Paramedic, Flight Nurse
By KEN MOSIER
For What2Be
Who am I?
Name: Angi ‘Goose’ Gooslin
Title: RN/EMT-P, Flight Nurse
Affiliation: Miami Valley Hospital CareFlight
Education: Bachelor’s degree, Morehead State University
Paramedic certification, Clark State Community College
Multiple certifications
Quote: “(Flight Nurse) is the best job I have had yet and I have loved every area I have been in so far. I loved critical care and coronary care and it has made me the nurse I am today. I have loved it,” she said.
What’s2Like:
►Challenging work
►Autonomy in the field — no one to call.
►Helping patients who are in maybe the worst times of their lives.
►Extra pay — a one-step increase
►Flight Nurses are generally highly respected.
What’s Not 2 Like:
►Shift work
►Fly in all temperatures
►Patient outcomes can sometimes be tragic
►Flight Nurse selection requires successful completion of a rigorous test/interviews.
When she was studying for her Bachelor of Science in Nursing degree at Morehead State University, Angi Gooslin was sure that she would have to go somewhere other than the local area to find exciting work.
“I guess when you grow up here, you don’t really think of the things you have (in the area) that are unique or special or different,” the Tippecanoe High School grad said. “So I never looked at this hospital as (in my mind) they couldn’t possibly have anything I would want to do here — I would have to go somewhere else to do something really exciting.”
That changed between her junior and senior years.
“Miami Valley (Hospital) had an extern program where they would take nursing students in a bachelor’s program and you would work in the hospital for a summer,” she said. “When I was here, I was exposed to CareFlight and I thought, ‘Oh! This is what I want to do!’”
After graduation, Gooslin set herself a goal of becoming a Flight Nurse. “I said that, ‘in 10 years, I should be pretty well-educated to take care of anybody and I will apply in 10 years’ and that is what I did.”
Gooslin said that the application process was tough — unlike when she first became a nurse. “I came in during a nursing shortage — (hospitals) were paying student loans back and they were paying hiring bonuses — all you had to do was be a nurse and you could get a job,” she recalled.
“This was one of the most intense application processes I have ever been through,” she said. “I thought I was pretty qualified.” Gooslin worked in critical care and emergency departments for the 10 years previous earning the Critical Care Nurse certification.
She applied three times before being selected.
“It was a three-day process they run you through. They make you go through a big peer interview with the director and some of the staff nurses and medics and the managers. You meet with the Medical Director and he runs you through a scenario on a patient simulator to assess your baseline knowledge of critical care and emergency response and things like that and how you are going to take it. Then you take a test that never know the results of — on general knowledge and it covers pediatrics, adults, obstetrics, cardiac, trauma — you name it.” Applicants then spend a month waiting to see if selected.
After selection, she was sent to Clark State Community College to take a one-semester course that also gave her the title of Emergency Medical Technician-Paramedic — a requirement for Flight Nurses.
CareFlight has a helicopter based at Miami Valley Hospital as well as one based in Urbana and another in Warren County. When the aircraft are grounded by weather — fog, ice or storms, for example — there are three Mobile Intensive Care Units that are used to provide service. “It’s the highest level of ground transport,” she said. “When you see an ambulance it might have two Basic-EMTs in it. The MICU carries a Flight Nurse and a Critical Care Paramedic.
“Transport time is a little longer and it is bumpy but you have the same care coming back (as in the helicopter).” She said that the MICU carries the same equipment and supplies as the helicopters. Both helicopter and MICU can handle two patients. Paramedics do not fly and the aircraft carries two Flight Nurses in addition to the pilot.
Gooslin, who, naturally, has been tagged with the nickname of ‘Goose,’ said that the nurses also act as co-pilots on the helicopters. “One of us sits up front and we are trained by (the pilots) on what we can touch and what we can’t and how to get in and get out so we don’t kick things. We know how to read some of the gauges and stuff like that,” she related. “We are another set of eyes for the left-hand side of the aircraft.”
Pilots have no medical training and their sole job is safe conveyance of the team and patient. “Our pilots are just experts in reading the weather and they are trained in that. They accept or decline each mission (based on weather).
“The pilot never knows what we are going for,” she continued. “They are not supposed to be told so their decisions are never influenced (by the call). They have to take that emotional piece out of it.”
Gooslin became a nurse educator a year ago and spends a great deal of time in her office between calls working on that. But when the call comes in, the communications center selects which unit is the best for the call and drops radio tones. “We wear radios here in the hospital and they will drop tones — there are aircraft tones and mobile unit tones — and we are trained like Pavlov’s dogs to respond to that. You go from zero to 60 right now.” If the crew is in the CareFlight unit on the seventh floor of MVH, she says that can be lifting off within five minutes after the alert. The unit can have as many as five to seven calls in an area from Cincinnati to St. Marys and from Richmond, Ind., to Columbus.
She said the difference between a Flight Nurse and a floor nurse is evident when they arrive on a scene. “It’s the autonomy,” she said. “We’ve been trained to do patient assessments, anticipate problems, treat them, evaluate problems and re-assess them.
“When you come in here, there is that expectation. You don’t have someone to call so you have to be confident in your abilities to assess accurately, treat and re-evaluate,” she said.
CareFlight has an elevator next to the flight deck which enables them to deliver the patient to the ER or surgery or whichever unit is needed. “Then we actually follow all of them here until they go home,” she said, adding that the flight personnel can often fill in gaps of the memory of the victim and their families.
Sometimes CareFlight will go on a mission that ends tragically. “We do the best that we can and sometimes it turns out the best and sometimes it doesn’t — those I will never forget,” she said. “You have to be prepared for the child that gets run over in a driveway. You remember what you see. So you wipe your tears and go on to the next mission because maybe the next person just got hit by a train. You can’t be crying over the one that you couldn’t help — you have to give 100 percent to the next one.” Although the crew is trained in stress management, they are allowed to call a ‘timeout’ if they are not emotionally ready.
Sometimes patients come back and thank them. Gooslin recalled a severe motorcycle accident in Troy and, five years later, the girl showed up at the 25th anniversary of CareFlight to thank her again.
Although weather is a factor in flying, temperature is not. “You have to be flexible. That means you have to go out when it is 110 degrees in a black suit from head to toe with a 2-1/2 pound helmet on your head. It messes your hair up and your makeup sweats off. Or you are at zero (degrees) and when the blades turn, the IV tubing will freeze. If you are not a flexible person and can’t handle change too well, this is not the job for you.”
