Flying into the public gaze

Aviation nurses work in civilian and military contexts in often demanding and autonomous roles. Linda Belardi speaks to one nurse in the field.

After 12 years as a flight nurse, Genevieve Brideson is about to commence Australia’s first PhD in aviation nursing.

Her research, to be undertaken at Flinders University where she works as a lecturer, will explore the visibility of nursing in Australia’s aviation health services.

The former Royal Flying Doctor Service (RFDS) nurse says flight nurses are often seen but not heard in both the academic literature and in popular culture. She says their role is poorly understood and myth and misconception still dominate the public consciousness.

“Many people are still unaware that in the vast majority of cases it is a nurse operating as a sole practitioner who is sitting in the back of the aircraft. A doctor will only be present on a flight when required.”

While the TV classic The Flying Doctors may have handed the glory to their medical colleagues, Brideson says it is highly skilled nurses who attend to patients day in day out, working at high altitudes in various weather conditions, often in Australia’s rural and remote locations.

To correct this knowledge gap, Brideson’s research will help document the role and scope of aviation nursing practice, as well as newly emerging roles such as aviation nurse practitioners.

There are also common assumptions about the role that need testing, she says. “It seems to be assumed that if you can work in critical care that you can transfer those skills into aviation but there is some evidence to suggest that isn’t necessarily the case.”

Brideson says flight nursing is a unique and multidisciplinary field, demanding a wide scope of practice, dual qualifications in nursing and midwifery and a minimum of five years postgraduate experience.

Flight nurses work with patients of all ages and across the gamut of conditions, including midwifery, the critically ill and aged care patients. “You can be putting an unwell baby on the aircraft in one flight and then on the next you could be transferring an elderly patient home to receive palliative care surrounded by their family and friends.”

In rural Australia, where mental health services are limited, flight nurses can also be involved in emergency and crisis response, and increasingly in the delivery of primary healthcare and clinic services. “Due to the space and the weight and balance requirements of the aircraft, you can’t have everything with you at all times, so advanced assessment skills are important,” Brideson says.

The first flight nurse flew with the RFDS in 1945 but hospital nurses have been seconded to the role since 1938.

According to the professional peak body, Flight Nurses Australia, aviation nursing practice began to really flourish in the 1980s. Since then, an increasing number of nurses have practiced flight nursing as an extension of their role within hospital-based retrieval services, hospital transport services and international repatriation organisations. In 2008 national standards relating to professional qualifications and practice were first developed.

Interestingly, Brideson’s 2010 honours thesis found that despite their midwifery training, it was very difficult for flight nurses to maintain their midwifery skills. Indeed, only approximately 5 per cent of cases involve midwifery patients.

At the same time, Brideson says most midwifery courses do not adequately prepare midwives to work in aviation health or address the particular needs of midwives in an aero-medical environment.

While this small but dynamic specialty is a popular choice amongst nursing students, she says there is limited capacity to offer clinical placements to students.

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