They don't claim to be faster than a speeding bullet, but they do promise they're more cost-effective than an air ambulance. While they aren't Supermen, these on-the-move nurses are super heroes to those they accompany around the globe.

Trading under the name Flying Nurses International (LLC) this team of over 40  bilingual nurses - all with at least 10 years of critical care and emergency medicine experience and actively employed as RNs in their specialty areas of practice - have something in common: An urge to see the world. When they have days off from their regular nursing positions, they sign on for travel duty.

Mobile Care

READY TO GO: Sharing a moment between missions are (from left) Bob Bacheler, MSN, CCRN, international flight coordinator; Kathleen Edwards, BA, RN; and Doug Whithed, RN.

And they do get around

"We've been to 50 states, 75 countries and six continents We're still hoping for our first case in Antarctica," said Bob Bacheler, MSN, CCRN, international flight coordinator for the medical travel service which was founded, is owned, staffed and operated by nurses.

After 19 years, Amy Bosich, RN, still directs - from Florida - the service she started while working as a nurse in Hawaii. She routinely saw injured or ill visitors to the remote island chain in need of a way back to the mainland or beyond.

Air ambulances for such a journey can be extremely expensive - think six figures - and a more economical alternative was devised.

The Stories They Can Tell

"The vast majority of patients can be transported on commercial carriers," said Bacheler. "Our rules are: the patient has to be able to sit up for 15 minutes [an FAA requirement for takeoff and landing]; we can usually get lie-flat seats in flight."

Bacheler, who also teaches the critical care nursing rotation as adjunct faculty member at Neumann University, Aston, PA, noted those they accompany are generally medically stable, and he was proud to note, "In 19 years we have never had even one bad outcome."

That's not to say there aren't mishaps. "A good day is a day when nothing happens," said fellow Flying Nurse Doug Whithed, RN, through a gale of laughter.

Sometimes, however, there are obstacles along the way. Whithed remembered one patient who was ventilated, quadriplegic and weighed about 400 lbs. "That was very tough, a lot of mobility challenges," he noted.

He and Bacheler worked in tandem to recover a woman with pneumonia who was in the midst of a world cruise when she got sick, and was more or less stuck in Singapore.

"We had to circumnavigate the globe to get her back in a timely manner," recalled Whithed. "We just kept traveling east until we got her back to New York City."

Never a Dull Moment

Kathleen Edwards, BA, RN, another of the Flying Nurses International cohorts, told of her first outing, accompanying a woman who recently had a heart attack. While they were waiting on the runway to take off, a truck hit their plane.

After a lot of maneuvering, unexpected delays, and more, they were off again 48 hours later. "As we were descending into Rochester, she went into congestive heart failure," said Edwards. She immediately alerted the air crew and arranged for an ambulance to be ready at the airport.

INFLIGHT NURSING: Doug Whithed, RN, attends to patient Troy Merrill, who is on a vent and is a quadriplegic, flying from Boston to Denver.

Bacheler underscored the need for fast-thinking, independent, problem-solving RNs. Whithed agreed: "That's why critical care experience is important. You must be experienced working independently, assessing situations quickly and reacting appropriately. And let's face it, you better love to travel."

The Requirements

Bacheler added, "The ideal flying nurse must have confidence to speak up to airlines, officials in the U.S. and other countries and foreign healthcare providers.

"From a nursing perspective, physicians in other parts of the world just don't know what U.S. nurses do," said Bacheler. "They don't understand the scope of our practice. They initially think there should be a physician flying along with the patient, until we explain our capabilities. Nurses in other parts of the world do not function independently as we do. We come as a big surprise to them."

Flying on board commercial carriers offers a definable bonus to the airlines. "One time when I was accompanying a patient from Chicago to Shanghai, another passenger, in first class, had inadvertently eaten crab and had an allergic reaction. He needed help," recalled Edwards. "I was able to administer an epi shot, check IV and meds."  

In another case, Whithed stepped in during an international flight when a passenger collapsed in the bathroom.

"He refused an IV, refused medication," he recalled. "But I was able to make sure he was OK to continue on. If I hadn't been on board, the flight would have had to be diverted to Germany. Diversions like that cost the airline a lot of money. They were glad I was aboard."