Not every day is the same for flight nurses who work in non-emergency medical transportation (NEMT). Every day, they deal with different types of patients who need a variety of medical services during their flight.
However, there are certain duties that often come up every day for a NEMT flight nurse. But first, it’s important to understand what NEMT is and how it differs from an air ambulance.
What Is NEMT?
NEMT involves the transportation of patients who require or desire medical assistance when traveling on scheduled flights on commercial airlines like Delta, United, Lufthansa, etc… both domestic and international. People hire a company like Flying Angels so a flight nurse can travel with their loved one. This can be for many reasons, including medical trips to specialist hospitals and doctors far away, for relocating an elderly parent, or for bringing home a loved one who was injured overseas. Family members are always welcome to fly with the flight nurse, but in most cases, it is just the flight nurse and the patient.
Whatever the case, flight nurses have a long list of duties. Flight nurses for Flying Angels all have experience in providing emergency medical care and have extensive experience in dealing with emergency and trauma situations.
Duties For Flight
So, what does a flight nurse do on a typical day? They usually include some or all the following.
Double Checking Plans
Flight nurses work with flight coordinators (who also are nurses) to handle the details in arranging NEMT with commercial airlines. They will review the procedures for the airports they plan to visit that day and reach out to any officials they need to speak with before arriving at the airport.
Packing The Medical
Prior to any transport flight coordinators prepare an extensive case file that will include relevant information on the patient, and all details related to the transport including ground, air, hotels, and points of contact. Flight nurses will review the case file of that day’s patient beforehand. They will know all the medical equipment they need to deal with any type of issue that might come up given the conditions of each patient. Before departing home, will make sure they have any specialty medical equipment needed for the flight such as specialty reclining wheelchairs, oxygen equipment, suction, nebulizers, etc…
Working in tandem with the flight coordinators, flight nurses make sure they meet all the pre-planned points on the trip, as laid out in the case file. The day before the flight the flight nurse will meet with the client at their residence and facility and will go over the plan for the following day. The flight nurse will confirm that all documents are in order, all medications are accounted for, and that all parties involved are aware of the schedule for the following day. The flight nurse will also will confirm that the ground transportation, arranged earlier by the flight coordinator is set up and in order. The flight nurse will stay overnight at a nearby hotel. The day of transport the flight nurse will return to pick up the patient at their home or residence and travel with them to the airport.
During the Flight
Flight nurses with Flying Angels have trained in flight physiology, and have extensive experience in air travel and the complexities involved getting through the check-in process, security, and customs & immigration for international flights. They also understand any psychological distress a patient might feel throughout the journey. Further, they know the specific circumstances of the patient they are flying with that day and know the signs of any problem. They also will monitor when it is time for medications and make routine checks.
Flights nurses oversee the patient disembarking from the plane safely and make sure they get through the airport to the awaiting ground transportation where they will travel with the patient to their final destination. Typically they will stay at an airport hotel and will then return to their point of origin the following day ready for another flight.
The daily routine of a flight nurse always has some variables, but it’s an exciting and challenging job no matter what the specific duties for each day’s flight. Flight nurses serve an important function in working with patients with medical conditions and illnesses, keeping them safe when they fly.
Patient advocacy has been around for many years. In the
past, a patient advocate usually meant a member of the family, a good friend or
perhaps a clergyman or pastor.
Family members, friends and others can still fulfill this
role. However, it long ago became a position held by people who, while not
medically trained themselves, were familiar with the operation of the
The idea is to have a person who understands the ins and outs of the healthcare system to advocate on your behalf with doctors, nurses and other medical staff. Patient advocates are independent of the medical system but at the same time familiar with it. A person hires a patient advocate in much the same way they hire an accountant or attorney. This way the client knows that the advocate works solely for them and is not beholden to any other interests. While patient advocates are not covered by insurance, they can be an invaluable ally in the client’s corner.
What Does A Patient Advocate Do?
What Patient Advocates do is either navigational (making
appointments, following up on paperwork, making sure prescriptions are filled, and
such) – or money-related (auditing medical bills, negotiating with insurers or
hospitals). Advocates in those positions do offer a good example of the
fundamental services that an advocate provides for a patient.
For example, they closely monitor the patient’s well-being,
both physical and emotional, and give them an opportunity to discuss those
issues. A patient advocate acts as a liaison between the patient and medical
In general, patient advocates help cut through red tape and
get patients what they need. They act as a supporter, promoter and spokesperson.
It’s a key position to help people get better medical care, and it leads to
better patient outcomes.
Where to find a Patient Advocate?
Fortunately, there are many organizations that function as
advocates for patients. Flying Angels works directly within many of these
They include the following.
• Academy of Special Needs Planners (ASNP)
• The National Guardianship Association (NGA)
• The Aging LifeCare Association (ALCA)
• The Alliance of Professional Health Advocates (APHA)
Flying Angels also is a proud sponsor and exhibitor at the International Conference on Patient Advocacy (ICOPA), which is being held this October in Chicago. The theme of this year’s conference is “a rising tide floats all boats.”
Flight Nurse Patient Advocacy
Unlike most medical situations, flight nurses and their
patients are on the move. They must plan out transportation to the airport,
through airport security and boarding the plane. They also have to ensure that
a patient is comfortable on the plane itself.
In addition to being a patient advocate while going through
the airport and onto the plane, flight nurses also must ensure that patients
have all their proper medications during the flight. They may keep track of
their wheelchair and other medical equipment and make sure it is stored safely
aboard the plane.
Flight nurses also help patients make informed decisions
during their trip. This can include everything from going through security to
finding the right seat on the plane that gives them the best access to the bathroom
or the exit from the plane.
Another part of patient advocacy is also explaining any medical terms or transport-related issues, such as how the TSA conducts security checks on wheelchairs.
Conclusion While Patient advocacy was originally left to families, designated friends and clergy, the complexity of the modern health care system can easily overwhelm a patient and the best of intentioned laypersons. Professional Patient advocacy started with nurses working in hospitals. They have long acted as a liaison between patients and other members of the medical staff. Modern Patient Advocates are highly skilled professionals who work directly for the patient and make sure they get the best care from the healthcare system possible.
The REAL ID Act passed
by Congress sets a minimum-security standard that states must meet when issuing
a driver’s license or other forms of identification. It also prohibits the
federal government from accepting IDs from states that do not meet those
It’s a TSA
travel tip that everyone should be aware of before making
travel plans. Because of the massive scope of the REAL ID Act, it is just now
about to go into effect. States have until Oct. 1, 2020 to reach full
Why Was The REAL ID
Congress passed the
REAL ID Act in the wake of the 9/11 terrorist attacks in New York City and
Washington D.C. The goal is to eliminate terrorism on airplanes by making
it more difficult to obtain a driver’s license and other identification at the
state level. It is typically these cards that are used for identification at
The act has led to better efforts by the states
in raising the requirements to obtain a license. The federal Department of Homeland Security reports that “every state has a more secure driver’s license
today than before the passage of the Act.”
Which States Are
A quick way to see if your license is compliant
is by checking the front of your driver’s license. Most states have adopted the
use of a gold star to show they are compliant with the REAL ID Act regulations.
However, some states that are compliant with the
new regulations still have not used the gold star, including Hawaii, Ohio, Tennessee
and Utah. Given that, it’s best to check with your state if you don’t see a
gold star. You might still be compliant.
One way you will know for sure that your ID is not compliant is if it has the words “federal limits apply” or “not for federal identification” stamped on the front of the card.
If You Are Not In
Stating in October 2020, TSA personnel will only
accept driver’s licenses and other state ID cards that comply with the REAL ID
Act. If your card is not in compliance, you can still fly, however. What you
will need is an alternative form of identification, such as a passport
Also, some states that are not in compliance have been granted an extension to get into compliance. They include New Jersey, Oregon, Kentucky and Oklahoma. Check to see if your state is in compliance before you make travel plans.
Keep in mind that you can still vote and drive a car with your state-issued ID, even if it isn’t in compliance. The REAL ID Act deals with air travel only. If traveling with a Non-Emergency Medical Provider like Flying Angels, all of the details of the trip – including any issues with the REAL ID Act, will be handled by an RN Flight Coordinator. That’s one of the many advantages of using the service if you are flying with an illness, injury or limited mobility.
The TSA Notification Card allows travelers with disabilities to notify security officials of any issues that may impact a security screening. For disabled travelers, it’s important to know what the card does, how to get it and when to use it.
The following looks at those issues. This information can help travelers with disabilities in understanding how to use the TSA Notification Card to make travel less difficult for them.
What It Does
The TSA Notification Card allows travelers with disabilities to discreetly inform airport security personal about any medical conditions, disabilities, medical devices on their person or medications that might impact the screening process. It does not mean that travelers with disabilities who hold the card can skip the screening process, as this is still a requirement.
However, the card easily conveys essential
information to security personnel. This provides a method for better, clearer
communication about the details involving your particular medical situation.
Those with both a TSA Notification Card and a TSA Pre-Check designation may not need to remove shoes, laptops, 3-1-1 liquids, belts or light jackets during screening.
How To Get It
The TSA provides the TSA Notification Cards to
designated disability groups. They also have an online PDF that people can fill in
with their specific medical issue, then print out. Some people couple the card
with a note from their doctor explaining their condition or the need for a
specific medical device.
According to the medical
and disabilities page offered by TSA,
the card can be used for many different situations. They include sections on:
- Alzheimer’s, dementia, aphasia or brain injury
- Autism or intellectual disabilities
- Blind or low vision
- Deaf or hard of hearing
- Use of external medical devices
- Implants or internal medical devices
- Mobility disabilities, aids, and devices
- Prostheses, casts, slings, braces or support appliances
- Radioactive medication and materials
- Respiratory equipment
- Use of service dogs and animals.
When To Use It
The TSA Notification Card should be taken to the
airport and presented to a TSA official near the screening area. Again, this
does not exclude you from going through screening. But it gives the security
officer a quick rundown of whatever issues might come up during the screening.
This especially applies to any liquid medications or medical devices. If you do not wish to go through the screening process, airport officials may have to perform a pat-down that can include removal of shoes, belts or light jackets, according to the TSA.
They also may swab any medical equipment,
mobility aids or “other external medical devices” to test for explosives.
In creating the TSA Notification Card, the
government is taking steps to make travel easier for those with a disability.
It’s a welcome step for those travelers with disabilities who might otherwise
have a more challenging time getting through security.
International travel is one of the most rewarding types of travel a person can undertake. Visiting other countries, experiencing other cultures, seeing historical sites and eating exotic cuisine are a few of the many pleasures of traveling abroad.
However, as you prepare for international travel, it’s important to keep in mind tips that can lead to a safer, more rewarding experience. Read on to learn some important tips for taking a trip outside of the country.
Before You Leave
Make sure to use the Internet to learn all the
details about where you will be traveling, including the best and safest places
to stay and any local issues you need to be aware of (some cities in Europe,
for example, have areas notorious for pickpockets).
The U.S. State Department advises that people check to see what documents you need in addition to your passport or visa. For example, some over-the-counter medication purchased in the United States may be illegal in other countries and may require you carry documentation.
Many countries may require that your passport is
valid for as much as six months after your trip dates, so check on this issue,
as well. Take a picture of your passport and put it into your cell phone just
to have a digital copy.
Also, check with the State Department to see if
there are any travel alerts for any of the places on your itinerary.
Notify your bank and credit card companies about your travel plans so they will not deny any purchases you make. Many banks will allow you to use your debit card in another country. However, check to see what the fees are for foreign ATMs. Depending on the bank or the country, they can get very high.
You’ll want travel insurance to protect your belongings if they get lost. However, you may also want medical travel insurance in case of an accident. Check your current policy to see if it covers the cost of, for example, medical care in another country or medical transportation to a hospital in case of an accident. This is also an area where you want to consider contracting a non-emergency medical transport company, especially if you are traveling abroad and have a disability or chronic medical condition.
Make sure to get all the required vaccinations for international travel as early as possible. You don’t want to wait until the last moment only to discover that the vaccination is not available in your area. The Centers for Disease Control and Prevention provides an easy-to-use webpage to determine what shots are required and recommended.
Protect Your Home
You don’t want to be walking down the
Champs-Elysees in Paris and suddenly remember that you forgot to have the mail
delivery temporarily stopped back at home. Make arrangements well in advance to
stop mail, get pets fed and have any chores you need done handled. It’s not a
bad idea to have a house sitter or a trusted friend come by and check on your
house regularly while you are out of the country.
You can buy a World Phone in advance and use
this while traveling. That can be a cheaper alternative to international rates
for your cell phone – if your service is even available. However, some cellular
providers have good plans for travel, especially in Europe. This is one that will
require some legwork to determine which method will work best for you to stay
Quick Travel Hacks
Here are some other travel tips to keep in mind.
Break-in new shoes. The last problem you want is to get blisters on vacation because you are wearing those new travel shoes for the first time.
Pack light. The
less you carry, the less you must keep track of at airports, on planes, in
taxis, buses and in hotels. Most people overpack, so take the time to toss out
things you aren’t sure you will need, especially a lot of extra clothes and
Also, things people often forget to pack
- Phone charger (bring two)
- Anti-bacterial wipes
- Sweater, even in summer (it gets cold on an overseas flight)
These tips and travel hacks should help you get started on a good trip. Remember, the more planning you do in advance for international travel, the more you can enjoy your trip once you are on it!
For those who need to travel with a guide dog, getting through the airport and boarding a plane can seem a daunting task. However, there are services available that can help you through the experience, as well as personnel at the airport who are trained to support those with a guide dog.
In the modern world, the need to travel with a guide dog should not keep people from taking a trip they need or want to take. Keep the following steps in mind to ensure that your trip goes well.
Organizations such as the Guide Dog Foundation,
Inc. will provide demonstrations and practices of what to expect at airport security,
so you and your guide dog are fully prepared and confident during the real
thing. If you contact TSA Cares 72 hours before a
flight, they will also provide you with information on what to expect. TSA
Cares can also coordinate a passenger support specialist to help you through
Picking a Good Day
Early morning flights are often best because
they experience the fewest delays. Traveling on Friday can present more
challenges as that is most often the busiest day at an airport. Saturdays are
usually the lightest day for travel.
Packing for Your
Remember to put your travel-sized liquids in a
quart-sized bag, and make sure any electronics larger than a cell phone are
easily accessible so you can remove them during screening. Liquids over 3.4
ounces are not allowed through airport security, unless said liquid is
medically necessary, though you will have to declare this to the TSA agents at
the screening for inspection.
Pack For Your Guide
Make sure to pack a small emergency-size kit for
your guide dog. This should include items such as medicine for an upset
stomach, hand wipes and paper towels.
Mapping Out the
When you travel with a guide dog, look up the airports you are going to be in to find the pet-friendly areas where you can sit and wait in case there is a flight delay. The website Pet-Friendly Travels provides such a list. Also look for the location of bathrooms, places where you can water or other items, etc.
Packing Dog Meals
Make sure to pack pre-measured meals for your
guide dog. They are not prohibited and can be put into resealable plastic bags
in your luggage. Make sure to bring a small amount of food and whatever treats
are appropriate for your dog in the case of lengthy delays at the airport or on
Reserve a Seat
Contact the airline at least one day before
departure – the earlier, the better – to secure the seat you need for you and
your guide dog. Some prefer to sit against the bulkhead. Airlines that do not
allow you to purchase a seat location in advance will allow you to pre-board
before the other passengers. Dogs can sit anywhere, as long as no part of their
body is in the aisle. In some cases, you may have to ask a fellow traveler to
share some of their foot space with your dog – an airline representative can
help you in this situation.
There is no point during screening at which you will be separated from your guide dog or required to remove your dog’s harness and leash, though your dog may have to go through additional screening if you leave these items on. You will have to remove your jacket, belt, and shoes (unless you have TSA Pre-Check). If you are unable to do so, you will go through additional screening. You may also have to walk through a metal detector or receive a pat-down.
The pat-down will always be conducted by an
officer of the same gender as your present, and they will walk you through the
process beforehand. They will ask for permission before touching your guide
dog, and you can always request a private screening with a companion of your
choice or ask that the officer use a new pair of gloves.
Advocate and Ask
Do not hesitate to ask airport workers, airplane personnel and even fellow passengers for assistance, if needed. Under federal law, airports and airlines must provide accommodations for those with disabilities. And fellow passengers are often far more helpful than you might expect! Also, ask to speak with an airline representative who is designated to work with those who have disabilities if you run into any difficulties anywhere along the process. These are some tips to review before you travel with a guide dog. With the help of those at the airport and your own preparation, it’s a process that can and should go smoothly as the world gets better at supporting those who are differently abled.