Flight Nursing Notes – The Feel of a Homecoming

Observations of an experienced ICU nurse and long-time AJN blogger who recently made the transition to flight nursing.

Marcy Phipps, BSN, RN, CCRN, ATCN, TNCC, is an occasional contributor to this blog. Some details have been changed to protect patient privacy.

“We’ve been married for 58 years,” my patient’s wife says. “Fifty-eight years…”

She turns her attention from me and gazes out the window of the plane.

We are on a medevac flight, 35,000 feet over the Pacific en route to an urban, American hospital near “home.” Her husband is being transferred to receive aggressive care for a grave illness.

We collected him hours earlier from a hospital on a foreign island. Local paramedics picked my partner and me up from the barren, windy tarmac. As we sped to the hospital in the back of an ambulance with a cracked windshield, the driver turned to warn us that we were going to “the worst hospital in the city.”

“It’s open-air,” he told us, as he dodged mopeds and swerved through narrow, crowded streets.

This didn’t surprise me. I’d been forewarned that hospital conditions on many of these remote islands could be shocking when compared to American standards. It was something I’d been curious to see firsthand.

Yet when we picked our patient up, we found him in a small and clean room in an intensive care unit. Despite the paramedic’s prediction and the visibly run-down hospital, he appeared well cared for and attended to. His wife told me later that she believed her constant presence at his bedside had guaranteed his good care.

And now it’s two in the morning and I sit in a private jet with the flight medic, tending our patient, who is remarkably stable and tolerating the flight with ease. We are also tending to his wife, albeit in less obvious ways. He’s secured to a stretcher; she sits in a bucket seat at his feet, nervously watching his chest rise and fall with the ventilator-delivered breaths. Each time I assess him or check his vital signs she looks at me anxiously.

“He’s okay?” she asks me.

“He is,” I reply.

It is not a smooth flight; we skirt storms throughout the long trip. Yet when we hit turbulence, she tells us that she has no fear because God is on our plane. She pulls out a photo album and shows us old pictures of her husband enjoying life as a handsome and healthy man. She insists on sharing the ham sandwich she’s brought on board, and recounts stories from their long life together while the medic and I politely nibble. Every once in a while she hazards a hope-filled comment about future plans. Most of the time, though, worry and grief emanate from her in waves.

I’m new to flight nursing. I’ve only been on a handful of flights, and yet I’m already aware of certain truths: so far, I’ve found that—whether the trip originates in the pursuit of more aggressive care, in the carrying out of a sworn promise, or in the return to a special place before death—each flight has the feeling of a homecoming.

And despite the apparent extravagance (I’m frequently asked, “How much does a trip like that cost, anyway?”), I can see that the financial arrangements are secondary, that coming home is priceless, and that money means so little, in the grand scheme of life.

(To read past blog posts by Marcy Phipps, click here.)