Peter Werlin, on flight nursing

By Bree LeMaire MS, RN
August 22, 2003

How did you get into nursing and then flight nursing?

I was sitting with my wife at Stinson Beach, north of San Francisco, reading the San Francisco Chronicle when I saw an article about the bachelor's-to-master's nursing program at San Francisco State and said, "That's what I want to do."

I'd worked with flight nurses in the mountains of Colorado as an EMT and fireman and was fascinated by the whole spectrum of what flight nurses did. So, when I got my MSN, that's where I went.

What are the best aspects of your job?

I think the greatest aspect of being a flight nurse is being able to safely move the most critically ill or injured people long distances using various modes of transportation (ground, fixed wing or rotor wing), with only your partner for help. It requires you to put all of your education and skills to work.

We work with EMS and fire departments throughout Colorado. I love working with those guys and am still a volunteer myself in the small town where I live.

Another aspect I enjoy is scene calls. Scene work allows us to use our clinical skills and make critical decisions based on our protocols. These protocols have been continually revised and improved over the 30-year history of the program. Some of our more advanced protocols include inserting chest tubes and central lines. It's nice to know that we are trained well enough to do those things, whether it's somewhere along the road or in the back of a helicopter.

What are the difficult aspects of what you do?

The environment in which we work can be very challenging. There can be helicopter engine noise and extremes of temperature. In the summer, we might be out on a hillside in 90-degree heat and in the winter it can be below freezing. We have to plan ahead and anticipate problems so that things don't go wrong. When we are on a mountain rescue, for example, we have to make sure we are dressed properly and use sunscreen because we could be outside for several hours. The mountains require us to be ready to take care of ourselves as well as our patients.

We carry all our own equipment. This includes such things as blood, chest tubes, central lines and laryngeal mask airways. There are five bases we maintain: an airplane, two helicopters, a newborn/children's pediatric base and a mountain base unit that's up over 9,000 feet.

What is Flight For Life? Who pays for the trip?

Flight For Life, established in 1972, is the nation's first civilian, hospital-based, medical helicopter program. St. Anthony's Hospital in Denver is the sponsoring hospital, but we transport to many facilities throughout the region. A patient's ability to pay is not a factor in an emergency situation, although most insurance companies do pay for emergency air transport.

What are some of your most critical cases?

One of my most critical transports involved a 23-year-old male who slid into a tree while skiing at a high rate of speed. The weather that day made a flight impossible, so we switched to our mountain-based, critical care ambulance. What followed was a three-hour ground transport in bad weather with Sunday night ski traffic. The patient was in catastrophic physical condition. His BP never went above 80 by Doppler the entire trip. We gave him four units of blood right away and had another four units delivered to us from Denver while en route. During the trip, we put in a chest tube and a femoral line.

When he got to St Anthony's, they did a thoracotomy and a laparotomy immediately. He got incredible care while at the hospital and six to eight weeks later he was released. He was among the sickest trauma patients I have had who survived.

What is "Share a Prayer"?

This is something new. I got the idea for the Share a Prayer cards after talking with a wife whose husband had died after one of my flights. She knew everything had been done from a medical standpoint, but she wanted to know that he was not alone and if people had been praying for him.

Every study that has been done about prayer chains shows that outcomes are better if a prayer chain is present. Thus, the idea was to create an instant prayer chain as the trauma patient hit the door of the trauma center. The cards are placed throughout the hospital so individuals can fill them out when a trauma activation is announced over the intercom. The chaplains collect the cards and give them to the patient or family.

We are excited about this program and look forward to its growth.