Critical care nurses' experiences of helicopter transfers

The Helicopter Transports of Patients Critically ill with COVID-19

Objective

The aim of our study was to describe specialist nurses’ experiences with the helicopter transport of patients critically ill with COVID-19.

Method

Our study followed a descriptive qualitative design anchored in the naturalistic paradigm and was based on qualitative content analysis. The study followed the consolidated criteria for reporting qualitative research.

Results

Six semi-structured interviews were conducted with specialist nurses who have cared for patients critically ill with COVID-19 during helicopter transport. The analysis of the interviews resulted in three themes—designing new routines before transport, working under new conditions and post-transport and reflections—with 11 categories. The goal of the intensive care transport of patients with COVID-19 was twofold: to prevent the spread of infection by using personal protective equipment and to prevent the contamination of the helicopter.

Conclusion

For the nurses, working in personal protective equipment created a feeling of distance from patients that compromised patient–nurse intimacy. Our results suggest that ensuring the sufficiency of equipment required in the event of major accidents and pandemics is critical.

Stories From Children's Nurses in Flight: Exploring Experiences of Air Medical Transfers

OBJECTIVE

Nurses are immersed in stories, and nurses who participate in flight transfers have stories to tell that may hold interest and offer insight for air medical professionals around the world.

METHODS

Using a narrative inquiry methodology, 5 nurses working for a children's transport service in England were invited to tell stories from their experiences of air medical transfers. The aim of this article was to describe the meanings the nurses assigned to their experiences of flight transfers and to develop an interpretation of the narrative accounts, investigating the implications of the stories.

RESULTS

This study provides a record of nurses' flight experiences within a predominately road-based children's transport service. The analysis considered the following topics: humor, parental presence on transport, and the joy and fear associated with the work. Implications for the training of nurses who fly were identified; it is recommended that the design of training should place the technical challenges of the work in the context of the emotional challenges.

CONCLUSION

This article is a timely reflection on the social context of this new nursing experience for any situation around the world, which is seeing expansion of children's air medical transport provision.

Critical care nurses' lived experiences of interhospital intensive care unit-to-unit transfers: A phenomenological hermeneutical study

OBJECTIVE

To explore critical care nurses' lived experiences of transferring intensive care patients between hospitals.

METHODS

A phenomenological hermeneutic approach using data generated through individual interviews with 11 critical care registered nurses.

SETTING

Two general intensive care units in Sweden.

FINDINGS

Five themes were identified: it depends on me; your care makes a difference; being exposed; depending on interprofessional relationships; and sensing professional growth. These themes were synthesised into a comprehensive understanding showing how transferring intensive care patients between hospitals meant being on an ambivalent journey together with the patient but also on a journey within yourself in your own development and growth, where you, as a nurse, constantly are torn between contradictory feelings and experiences.

CONCLUSION

Interhospital intensive care unit-to-unit transfers can be a challenging task for critical care nurses but also an important opportunity for professional growth. During the transfer, nurses become responsible for the patient, their colleagues and the entire transfer process. In a time of an increasing number of interhospital intensive care unit-to-unit transfers, this study illuminates the risk for missed nursing care, showing that the critical care nurse has an important role in protecting the patient from harm and safeguarding dignified care.

"Flight Nurses," or "Nurses Who Fly"? An International Perspective on the Role of Flight Nurses

OBJECTIVE

Discovering how transport nurses around the world are prepared and supported for a flight role may illuminate areas of best practice. This article reviews the flight nursing research, exploring what the international literature tells us about the role of flight nurses and discovering lessons from their experiences that may have particular relevance for the UK context.

METHODS

The results of a literature search and thematic synthesis for flight nursing research are described.

RESULTS

Thirteen research articles were obtained covering a broad range of countries. The scope of practice encompasses primary and secondary transport services and both civilian and military personnel. In an attempt to distill the role, work, and purpose of a flight nurse, a list of all the themes and categories that could be identified within the literature was assembled. These were inductively refined into 8 cluster themes, seeking to capture a broad description of the role of a nurse who flies. The definition of a "flight nurse" in the international context is debated. Thoughts related to training and education and, in particular, the nontechnical challenges of the role are discussed.

CONCLUSION

This reflection provides insights that will influence the ongoing conversation around future air medical service development.

Implementation of the protocol of nursing care in trauma in aeromedical service

ABSTRACT Objective: To analyze the implementation of a nursing care protocol for trauma patients before, during and after the flight. Method: A cross-sectional quantitative study carried out in an aeromedical service, using a checklist with 106 care: 79 before flight, 25 during, and 2 after flight. 97 patients were included in the study. Results: Most care (n = 59; 55.7%) was implemented, totaling 4,435, 1,480 and 192 cares performed before, during and after the flight, respectively. They stood out as unrealized care: protect ears with ear muffler (n = 55) and avoid leaving the pulse oximeter exposed to the sun’s rays (n = 22). The main reason for the non-performance was lack of appeal (n = 94). Conclusion: Although most protocol care has been implemented, unrealized care compromises the quality of care, which requires the management of the service to provide more incentive to nurses and adequate resources for its implementation.

Experience of physician and nurse specialists in Sweden undertaking long distance aeromedical transportation of critically ill patients: A qualitative study

INTRODUCTION

Transportation of critically ill patients, intra- or inter-hospital, always involves risks when resources are limited. With aeromedical transports, additional risk factors are incurred. The physiological effects of altitude, when both pressure and density decline, can lead to hypobaric hypoxia and gases trapped in body cavities will expand and cause stress on biological tissue.

AIM

The aim of this study was to explore the experiences of nurse and physician specialists in Sweden undertaking long distance aeromedical transport of critically ill patients, with a flight time of more than two hours.

METHOD

A qualitative approach with a descriptive design. Thirteen recorded semi-structured interviews with physician and nurse specialists were analyzed using inductive qualitative content analysis.

RESULTS

One overall theme emerged, To be one step ahead to ensure patient safety in the air; with three categories 1) With the patient in focus, 2) To be part of a team and concerned about patient safety and 3) To be in need of recovery.

CONCLUSION

This study demonstrates the challenges with long distance aeromedical transport of critically ill patients. The healthcare personnel make decisions and actions to be one step ahead to ensure patient safety. This isolated work is improved with experience, education, training and good communication skills.