Flight nursing is a specialized healthcare role that requires transitioning from traditional hospital settings to prehospital emergency care, involving comprehensive training in advanced life support, pharmacology, equipment operation, and autonomous clinical decision-making, with the key difference being that flight nurses must independently assess and treat patients in dynamic, resource-limited environments without physician oversight.
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Deep Dive
REGISTERED NURSE — days in my life, emergency department, flight nurse, RN, healthcare, HEMSAdded:
Happy birthday.
>> Today is the first day of my new job as a flight nurse.
Good morning.
Good morning.
Morning. It is about 5:00 a.m.
We have a full 12-hour shift ahead of us in the ER. In fact, this is my last shift in the ER. Well, not really, but it's my last shift until I start my new job as a flight nurse next week. So, I will be picking up shifts in the hospital intermittently, but tenatively.
This is my last shift for the foreseeable future, which is crazy. I'm on a struggle bus.
I've been up since like 3:30 a.m. and wasn't able to go back to sleep. So, it's okay. We going to get through it with caffeine and we're going to head to the gym, which always makes me feel more awake and just allows me to have a better shift. We're going to get ready at the gym and then head to work. One thing I always do the night before my shift is I set everything out. Like I pack my lunch so I can just grab it from the fridge. I set out my clothes that I want to wear to work. I set out my gym clothes. I pack my bag that I'm going to take to the gym with like my towel and toiletries and things like that. Then I have my work bag all situated. It just makes for such a more smoother, peaceful morning and I'm not digging around trying to find something and then getting a little grumpy. So, it's going to be a good day. This is the hardest part of leaving in the morning.
I just want to cuddle with him forever.
Goodbye.
Morning.
I just got to work.
It's sprinkling outside. And I swear the last time I filmed a video, I was also underprepared for it to be raining outside. I don't know how this keeps happening. I'm leaving my rain jacket at home. It's cuz it's been such a weird winter here in Oregon. It's been a very dry winter, which makes me nervous for for summer, but we're not going to think about that right now. Um, I have my work bag, my lunch box is in it, my water bottle, my coffee. Oh my gosh. I want to show you guys this new badge roll that I have.
Can you see?
How do I make you see it?
I had to show you in different lighting.
Oh, can you see it? That is sunny.
I need to make one for a camper, too. I actually make these and sell these in my business, Rooted in Rogue, which will be linked down below if you guys want to get a badge roll of your puppy or your kitty or the love of your life. All right, I am running a little behind, per usual. So, we're going to run into work and have ourselves a good day.
I'm currently on my lunch. It's kind of early. It's 11 a.m. I don't mind going early because I like to go on a walk when I can and get some fresh air. Step away from the hospital.
And it stopped raining, so it's actually pretty nice out. It's overcast. Feels good out. I find that if I go on walks on my breaks, I have way more energy throughout my shift and I don't need another cup of coffee or an energy drink. Although I did bring an energy drink today and I will be having that because it sounds good. Anyways, I am going to continue enjoying my walk outside.
I just had a peanut butter one.
>> There you go.
>> Thank you.
We did it. We survived a 12 and a half hour shift.
It's now starting to rain. Can't wait to get cozied up at home with my doggies.
Overall, I would say it was a pretty good shift. Um, it didn't go by quickly.
That's okay. Me and my co-worker kept looking at each other like, "Why is this day going by so slowly?" Um, but overall it was a good shift. I started my shift off giving a denazine at like 7:00 a.m.
with a co-orker for a patient with SVT.
Um, and that was probably the most exciting thing that happened and they converted back to normal sinus rhythm.
Um, otherwise I had a lot of psych patients. I was working in the psych patient corner. So had a patient whose potassium was above seven. So we did the hypercalemia protocol where we give dextrose, insulin, lasix and we gave sodium by cararb. Um, and that was just right at the end of my shift. But overall, it was a pretty mostly chill shift. Um, and it was my last one for a little bit, which is crazy, but also super exciting.
I'm going to head home now, go shower, and have a chill night. Try to go to bed as early as I can. I did finish my energy drink at like 6:00, which was my mistake.
Woo!
It's pretty cute.
>> I don't know WHY I'M WEARING GO.
>> READY. ONE, TWO, THREE.
>> Happy birthday to you.
Happy birthday to you. Happy birthday, dear Kar.
Happy birthday to you.
>> Oh, snipper.
>> Good morning.
Good morning. Today is the first day of my new job as a flight nurse. I am so excited. I am just so happy. I don't really know what today entails or the remainder of the week. I think it's a lot of HR related things like insurance and benefits and about the company. But we're going to find out together and I'm excited to bring you guys along. Hello.
I just got some In-N-Out. I'm on my lunch break.
I didn't pack a lunch cuz I wasn't sure what to expect, but we have an hour long lunch break and I think it's kind of nice to get out and go get some food and take advantage of In-N-Out being only 4 minutes away. So, it's nice.
You guys, I'm so excited. I'm just genuinely so excited for this new phase of my life. I just feel really really good about this choice right now.
First day basically just an orientation kind of like what I thought it was going to be. We had somebody going over benefits, health insurance, dental, vision, retirement, just different things like that. And then we've had a lot of different presentations by different people within the company just sharing their roles and their experiences and their histories and stories. And I think it's really nice to work for a company where a lot of their leaders used to work directly with patients and used to be EMTs or paramedics and had that actual patient care experience and have moved themselves up the ladder and are now, you know, the bosses. They know what it's like to be the employees that they're managing. I can really really appreciate that. So, everything's been really good so far.
Got a binder and some paperwork in it and a book just kind of about my curriculum for the next couple of weeks as I'm in my training program. But I'm going to eat my food, relax for a little bit, and then we have I think five more hours. Literally doesn't get better than this. If you're not getting chilis on your burger, you're doing it wrong.
Good morning, you guys. The craziest thing happened and I slept through my alarm. I don't even remember the last time I've done something like that. I don't set multiple alarms. I only set one. So then I fell asleep for another 30 45ish minutes and then luckily woke back up. But I obviously missed going to the gym this morning, which I'm like not too upset about, but kind of upset about cuz I always have such a better, more energized day when I do go to the gym. So we have to make it a priority tomorrow. I also need to be running again. I'm wondering if I'm so tired because I did a 10 mile race 2 days ago and I don't know if my body is still needing to recoup from that because I went to bed at like 8:45 last night. So, it is what it is. But, we are going to head to our second day. I'm not totally sure what's on the agenda. I feel like it's more powerpoints and just talking about like just culture and infection prevention, things like that.
But I'll keep you guys posted.
>> Hello. I have royally sucked at keeping you guys updated, but here we are. We're on day three. Yesterday we even remember Oh my gosh. What did we do yesterday?
Oh, we went through a lot of our bags that we'll be carrying as a flight nurse and flight medic. Our go bags or our airway bags, our bags with all of our medications and IVs and supplies and then like an extra bag we have that has just extra things. But these are bags we carry on our back and just kind of got comfortable with where things are at there. There's a lot of information that I'm learning and it's kind of reminding me of being back in school, but in a good way, like in a really really exciting way, but just like having to remember things that I haven't thought about in a while or learn new things. There's a lot of that. So today we went over some more like medical emergencies, poly traumas, kind of like TNCish of what I've learned before, which is trauma nursing core curriculum and kind of the process of going through that.
pediatric emergencies, the process of EMS and how you arrive on scene and just things that I'm not super familiar with working in the ER because I obviously get the patient after all that has happened. ER is considered chaos to people, right? But truly, it is like a controlled chaos environment. We have everything we need there. We have multiple hands. We have control of who comes in and out of the room. Whereas in a true emergency where you're first on scene, you're having to litigate all of that if you don't have like fire or law enforcement helping you. You're the first one responding. So that's not something that I'm super familiar with in any way, shape, or form. So that's going to be something I'm going to have to learn to navigate.
And I'm just I'm so excited. So excited.
I officially got my schedule. So now I can kind of plan my summer out and make all the plans that I want. And then what else? I was going to show you guys a couple things that I was given.
So I was given this book. It's called Ventilator Management, a prehosp perspective written by a flight paramedic. I think I'm going to try to get through some of this this weekend and really start studying cuz I have a test next Friday and it's not punitive. It's just to see where I'm at in regards to intubation, medication, knowledge on the fixed wing and on the rotor wing and just aerospace laws, things that I need to learn. Um, so I have a study sheet that I'm making for that. And yeah, so far everything's been really, really good.
And I'm having a good time. And I'm just I'm just so happy. I took this little leap and I'm so excited for what is to come. I just had my lunch. I got some sushi and some soup. And then we're heading back and I'm not quite sure what we're doing. I think we're taking we just took a tour of like the ambulances and where things are stored inside of them. I think we're going to some of the hospitals and then to the second base that we have with another helicopter and then that will be pretty much the end of the day. And then tomorrow I am going to be learning to drive an ambulance.
You should all be very very scared.
I'm on lunch right now. We just finished up going over all of our policies and standing orders, which was really nice to go through each of them word for word and be able to ask any clarifying questions or questions that come up instead of just sitting there reading through them by yourself and just staring at a bunch of words cuz it's super overwhelming. After lunch, I think we're going to do like a quick pharmarmacology session where we're going to get familiar with Sapphire pumps, which I've never used before. We use the Brun pumps in the hospital that I work at, but I've heard Sapphire is like awesome. So excited for that. Um, and then just figuring out how to reconstitute medications and make push dose epi and make certain medication drips because that's something that I have never done working in the ER. We have pharmacy to do those sorts of things for us. So, this is all super new, but it's super exciting and I'm having fun. Like, I just am enjoying learning all this and I feel like it's just going to make me such a better ER nurse and just ah I'm just really happy and really excited. So, let's go get some coffee.
I'm home. I have this massive pile of dishes to do. But disregard, I'm going to take Sunny on a run right now cuz she's got a ton of energy. And if I don't go on a run right now, then I'm not going to go on a run and be lazy.
So, we're going to go right now and then I will chat with you guys about the rest of the day, which was really good. But, I have some studying I need to do before tomorrow when we're going to be going over events and things like that. I am tired. I went on a run with Sunny. I showered. I did a little meditation.
Um, did the dishes.
Folded some laundry. I'm about to eat dinner now. I did a little bit of studying. Like when I was folding laundry, I listened to a YouTube video, just like a refresher on vents and settings. But tomorrow morning, I'm going to wake up early. I learn and like retain information so much better in the morning. I would way rather wake up at like 4:00 a.m. and study for a test and stay up super late.
That's how I've always been. So, we're going to wake up early tomorrow. We're going to get some studying in for the day ahead of us cuz I know it's a full day. After I talk to you guys, what did we do? Oh, we went over the Sapphire pumps, which are that was really nice to like go through and learn those. And then we just went over like all of the pharmacology and the medications that are in our standing orders, which I still need to learn cuz there are certain meds that are not in our standing orders, which I'm used to giving in the ER. And then also just like I get to choose what I think is appropriate and I have that autonomy which is totally not what I normally have. So that's something that's a little different. But overall very good day and I'm just having fun.
It's a good time.
camper still has to get his bordella vaccine so he can come there so he can be a little hanger doggy.
Just feel like he could be a little mascot there to get him like goggles or like a really cute bandana. I'm so excited to bring him to work. Are you kidding me? I'm going to have some tacos and I will see you guys in the morning.
our favorite time. I love waking up and saying good morning.
Morning. Today is intubation day. So, we're going to be going over a couple scenarios. I think ACLS and PALS related. And then I'm going to learn to intubate, which is super exciting and also so weird to say out loud.
Hello.
I need to update you guys because we are at the end of my two week orientation training of starting.
Okay, this is just my boyfriend is literally staring at me right now. Stop.
go back to doing what you need to do.
He's got a long to-do list and he's not focused. I've officially finished my two week introductory course into flight nursing. I still have another 4 to 6 months to go before I'm actually on my own. But the past 2 weeks have been really good and they've gone over a lot of different things. We went over the new company that I'll be working for, their values, um, their policies and their procedures. Got to meet mostly everybody higher up within the company because it's actually a smaller company which is super awesome.
It's everybody knows everybody's name and I can really appreciate that. And I think I mentioned this before about how a lot of the people that are in managerial roles are people that used to work the jobs that they're overseeing.
And I I just so appreciate that cuz they have a different understanding than somebody coming into a role that they've never worked. And I also can acknowledge that they often allow people to move up within their company, which I think is super great. So, we have a whole book of things that we are allowed to do within our scope of practice, which is kind of like the same as the hospital, except I'm making that ultimate decision. I'm not waiting for an MD or DO or NP or PA to tell me, please give this patient 4 milligrams of Zopran. I am the one that is making that decision and implementing it.
So, it's just a little weird. Um, Zopran is really not that big of a deal, right?
But like with other medications like intubation medications where you're having to make those decisions, um, that's a little bit different. It's a lot to learn and get used to and be comfortable with, and I know it's going to take some time. We went over the ventilator, which I think I've been super spoiled at the hospital that I work at because we have RT and anytime there's a problem with our intubated patients, we just, hey, please call RT or we send them a message and they're like down in an instant and we just don't have a ton of experience using the vent settings, which I'm like super grateful for. I'd rather have somebody that like went to school for that and knows how to adjust all of that, but there's like a discrepancy because I'm not super familiar with adjusting a lot of the settings. Like I know how to adjust the FiO2. I know like increase that if my patient is short of breath and their oxygen saturations are deteriorating, but other than that, we typically call RT. And I know that's like a luxury, but in this instance, it's working against me because I haven't put a lot of time and effort into learning the vents, which I will have to do now. And I think it's also one of those things that the more experience you have with them, like the better you have at understanding them. They seem very user friendly and also like conform to like how the patient's doing.
So, I think the Hamiltons are a really good fence. But if you have any recommendations or like any alternative resources for studying, please send it my way. We went over pharmacology and a lot of the meds that we give in EMS, which most of it I'm a thousand% familiar with. The only drug that's very interesting that they use more so than we do in the ER is ketamine. It's very interesting because as I'm doing more research on ketamine and becoming familiar with it.
I feel like it's a great drug if used properly and we don't use it a lot in the ER. I've seen children react really poorly to ketamine during a procedural sedation where they're like coming down from it and just I they call it the cable. I don't know. Uh but we just don't like use it a lot. I I it's probably provider discretion but they use it a lot in EMS and it has these properties where if you are hypotensive and brada cardartic it can elevate both of those vital signs.
My next mission is the next time that I work I plan on talking to some of the ER providers about why we don't use ketamine more often for analesia for sedations for intubations. We use accommodate all the time. I don't even know the last time I've ever given ketamine for an innovation. And then we did like a big overview presentation on like the night vision goggles and how those work, which are exciting for all of the people that like NVGs and nerd out on that, which I think is super cool. I just I'm so excited to fly. Like it's going to be so fun. A lot of online training modules and just a lot of like online basic courses and I still have a lot more to do. And then the last thing was I had to take a test and I was told I didn't have to pass it, but it was basically to see where I'm at.
And then it's being sent to my I want to say preceptor, but that's not what it's called in EMS. It's being sent to my FTO, field training officer. just getting my test and seeing how I did to see like, oh, I'm not super familiar with this or that and then going to kind of cultivate my experience around that.
Um, but I actually did pass it, which I was very surprised. I got like an 84 out of 104 or 85, I don't know, like a B. But I'm proud of myself with that.
And I'm just so excited for what is to come. And I was talking with one of my co-workers in the hospital who used to be a flight nurse and he recently came back to the ER and he's asking me how he's feeling and I was just telling him I am just like overwhelmed and I just feel like I know nothing, you know, like I mean I know I know a lot but like in this world of EMS and responding on scene and in ambulance and all that like it's so much to learn. And he brought up a really good point of when I first started in the ER or when any new nurse first starts in any floor in any capacity, it is so much to learn. You are like a fish out of water, right? Like you don't know what the heck is going on and it takes time to figure those things out, but you will and you do. And he kind of just reassured me. I didn't think about it like that. Like I've felt this exact same way before when I first started in the ER. You want to come say hi? Come here. But I did feel that way. I was like, there is no way I'm ever going to feel comfortable and confident in all this. And now I do. I do. So, I mean, not all the time. There's always always things to learn. And you never know, like somebody could come in for something and they have something completely else going on. But a level of like confidence and knowing and trusting in yourself and your ability that you can handle whatever is presented to you and you have a good team that you can rely on, I feel like is such an important thing. And I know that I will feel that way eventually with this job.
I think it's just going to take time and it's it's just so weird to to go from working in an environment to feeling comfortable in and then it going like it feels like backwards, but I know it's not backwards because I am learning so much and so many of the things I'm learning in flight will be so applicable to the ER that I will be a much better ER nurse.
It's just it's just new. It's new. I think it's all about your perspective and and how you look at it. And I'm going to choose to be excited and I know it's all going to work out and we got a lot to learn. Girlfriend, she just ran three and a half miles with me today. She did so good and camper did a mile and a half. Um, but that is the big update. I have my first official 24-hour shift tomorrow. Um, and it's on a Friday night and it's a full moon.
What are the odds of that? I don't know.
I went to the store today and got a couple of things that I wanted to bring with me. So, I got this water bottle from REI. It's light. What do you think?
Come here. Do you want to come say hi?
Oh. Oh, camper's hungry. He wants me to make him dinner. Um, and then I got a pair of boots.
I like Blendstones because they are comfortable after you break them in.
They last forever. They're mostly water weatherproof and they last forever. I have a pair that are 4 years old. So, I got a pair of these for my uniform with my flight suit. They have to be all black. That about wraps up my first couple of weeks in training and learning about my new job. So, I'm so excited to continue sharing things with you guys.
If you guys have any words of wisdom or advice or have any questions or just want to say anything at all, please comment down below. And I appreciate all of you guys. And I hope you guys are all doing well and I will see you in my next video. Bye.
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