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How to become a flight nurse

“What is the best job on a medical helicopter?”

That’s one of the questions I get asked as director of EMS Flight Safety Network.

I always answer the same way.

Flight nurse is the best job.

Let me explain.

In the United States, the most typical crew configuration for medical helicopters is one pilot, one flight nurse and one flight paramedic.

Why Flight Nurse Is The Best Job

Why is flight nurse the best job on a medical helicopter?

There are lots of reasons, but the biggest reasons are outside the helicopter and air medical world. The best reasons have to do with opportunities after you leave flying.

Flight nursing is the best career on a helicopter because it gives you the most opportunities outside of the helicopter world.

Reality is all flight crews give up their wings someday. And once they do stop flying, the question is always some version of “what do I do now?”

Flight nursing provides the most opportunity out of the three careers on a medical helicopter —  flight nurse, flight medic or EMS pilot.

That’s not a bust on flight medics or EMS pilots.

They do great work as well. But typically when I get asked this question, it’s from someone who’s just beginning their career. They literally can do anything they want with their lives and want to know my opinion on the best job on a medical helicopter.

Now you know what I tell them….and why.

In the spirit of full disclosure, flight nurse is the one position I have not done professionally. If you’ve followed me for awhile, you know I refer to myself as a failed medic who became an EMS pilot. Ironically for this article, I’ve never been a flight nurse.

How do you get started as a flight nurse?

This article will get you on the right path.

What is a Flight Nurse

Flight nurses are registered nurses who provide nursing care on board medical helicopters, airplanes or jets.

In the United States, flight nurses respond to primarily two primary types of cases or requests for assistance: response to accident scenes (commonly referred to as scene calls) and requests for inter-hospital patient transfers.

Flight nurses provide care to patients from the accident scene to the trauma center or hospital; and also from one hospital to the next when conducting inter-hospital transfers.

A short list of flight nurse responsibilities includes:

  • Providing patient care before and during patient transport, while maintaining flight crew safety.
  • Track and document patient’s condition from initial contact with patient through transfer to receiving hospital.
  • Report changes to patient condition to receiving hospital and administer medications as directed.
  • Operate specialized equipment unique to flight nursing and aviation.

What Do Flight Nurses Get Paid

According to, as of October 2016, the average pay for a flight nurse in the United States is $29.00/hour, or 69,369 median salary per year.

Women Flight Nurses who took the survey just slightly outnumber men. Medical benefits are awarded to most, and a strong majority earn dental coverage. Most Flight Nurses like their work and job satisfaction is high.

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Who Can Become A Flight Nurse

Becoming a flight nurse is hard work.

It’s a multi-step process that begins with becoming a Registered Nurse (RN). A simple Google search will reveal the requirements to become an RN.

It’s important to understand there are unique challenges to each step of becoming a flight nurse.

Nursing school has its own requirements for entry and earning a nursing degree is hard work in and of itself. The curriculum is tough and consists of both academic and hands-on performance evaluations.

Many of our most successful EMS Flight Safety Network nurses have bachelor of science nursing degrees (BSN) or higher; however, there are other routes to becoming a registered nurse. Some flight nurses get qualified via associate degree programs or certificate nursing programs.

Finally, after completion of nursing school, you’re simply eligible to begin the flight nurse journey. You still need the nursing experience required to apply for a flight nurse positions.

If all of this sounds discouraging, don’t despair.

Becoming a flight nurse is absolutely an attainable goal, but like all goals worth pursuing, there is some effort required.

Remember that success is a process, not a one time event. A technique I’ve seen work well for coaching students is the ability to break big goals into smaller, more manageable chunks.

Then, chip away at the smaller “chunks” until you reach your bigger goal.

It’s important to keep the process simple. Simplicity keeps you motivated and avoids overwhelm.

You’ll see what I mean when I show you the exact steps to becoming a flight nurse below.

It’s a simple process, but not an easy one.

Who should NOT Become a Flight Nurse

If you’re not a serious student (or ready to become one) willing to commit time and effort to completing nursing school, you’re not a good candidate for a flight nurse position.

If you’re not willing to commit to life-long learning, you’re not a good candidate for a nursing position.

If this advice seems obvious, that’s a good sign. It means you get the fact there is work involved in getting qualified.

If your only interest is the prestige associated with being professional flight crew, again, you’re probably not a good candidate for becoming a flight nurse.


Because in my experience, the “prestige” of a flight nurse position isn’t enough motivation to become a registered nurse and complete the nursing experience required to compete for flight nurse positions.

Only you know what’s in your heart. Nobody can do the work for you.

Basic Qualifications To Become A Flight Nurse

Here’s the technical stuff required to start a flight nurse career.

The information is grouped into required, preferred and real-world categories.

Realize the qualifications can and do change. Also, individual flight programs sometimes require additional program specific training. All flight programs provide ground to air transition training for new hires.

Education: Graduate of an accredited School of Nursing

Experience: Minimum three years’ critical care/emergency nursing experience

Licenses & Certificates:

  • Current RN license(s) for states of practice
  • EMS or MICN certification/licensure as required by state regulations
  • Current certifications in Healthcare Provider BLS/CPR; ACLS; PALS or equivalent (AHA courses if state or county required) and TNCC/ITLS-advanced provider (if state or county required)
  • Specialty certification (CFRN, CCRN, or CEN) required within two (2) years of hire
  • Advanced Trauma Course requirement: One (1) of the following certifications are acceptable: TNATC, ATLS/ATCN, or TNCC within six months of hire (please note advanced skills lab must accompany all of the above mentioned advanced trauma courses)
  • NRP lessons 1-9 within six (6) months of hire
  • NIMS Training IS 100, 200, 700, 800 and HazMat upon hire

*Source: Air Methods Human Resources Guide


Education: BSN or bachelor’s degree in health-related field

Experience: Pre-hospital experience and flight experience

Real-World (as of Today):

  • Experience in any 911 system is acceptable
  • Applicants with no degree routinely accepted
  • After hire coursework extensions beyond 6 months, granted on a case-by-case basis

Where To Start If You Have No Experience

If you’re starting from Ground Zero with no medical experience at all, I recommend completing an Emergency Medical Technician (EMT) certification course.

This will give you the basics of what’s involved in flight medicine in general, as well as a benchmark to determine your own suitability for a flight nurse career.

Understand this is the entry level qualification, and of course more is involved in being a flight nurse. But this will get you started and give you a sense of how much you like pre-hospital services and how well suited you are for the career.

Stuff To Know About Becoming a Flight Nurse

The number one question I get asked as director of EMS Flight Safety Network is “How do I become a flight nurse, or medic, or pilot?” and “Is there a system I can follow to get a flight job?”

Both are good questions.

The answer to the first question is the resource guide / blog post you’re reading now.

The answer to the second question is more complicated. Why is the answer more complicated?

Because the answer is both yes, and no.

Yes, there is a system you can follow. But no, there is no magic “pill” to become a flight nurse. Hopefully I dispelled some of those myths in the “Who should NOT become a flight nurse” section above.

Here is some good news: there are strategies students have repeatedly used to shorten the average time it takes to successfully land flight nurse careers.

Here’s an important note about the steps to becoming a flight nurse below: The steps are NOT linear.

What I mean is — you don’t have to do all the steps in a specific order. You can jump around.

The steps that need completed first are obvious. You already know it makes no sense to apply for flight jobs before you’re qualified, right? (For the record, some people test this principle, and so far, all have failed).

The benefit to non-linear steps is that you can start right now, today.

For example, a lot of successful flight nurses credit their personal and professional networks for opening doors to flight nurse opportunities.

You can start building your professional network today. You don’t need any special medical qualifications to do so.

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Here Are The Steps To Become A Flight Nurse

These are the steps I teach future flight nurses who enroll in INSIDER training program at EMS Flight Safety Network.

In the training program, each step is covered in much greater detail. But the steps and supporting information below will give you a very good start.

1.) Get Qualified

See the Basic Qualifications to Become a Flight Nurse information above.

If you’re starting at ground zero with no experience, step one is a Google search for EMT training +plus your city and state.

Example: EMT certification in Austin, TX

This will give you a starting point.

2.) Identify Target Flight Programs

All flight programs do great things, but not all flight programs are created equal.

What exactly does that mean?

Put simply, it’s in your best interest to spend time thinking about which flight programs you really want to work for. From the outside looking in, it may seem like any flight job is a good job. But unfortunately, that’s not always true.

Don’t worry, I get it. I was once in your shoes looking for my first flight job. I remember what it’s like to want a flight job so badly you’d chew your own arm off for a flight job.

Remember that even if your first flight nurse job isn’t perfect, there are benefits to getting initial flight experience. Some experience is obviously better than no experience.

Having said that, know that it’s in your best interest to choose flight programs wisely.

3.) Research Flight Programs

How do you research flight programs?

Like all the other steps, research is a process, not one-time event.

The INSIDER training program at EMS Flight Safety Network devotes an entire training module to this topic. My point is simply that it’s too much information to cover in this blog post, but here is a good place to start:

Create a “cheat sheet” for each of your target flight programs.

What is a cheat sheet?

A cheat sheet is like a flight program avatar. A document that brings your flight program to life. It lists all the basic data about your target flight program. For example:

  • How many aircraft does the flight program own?
  • How many bases does the flight program staff?
  • Are all the bases full time?
  • When was each base established?
  • What type of aircraft does the program fly?
  • Is the flight program IFR or VFR?
  • If the program markets itself as IFR, does it really fly IFR?

You get the idea.

There’s of course a lot more to add, but the list above will get you started.

The benefit to creating a profile for each of your target flight programs is hopefully, obvious. Once you have profiles in place, it’s easy (or at least easier) to compare different flight programs. It’s also the type of information you want to know cold before a flight interview.

4.) Build a Better You

You’ll want to bring your very best to a flight interview and flight nurse position.

If you’re new to EMS or health care, what I’m about to tell you may sound a little hokey…

It’s an honor to take care of people in time of need. If you’re not sure what I mean, or if you’re questioning the validity of what I just said, talk with experienced EMS or air medical crews and have them explain it to you. It’s important to understand. It’s one of the reasons you should decide right now to commit to self-improvement.

How do you get started building a better you?

My advice is to start with stuff you already do well, build yourself up, and then start working issues you know need improvement. Think of the advice you would give to a friend. Don’t be harsher on yourself than you would a close friend.

Remember that everybody is good at something. Maybe academics are your strong point? Maybe fitness and health are your strong points? Whatever it is, start strong. Then work on areas you know need improvement.

Here are some articles to get you started (click the red link titles):

10 Ways To Keep Your EMS Soul Alive
The 7 Habits of Highly Effective Future Flight Crew
An Open Letter To EMS Who Want To Fly

5.) Grow Your Network

Successful flight nurses rarely go it alone.

Successful flight nurses often have huge personal and professional networks. The inside joke at EMS Flight Safety Network is how many of our flight nurses’ facebook profiles look like facebook business pages. Seriously.


Because their networks are so big! Many have thousands of facebook friends. To some this may seem trivial, but when it comes to networking for a flight nurse position, it can become very important.

It literally can become the tipping point between landing a dream job or never getting the opportunity to fly.

How do you build a strong personal and professional network?

One fan, follower or connection at a time.

If you’re serious about pursuing a flight nurse career, I’m serious about helping you get started. Click to connect with me on LinkedIn – just put “Future Flight Nurse” in your connection request, and use ask @ for my email address, if LinkedIn asks you to provide one.

LinkedIn is a the biggest professional network on the planet. The benefit to connecting with me (and others) is all of my EMS and air medical connections will immediately become your 2nd level connections.

I hope this helps you get started.

6.) Schedule a Fly-along Day

An important step in the “Get a Flight Nurse Job” process is scheduling a fly-along day.

What is a fly-along day?

Fly-along day is similar to any other job shadow day, with one important exception: you get to fly on-board a trauma helicopter with real flight nurses, flight paramedics and EMS pilots.

If this sounds crazy or too good to be true, I understand. When I first explain the opportunity to folks outside of EMS, the looks I get are priceless. But the opportunity is absolutely real. Call your local air medical base for details.

7.) Write a Killer Flight Resume & Cover Letter

Your flight resume and cover letter is important.

Flight resumes are different than regular resumes. This is especially true for wannabe EMS pilots, but it also applies to flight nurse applicants.

My best advice is to find someone in your EMS network who successfully transitioned to an air medical career, and use their resume and cover letter as a guide.

Note: I did not say copy verbatim. I said use as a guide to get started.

Here are some flight interview articles to help you get started (click the red link titles):

10 Smart Questions To Ask In A Flight Interview
51 Flight Interview Questions for Future Crew
3 Surprising Ways Wannabe Flight Nurses Fail


8.) Setup a Mock Flight Interview

What is a mock flight interview?

A mock interview is exactly as the name implies. A mock flight interview simulates a real flight interview.

The better the simulation, the better your chances in a real flight interview. My advice is to set up a panel style interview where several of your friends grill you with questions repeatedly.

Remember that the key to success is making the mock interview as genuine and realistic as possible.

Explain to your friends ahead of time how important getting a flight job is to you. Ask them to take it seriously on your behalf. If you have a friend willing to do a little extra for you, have them recruit their friends, preferably unknown to you.

Again, the better the simulation, the better you’ll do in a real flight interview.

9.) Nail Your Real Flight Interview

Doing well in your real flight interview is obviously a prerequisite to get hired as a flight nurse.

How do you do it?

Remember that knowledge is power. The more you understand about the flight interview process and how real flight interviews work, the better you’ll do.

Here is something to get you started:

Understand that the majority of flight interviews are what I call “panel style.”

What panel style means is that several interviewers participate in your interview simultaneously, and ask you questions in a round-robin type format.

This can be intimidating if you’re not used to this style of interview or you’ve never experienced it before. It’s another great reason to take the time and effort required to setup a mock flight interview.

10.) Pick The Best Flight Program for You

If you just getting started, the idea of having to choose between several different flight many positions probably sounds crazy to you, right?

But at EMS FlightSafety network, we’ve been successful enough with our coaching programs to make adding this step to our process a necessity. It’s something you want to consider carefully.

Like I mentioned earlier, all flight programs do great things, but not all flight programs are created equal.

You want to know ahead of time your flight program preference list. Reality is that choosing is never as simple as simply going down the list and checking off your top choices in order. Life is messy. So are job offers.

You probably won’t have the luxury of getting offers in order of your favorites list from top to bottom. But defining your flight program preference list ahead of time will save you a lot of stress and potential hassle.

11.) Make Smart Choices Once Hired

Believe it or not, your first job offer to become a flight nurse is just the beginning.

It’s really your “license” to continue learning.

One of the big keys to success in air medical is what I call the “flying mindset.” What is the flying mindset?

The flying mindset is the inner confidence to know you have what it takes to get hired as a professional flight nurse, and to succeed as a professional flight nurse after you get hired.

What I tell my coaching students at EMS FlightSafety network is this: the only difference between you and current flight crew is a six week training program that teaches you the unique parts of flying for flight program XYZ. That’s it!

You may not believe my advice right now, but once you start flying you’ll see it’s spot on.

Reality Check About The Steps To Become A Flight Nurse

Here is something to note about the steps to becoming a flight nurse.

The steps change.

Why do the steps change?

The steps to getting a flight nurse job change to reflect the changes in what helicopter companies and health systems want in flight nurse candidates.

The good news is the changes are historically slow and the fundamentals to getting a flight nurse job remain constant.

My point is to check back here periodically for the most up to date information. Keeping this information as up-to-date as possible is fundamental to what we do at EMS Flight Safety Network.

For information about other EMS Flight Safety Network careers, read What Is EMS Flight Safety Network — And Why You Should Give A Crap About It!

Most Asked Questions About How To Become A Flight Nurse

Is it hard to become a flight nurse?

Answer: See “Who Can Become A Flight Nurse” above

How much does it cost to become a flight nurse?

Answer: Costs vary dramatically based on geography and choice of certification program.

How long does it take to become a flight nurse?

Answer: Years. It several years to complete requirements to become a registered nurse. It then takes several additional years to make yourself competitive for flight nursing jobs.

Can anyone become a flight nurse?

Answer: See section above

How much do flight medics get paid?

Answer: Median annual salary as of October 2016 survey is $69,326.

Do flight nurses fly the helicopters?

Answer: No, only licensed pilots may fly the helicopter.


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What Is INSIDER Training Program

INSIDER is EMS Flight Safety Network’s professional coaching program for future flight medics, flight nurses and EMS pilots.

Enrollment is currently closed, but I open the program to new enrollments 2-3 times per year.

Here’s the “catch” you’re looking for:

Enrollment is limited by number of applicants and geography. This keeps the training personal and keeps INSIDER members from having to compete against each other for air medical jobs.
You can check back here for open enrollment periods, as well as go to the INSIDER membership portal to sign up for the free portions of INSIDER training.

What To Do Now

Here’s how to help improve this resource for everyone:

Add your comments, suggested updates and changes to the blog comments (at the bottom of this post).

Be sure to mention if your recommendation is program specific.

Share this post with anyone you believe is a good choice for the flight nursing profession. That’s it!

Thanks in advance for helping us make this guide a great resource for anyone interested in a flight medic career.

Listen to the Audio Version Here:


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Troy Shaffer
Troy Shaffer

About the Author: Troy is an Air Medical Career Expert passionate about a team approach to improving air medical safety from the ground up. Troy is a former Army medic, Army pilot, Coast Guard pilot and EMS pilot. Troy has taught hundreds of wannabe flight medics, flight nurses and EMS pilots the exact steps needed to launch air medical careers.

    8 replies to "How To Become A Flight Nurse"

    • Torie

      I would add a recommendation that an ER RN commit to 1 year of ICU, and an ICU RN commit to 1 year of ER to make their nursing experience well rounded. It also looks great on resumes.

      I was hired with 3 years of ER RN experience.. but with 7 years of paramedic experience, still actively running 911. I was the exception to the rule than most.

      I’ve been flying for 5 months now. And you are right–this job is definitely almost all on the job training. No amount of ICU clinical time (in a pristine, controlled environment) has been super beneficial for the unpredictable flight environment.

      • Troy Shaffer


        Thanks for sharing your experience and advice.

        I agree that a blend of ER and ICU experience looks great on a resume and rounds out any ER or ICU nurse’s experience.

        Having said that, we do have lots of EMS Flight Safety Network nurses who transition from ground to air with backgrounds in solely ICU or ER. Every situation is a little bit different.

        Again, thanks for sharing your experience and taking time to comment.

        Clear Skies & Tailwinds,

    • Thomas Tribbett

      Heart is one thing I have in great abundance. I will be a flight nurse someday. I just got my RN license. I have been an LPN for the last 3 years in long term care. I know that’s far from this field. I started this journey in 2009 when I left the military.

      In the army I took the combat lifesaver course and had a chance to ride the medivac Blackhawk helicopter. From that day forward I sought to do whatever it takes to make this my career for the rest of my life. Since then I earned an associates degree in science and entered RN school failed the first year, went through LPN school, got my license and practiced for two years and went back to RN school. And now here I am. I also held an EMT-B license for a few years which expired in 2013.

      I never got to receive real experience with that however. Currently I’m starting at a hospital on the cardiac stepdown floor. I can’t seem to get into the ER without experience but I hoping this will help get me in there soon. Any suggestions for pathways to get into flight nursing.

      • Troy Shaffer


        Thanks for sharing your experience and for asking a great question. To a certain extent, this entire website is about helping people like yourself transition to air medical careers.

        If you’re interested in our INSIDER training program or one of our custom coaching programs, the best thing to do is sign up for Crew Newsletter on the home page. Just drop your name and email into the blocks on the home page and we’ll take care of the rest.

        Clear Skies & Tailwinds

    • Nica Dowd, RN BSN

      Troy! I have been a nurse for 23 years with a BSN from the University if South Carolina. Since that time I’ve worked in many areas. Alot if PACU/ICU/TRAUMA experience…one year ER long ago! I’m very interested. I live in Newberry, SC. Getting my MSN as well while working 3 12 hour shifts a week. What do you think?

    • Troy Shaffer


      Thanks for the question and for sharing your experience.

      You definitely have a strong background in nursing. And good on you for continuing to improve yourself and your skills by working toward a Masters in Nursing (MSN). Recency of experience is a factor – you mentioned your ER experience was a long time ago, but flight programs of course look at the “total package” in terms of your experience and what you bring to the current flight team.

      All that is to say I think you’re definitely on the right track. And your timing is impeccable. I literally finished creating the “Future Flight Crew Private Group” on Facebook as your comment arrived. If you’re interested in joining, click the link below to send your request:

      Thanks again for sharing your experience.

      Clear Skies & Tailwinds,

    • Ivy

      I am interested to know more about which courses are available for a flight nurse.

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