Characteristics of flight nursing practice.
The purpose of this study was to describe the roles, levels of responsibility and backgrounds of flight nurses employed in flight programs across the country and to determine if the role of the flight nurse varied as a function of crew configuration or size of program. In 1991, a retrospective statistical questionnaire was sent to 105 programs with 50 or more flights per month. This survey provides national data regarding description of programs, evidence of the critical-care environment, professional profiles of flight nurses and practice differences between nurse and paramedic personnel. A difference in the practice for nurses existed in the larger programs (> or = 1,100 flights) with nurse/paramedic flight configurations. Nurses more frequently performed interventions regarding initiating and discontinuing medications (p = 0.00023)--especially paralyzing agents (p = 0.012) and blood (p = 0.0016)--and recognizing by physical exam the need for interventions to decrease intracranial pressure (p = 0.0194). In the larger programs, nurses also were more responsible for decision making regarding titration of medications (p = 0.027). Flight nurses practice in advanced autonomous roles, performing duties and skills consistent with critical care and emergency medicine in air medical transport.