Flight nursing is a profession that requires a high level of critical thinking skills, confidence, and physical endurance, due to its long hours and flight stressors. Duke Life Flight nurse Kevin Mumma, who has been a nurse for 13 years, 7 of which he has spent in flight nursing, can attest to this fact. Mumma described a day in the life of a flight nurse.

"On a day-to-day basis in my position, it's not out of the ordinary to jump in the rotor-wing aircraft at the beginning of my 12-hour shift and fly to pick up a patient who has been involved in a motor vehicle crash," he said. "But before I can see or help the patient, the flight crew (both medical crew personnel and the pilot) must negotiate the landing zone set up by the local fire department, which can be dangerous.

"After the patient is cared for and transported to the Level 1 trauma center, a critically ill, middle-aged man might be waiting at a local emergency department (ED), suffering an acute myocardial infarction that requires emergent transport to an interventional cardiac catheterization lab. Midway through the day, after a few bites of lunch, there might be a call to transport a baby who was born prematurely-an infant so small it could fit into the palm of my hand.

"These situations are extremely challenging, which makes this position the best so far in my career. By the time my day is almost over, there might be a patient that requires transport to the tertiary center. If the referring facility doesn't have a helipad, we'll jump into our critical care ground unit and head for the patient."

Though the job is fast-paced and fascinating, Mumma said it's not without its challenges.

"Sometimes transporting a patient by helicopter has its advantages and disadvantages," he said. "Many factors depend on the location of helipads and the equipment the patient requires-be it a ventilator, an intra-aortic balloon pump, or a left ventricular assist device-which may take considerable preplanning and logistics in moving the patient. In the face of these challenges, flight nursing remains an incredibly rewarding nursing specialty. Many men in this field have transitioned from paramedicine or other allied health careers. Being a flight nurse has opened many opportunities for me and will for any man or woman who enters the field."

Life-or-death situations

Initially, Mumma wasn't sure which nursing specialty interested him the most, but during the summers between semesters he worked as a nursing assistant in an ED. He was immediately sold on the field during his first week.

"Seeing patients coming into the ED that were in dire need of help and watching the nurses and doctors save their lives was enough for me," he said. "I was hooked. There's no better satisfaction than this. Flight nursing came along only after many years of preparation and learning the skills that are required for this type of nursing."

Mumma appreciates the increasing diversity of the profession's members. "The nursing profession, a profession that has been successful for many years for many women, is now very diverse with both genders taking advantage of its benefits," he said. "My experience with nursing has been fantastic, as I've had the opportunity to work at incredible institutions with amazing people who all have the same goal in mind: to heal the ailing patient."

Mumma recently answered Men in Nursing's Fast Five:

1. What influences do you credit with helping you achieve your professional goals within nursing?My influences include a caring family upbringing full of support for my career choice, strong clinical mentors, and the opportunity to practice in critical care shortly after graduation.Strong clinical mentors can either make or break your orientation to the flight nurse role. I was lucky to have many incredibly smart and outgoing mentors. Karen Johnson, RN, BSN, EMT-P; John Munsie, RN, CCRN, EMT-P; Edd Shope, RN, CCRN; and Maj. Todd Mckee, RN, EMT-P, were always willing to show me the way and open my eyes to the tricks of the trade. Other elements that have helped me achieve my professional goals include maintaining a consistent and strong work ethic, keeping up on new research and patient care trends, and attending continuing education events around the country.

2. Of the things your position enables you to accomplish, which ones do you find to be the most rewarding?My position enables me to make autonomous critical care decisions for my patients and see immediate results. Certain circumstances require quick thinking and immediate interventions that have a tremendous impact on a patient's survival. For example, when my partner and I were transporting a premature baby by helicopter from the eastern part of North Carolina to Duke University Medical Center for level 3 intensive nursery care, initially, the baby was doing well in the Isolette. Twenty to 25 minutes into the flight, the baby began experiencing respiratory difficulty with bouts of apnea and bradycardia. My partner and I ran through the usual treatments of repositioning, stimulation, and increased oxygen administration. After several minutes of unsuccessful abatement of the apnea and bradycardia, the baby required intubation, which isn't the most comfortable intervention to perform in the air. There was obviously no time to call a doctor about this, so it was up to my partner and me to secure the baby's airway without hesitation. Fortunately, the baby responded to intubation with stable vital signs and arrived at Duke in improved condition. The baby did well and was discharged back to the referring facility about a week after admission.

3. Based on your professional experience, what words of wisdom would you offer to other men in nursing who are attempting to chart their career course?When you're caring for a patient, not knowing is not an option, so study hard and don't be afraid to ask questions. Always be prepared, whether it's by starting an intravenous line or having everything ready in case a patient codes. Keep yourself up on the latest nursing and medical research by subscribing to journals and magazines, as well as joining organizations in your particular specialty. Pay close attention to your senior mentors, who've walked the road or flown the skies and can be of great benefit when learning your new position.

4. What career strategies did you use to attain your current role?My most attributable strategy was preparation. I prepared by attending intra-aortic balloon pump classes, sitting for an EMT class, sitting for the Certification in Critical Care Nursing (CCRN) exam, and most importantly, practicing in large busy trauma and critical care institutions. As with most critical care nursing positions, obtaining certifications such as ACLS (Advanced Cardiac Life Support), PALS (Pediatric Advanced Life Support), NRP (Neonatal Resuscitation Provider), PHTLS (Pre-Hospital Trauma Life Support), TNCC (Trauma Nursing Core Course), and EMT-B or EMT-P (Emergency Medical Technician-Basic or Emergency Medical Technician-Paramedic) is very beneficial. It's important to study and sit for exams such as the CEN (Certified Emergency Nurse), CCRN, or CFRN (Certified Flight Nurse). It's best to start studying for these after you get your feet wet in the intensive care unit (ICU) or ED.

5. How has your gender impacted your ability to reach your goals within the profession?I think that the male gender has a significant role in the nursing profession. My gender has helped me work toward being successful in the critical care arena, which requires quick critical thinking skills and a keen eye for spatial awareness. Men generally have "thicker" skin and may not be affected by certain situations that may cause others to get attached to the patient and/or family. This is not to say that building rapport with patients and their families isn't important. But men seem to be good at doing so without getting too attached.

Flight practitioners, be they flight paramedics, flight nurses, flight respiratory therapists or flight physicians, tend to be cut from a different mold and are more aggressive in their care. This aggressive attitude can be notable in the male species, though it's also exemplified by many female practitioners.

Regardless of specialty, gender roles in all workplaces are changing, and I think men in nursing have a positive impact on and relationship with their female counterparts.