POSITION DUTIES AND RESPONSIBILITIES:
· Flight nurse must be able to perform duties as described herein and as defined in the Transport Procedures section of this manual. Flight nurse is also subject to the review of the Medical Fitness Standards included in this manual.
· Responsible for independently providing patient care and education through the nursing process to assigned transport patient population(s) while ensuring safe and effective transport as described in the Medical Protocols/Standing Orders. Establishes supportive relationships with patients, significant others and other members of the health care team through the use of positive interpersonal skills. Provides support for administrative activities.
· Responsible to collaboratively assess, provide and evaluate patient care within the aircraft, airport, commercial airline, ground ambulance or within the hospital or clinic setting for assigned patients in conjunction with all members of the health care team.
· The transport nurse must abide by the policies and procedures outlined in this manual at all times while representing AirMed.
· The transport RN must have a valid RN license and required number of years of critical and/or acute care experience in the area appropriate to patient population(s) to be transported. The RN must be able to work in all types of climates. He/she should present a well‐groomed and neat appearance. Transport nurses who staff international transports and commercial airline medical escorts must obtain a passport and must maintain currency with international immunizations as required by policy.
· Maintain current licenses and certifications defined in the job description for the position held.
· Maintain appropriate expertise and certification for age specific populations in which they provide care.
· Maintain currency in required in‐services, such as Aircraft Safety, AMRM, Altitude Physiology, Stress Recognition and Management, and Skills Competency Lab.
· Medical crew member(s) assigned to long‐range, international, scheduled transports, and/or commercial medical escorts are selected based on assigned scheduled days or availability. Each contract flight nurse will submit dates of availability to the Program Director each month. Any contract member failing to submit availability status for periods greater than two consecutive months will be placed on inactive status.
· For Non-Emergent transports, the medical team will be alerted by the GOCR at a minimum of two hours prior to the scheduled departure time of the assigned transport. Medical team members must arrive at least one hour prior to the scheduled departure
time to ensure that a complete patient medical report has been obtained, and all necessary medical equipment and supplies are onboard prior to the scheduled departure from base. Medical crew member(s) assigned to a defined shift must arrive promptly as per their scheduled shift.
· The medical team will receive a written patient report and will contact the Clinical Coordinator through the GOC at a minimum of one hour prior to the scheduled time of departure from AirMed to obtain a verbal report of information of the medical triage and any additional information available: patient and physician name; date of birth; diagnosis; referring hospital; address and phone number; accepting physician and phone number; receiving unit. Dispatch will provide the proposed itinerary.
· If necessary, the medical team may obtain additional information by calling the referring hospital and documenting on the Pre‐Departure Form the information that is appropriate to the patient. If there are necessary changes to the arrangements completed by the communication center or clinical coordinator prior to this call, these will be communicated directly to the coordinator by the medical team for final approval.
· Obtain the drug kit from the locked storage area. Narcotics may be obtained from storage to the Flight Nurse with a valid I.D. and will be signed out on the registration form by the Flight Nurse for use on air medical transports only. Controlled substances will not be removed from AirMed’s inventory for use on a commercial medical escort.
· Will assist with loading the aircraft with the routine medical transport equipment.
· If the team is not complemented with a Respiratory Therapist (RT) and/or Paramedic (EMT‐P), the nurse is responsible to complete the responsibilities otherwise assigned to the RT or EMT‐P.
· Obtain the appropriate respiratory equipment.
· Check oxygen levels of the tanks on the stretcher, stretcher base, and LOX tanks accordingly.
· Replace stretcher e‐cylinders if PSI less than 1000, and will coordinate service of LOX and/or base MM cylinder to full capacity prior to departure.
· Confirm O2 has a PSI of 50 at minimum.
· Confirm suction has 120mm pressure at minimum.
· Check the pulse oximetry monitor for proper calibration.
· Prior to departure, check the connections in the oxygen system onboard the aircraft to confirm there are no leaks and all connections fit.
· Ensure that a PEEP bag is onboard the aircraft and in good working order.
· Provide respiratory care during the entire transport, making appropriate adjustments for altitude when applicable and document care, ventilator settings, interventions, changes in patient status, pulse oximeter measurements, EtCO2 as applicable, ABG results and all other aspects of the patient’s respiratory assessment and status per the documentation protocols.
· Upon completion of the transport, restock the aircraft and the medical supply pack with the respiratory equipment and supplies, disinfect any used equipment, stretcher and aircraft patient care areas with antiseptic cleaner per protocol, and check the PSI of the e‐cylinders and replace is less than 1000.
· Additional needed supplies not normally stocked in the pack or aircraft will be obtained from the medical supply room. Assemble chart material as defined in Section 1 of this manual and any additional equipment needed for the patient from the medical storeroom. The team will review the report, to determine the need for and additional equipment, supplies, and/or drugs prior to departure. Assess and stabilize the patient as needed prior to transport (i.e., check IVs change over equipment as needed, secure all lines etc.).
· On international transports, the entire medical crew will visit the patient upon arrival to discuss logistic plans and to provide information. All transport arrangements should be confirmed at this time and any medical orders necessary should be communicated with referring staff. Upon completion of the initial visit, the medical crew will report to the
Clinical Care Coordinator. All pre‐arranged plans should be confirmed with the Clinical Care Coordinator and should be updated if these plans change.
· During the transport, the nurse is responsible to provide the patient status updates as outlined in the Coordinating Patient Transports policy of Section 3 of this manual.
· Call the receiving nurse prior to departure from the referring hospital or the last fuel stop on long‐ range flights to give the nursing report and ETA.
· Provide nursing care during the entire transport and/or commercial medical escort according to the AirMed transport policies and procedures and document all care and changes on forms.
· Take the patient to the designated room or unit bed of the receiving hospital; give report to the receiving nurse. Provide copies of all charting forms to the receiving hospital and return originals to AirMed.
· Restock aircraft and medical supply pack with supplies from the storeroom at the end of the transport and/or assigned shift. Used narcotics must be signed for in the medical record with witnessed waste form completed when applicable. The drug kit will be returned to the locked storage area.
· The AirMed Flight Nurse will assess the patient continuously.
The AirMed Flight Nurse will:
· Collect pertinent physical, psychological and social data from the referring nurse, patient’s chart, subjective and objective data gained from the patient and other health team members and revise the database as new information arises. Accumulated database will be communicated to the receiving nurse.
· Document all pertinent data on the pre‐departure form and nursing notes.
· Collaborate with other health team members to collect and share data through physical assessment and effective communication skills.
· Demonstrate competency and completeness in collecting data through physical assessment and effective communication skills.
· The AirMed Flight Nurse will identify patient problems and plan of care based on collected data, knowledge of biological, physical, behavioral sciences and the physiological effects of the air medical transport.
The AirMed Flight Nurse will:
· Use written and verbal communication to maintain quality patient care, to enhance team interaction and to promote the goals and objectives of the AirMed transport program. Uses positive interpersonal techniques to establish and maintain therapeutic relationships with patients, family, and other personnel.
· Collaborate with the patient and other health team members in identification of problems/needs and plan of care.
· Reassess problems/needs and their priority as the patient’s condition changes and communicates them to the receiving nurse.
· The AirMed Flight Nurse will implement the plan of care.
The AirMed Flight Nurse will:
· Use current knowledge of the sciences and air medical transport, as well as competent psychomotor skills in carrying out interventions. Provide safe care in a manner preventing complications and life-threatening situations to the patient.
· Implement the plan of care in collaboration with the patient and other health team members as explained to the patient.
· Support the patient’s right to participate in his care.
· Document assessments and interventions in the patient’s transport record no less than every 2 hours on long‐range and/or international transports if patient’s condition is stable.
· Follow physician’s orders if physician present during flight and will sign off orders as completed.
· Will implement care as defined in Medical Control Standard Orders if physician not staffing transport.
· The AirMed Flight Nurse will continuously evaluate the effectiveness of provided care.
The AirMed Flight Nurse will:
· Compare the patient’s condition to the expected goal, attempt to determine the cause of any significant differences between the two and revise the plan of care accordingly.
· Collaborate with the patient and other health team members in the evaluation process.
· Document findings in the patient’s transport record and communicate to the receiving nurse.
MINIMUM JOB QUALIFICATIONS:
· Registered nurse with a valid nursing license from the country and/or state(s) of primary practice as required for their assigned base of operations. For foreign‐based operations, must hold valid nursing license from comparable programs of nursing. Bilingual language skills may be required.
· Must hold current passport for unrestricted travel.
· Minimum of three years of experience in a critical and/or acute care setting.
· Recommendation from appropriate supervisory nursing personnel.
· Current certification in CPR and other population specific advanced certification, such as Advance Cardiac Life Support, Pediatric Advanced Cardiac Life Support, and Neonatal Resuscitation Program.
· Successful completion of the Trauma Nurse Core Curriculum (TNCC) an advanced trauma certification (audit ATLS or completion of TPATC).
· Successful completion of the AirMed Transport Program orientation.
· Successful completion and currency of Certified Flight Registered Nurse for all full time nursing staff is required within two years of hire. Completion of nationally recognized certification of other specialties strongly encouraged for contract nurses and required for employed nurses within two years of hire date, e.g. Certified Flight Registered Nurse or Critical Care Registered Nurse are accepted.
· The transport environment can be challenging both physically and mentally. As such the crew member must meet the following requirements:
· Must be able to withstand stress/demands of an active position.
· Must be able to withstand many hours of: standing, sitting, walking, bending, & lifting.
· Must be able to lift and move patients and equipment used.
· Must be able to read, write, and speak English fluently.
· Must have manual dexterity, good eye-hand coordination and adequate vision.
· Must have no medical conditions that can be exacerbated by altitude changes.
· Must be able to function effectively while exposed to environmental elements.
· Must not be affected by motion sickness caused by aircraft operations.
· Conditions which differ from the normal work office environment include but are not limited to:
· Exposure to blood, bodily fluid and tissues.
· Adhere to all OSHA Requirements
· Exposure to operating aircraft, ground transport vehicles, loud noises, vibrations, & hot exhaust gases.
· A small cabin area to deliver patient care with limited ability to maneuver.
· Carrying transport equipment, lifting patients and stretchers.
· Performing patient care for extended periods of time in potentially adverse conditions/situations.
· Space constraints and a constantly moving environment.
· Emergency exits are specific dimensions.
· Aircraft are limited to certain weight & balance.
· Exposure to hot/cold environments.
POSITION REPORTS TO: Director of Medical Operations (DMO), Medical Director(s)/Associate