ED nurses looking to transition into transport need to be comfortable with making quick decisions without the backup they are used to in the ED, according to Brittany D’Amato and Sean Bryan.
Critical care transport nurses, or CCTNs, are similar to emergency nurses in that both professionals regularly need to make quick decisions to help patients facing potentially life-threatening medical situations. The biggest difference, according to Sean Bryan, MBA-HM, BSN, RN, is that CCTNs are making these decisions autonomously with little to no backup. At Emergency Nursing 2024, Bryan and Brittany D’Amato, RN, CEN, CFRN, shared with a large audience of engaged ED nurses what is needed if they want to become CCTNs.
“[Autonomy] is one of the biggest adjustments for nurses going into the flight world — not having someone there to give you that reassurance,” said Bryan, director of medical operations for REVA Inc., an air ambulance company. Many of the processes and tools used in critical care transport are the same as in the ED, but space and other environmental constraints require more innovation in how they’re deployed. CCTNs must be able to act quickly and decisively. “If you’ve been working in the ED for some time, you know what you’re going to give, and in the world of transport, we’re not reinventing the wheel,” said Bryan.
Bryan and D’Amato said that most flight programs are looking for nurses with three to five years of experience, and the certifications that are required will vary from program to program. While all ED nurses should have basic resuscitation certification, prospective CCTNs may need more advanced certifications to be prepared for more unique situations, such as delivering a baby midair when transporting a pregnant patient. Many programs, however, do not require a CFRN certification coming in. D’Amato, who does critical care transport for Nicklaus Children’s Hospital in Miami, said she was not fully prepared for the CFRN test until after she’d already started working in the air. “That real-world experience is what’s going to help you pass that test,” she said.
Sean Bryan and Brittany D’Amato said the gratitude they experience from patients is one of the most fulfilling reasons they love being critical care transport nurses.
Bryan and D’Amato also gave attendees an idea of what a typical shift looks like for a CCTN. This depends on the type of model used by the flight program. Generally, it will be a community-based, traditional hospital or government/EMS-based model. D’Amato works in a hospital-based model through Nicklaus Children’s, working in shifts, while Bryan said his teams are on call 24 hours with a week off every other week.
“The reason I fell in love with it … is because it’s the most rewarding job in medicine I’ve ever had,” said Bryan. “When we show up in every country or every place, there’s a family there who’s ecstatic to see you.”
“I do not see myself doing anything else full time. It’s honestly the best decision I’ve ever made for myself,” said D’Amato.