Flight Nurse

The field of flight nursing began in the middle of World War II. After successful air evacuations in Alaska, Burma, and New Guinea, in 1942, the United States Army Air Forces (USAAF) began training surgeons, medical technicians, and nurses to provide in-flight medical care at Bowman Field in Louisville, Kentucky. Despite the perilous conditions, by the end of the war, nearly 500 army nurses served in 31 medical air evacuation squadrons around the globe. Miraculously, army medical teams airlifted 1,176,048 soldiers from 1942 to 1945, of which only 46 died en route.

Nowadays, in the 21st century, flight nurses remain a fundamental part of aeromedical evacuation teams, providing healthcare on the ground and in the air. There are two types of flight nurses: military and civilian. 

The U.S. Air Force or another military branch employs military flight nurses. They transport critically wounded and ill military service members to better medical facilities and away from combat locations in military aircraft. Military flight nurses work with flight physicians and flight medical technicians to treat all matter of battle wounds, including bullet and burn wounds or appendage loss. 

Hospitals or regional emergency health services employ civilian flight nurses. They see a wider variety of patients needing acute medical care for injuries and illnesses. Civilian flight nurses may transport patients from one hospital to another to receive specialized treatment or via Life Flight. Patients range in age from neonatal babies who need life-saving medical treatments to critically-injured adults who need medical transport from mountaintops to the nearest medical facilities. 

Flight nurses (FN) are registered nurses (RNs) with bachelor of science in nursing (BSN) degrees and special training to provide medical care to acutely ill and injured patients in an aircraft. Some flight nurses are advanced practice registered nurses (APRNs) and hold a master of science in nursing (MSN) degree or a doctorate of nursing practice (DNP). In addition, flight nurses may hold certification from organizations such as the Board of Certification for Emergency Nursing (BCEN). To be eligible for certification, RNs must have two or more years of nurse experience working in acute and critical care environments. 

Flight nurses are in high demand for specialized skills and training and must work in high-stress and risky conditions. As a result, openings for registered nurses will grow 6 percent from 2021 to 2031, according to the US Bureau of Labor Statistics (BLS 2022), about as fast as the national average. Approximately 195,400 new positions will open up in the same period and pay median salaries of $77,600 annually. 

Check out flight nurse specializations, admissions requirements, program profiles, a step-by-step career guide, and certifications.

While all flight nurses are registered nurses (RNs), they may have unique qualifications earned through degree or certification programs. This expertise can be learned in healthcare, the military, or certification programs.

Here are some common specializations for flight nurses: 

• Extracorporeal membrane oxygenation (ECMO)
• Neonatal acute care
• Pediatric acute care
• Adult-gerontology acute care
• Aeromedical evacuation in combat (for military flight nurses)

There are numerous points of entry for nursing education and degree programs. Here is a list of common nursing degree programs and their time-to-completion: 

• LVN: Licensed vocational nurse (one year or less)
• ADN: Associate of science degree in nursing (two years)
• RN-to-BSN: For those with an ADN degree (two years) 
• BSN: Bachelor of science in nursing (four years)
• ABSN: Accelerated BSN for those with non-nursing degrees (one to three years)
• RN-to-MSN: For those with an ADN degree (three to four years)
• MSN: Master of science in nursing (two to three years)
• Post-master’s certificate: For those with an MSN or higher (one to two years)
• BSN-to-DNP: For those with a BSN who want to earn a DNP (three to four years)
• DNP: Doctorate of nursing practice (two to five years)

Admissions requirements for flight nurse training programs vary but typically include these prerequisites: 

• Two to three years of acute care experience in an intensive care unit (ICU) or emergency room (ER) setting (recommended)
• Bachelor of science in nursing (BSN) 
• Current RN license

Attending an accredited nursing program is essential in one’s nursing career. Two of the nationally-recognized organizations are: 

• Commission on Collegiate Nursing Education (CCNE) 
• Accreditation Commission For Education in Nursing (ACEN)

Graduating from a CCNE- or ACEN-accredited nursing program is vital for many reasons:

• Students who complete accredited nursing programs demonstrate to employers and patients that their education meets the highest standards. 
• To qualify for the NCLEX exam and earn RN licensure, ADN and BSN graduates must attend an accredited nursing program.
• Those taking out federal loans to finance their education can only attend accredited programs.

Accreditation ensures that students in such programs work towards clear standards, uphold expectations of programs, and provide the essential experiences and skills necessary for the field. 

Herzing University – RN-to-BSN, ABSN, MSN

Herzing University offers both on-campus and online degree programs at the undergraduate and graduate levels and several bridge programs for allied health professionals and non-nursing bachelor’s degree holders. 

There are 11 on-campus options across numerous states: Ohio, Georgia, and Alabama, four in Wisconsin, Minnesota, Louisiana, and two in Florida. This program is designed for working professionals in the healthcare field to advance their education and gain practical experience in their place of employment. 

• Location: Several campuses in midwestern and southern states
• Duration: One to three years
• Accreditation: Accreditation Commission for Education in Nursing (ACEN); Commission on Collegiate Nursing Education (CCNE)
• Tuition: $395 per credit (RN-to-BSN); $735 per credit (MSN) 

Case Western Reserve University – MSN

Students interested in a midwest-based program for nursing should look at Case Western Reserve University. The Frances Payne Bolton School of Nursing offers flight specialty courses as part of its MSN adult-gerontology acute care nurse practitioner program. Students in the flight nurse specialty take five to nine additional credits of didactic, laboratory, simulation, and clinical courses to gain theoretical and practical experience.

The flight nurse portion includes a unique aeromedical helicopter simulator for students to experience the nursing care they could work within. The program consists of a clinical practicum that works directly with an aeromedical team who performs active transports. In addition, they provide two flight nursing camps in which courses covered include: gerontology, pathophysiology, pharmacology, and many more studies, including a nurse’s ethical issues class. 

• Location: Cleveland, OH
• Duration: Four semesters
• Accreditation: Commission on Collegiate Nursing Education (CCNE)
• Tuition: $108,624 total

Vanderbilt University – MSN, DNP, Post-Master’s Certificates

Ranked #8 best nursing school by U.S. News & World Report (2023), the MSN program at Vanderbilt University’s School of Nursing prepares students to become integral parts of healthcare support teams. The MSN program prepares candidates interested in pursuing a flight nurse role specialty, offering an on-campus program that students can complete in four semesters. 

The DNP provides advanced practices and leadership guides and helps candidates create economic principles of care. The DNP program consists of five to six semesters with three optional tracks: the advanced clinical practice track, the executive leadership track, and the advanced systems practice track. 

• Location: Nashville, TN
• Duration: Four to six semesters
• Accreditation: Commission on Collegiate Nursing Education (CCNE)
• Tuition: $1,883 per credit

Rivier University – RN-to-MSN, MSN Bridge, Post-Master’s Certificates

Based in Nashua, New Hampshire, the Rivier University Nursing School offers multiple on-campus and online nursing programs for RNs, non-nurses, and advanced practice registered nurses (APRNs). All programs feature access to state-of-the-art experiences at the newly renovated Nursing Simulations and Clinical Education Center, emphasizing telehealth and remote clinical assessment experiential learning. 

• Location: Nashua, NH
• Duration: Three to five years
• Accreditation: Accreditation Commission for Education in Nursing (ACEN)
• Tuition: $660 per credit (nursing courses); $1,030 per credit (clinical courses)

Southern New Hampshire University – RN-to-BSN, RN-to-MSN, MSN

Aspiring students seeking an affordable nursing degree look no further than Southern New Hampshire University. This program offers five MSN options and two BSN programs, which students can complete part- or full-time. In addition, an RN-to-MSN program gives students with associate’s degrees the opportunity to earn a BSN and an MSN and graduate in an accelerated time frame. 

The advanced RN-to-MSN option works strategically to advance RN careers. Two of the MSN courses are advanced health and literacy assessment and advanced pathophysiology across the lifespan. An immersion experience is required; after completion, students can earn 650 clinical hours. This online program is a step toward future work as an FN. 

• Location: Manchester, NH
• Duration: Two to five years
• Accreditation: Commission on Collegiate Nursing Education (CCNE)
• Tuition: $320 per credit (undergraduate); $627 per credit (graduate)

Western Governors University – RN-to-BSN, BSN, RN-to-MSN, Post-Master’s Certificate

Western Governors University provides several online nursing programs aimed at helping those with and without nursing backgrounds begin a career as an RN or APRN. The prelicensure BSN program is a four-year program designed to prepare those without prerequisites for RN licensure and earn a BSN. Many hospitals seek nurses with BSN degrees and the foundational requirement of having an RN license; these are critical components towards the ultimate goal of flight nurse work. 

Western Governors University also offers an online RN-to-BSN, RN-to-MSN, and a post-master’s certificate in nursing leadership and management. All of their programs provide the essential next steps toward FN status. 

• Location: Several campuses in midwestern, southern, and western states
• Duration: One to four years
• Accreditation: Commission on Collegiate Nursing Education (CCNE)
• Tuition: $8,746 per year (RN-to-BSN)

The University of Alabama in Huntsville – RN-to-BSN

This online program is designed for the candidate seeking a flexible, 100 percent online course that can take one year or less to complete the pathway from RN-to-BSN. Obtaining a BSN is a crucial step toward flight nurse certification, and the program requires that RN status is maintained while working through the courses. The program includes seven courses that add up to 26 credits. In addition, there are six start dates throughout the year to meet the needs of busy candidates. 

• Location: Huntsville, AL
• Duration: One year
• Accreditation: Commission on Collegiate Nursing Education (CCNE)
• Tuition: $12,200 total

Thomas Edison State University – RN-to-BSN, ABSN, MSN, DNP

Students seeking an online RN-to-BSN, MSN, DNP, or accelerated BSN degree program can find their pathway to flight nursing at Thomas Edison State University. The master of science in nursing or MSN degree has a 36-credit minimum that focuses on direct care core, core, electives, specialties of interest, and a practicum. The MSN requires two years of nursing experience and a BSN from an accredited program. Students can transfer up to 12 credits from prior programs. 

• Location: Trenton, NJ
• Duration: 15 months
• Accreditation: Commission on Collegiate Nursing Education (CCNE)
• Tuition: $411 per credit (residents); $535 per credit (non-residents)

Flight Bridge ED – exam prep and continuing education

Flight Bridge ED offers affordable and flexible online and in-person options for certified flight nurses seeking certification or continuing education. The required content and knowledge to pass the CFRN exam can be daunting, and this course provides an opportunity to meet the needs of candidates in the field to find success before exam results. 

Critical care paramedics and nurses helped fine-tune the content for the focus to be as honed in as possible. Some topics covered include oxygen physiology, flight physiology, neurological emergencies, and cardiac physiology, among many other critical issues. In addition, the course offers one year’s access to course content on a 24/7 flexible timeline. 

• Location: Bowling Green, KY
• Duration: Self-paced; one-year license
• Accreditation: Better Business Bureau (BBB); Kentucky Board of EMS Critical Care; Wisconsin Critical Care Paramedic Endorsement
• Tuition: $300-$895 depending on course type 

IA Med – exam prep and continuing education

This fully online course by IA Med meets the needs of medical care specialists seeking a CFRN recertification program at an affordable rate. One of the courses included is a flight medical provider 32 CEU class that provides for pulmonary disease, ventilator management, trauma and burns, environmental emergencies, and lab values. 

The course includes a one-of-a-kind flight medical provider study guide booklet, also available online for reference, study, and practice comprising three hundred and three pages. Professionals in the field designed the 100-hour recertification program. 

• Location: Online
• Duration: Six to 12 months
• Accreditation: California Board of Registered Nursing (CBRN)
• Tuition: $697 total

Aspiring certified flight nurses can expect the process to take around 11 to 12 years, including high school. It takes approximately four years of high school, four years for bachelor’s completion, two to three years for acute care clinical experience or a master’s degree, and a certification exam. 

Flight nurse certification requires RNs to have a minimum of a BSN. However, some FNs opt to complete a master’s program to make their education more robust and competitive in the job market.

Step 1: Graduate from High School or Complete a GED (Four Years)

High school is the first step to becoming a flight nurse. The traditional route for high school can take four years, and the GED option can take up to one year. Both options provide a high school diploma and allow candidates to move towards secondary education after completion. During a candidate’s high school years, taking courses in science, STEM, mathematics, health roles, and anatomy helps provide a layered background to draw upon later in a nursing career. 

Step 2: Complete a Bachelor of Science in Nursing (One to Four Years)

Completion of a BSN is an essential step on the pathway to flight nurse work. A student with an associate’s degree in nursing can earn a BSN through an RN-to-BSN degree completion program. A BSN provides education, clinical practice, and fieldwork that prepares future nurses for success.

A bachelor of science in nursing (BSN) typically takes 2-4 four years. One-year accelerated BSN programs are available for those with a bachelor’s degree in a non-nursing field. 

Step 3: Become a Registered Nurse (Timelines Vary)

Many state requirements vary for registered nursing status, but one thing remains the same: the background work required for RN licensure. Earning an associate’s or bachelor of science in nursing from an ACEN- or CCNE-accredited program is required for RN licensure, completing a criminal background check, and passing the National Council Licensure Examination (NCLEX-RN). 

Step 4: Gain Work Experience (Two to Three Years, Minimum)

Flight nurse certification recommends 2-3 years of nursing experience in ER or ICU settings. This is because flight nurses need to know they can work under intense pressure, collaborate with colleagues, make informed decisions, and continue working in high-intensity stressful environments for prolonged periods. In addition, gaining experience in these two hospital wards prepares flight nurses to work under pressure in high-stress aircraft environments at altitude. 

Step 5: Complete a Graduate Degree in Nursing (Two to Four Years)

This step is optional along the pathway toward FN work. However, an MSN or DNP can provide additional training and specific practice for FN work. Many FNs have specialty training in adult-gerontology acute care, pediatric acute care, and neonatal intensive care. 

Step 6: Obtain National Certification for Specializations (Timelines Vary)

The Certification for Flight Registered Nurses (CFRN) is approved through the Board of Certification for Emergency Nursing (BCEN). The process for passing this exam requires candidates to do the following:

• Set up an account 
• Check eligibility that includes holding an RN license (two years of ER and ICU work experience is recommended but not required)
• Complete an application
• Apply and provide payment
• Become approved 
• Schedule the exam date and time
• Study and prepare for the exam
• Complete the exam and obtain the results 

Step 7: Obtain State Licensure (Timelines Varies)

There is no specific licensure for flight nurse work; however, hospital- and military-based positions may require the following certifications:

• BLS: Basic life support
• ACLS and PALS: Advanced cardiovascular life support and pre-arrest (heart failure) states in children
• PEPP: Pre-hospital medical information for the emergency care of infants and children
• PHTLS/TPATC/TNCC/ITLS: One completed trauma course

Step 8: Maintain Certifications and State Licensure (Timelines Varies)

RN licenses expire on the applicant’s birthday. How long an RN license is valid depends on individual state board of nursing requirements. For example, RNs in Oregon must renew every two years and submit seven hours of continuing education in pain management.

Flight nurses provide immediate care to critical health management patients. Some daily specifics of what flight nurses do include:

• Communicating with dispatch and hospital staff
• Evaluating patient illness and care needed
• Continuing education for in-flight health trauma care
• Checking in-flight medical equipment and performing maintenance
• Taking inventory of medication, tools, and instruments
• Abiding by in-flight regulations and assisting the pilot in specific duties required
• Communicating ETA for arrival and care team
• Maintaining detailed lists of medicine
• Continuing care after patients are admitted
• Implementing critical care interventions for patients

A flight nurse requires advanced certification beyond a registered nursing (RN) license. Below is a list of certifying organizations and flight nurse certifications.

American Association of Critical Care Nurses (AACN):

• Critical Care Registered Nurse (CCRN)

Board of Certification for Emergency Nursing (BCEN):

• Certified Pediatric Emergency Nurse (CPEN)
• Trauma Certified Registered Nurse (TCRN)
• Certified Emergency Nurse (CEN)
• Certified Registered Flight Nurse (CFRN)

The average salary for registered nurses is $77,600 annually, which breaks down to $37.31 per hour. RN salaries vary due to education, experience, and work environment. The BLS (May 2021) showed the following wage percentiles for RNs:

• 10th percentile: $59,450
• 25th percentile: $61,790
• 50th percentile: $77,600
• 75th percentile: $97,580
• 90th percentile: $120,250

Here are the top-paying states for RNs (BLS 2022): 

• California: $124,00 per year
• Hawaii: $106,530
• Oregon: $98,630
• District of Columbia: $98,540
• Alaska: $97,230

The BLS does not track data salary specifically for flight nurses. However, Payscale.com (Jan. 2023) shows that flight nurses earned $85,000, based on 108 self-reported salary profiles. In addition, Salary.com (Jan. 2023) offers even higher rates of  compensation for flight nurses at $91,130 per year, the middle of a range from $80,880 to $102,340 annually.

Flight nursing can be one of many specializations in an RNs career. Here are some nursing specialties that pair well with flight nursing.  

Become a Clinical Research Nurse (CRN)

Those flight nurse applicants seeking a varied pace of work could find an alternative to a flight nurse job in clinical research nursing. This role requires nurses to observe, document, and collect data in clinical research trials. CRNs help ensures that the clinical trial complies with state, federal, local, and international regulations. They typically work directly with research participants to monitor, check, complete paperwork, and organize follow-up proceedings.

• Typical Education: BSN, MSN, or DNP
• Licensing or Certifying Organization: Association of Clinical Research Professionals (ACRP)

Become a Hospice Nurse

Trauma and nursing go hand in hand. While flight nurse work is focused on actionable care in the air, hospice involves support and care for terminally ill patients and their family members in an aircraft, hospital, or home-based setting. 

• Typical Education: BSN, MSN, or DNP 
• Licensing or Certifying Organization: Hospice & Palliative Credentialing Center (HPCC)

Become a Travel Nurse

Travel nurses work with the public across the country to fill in the gaps in nursing care in many locations. Travel nursing is similar to flight nursing regarding the fundamentals of training, but the intensity of the position and hours vary. 

• Typical Education: BSN, MSN, or DNP
• Licensing or Certifying Organization: RN license, state-specific license requirements, and additional certifications depending on position descriptions