HealthTimes speaks with Sophie Jo Pepper, a flight nurse with the Royal Flying Doctor Service in Western Australia. 

What is your current employer, title and role?
I currently work full time as a Flight Nurse/Midwife for The Royal Flying Doctor Service, Western Operations in an evacuation/retrieval role.

Why did you become a nurse?
From a very young age I was interested in becoming a nurse and what the profession offered. I grew up in a small country town and in a family of health professionals that were dedicated to promoting health. I spent many hours in rural hospitals volunteering my time and learning about the profession before enrolling in university on completion of high school. The concept of being able to provide care, support, compassion, knowledge and skills to people in need whilst being exposed to a variety of situations gave me the enthusiasm and drive to pursue a career in healthcare and specifically nursing.

Where did you study Nursing?
I studied a Bachelor of Nursing at Charles Sturt University in Wagga Wagga, NSW. At this time I was also enrolled in a Bachelor of Nursing/Midwifery as a double degree but prior to its completion, the midwifery component was dropped due to restructuring of the course and restructuring of the Midwifery registration requirements. Throughout my degree I undertook placements in rural and remote areas and was given the opportunity to see the fantastic healthcare that is provided in these areas with limited resources, and I was also exposed to aeromedical retrieval for the acutely ill when tertiary care was required.

What was your career pathway in flight nursing?
During my time at university it became apparent to me that a career in retrieval medicine, and specifically The Royal Flying Doctor Service was my chosen career pathway. On completion of a Bachelor of Nursing, I accepted a New Graduate Position in Mona Vale and Manly Hospitals in Sydney to gain experience and knowledge in metropolitan areas.  After completing my new graduate year, I also undertook a Graduate Certificate in Critical Care Nursing whilst working in the critical care fields to gain knowledge, skills, experience and exposure to situations whilst striving towards a career with RFDS.

During this time I became aware of a degree being offered through the University of Wollongong to complete a Masters of Science/Midwifery Degree. I was successful in my application and relocated to the Illawarra area, working at both the Wollongong and Shoalhaven hospitals in Emergency, Intensive Care unit, Nuclear Medicine, Medical imaging, Neuro HDU, Paediatric Emergency and many more fields.

My second year of the degree I undertook my midwifery placement at Shoalhaven hospital, Watson House Maternity unit. After Graduating from this degree I relocated back to Jindabyne, NSW and worked as a Registered Nurse and Registered Midwife as a sole practitioner on each shift in Maternity and Emergency at Cooma Hospital.

During this time I gained further experience and was exposed to the complexities in healthcare. Throughout the year I worked in many leadership and management roles throughout the hospital and decided to undertake a Graduate Certificate in Healthcare Leadership and Management, distance education through the University of Wollongong. Post its completion I felt I had the skills, knowledge, education and enthusiasm to be a Flight Nurse. I was successful in obtaining a Flight Nurse/Midwife position with the Royal Flying Doctor Service, Queensland section and my lifelong ambition was fulfilled.

How long did you work in other areas of nursing before becoming a flight nurse?
Prior to becoming a Flight Nurse I worked as a Registered Nurse and Registered Midwife in various rural, remote and metropolitan areas. I worked in various roles and fields such as; medical, surgical, emergency, intensive care, cardiac, paediatric, neonatal, neurology, nuclear medicine, radiology, day surgery, obstetrics and the list goes on. During this time in furthering my personal and professional development I elected to continuously study further degrees, and this exposure gave me the opportunity to gain knowledge and skills in various healthcare fields and also gave me the opportunity to share knowledge and skills with students and colleagues alike.

I worked for 5 years in the hospital setting before joining The Royal Flying Doctor Service and during this time undertook professional development opportunities both internally and externally. Along with the degrees listed I was fortunate to be gain certificates in BLS, ALS, PALS, ALSO, TNCC, airway management and many more.

What got you interested in flight nursing?
It was a combination of aspects that got me interested in flight nursing. Firstly; a strong interest and enthusiasm in the fields of critical care and midwifery, secondly an interest in providing the highest standard of care to rural and remote areas of Australia, and then the fun and excitement of no day ever being the same, seeing different places every day, balancing aspects of patient care, support and interventions with aeromedical logistics and being an independent clinician.

What’s the most satisfying/rewarding part of your job?
I personally love being a flight nurse and find it very rewarding. Aspects of the job that I love the most are; being able to provide the highest possible standard of care to people in need, in the most isolated communities in Australia. The teamwork and close knit community in which we work, the various rewarding and exciting situations in which we are exposed to, the various professions that interlink in supporting patients to receive care, and finally the logistics of getting an experienced team together into an aircraft with prioritization, communication and emphasis on the patient’s needs. I find it very rewarding to work beside some of the most experienced health professionals, learning from them and seeing patients conditions improve before we reach our final destination.

What do you think makes a good flight nurse?
There are many aspects that make a good flight nurse.  Being accountable, flexible, autonomous, and professional.  Ensuring you have the knowledge, skills, and education to provide current best practice treatment, investigations, diagnostics and interventions specific to the patient’s needs. Working within a small team and conversing with many external parties requires good communication skills, being ethical and respecting rights and wishes, being kind, compassionate and dedicated.

To be a flight nurse specific essential criteria is required including; registration as a Registered Nurse and Midwife with AHPRA, relevant post graduate qualifications and/or experience in obstetrics/critical care, ALS competency and the ability to work as a sole practitioner in an isolated environment, ability to work independently and within a multidisciplinary team, initiate and implement management and treatment protocols, confidence in decision making abilities, exceptional record keeping skills, being professional and maintaining professional developments with a diverse range of people, and a current drivers licence.

As we all know not all goes to plan, so situational awareness and having the ability to adapt and be flexible, whilst working within our current scope of practice is paramount.  And to enjoy the job I think being kind, caring, compassionate and enthusiastic makes for a great day and rewarding experience.

What does a typical day as a flight nurse look like?
There is no typical day as a flight nurse, life is never boring. It’s exciting and on the go and everyday varies significantly. In a week a flight nurse may work a variety of nights and days, with a variety of people. They may land on a road, may land on a remote dirty strip, may land at a city, may fly out to an isolated community to deliver a baby, may transport a sick neonate or intubated patient from one hospital to another.

They may be mid-flight to transport a patient and get diverted to a serious quad bike accident, motor vehicle accident or station accident that requires immediate treatment.

A typical day includes; communication, prioritization, logistics, checking equipment, packing an aircraft and preparing equipment. It includes treating, diagnosing and providing care to patients, liaising, loading and transporting, then documenting and restocking.

What is the most interesting thing that has happened while working as a flight nurse?
I cannot name just one interesting thing that has happened while working as a flight nurse. I have been exposed to minor cases through to some very serious cases involving huge media attention. I have experienced road landings, dirt strip landings, headlight and flare landings, and being involved with birthing babies on the tarmac.

From day to day I have met some very influential people and amazing characters from far and beyond stations. I have had to push an aircraft off the runway whilst being stranded in remote areas of the Northern Territory and Queensland and had many cups of coffee at farmhouses. I have had many medical and obstetric emergencies and worked within some extremely small restricted environments to retrieve patients.

Has anything about flight nursing surprised you?
The thing that has surprised me the most is how large Australia is, how long it takes to get to people in need, and most of all how resilient people in outback communities are. Someone in a remote community may sustain a serious life threatening injury in which may take 2 hours for us to get to them, although despite this, the communities band together with knowledge, skills and a friendly attitude to all play a part in making it easy to get them help, comfort, support and keep them alive until assistance arrives. This may include using an RFDS medical chest from a station 200km away.

What would you tell someone who is thinking about becoming a flight nurse?
DO IT, DO IT, DO IT!!!!!!
I encourage everyone to become a flight nurse. I love my job and would not change a thing, however I do inform them of all involved, including; safety requirements, logistics, education requirements, and enthusiasm and dedication to the job so that they can make an informed decision about their suitability and ability to provide the best possible care to patients in which we treat.