all roads lead to moisture management. (I said moist and I’m not apologizing for it)

Now we’re discussing the kind of operational knowledge that only comes from experience. The combination of heat, stress, vinyl seats, whatever legal stimulants you consume, and long shifts creates conditions capable of generating their own biome inside your Gibson Barnes. Anti-chafing products, baby wipes, powder, fresh socks, dry shampoo, and backup underwear become less of a luxury and more of a survival strategy. Experienced flight clinicians don’t pack these items because they’re high maintenance rather they carry them because they’ve suffered enough to know better and all the partners rejoiced for their destankifaction efforts.

There is also a time-honored tradition among flight crews of stepping outside the aircraft and pretending to be deeply invested in weather conditions when in reality they’re simply trying to create enough airflow to cool down portions of their anatomy that haven’t seen fresh air in twelve hours. Desert crews understand this instinctively. If you see someone Captain Morgan’ing on a skid when the wind blows… mind your business. Summer flight medicine in Arizona often feels like existing one degree below spontaneous human combustion. You do what you can to air out and cool down. Cold-weather crews like to think they’re immune until they walk into a heated hospital wearing thermal layers and immediately transform into juicy rotisserie chickens in a Costco wrapper.

The lesson here is simple. Take care of yourself before discomfort becomes a problem. Change your socks. Bring the backup underwear. Protect your skin. Nobody has ever received an award for being the most miserable person at the base, and despite what flight medicine culture occasionally suggests: suffering is not a competitive sport.

How Not to Become a Dried-Out Sea Monkey (Beyond “Just Drink Water”)

One of the most annoying pieces of advice in flight medicine is also one of the most common: “stay hydrated.” Gee…Thanks. I’ll be sure to get right on that as I pop open my second Sadness Soda ™ of the day (credit to my partner Aaron for that name).

The people giving this advice are never wrong….exactly. They’re just dramatically underselling the challenge. Staying hydrated in flight medicine isn’t the same thing as remembering to carry a water bottle around on a trip to Target. It requires actual planning because the job seems specifically designed to interfere with every normal human activity and that includes drinking water.

Somewhere along the way many of us develop a toxic enough relationship with caffeine that would concern a cardiologist and probably qualify us for a short stint in rehab. Entire flight programs appear to function on a delicate ecosystem of energy drinks, coffee, and mutual irritation. We drink caffeine because we’re tired but we’re tired because we work weird schedules but we work weird schedules because somebody thought it would be a good idea to combine critical care medicine with aviation…and we have to fund our extravagant lifestyles.

However the problem is that after your second coffee and first energy drink of the day, your brain starts counting those fluids as hydration but they are not hydrating. They’re just beverages wearing hydration’s skin.

I’m going to hold your hand while I say this, ok? At some point… actual water has to enter your body.

This becomes especially obvious when you work in places like where I work in Arizona where summer feels less like a season and more like a personal attack. Summer flight medicine in Arizona often feels like the devil opened the oven door to check on his cookies and accidentally created an entire state. Literally everything in Arizona wants to kill you and the heat is at the top of the list. Arizona is a state that the sun gives its middle finger to for 3/4’s of the year. The heat doesn’t care how experienced you are. It doesn’t care how smart you are. It doesn’t care that you were “only outside for a minute.” It just sits there waiting for you to make a mistake. It reminds me of a creepy voyeur watching you make poor life choices.

One of the best tricks I ever learned was the partially frozen Camel Back hack. Not fully frozen. That’s rookie behavior. A completely frozen Camel Back is just an oddly shaped brick that just feels weird but if you fill it halfway and lay it flat to freeze it becomes something magical. Then take that and slip it down the back of your flight suit. You get cold water for hours to daintily sip on and for a brief period of time it feels like someone installed air conditioning directly against your spine (heavy on the “brief”). During an Arizona summer that qualifies as a religious experience.

The other lesson I learned the hard way is that just water isn’t always enough. When you’re sweating through a flight suit, hauling equipment through the major tertiary hospitals, and spending hours in triple-digit temperatures, you’re losing more than fluid. Eventually you reach a point where you can drink water all day and still feel vaguely terrible (more than usual if youre over 30) and that’s usually your body reminding you that electrolytes exist and perhaps you should stop treating them like a suggestion.

The truly dangerous thing about dehydration is that it rarely announces itself in a dramatic fashion. Most people expect heat illness to look like collapsing on a helipad when in reality, it usually starts with becoming progressively dumber. You get a headache. Then you become irritable. You can’t seem to focus and simple tasks require an unreasonable amount of concentration. You find yourself staring at equipment you’ve used a thousand times while your brain makes the AOL dial-up noise. AND because we’re healthcare professionals our response to these warning signs is usually to ignore them because we’d know if we were dehydrated…right?

Flight clinicians are exceptionally good at recognizing dehydration in patients although we are considerably less talented at recognizing it in ourselves. We will spend an entire shift teaching about heat exhuastion while surviving on half a bottle of water and three energy drinks.

Eventually you reach what I like to call the Desert Lizard Phase (noun): This is the point where your lips are dry, your urine resembles sweet tea, and you’ve developed an emotional attachment to the nearest air conditioner. Every inconvenience feels personal. Every task feels harder than it should. You’re technically functioning but only in the same way a phone functions when it’s at 2% battery. The frustrating part is that all of this is preventable. Is it glamorous, exciting, worthy of a conference lecture…no, no, and also no. Its simple and just plain preventable.

So here is how you do it: It drinks the water (stop pretending your energy drinks count as hydration) and it uses the electrolytes or it gets the hose, again… and by hose I mean probably a bag of saline in the back of your least favorite ground crew’s vanbulance.

Hydration is one of those things we all know is important and yet we routinely ignore until we start wondering why we’re getting headaches, snapping at our partners, and making questionable life choices. This becomes especially true when you are now working in a flight suit that doesn’t breathe, out in the elements, and slowly getting dehydrated at altitude. Unlike me, heat exhaustion doesn’t announce itself with dramatic fanfare. It sneaks up on you while you’re standing on asphalt in the sun, carrying equipment, wearing layers of protective clothing, and surviving primarily on coffee, beef jerky, and hostility. By the time you recognize it, you’re already behind.

The Bathroom Olympics

There are many things people imagine when they picture a flight clinician: helicopters, high speed critical care badassery, cool flight suits and maybe a slow-motion walk across a helipad while Hans Zimmer music plays in the background. What they do not imagine is a grown adult trying to hoover over the toilet in a small municipal airport bathroom while desperately trying to keep a flight suit from touching a floor that appears to have escaped several public health investigations. And yet…somehow, that is a much more accurate representation of the job some days.

One of the strangest parts of flight medicine is how quickly you learn that basic human needs become logistical challenges. Eating becomes a challenge. Sleeping becomes a challenge. Going to the bathroom becomes a challenge. Things that most people accomplish without a second thought suddenly require planning, timing, strategy, and occasionally a small amount of luck. And before I jump into that, I’d like to say this is mostly aimed at women but this goes for the men too.

When I first started flying, I operated under the same assumption most new flight clinicians do, “I’ll just go before we leave on a call.” I mean that sounds reasonable until you actually start doing the job. Now the tones drop, your agency expects dispatch to launch in seven minutes, you need to collect your blood out the fridge, push the aircraft out of the hangar or secure the air-conditioning unit, you still need to walk-around, and, and, and… then you’re trying to power-pee while hugging the sleeves of your flight suit for dear life.

“I’ll go when I need to.” The phrase assumes you’ll have time when the dispatch comes. You don’t always. You might be launching in that seven minutes. You might be launching after 30 minutes of standby. Flight medicine exists in a constant state of “it depends.” The quick transfer becomes a trainwreck stabilization case. The local flight becomes a cross-state adventure. The patient who was “ready to go” somehow isn’t or doesn’t have a receiving bed assignment. And your bladder, unfortunately, refuses to exercise flexibility. Lesson: go when you first notice you have to and have the time… don’t wait until its urgent.

Over the years…I’ve become convinced that the human bladder is one of the most selfish organs in the body. It doesn’t care about scene times, flight times, launch requests, or weather delays. It doesn’t care that you’re twenty minutes from the nearest bathroom or that you’ve just strapped a critically ill patient into the aircraft. It wants what it wants. Immediately. The bladder is the honey badger of the body: it does not give a single f!ck. And don’t get me started on the poo-panic you get when you’re still 40 minutes out from the receiving.

Women eventually discover that peeing in a flight suit is less of a bodily function and more of an acquired skill. Nobody teaches it during orientation. There isn’t a competency checklist. There should be. At some point you learn how much of the flight suit needs to be unzipped, where to place your sleeves, and how to accomplish all of this without allowing any portion of the suit to touch the floor or toilet bowl. This becomes increasingly difficult the smaller the bathroom gets and the more horrifying the bathroom becomes. It’s a process that requires balance, coordination, and occasionally the flexibility of a circus performer.

So, for the women new to flight… let me help you out. Stay away from the toilet when you unzip, fold your sleeves into the crotch of your flight suit, and tuck them into each leg to secure them. Use one hand to hold it away from the bowl. Voila. Seems simple but several people I’ve spoken to literally took a few shifts to figure it out and the panic I felt when a sleeve touched my all-male base’s bathroom floor cannot be fully expressed in writing.

The men reading this are probably wondering why any of this is complicated. Respectfully, I do not wish to hear from you at this time. Your flight suits zip up from the bottom. Stand closer to the damn toilets, its not as long as you think and your stream isn’t that powerful. I say that with immense love but blunt honesty. If you don’t believe me, take a UV light and look at the front of the toilet and floor. Yeah. Enough said.

ER and muncipal airport bathrooms deserve their own discussion entirely. Like our patients (and most of our colleagues), they exist on a spectrum. Sometimes you walk into a restroom clean, stocked with quality two-ply, and so well-maintained that you briefly consider writing a positive Google review. Other times you open the door and immediately begin reevaluating every decision that brought you to that exact moment and internally ask if you’re up to date on your shots.

The challenge is that you never know which version you’re getting and by the time you’ve gathered enough information to make an informed decision, you’re already committed. It leaves you feeling ick. Cue small individual wipes. I firmly believe wipes should be considered medical equipment. Not convenience items. Not optional supplies. Medical. Equipment. Period.

Throughout my career, wipes have solved an astonishing number of problems. They’ve cleaned hands, faces, equipment, boots, flight suits, coffee spills (as seen on my Instagram reels), and whatever else mess I find. After enough years in flight medicine, you stop viewing wipes as a hygiene product and start viewing them as a universal problem-solving tool.

The longer you do this job, the more you appreciate small comforts. A clean bathroom with actual two-ply toilet paper starts to feel like a luxury resort. A sink with soap feels oddly exciting. The chance to rinse your face, change your socks, or spend thirty uninterrupted seconds not solving somebody else’s problem becomes disproportionately rewarding.

These things sound insignificant until you’ve spent ten hours moving between hospitals, helipads, ambulances, and aircraft. Nobody talks about these things because they aren’t sexy. They don’t make for compelling reels. Nobody posts motivational social media content about successfully peeing without contaminating your flight suit. Trust me on this.

When I first started flying, I thought becoming a good flight clinician meant mastering the medicine and aviation. Years later, I’ve learned it also means figuring out how to function after twelve hours in a flight suit, remembering to drink water before you become mummified, and successfully paying tithe to the Porcelain Gods. And don’t get me wrong…the medicine is still the important part.

But nobody ever talks about the fact that before you can take care of the patient, you have to figure out how to take care of the idiot wearing the flight suit (that idiot is usually you). So hopefully this saves you from learning a few things the hard way. Or at the very least convinces you to pack backup underwear. Trust me on that one… I heard it from a friend.

In the next installment of this series, we’ll move beyond flight suit survival and into the strange world of actually living this job. We’ll discuss the differences between twelve-hour “princess shifts” and the base-squatting lifestyle of 24- and 48-hour crews, including packing strategies, coping mechanisms, and the predictable stages of grieving while on the clock (joking).

We’ll also tackle base life, basemate etiquette, sleep deprivation, nutrition, long shift hygiene, and the collection of random items this experienced flight clinician carries. From emergency snacks and morale showers to emotional support go-bags and the fine line between preparedness and hoarding, we’ll cover all the things nobody teaches in orientation but everyone eventually learns the hard way.

-Clear Skies and Tail Winds

Six Sentiments for Season Six: Nurses Week 2020

Posted in COVID-19, Motivation, Personal Growth, Uncategorized by

Heeeeeeey Nurseeeeeee!

In honor of Nurses Week 2020 and what will be my sixth year of nursing, I wanted to make a post with the six observations I have about who I am as a nurse and pieces of wisdom I wanted to share.

  1. I came into this profession shiny and new with clean, pressed edges and resounding hope. While I still believe in the goodness of people, my cotton is a bit wrinkled now from the disregard shown by humanity. It’s intact still, not threadbare and laid waste from years of abuse quite yet. You can see the change notably from six years ago. Sometimes something really good happens that irons out the wrinkles and makes the cotton look renewed though. Sometimes when a small tear happens, a kind soul will come along a patch it up. In our profession, we can’t expect our cloth to stay immaculate–we should expect it to become a bit dirty and a bit worn. But we need to allow ourselves to let it be repaired and refreshed. Our work is meaningful.
  2. Protect your “helpers.” Value them. Now when I say “helpers” I don’t mean that these people are there to serve YOU (The Nurse)–you are all there for the common goal of bettering a patient. These individuals help in making your jobs easier though. So value them. Protect their interests. Are your respiratory therapists lobbying for better equipment? Join them. They know their specialty and there is probably a reason. Is another nurse abusing her patient care technician? Step up. Be a leader by advocating for that person. Is the department paramedic pushing for more privileges their license allows them to do? Speak up! These are our team mates. Rally to their sides.
  3. Pass on what you learn. It is so easy to find information and hoard it but its better for a department when you disseminate it. In this pandemic, I early on volunteered to moderate a Facebook Group Covid-19 Healthcare Professionals (click for link) which at the time (early March?) had like 300 people. The idea was to have a place for professionals to share information and develop a community. It quickly grew to over 84,000 people (at time of writing). Ideas flew like crazy from how to prevent skin breakdown from face masks to setting up vents and pumps outside negative pressure rooms. But the idea was this: knowledge sharing. Teach what you know to others–precept new team mates and if more experienced or older staff ask for help with something, teach without judgement. Do all acts for the betterment of the whole.
  4. Nursing will disappoint you. A lot. Frequently. Management will promise you the world only to give you scraps whether on purpose or not. Toad, Four Year Degree in Bladder HoldingPatients will burn you despite you breaking your back for them. The pay will never equal the work some days. Lunches won’t come some days and your bladder will harden to that comparable to those weird frogs that hibernate for years in Australia (I pulled out that metaphor from somewhere…don’t @ me).
  5. You don’t always get what you want (to quote the Rolling Stones). In fact–get used to it. I had a lot of “no’s” told to me in six years. Career paths I thought I wanted that went to other people. It hurt, guys. Baaaaaaaad. But the funny thing about “no” is sometimes it’s just a primer for “because here’s this instead! TA-FRIIIIGGGGIINNN-DAAA!” And it really is better. I didn’t always trust that I was told no for a reason. I felt like that no was my own resounding failure when in reality it was just because I was a better fit elsewhere. That job I thought was perfect? It took a wiser nurse sitting me down and telling me I wouldn’t be happy doing it. I didn’t believe her for a while and I was bitter at her assumption–how could she possibly know what I wanted? But she was right. I should’ve listened instead of being angry. Because my dream job offer came half a year later. Even if you don’t get that dream offer like I did right away, keep at it. Something I always tell new nurses or nurses trying to strive for something is this: Never accept “no”–rephrase it as “not right now.” By accepting that no and letting the door slam in your face, you’re missing possibilities of three more doors opening just down the road to even better opportunities.
  6. While nursing has given me the most painful memories and caused me some of the worst heartaches–it has given me so much more. It has given me purpose. Friendships. Meaning. It has saved my life when I felt it didn’t mean anything. Days I didn’t want to get out of bed–I knew I was needed by my coworkers and patients. Somedays that made the difference for me just knowing that the work I did with my two little hands caused change gives my career meaning. I’m proud of what I do and I couldn’t imagine doing anything else even on my worst days… find meaning in your work. This will help you power through the ugliest parts of our job.

 

So this week… this whole month… this whole year… hold your heads up high, Nurses.

We have faced insurmountable odds in some parts of the world and in those not necessarily being inundated by viral illness but rather facing unemployment from low-census or budget-cuts. The world sees us and while they may not necessarily empathize with our plights and administration may still gift us pizza parties (not you night shift–you get half eaten stale donuts because “tradition”) instead of safe staffing and all the things we really need…we’ll still keep showing up and providing top-notch care.

Happy Nurses Week!

 

 

So I Did A Thing, You Guys

Posted in Uncategorized by

A couple months ago, the good sir Kevin McFarlane of The Art of Emergency Nursing graciously had me on his podcast! Originally we were just supposed to be talking about my career as a flight nurse but the conversation took an interesting turn! We shifted into discussions about social media and the power of peer mentoring, how my attitudes in life have shifted over the years, how EMS has affected my career in nursing, how the bad things in my life shaped my emotional resilience and actually helped me get to where I wanted to be (in a funny twist of fate!), how networking can help you find your way and the important of paying it forward, never underestimating anyone because of their title, and always following your dreams.

It was a great opportunity and I’m excited to have been hosted by Kevin! You can find the podcast here CLICK HERE (:

And be sure to check out ART OF EMERGENCY NURSING for the heart and soul of ER and trauma nursing … for humor and career building with some of the biggest names in the industry.

You can also follow Kevin on his Instagram at Art of Emergency Nursing on Instagram

Oh Hi There!

Well HELLO and welcome to my tiny piece of the internet! If you’re here, it’s because you can looking for more information on flight or emergency nursing (and associated certifications), you found my Instagram (or a link from somewhere else I imagine), or because I gave you the link when you asked me a question (not because I was trying to turf you but because I wanted to make sure you got the full answer without missing any details).

I encourage you to look through everything but if there is a particular topic you’re interested in, I have organized the posts according to category for your ease (you can find those topics on the right side of the page).

As always, my opinions are my own and don’t represent that of my employer.

Please leave me some comments with your opinions on the posts and any questions so I can continue to grow my content over time. Otherwise–enjoy!

–Stephanie

So, You Wanna Be A Flight Nurse: The Sequel.

Posted in Flight Nurse, Motivation, Personal Growth, So You Wanna Fly, Uncategorized by

Scene: “The Interview”

So if you’re here, it’s for one of a few reasons…

  1. You read my first blog post “So You Wanna Be A Flight Nurse?” where I outlined my journey from start to “finish” of getting into a flight suit with “Flight Nurse” on my badge.
  2. You were driven here by my Instagram account @Pyrovixi where I share my career, my love of travel, my dogs, occasionally the man who puts up with my crap and feeds me (shout out to Chris!), and overall live the fabulous life of an InstaCeleb (at least I play one on TV).
  3. A search engine deposited you in my tender loving care because you scored your first (or fifth) flight nurse interview and you wanted to prepare for it. I relate–I googled “Flight Nurse Interview” once and didn’t come up with anything specific.

Well… welcome. I’m glad you’re here. Make yourself at home. I’d offer you a drink but well this is the internet and my jokes are tired AF to be honest. Scoring your interview was a huge obstacle to overcome and regardless of your outcome you need to be very proud of that fact. Not only did you meet the requirements to be entertained but you slayed the human resource’s beast guarding the gates of your future. I cannot tell you how many bright and high-potential people I’ve seen be weeded out because of clerical errors and automated systems. So you did well! Moment of silence for you to bask in that awesomeness!

So before I get into the meat and potatoes (or salad and vegan alternative meats for my plant-based friends) of the matter, I want to make sure I am transparent. I am by no means an expert in human resources, flight nursing, or really ANYTHING. I have been successful in life by a series of trial and error situations, good networking, persistance in the face of adversity, and by continued education. My nursing career is still young (at the time of writing this I have been a nurse for just under 6 years and a flight nurse just over a year). But I have the wisdom bestowed upon me by those who are much more experienced than me that I want to pay forward as well as my own personal experiences. Do not feel obligated to take my word as the end-all-be-all and use your own judgement when evaluating my statements.

In this post, I also may offer some tips that come off super commonsense for interviewing but when you read articles about interviewing, evaluators will states that the most commonsense things will often be the most overlooked by interviewees. Further, it’s not meant to sound redundant but act as simple reminders before you go in. Hopefully there are some new things you take out of this!

I think I’ve done enough prefacing. Let’s jump in!

 

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Do Your Research Before the Interview!

You probably know about the agency you applied to. You may have a friend who works for them or have heard about them in the media or seen them on Facebook. However, did you take a few moments to scroll through their “About” page on their website? If you were asked “what is ABC Med Flight’s mission statement and can you discuss their values?” would you be able to talk about it? If not, you were underprepared. It really is important to understand the meaning of the work you say you want to do when you’re pleading your case to your interviewers. Incorporating their buzzwords into your interviewer shows you align with their end goals and make you more marketable. I try to look for these things before I interview so that I look like a candidate that will mesh with the company.

I also like to try to know a tiny excerpt of history about the agency as well as their current status. These are all usually searchable online. A lot of agencies post their service areas on-line and well as the background of their company.

If you know someone in the agency, ask them about their interviews. It’s not really some big industry secret. One interview I went to was an interview followed by a medical simulation then a trauma simulation. Another was a basic knowledge assessment followed by an interview then if you did well a second interview where you completed a simulation with the leadership team. So knowing what you are walking into can help you leaps and bounds. Interviewers may tell you upfront what to expect but it never hurts to ask. I know I helped someone in our agency by telling him about my experience. Depending on the agency’s policies, you may be able to get a copy of their protocols to help you prepare for your interview.

Take a Moment for Self Reflection–Before You’re Put On The Spot.

Interviewers are going to be curious about how you handle things and who you are. Your resume gives them your certificates and your job history but no real insight on the personal growth factor those things entailed. So sit down and brain storm the following:

  1. What are your strengths? I personally like to avoid “I’m really nice!” Well that is important please don’t get me wrong but nice doesn’t save people, to be blunt. No one ever came back from a trauma arrest because we told them they had a nice smile. I usually encourage people to focus on their abilities to adapt to change. The critical care transport environment is one where patients just REFUSE to stay nice and stable (how rude!). However it’s also the weather, wildlife, bystanders, the spinning rotor blades of death we motor around in, other healthcare workers, and a million other factors that throw wrenches into our cogs and we need to be able to continue to function around these. But it isn’t just on flights. You need to have the ability to adapt with the changes in medicine–I know since I’ve started, I’ve seen a great deal of change in my program. I’m proud to say I was around for the implementation of the blood program but it was a challenge. The requirements are never static and thus, neither should we be. So when you’re laying out your strengths consider what would benefit the company, the patient and their families, your new coworkers, and the agencies we will be working with (EMS/Fire/Rescue/Police and other hospitals): critical thinking, assertiveness, enthusiasm/drive, reliability, and customer service. The final thing I really want to emphasize is this: if it isn’t a strength already make it one… ATTENTION TO SAFETY. Aviation has inherent dangers that we make every attempt to mitigate through our combined efforts of many individuals. It requires consistent vigilance and complacency can kill you and if it hasn’t yet it will eventually. Every few weeks we hear reports about another aviation mishap so having a respect for safety is a foundation strength; I don’t say this to scare you away because many companies have strong emphasis on safety (I recommend you check out the ECHO Heliops Community if you’re curious about aviation and safety–if the agency you’re interested in is on their radar, you may want to re-evaluate your options).
  2. What are your weakness? I think everyone is pretty wary of talking about these. I mean, who really wants a light shown on their shortcomings? We all want to be picture perfect people performing perfectly. However I really encourage you to admit these! It shows you have good self-awareness but also humility. Arrogant people are dangerous–if you know everything, you are less receptive to other’s input and in critical care transport that is a recipe for absolute disaster. So you came up with some weaknesses (“I lack neonatal experience; I’m no confident with obstetrics; I didn’t see a lot of ventilators”) and are probably thinking that will disqualify you. I want to reassure you that very few people without flight experience come 100% prepared and flight programs have training plans to address this. So be transparent and tell your interviewers–it isn’t a personality flaw and is a workable issue. I also recommend that you follow up every weakness with a proposed plan to tackle it. So going into the interview for this job,  I knew my weaknesses and explained that I planned to do more studying on the topics, listen to podcasts, and asked to shadow on units pertaining to that subject. I was actually surprised to learn it was part of my orientation anyway. So own your weaknesses!
  3. Remember a time when you were challenged as a nurse (this one I usually try to think of a complex pathology, a difficult family member, a coworker with an ethical issue, how I overcame a personal struggle with an emotionally taxing patient, how I worked without enough resources). Use this question to demonstrate your ability to be resilient and creative. It is a question they use to assess your ability to handle stress and overcome using your intellect.
  4. If you noticed a coworker was tired or came to work smelling like alcohol or was diverting narcotics or any form of this question… always reflect on how this would affect the safety of the crew. See rambling discussion above about safety. If anything ever puts you, your crew mates, your patient in any danger, err on the side of safety: speak up, cease the action, intervene if necessary, and if all else fails, involve your leadership. And after your interview: remember these things, don’t just say it and forget it!
  5. Why do you want to do this? Awww! This is my favorite and maybe it is because I’m not all salty and burnt out yet but my reasons bring tears to my eyes. If your reasons don’t move your soul and/or inspire and excite you, perhaps you have the wrong reasons. I really, really, really stress this: DO NOT say because it would be cool to wear a flight suit and fly in a helicopter. We all know that haha. But it is a vapid reason. Too many times I get sweet little nursing students who message me about this and say how they want to wear a flight suit or be a flight nurse so they could putz around in The Bird©. Focus on your personal growth/new challenge, the working with the sickest patients, join a team of like-minded/education-aggressive individuals… Think outside the box because there are probably three more applicants with the same reasons as you–make yours memorable.

Have Questions Prepared for Your Interviewers!

At the end of interviews, applicants are asked “Do you have any questions?” This is your chance to get them asked. In the days or weeks leading up to your interview, think up everything you want to know about the job. How do the shifts work, what happens if pilots/crew members call off (are you moved to another base?), what opportunities are there for public outreach or education, does this agency participate in mission trips or disaster quick response, are there opportunities to assist with projects in the agency, or are there any research projects the company is participating in? What do a majority of their calls consist of? Medical/trauma, adult/ped, scene flight/interfacility transport?

Don’t be afraid to ask about their safety practices. Do they participate in “3 to go, 1 to say no” practices? Do they operate at FAA weather minimums or do they have more rigorous standards? Do they offer safety and survival training? How is their safety record? What are they doing to ensure the safest practices for their crews and patients? (Dual engine helicopters, night vision goggles, flight tracking softwares).

But most importantly, ask if they are CAMTS accredited. If they are, are they expecting to? How do they ensure staff are maintaining CAMTS mandated proficiencies? How does their education work? What do they do to ensure staff are staying up to date with the the changes in medicine?

Write your questions down as they come up. Some may answer themselves in your interview but at least you show you’re interested! Do not skimp on asking about safety–its a hot topic in aviation and if your interviewers seem shy about it, that should be a red flag to you. Transparent, safety conscious companies will be up front with you about their practices.

Medical Knowledge: Some Things You May Want to Know

I’m going to through some things up here but ultimately flight systems can vary so much I can not give you a comprehensive prep list. My recommendation is you check out the Board of Certification of Emergency Nursing’s Content Outline for the Certified Flight Registered Nurse because its a very good list of major topics we encounter.

My recommendations:

  • STEMIs (Inferior/Posterior) and Rhythm Interpretation/Management
  • Strokes (ICH/CVA, BP Management)
  • Sepsis
  • High-Risk Obstetrics (Use of Magnesium)
  • Trauma Management
  • Know your state EMS protocols–usually accessible online
  • Come being able to do dosage calculation, calculate drip rates… good refresher here and here!

I recommend this great app if you’re looking to grow your knowledge of critical care–it is called CRITICAL and does cost money to use but it is well worth its weight in gold. I currently could only find it for Iphones so I apologize for Android users.

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DOOMSDAY! Just Kidding: Day of The Interview

So by now you know what to wear to these things, so I’ll save the talk on that 🙂

However some little things that get looked over are the following:

  • Eat a light breakfast or lunch–enough to satisfy any hunger and ward off any stomach growls/sugar crashes but not enough that you may have to consider a bathroom break during your interview or leaves you in a brain fog (remember going to class after a carb-heavy lunch?)
  • Show up 10-15 minutes early.
  • Have at least 5 copies of your resume printed, one side only on decent paper (they have the electronic format but I’ve been complimented many times on my preparedness and thoughtfulness).
  • Bring a note pad and pen with you to take notes.
  • Start the day with positive thoughts and if you can remind yourself to, smile throughout the day–there are a lot of studies that show that it sets you up for a better mood.
  • Immediately before your interview try to take a series of deep breaths, clear your mind of the possibility of not being successful, and relax your shoulders.

In The Interview

This is it! Dun dun duuuuunnnnnnnn. So now that you’ve done all the prep, spit out your gum (before you got there, obviously), ditched your coffee, and brought your resumes you enter the Chamber of Destiny (any fantasy fans out there?)

Likely the individual retrieving you will introduce you to the group. However, make sure when you first speak, it is to introduce yourself. Remember to greet every interviewer with a handshake, making eye contact, and thank them for their time. This is your opportunity to offer copies of your resume but don’t be offended if they decline, they may have one already. If they don’t, provide one. Then you can refer to items on it throughout your interview and they have a small reminder of your existence at the end of the day after they conclude other interviews.

As you speak, sweep your eyes across your interviewers and be sure to smile. If you’re on a phone interview, remember to smile! It sounds cheesy but your voice changes when you don’t and it can make you sound more approachable and relaxed. Try to commit their names to memory and if you answer a question one has asked you, try to start your answer with their name. Example, the female interviewer is named Karen (because they are always Karen, am I right?!) and she asked about your last job: “I’m glad you asked, Karen….” This also prompts me to say: while it isn’t unreasonable to identify weaknesses your last job may have had, I would avoid condemning it or sounding condescending about it. There is a way to frame these things politically correct so always come out on the high road– interviewers may be made to thought “if they talked about their old job this way, how will they talk about us?”

You’ve prepared the hard self-reflection questions already so those should be easy by now! Highlight that you can operate alone and as a team mate. Make sure you discuss how you feel confident in your knowledge but also realize you have a lot to learn, recognize that you don’t know what you don’t know but know how to utilize your resources (protocols, experience, partners, other agency providers) and your medical command. It shows you’re competent and confident as a provider but also humble and not a cowboy. Be willing to learn, willing to help. Also willing to stand by to decisions when it comes to safety—- that is HUGE in aviation. Safety of the crew is 100%.

Something that came up for me that tricked me up was the question “Who are our customers?” Well of course they’re our patients! Right? Yes and no. We also have to consider the facilities we go into and work with. In my interview I literally felt so goofy–of course! Bad interactions with other facilities reflects poorly on the whole organization. My director said it best and it has stuck with me since–the flight suit represents quality and we have to always be aware that people expect that (paraphrased). Hospitals have the ability to call other flight services or ground services (some places don’t have many because they are rural but still) but they make a choice to use yours; this is not something we should take lightly. Losing the trust of a facility means we may not go back. It may mean utilization of another flight service who may not be as good or may be more expensive and consider how that may effect our patients but also, its not good for our company’s bottomline. While I don’t like to think about making money off of sick people I also recognize the reality that we operate and have the ability to do so because we can afford to.

So now you have the opportunity to wrap up the loose ends of the interview! Make sure you clarify anything you might have said that might have you cringing now (example: I once said something about working with new grad nurses… it wasn’t that I disliked them and when I was talking later, I realized the context was lacking when I discussed it earlier. I’m glad I circled back because the impression the original statement left was not the one I intended). Ask the questions you prepared. And finally, ask for business cards!!! If they do not have them, ask if they would be willing to provide emails for follow-up questions.

Again shake the hand of every interviewer for their time and consideration, looking them in the eye with a smile. I like to throw the “I hope the next time we meet is when I am beginning my training but regardless I appreciate the opportunity to have been here today.” I think conveying confidence and excitement/hope with being realistic and grateful is a good blend of human emotion and social interaction.

After The Interview

Alright! Go you! Not only did you survive the interview, you survived 3,340 words of this blog post (:

Now is the time to relax and reflect. Every interview is potentially practice for the next. What went well? What didn’t? File it away. We always hope we’ll never need to interview again because we got our dream job but approaching this with realism is tactful and responsible. Interviewing is a skill and like any other skill, it requires practice. I know I was cruddy at foley catheters for a long time but eventually I hit the right hole! Interviewing is kind of like that–eventually you kind of just fall into the right hole.

Within 24-hours, I recommend pulling out those business cards or the list of emails and composing thank you emails. Generally I like to take the opportunity to highlight the major key points of the interview, reiterate why I feel I am a good fit for the position, as well as include any things I may have forgot to mention and other questions I might have had. Conclude with a thank you for the time the interviewers provided and another statement that you will hope to speak to them again moving forward.

Now hurry up and wait, ya’ll!

 

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If you’re applying for a flight job, chances are you have a few interviews under your belt. And realistically, you probably had this all on your own if you were out researching how to prepare–because the kind of people who get hired and thrive in flight are the types who want to be the best and put in effort.

 

Finally I want to end my post with a quote posted in our base:

LIVE YOUR INTERVIEW

DO WHAT YOU SAID YOU WOULD

It’s one thing to say all the right things but just make sure you follow through–our work matters and people will look differently at you when the flight suit goes on. Be cognizant and never forget what you said.

Clear skies and tail winds, friends!

 

 

Did you use this blog to get a flight job? Please leave a comment if you used this post in an interview and how your interview went! I am vested in the success of future flight nurses and would love to continue to develop this for future readers. Suggestions and honest feed back is greatly welcomed.