A flight nurse is an experienced nurse who provides care to patients who are being transported by aircraft to a health care facility. Flight nurses are part of a critical care team and most of the patients they work with are either critically ill or have been rescued from an unstable environment. This means these nurses need to be calm, confident, and capable of working in challenging environments and confined spaces.
There are many different job titles in the world of flight nursing. Aspiring flight nurses have the option of joining the military, serving as a flight paramedic, or going into search and rescue. Another option is working in patient transport and transporting critically ill patients who need specialist care at another facility. There are medical transport networks such as Life Flight that provide air ambulance services on a not-for-profit basis, helping critically ill patients in more remote areas access the care they need in a safe and expeditious fashion.
Flight nurses offer a high level of patient care in a challenging environment. They support patients who are severely ill and deliver critical care to keep them alive until they’re safely at a well-equipped hospital. Because of the complexity of care they provide, they’re usually expected to have extensive clinical experience as well as flight experience.
A flight nurse should be educated to at least the Registered Nurse level, and many are clinical nurse specialists or nurse practitioners who use their experience and training to provide the highest level of emergency nursing.
Salaries for flight nurses in a civilian environment compared to a military environment
The high level of training and experience required for flight nurses means they often command higher salaries than their hospital-based registered nurse counterparts. The exact salary of a flight nurse will vary depending on whether they’re educated to Nurse Practitioner level or not. The setting in which they work can also make a difference.
What are the differences between salaries for civilian and military flight nurses?
The average salary of a flight nurse varies depending on their job title. For example, a travel nurse in the United States could expect to earn up to $106,973. Nurses with the title RN – Staff Transport have a median income of $86,814 per year.
Starting salaries in the military are usually lower than those in the civilian world. A nurse who has fewer than two years of service at O-1 rank will have a basic nursing salary of $39,445. However, this does not take into account the long-term benefits and promotion opportunities offered to nurses in the military.
Why do salaries vary between civilian and military flight nurses?
There are many reasons for the disparity in earnings between civilian and military flight nurses. Firstly, most flight nurses are expected to be educated to Bachelor’s Degree level. Earning a bachelor’s degree if you’re self-funded will most likely cost between $40,000 and $100,000, which means most nurses in the civilian world start their careers with a lot of debt.
Many nurses opt to earn an associate’s degree and then build up some clinical experience, working in a clinic or hospital while upgrading their qualifications part-time. This means by the time they’ve earned their specializations and built up the experience in critical care, emergency departments or the ICU required to transfer to flight nursing, they’re a few years into their careers. This extra training and experience contributes to the higher salaries a civilian flight nurse can command.
Military nurses, in contrast, have the option of joining the nurse corps or the ROTC while they’re in college, getting support to pursue their degree and earn their license. These nurses can then access extra training and get the supervised experience they need to become a flight nurse more easily.
The exact salary of a nurse in the military depends on which branch they join, and their rank. A nurse will join the Army at commissioned officer rank, which has a starting salary of $39,445. This is in the bottom 10% of registered nursing salaries in the civilian world, but it’s important to take into consideration the benefits of the job. Nurses who live on a military base don’t need to pay for housing or food, for example, and nurses that live off-base get an allowance to cover the cost of their accommodation. Medical, dental, and life insurance are included in the military benefits packages.
In addition, military promotions are merit-based and fairly regular, so a nurse who is good at their job should progress through the pay grades quite quickly. There are pay incentives for nurses who take the time to upgrade their qualifications to MSN or DNP level. Financial assistance is available for nurses who wish to do this, and nurses are encouraged to study part-time while they serve.
If someone earned their RN or a higher nursing qualification while they were a civilian, then chooses to join the military, they may be able to apply for a loan repayment program and have some or all of their student loans paid off in return for service.
What are the differences in duties between civilian and military flight nurses?
The duties of a flight nurse can vary significantly in the civilian world, depending on the organization they work for and whether they’re a flight paramedic, emergency nurse, travel nurse, or in some other role.
Flight nurses in the military must pass strict requirements. In addition to needing to be U.S. citizens with a valid registered nurse license, they must also meet height, age, and weight requirements. Nurses must pass physicals to show they are fit to be in the field, and complete a written examination.
Military nursing can require performing aeromedical evacuations and supporting injured airmen or army personnel. Nurses will be expected to dress wounds, treat severe trauma and injuries, and manage common illnesses as well. They must be calm under pressure, able to communicate clearly and effectively with their leadership, the troops they serve, medical professionals, and any civilians they encounter.
A military nurse may find themselves in a combat environment or offering support to civilians who have been impacted by a natural disaster. Flight nurses are often on call, working long shifts and unpredictable hours. When they’re not flying out to perform emergency care, they may offer their services on the base to support other registered nurses.
In contrast, civilian nurses could be based out of a hospital, work for a medical transport company, or be attached to a fire department or search and rescue team. Just like an army or navy nurse, a flight nurse in the civilian world needs to be highly trained, calm in a crisis, and have good communication skills. However, the types of patients they deal with could vary significantly.
Some medical transport companies specialize in transporting critically ill patients from a hospital in a rural area to a larger hospital with the equipment required to treat the illness in question. These patients need skilled medical care and attention, but the nurses have the benefit of knowing in advance what treatment the patient needs, and they can therefore prepare and stock the aircraft to take care of that patient.
A flight nurse who is working for a search and rescue organization may have to travel to dangerous areas and treat patients who are seriously injured, suffering from hypothermia, or in shock. In these cases, the nurse won’t know what condition the patient is in until they get to the scene of the incident. The nurse must assess the patient quickly and accurately, document their condition and administer the highest priority treatments to stabilize them.
Upon arriving at a hospital, the flight nurse must then complete a handover for the patient, explaining any treatments they were given and ensuring good continuity of care.
Factors that impact the salary of a flight nurse
There are several things that can impact the earning potential of flight nurses and other health care professionals. These factors include education, location, the type of organization they work for, and job title. Let’s consider some of the most important factors:
Flight nurse salaries vary depending on the geographic area you live in. A part of the variation in salary comes down to the cost of living in different countries, or indeed in different parts of the United States, but job demand and even how risky the job is can make a difference too. For example, a flight nurse in Alaska has an average salary of $97,320, yet one in Tennessee would most likely earn $78,800.
The comparative remoteness of many parts of Alaska, coupled with the challenging conditions flight nurses find themselves operating in, contributes to the higher earnings those in that state enjoy.
Education and experience
All flight nurses are expected to have some experience working in trauma, emergency departments, or intensive care. They’re also expected to be educated to at least the Registered Nurse level. However, it’s possible for nurses to continue their education far beyond this point.
A nurse who is qualified as an Advanced Practice Registered Nurse or a Nurse Practitioner and has thousands of hours of clinical experience is going to be able to command a higher salary than one who is relatively new to the profession and has only a basic certification.
Earning a qualification such as the Certified Flight Registered Nurse is a good starting point for those who wish to access higher-paying jobs and have more confidence and autonomy when treating patients while in the air.
Flight nursing for different organizations
In general, private, for-profit medical transport organizations pay more than their public sector counterparts. Nurses who work for a non-profit hospital or a public sector emergency service organization will likely earn less than someone who provides air ambulance and patient transport services in the private sector.
Flight nurses working for a coastguard, fire department or search and rescue organization may be faced with challenging, stressful and dangerous situations for comparatively low pay, but they get the satisfaction of knowing they are saving lives on a daily basis.
Military flight nurses usually receive lower starting salaries but can climb through the ranks to see sizable pay rises later on in their careers. They’re also more likely to enjoy generous retirement bonuses.
Working hours and conditions
The working hours of a flight nurse will vary depending on their employer. Most nurses are expected to work full time, which is around 40 hours per week. Jobs often include being on call and may include working evenings and weekends. A nurse who does not have a fixed base and spends a lot of time moving around, working odd hours, will likely see a higher salary than a nurse who is based in one specific hospital and whose main job is ferrying patients to other, out-of-town hospitals on a relatively predictable schedule.
What should flight nurses expect when negotiating their salary?
Flight nurses are very much in demand, and they receive fairly competitive salaries compared to people who are not in the medical profession. Because flight nurses require a high level of education and are expected to engage in continuing professional development, they’re in a strong position to negotiate their salaries and to ask for benefits.
If you’re applying for a flight nurse, or already work as one, and want to negotiate, you may find it easier to ask for benefits than to ask for an outright raise. This is especially true if you’re applying to an organization that has a limited budget, or partway through the financial year when it’s harder for organizations to alter their budgets.
Consider asking for the following:
- Overtime pay
- Paid time off
- Medical insurance
- Vision and dental cover
- CPD training/conferences covered
You can make the case for those extra benefits by highlighting your skills and experience as a nurse:
- How many hours of clinical practice do you have?
- How much of that time was in the ICU/emergency room or similar departments
- What certifications do you have?
- How long have you been licensed?
- Do you have flight experience or paramedic experience?
- Are you educated beyond degree level?
If you do feel the salary you’re offered is too low, take a look at major salary and job comparison sites such as PayScale, Indeed, and GlassDoor. This will give you an idea of what other employers in your area offer. You can reasonably expect to earn more than an entry-level registered nurse when you’re working as a flight nurse, so you can use that as a reference point.
Emergency nursing is a skilled position that can be stressful, dangerous, and challenging but is also rewarding. Make sure you’re fairly compensated for your skills and the work you’re putting into saving lives.
The average salary for flight nurses
Flight nursing is a broad job title that covers nurses with a variety of qualifications and different levels of education and training. The average salary for someone with the title of Flight Nurse is $71,945 before bonuses. This works out at around $32.23 per hour. Salaries can vary significantly, however.
Nurses who are in the bottom ten percent in terms of earnings have a salary of around $58,000. The top ten percent of earners see a salary of $104,000 or more. Salaries for nurses have risen steadily over the last ten years, and demand for nurses is expected to increase in the next ten years too.
The Bureau of Labor Statistics doesn’t offer detailed projections for the career outlook for flight nurses, but projects that the demand for nurses who are educated to the Registered Nurse level and who hold a bachelor’s degree will grow by 7% between 2019 and 2029, adding more than 221,000 jobs.
Many flight nurses are trained to advanced practice level and have a postgraduate education. Demand for nurses at this level is even higher. Clinical nurse specialists and other nurses who have certifications are projected to be in short supply in the coming years, as the current wave of trained nurses reaches retirement age. Job growth for nurses with a postgraduate education is expected to increase by 45% between 2019 and 2029.
How do salaries for flight nurses vary by state?
Flight nurses who work in states with a significant rural population or where they’re likely to have to attend highly dangerous callouts, such as Alaska, are more likely to command higher salaries than those in cities where most of the work is hospital-to-hospital transportation.
There are some exceptions to this. States with a very high cost of living often offer higher salaries to make up for that, but this means the nurses who live and work there don’t see an increase in their overall quality of life.
If you’re considering a flight nurse job, it’s a good idea to think about the sort of callouts you’d like to handle before you start looking at relocation. A neonatal nurse who transports premature babies would have a very different job to a flight medic in the military or a flight paramedic attached to a search and rescue team in Alaska.
When you become a certified registered flight nurse you can apply for positions that match your interests and the type of work you’re most comfortable with. Working as a Life Flight Nurse, for example, is going to be a vastly different environment than working in the navy. Whatever you choose, you can expect a salary that reflects the important work you’re doing, and challenges that are very different from those seen by nurses who work in a clinic.
Highest salary that a flight nurse can earn
To earn the highest salary that a flight nurse can earn, you’d most likely have to spend a long time in the military or climb the ranks in a private medical transport company. These companies typically offer better pay than the public sector and non-profit hospitals.
Getting access to these jobs can be difficult because of the high level of skills and training required, plus the amount of clinical and flight experience these companies demand. It can take many years to qualify as a flight nurse and many years of working as a more general flight paramedic before you can access the mores specialist positions.
What is the typical career path of a flight nurse?
Most people who become a flight nurse followed the traditional ADN to RN or BSN to RN route into nursing. This means earning an associate’s degree or bachelor’s degree then passing the NCLEX-RN examination.
After passing this exam, nurses can work in a hospital or clinic setting in a general capacity. Most medical transport companies expect nurses to have extensive clinical experience before they can work as a flight nurse or a flight paramedic. For example, Life Team expects anyone applying to get into flight nursing to be a registered nurse with at least three years of critical care experience. This doesn’t have to be paramedic experience, emergency rooms and trauma centers are acceptable options too.
The BCEN Certified Flight Registered Nurse qualification is the most well-known qualification for those looking to become a flight nurse, and this qualification is open to all registered nurses, although the BCEN recommends that people have at least two years of experience in an area related to their chosen specialization before trying for the exam.
Many nurses choose to work in emergency rooms or serve as a paramedic on the ground to get the experience they need to transfer into flight nursing. Most private organizations are happy to train nurses in the safety protocols and procedures associated with aircraft, but consider the critical care aspects of the job non-negotiable.
Gaining critical care experience on the ground helps nurses become more skilled and more confident before they’re put in a difficult and demanding situation on an aircraft. Nurses who are working in patient transport have fewer tools at their disposal and also limited access to help from doctors or specialists, so it’s vital they’re confident, skilled, and able to think quickly and clearly under pressure.
What skills and qualifications can help flight nurses get higher salaries?
A flight nurse who is looking to strengthen their resume and earn a higher salary can pursue additional education and certifications. While many jobs accept flight nurses who are educated to the registered nurse level, there are lots of openings that are better suited to nurse practitioners or advanced practice nurses.
Earning an MSN or a DNP will stand any nurse in good stead, whether they’re aiming to become a nurse educator, pediatric nurse practitioner, or flight nurse
By pursuing certifications such as:
- Basic Life Support for Health Care Practitioners
- American Heart Association Advanced Cardiac Life Support
- American Heart Association Pediatric Advanced Life Support
- Certified Flight Registered Nurse Specialization
- Transport Professional Advanced Trauma Course
- Certified Emergency Nurse (for entry-level nurses)
- Critical Care Nurse (for entry-level nurses)
A nurse will make themselves more attractive to a wider range of employers, opening up jobs with private medical transport companies or other organizations.
Flight nurses are expected to keep up with a program of continuing education and to re-certify for their specialization every five years. If a nurse does not earn the required amount of clinical experience hours or fails to record enough continuing education they may be at risk of losing their certification or being forced to re-do the training and re-take the examination.
Many nurses find that after a few years of working as a flight nurse the unpredictable hours and high-stress situations start to take their toll. These nurses may look to move into other areas of health care. Flight nurses have the option of moving into leadership roles, going back into wards so they can continue offering patient care in a more stable environment, or transitioning into a nurse educator role. Some may even look to transfer into a dispatch or resource management position within the medical transport company they were working for.
Nursing is a field where sideways and upward movements are common. This gives aspiring flight nurses the chance to sample other areas of patient care while they’re earning their qualifications and gives experienced flight nurses plenty of options for progressing their careers.
If you’re interested in trying this field, talk to the nurse educators at your hospital, or, if you’re not yet qualified as a nurse, look for a university with a teaching hospital in your local area. The academic aspect of the BSN is important but the real-world experience you earn through supervised practice hours while studying for your BSN will pay off when you come to apply for your critical care certifications and look for your first job with a patient transport company.