“What many people don’t realize is that flight nurses operate at the highest level of critical care nursing, often in the most unpredictable and high-stakes environments imaginable.”
Brenda Nelson, CFRN, Chief Flight Nurse and Chief Quality Officer, Airlift Northwest
The field of flight nursing began in the middle of World War II. After successful air evacuations in Alaska, Burma, and New Guinea in 1942, the United States Army Air Forces (USAAF) began training surgeons, medical technicians, and nurses to provide in-flight medical care at Bowman Field in Louisville, Kentucky. Despite the perilous conditions, by the end of the war, nearly 500 army nurses served in 31 medical air evacuation squadrons around the globe. Miraculously, army medical teams airlifted 1,176,048 soldiers from 1942 to 1945, of which only 46 died en route.
Nowadays, in the 21st century, flight nurses remain a fundamental part of aeromedical evacuation teams, providing healthcare on the ground and in the air. There are two types of flight nurses: military and civilian.
The U.S. Air Force or another military branch employs military flight nurses. They transport critically wounded and ill military service members to better medical facilities and away from combat locations in military aircraft. Military flight nurses work with flight physicians and flight medical technicians to treat all matter of battle wounds, including bullet and burn wounds or appendage loss.
Hospitals or regional emergency health services employ civilian flight nurses. They see a wider variety of patients needing acute medical care for injuries and illnesses. Civilian flight nurses may transport patients from one hospital to another to receive specialized treatment or via Life Flight. Patients range in age from neonatal babies who need life-saving medical treatments to critically-injured adults who need medical transport from mountaintops to the nearest medical facilities.
Flight nurses (FN) are registered nurses (RNs) with bachelor of science in nursing (BSN) degrees and special training to provide medical care to acutely ill and injured patients in an aircraft. Some flight nurses are advanced practice registered nurses (APRNs) and hold a master of science in nursing (MSN) degree or a doctorate of nursing practice (DNP). In addition, flight nurses may hold certification from organizations such as the Board of Certification for Emergency Nursing (BCEN). To be eligible for certification, RNs must have two or more years of nursing experience working in acute and critical care environments.
Flight nurses are in high demand for specialized skills and training and must work in high-stress and risky conditions. As a result, openings for registered nurses will grow 5 percent from 2024 to 2034, according to the US Bureau of Labor Statistics (BLS 2025), about as fast as the national average. Approximately 166,100 new positions will open up in the same period, paying a median salary of $93,600 annually.
Check out flight nurse specializations, admissions requirements, program profiles, a step-by-step career guide, and certifications.
Meet the Expert: Brenda Nelson, RN, CFRN
Brenda Nelson serves as chief flight nurse and chief quality officer at Airlift Northwest, where she has dedicated more than 25 years to advancing flight nursing and patient care. She began her career in Montana after earning her BSN from Montana State University in 1986, gaining experience in neonatal intensive care and emergency nursing before her first flight mission in 1988.
After working in both the NICU and ED in Montana, Seattle, and Connecticut, Brenda joined Airlift Northwest in 1986. She advanced to assistant chief flight nurse after ten years and was named chief flight nurse in 2011. Her career reflects a lifelong commitment to emergency and critical care nursing, as well as leadership in quality and safety for air medical transport.
HealthcareDegree.com: What do you wish the people understood about flight nurses?
Nelson: Flight nurses are among the most highly skilled and adaptable professionals in healthcare—yet their role is often misunderstood or underestimated. What many people don’t realize is that flight nurses operate at the highest level of critical care nursing, often in the most unpredictable and high-stakes environments imaginable.
They are high-functioning and perceptive, able to assess complex medical situations rapidly and make life-saving decisions with limited resources. Their ability to adapt to any scenario—whether it’s a trauma in a remote location, a cardiac arrest mid-flight, or a neonatal emergency—is unmatched. They don’t just follow protocols; they know when and how to operate beyond them, using their deep clinical judgment and experience to do what’s best for the patient.
Flight nurses are also “community-driven caregivers”. Their mission isn’t just about transport—it’s about bringing advanced care to people who might otherwise not have access to it, whether that’s in rural areas, disaster zones, or underserved communities. They are the bridge between the front lines and definitive care, and they carry with them not just medical expertise, but compassion, courage, and a deep commitment to service.
HealthcareDegree.com: What advice would you give to aspiring flight nurses?
Nelson: Becoming a flight nurse is one of the most challenging and rewarding paths in nursing—and it requires more than just clinical skill. If you’re aspiring to join this elite group, here’s what you need to know:
- Start by connecting with the flight team you’re interested in. Visit them, ask questions, and learn about their organization’s culture, values, and hiring requirements. Every program is different, and understanding what they look for will help you tailor your path.
- Build a strong foundation in hospital-based critical care. Most flight programs require experience in high-acuity areas like ICU, Emergency Department, or Pediatric Critical Care. This is where you’ll develop the clinical judgment and rapid decision-making skills essential for flight nursing.
- Go beyond bedside care—become a contributor to the profession. Participate in committees, quality improvement initiatives, and help shape nursing practice in your area of expertise. Leadership and collaboration are key traits of successful flight nurses.
- Expand your skill set beyond traditional nursing roles. Learn ventilator management like a respiratory therapist, understand how to interpret basic trauma X-rays, and master lab values—not just what they mean, but how to treat based on them. Flight nurses often work in environments where they are the most advanced clinician on scene, so broad competency is critical.
- Stay humble, stay curious, and stay prepared. Flight nursing is not just about flying—it’s about bringing the highest level of care to people in their most vulnerable moments. Your adaptability, clinical excellence, and commitment to continuous learning will define your success.
HealthcareDegree.com: What is your favorite thing about flight nursing?
Nelson: One of the most rewarding aspects of flight nursing is the deep sense of community and purpose that comes with the role. You’re part of a tight-knit team that shares a mission: to bring critical care to people when and where they need it most.
Whether you’re landing in a remote area or responding to a high-acuity trauma, you know you’re making a real difference—every single day, in someone’s life. There’s also a unique independence in flight nursing that sets it apart. You’re trusted to make complex decisions, often autonomously, and to practice at the very top of your license. That level of responsibility is both empowering and humbling.
And then there’s the challenge—the part that keeps you sharp and engaged. Flight nursing demands that you use every skill you’ve ever learned, and then some. From critical care to trauma, ventilator management to interpreting labs and imaging, you’re constantly drawing on a wide range of expertise. It’s intense, but it’s also incredibly fulfilling.
In short, flight nursing is more than a job—it’s a calling. It’s about being part of something bigger, serving your community, and rising to the challenge every time the tones drop.
Flight Nurse Specializations & Degree Types
While all flight nurses are registered nurses (RNs), they may have unique qualifications earned through degree or certification programs. This expertise can be learned in healthcare, the military, or certification programs.
Here are some common specializations for flight nurses:
- Extracorporeal membrane oxygenation (ECMO)
- Neonatal acute care
- Pediatric acute care
- Adult-gerontology acute care
- Aeromedical evacuation in combat (for military flight nurses)
There are numerous points of entry for nursing education and degree programs. Here is a list of common nursing degree programs and their time-to-completion:
- LVN: Licensed vocational nurse (one year or less)
- ADN: Associate of science degree in nursing (two years)
- RN-to-BSN: For those with an ADN degree (two years)
- BSN: Bachelor of science in nursing (four years)
- ABSN: Accelerated BSN for those with non-nursing degrees (one to three years)
- RN-to-MSN: For those with an ADN degree (three to four years)
- MSN: Master of science in nursing (two to three years)
- Post-master’s certificate: For those with an MSN or higher (one to two years)
- BSN-to-DNP: For those with a BSN who want to earn a DNP (three to four years)
- DNP: Doctorate of nursing practice (two to five years)
Admissions Requirements for Flight Nurse Programs
Admissions requirements for flight nurse training programs vary but typically include these prerequisites:
- Two to three years of acute care experience in an intensive care unit (ICU) or emergency room (ER) setting (recommended)
- Bachelor of science in nursing (BSN)
- Current RN license
Flight Nursing Program Accreditation
Attending an accredited nursing program is essential in one’s nursing career. Two of the nationally-recognized organizations are:
- Commission on Collegiate Nursing Education (CCNE)
- Accreditation Commission For Education in Nursing (ACEN)
Graduating from a CCNE- or ACEN-accredited nursing program is vital for many reasons:
- Students who complete accredited nursing programs demonstrate to employers and patients that their education meets the highest standards.
- To qualify for the NCLEX exam and earn RN licensure, ADN and BSN graduates must attend an accredited nursing program.
- Those taking out federal loans to finance their education can only attend accredited programs.
Accreditation ensures that students in such programs work towards clear standards, uphold expectations of programs, and provide the essential experiences and skills necessary for the field.
On-Campus Flight Nurse Degree Programs
Herzing University – RN-to-BSN, ABSN, MSN
Herzing University offers both on-campus and online degree programs at the undergraduate and graduate levels and several bridge programs for allied health professionals and non-nursing bachelor’s degree holders.
There are 11 on-campus options across numerous states: Ohio, Georgia, and Alabama, four in Wisconsin, Minnesota, Louisiana, and two in Florida. This program is designed for working professionals in the healthcare field to advance their education and gain practical experience in their place of employment.
- Location: Several campuses in midwestern and southern states
- Duration: One to three years
- Accreditation: Accreditation Commission for Education in Nursing (ACEN); Commission on Collegiate Nursing Education (CCNE)
Case Western Reserve University – MSN
Students interested in a Midwest-based program for nursing should look at Case Western Reserve University. The Frances Payne Bolton School of Nursing offers flight specialty courses as part of its MSN adult-gerontology acute care nurse practitioner program. Students in the flight nurse specialty take five to nine additional credits of didactic, laboratory, simulation, and clinical courses to gain theoretical and practical experience.
The flight nurse portion includes a unique aeromedical helicopter simulator for students to experience the nursing care they could work within. The program consists of a clinical practicum that works directly with an aeromedical team that performs active transports. In addition, they provide two flight nursing camps, the courses of which cover gerontology, pathophysiology, pharmacology, and many other studies, including a nurse’s ethical issues class.
- Location: Cleveland, OH
- Duration: Four semesters
- Accreditation: Commission on Collegiate Nursing Education (CCNE)
Vanderbilt University – MSN, DNP, Post-Master’s Certificates
The MSN program at Vanderbilt University’s School of Nursing prepares students to become integral parts of healthcare support teams. The MSN program prepares candidates interested in pursuing a flight nurse role specialty, offering an on-campus program that students can complete in four semesters.
The DNP provides advanced practices and leadership guides and helps candidates create economic principles of care. The DNP program consists of five to six semesters with three optional tracks: the advanced clinical practice track, the executive leadership track, and the advanced systems practice track.
- Location: Nashville, TN
- Duration: Four to six semesters
- Accreditation: Commission on Collegiate Nursing Education (CCNE)
Rivier University – RN-to-MSN, MSN Bridge, Post-Master’s Certificates
Based in Nashua, New Hampshire, Rivier University Nursing School offers multiple on-campus and online nursing programs for RNs, non-nurses, and advanced practice registered nurses (APRNs). All programs feature access to state-of-the-art experiences at the newly renovated Nursing Simulations and Clinical Education Center, emphasizing telehealth and remote clinical assessment experiential learning.
- Location: Nashua, NH
- Duration: Three to five years
- Accreditation: Accreditation Commission for Education in Nursing (ACEN)
Online & Hybrid Flight Nurse Degree Programs
Southern New Hampshire University – RN-to-BSN, RN-to-MSN, MSN
Aspiring students seeking an affordable nursing degree look no further than Southern New Hampshire University. This program offers five MSN options and two BSN programs, which students can complete part- or full-time. In addition, an RN-to-MSN program gives students with associate’s degrees the opportunity to earn a BSN and an MSN and graduate in an accelerated time frame.
The advanced RN-to-MSN option works strategically to advance RN careers. Two of the MSN courses are advanced health and literacy assessment and advanced pathophysiology across the lifespan. An immersion experience is required; after completion, students can earn 650 clinical hours. This online program is a step toward future work as an FN.
- Location: Manchester, NH
- Duration: Two to five years
- Accreditation: Commission on Collegiate Nursing Education (CCNE)
Western Governors University – RN-to-BSN, BSN, RN-to-MSN, Post-Master’s Certificate
Western Governors University provides several online nursing programs aimed at helping those with and without nursing backgrounds begin a career as an RN or APRN. The prelicensure BSN program is a four-year program designed to prepare those without prerequisites for RN licensure and earn a BSN. Many hospitals seek nurses with BSN degrees and the foundational requirement of having an RN license; these are critical components towards the ultimate goal of flight nurse work.
Western Governors University also offers an online RN-to-BSN, RN-to-MSN, and a post-master’s certificate in nursing leadership and management. All of their programs provide the essential next steps toward FN status.
- Location: Several campuses in midwestern, southern, and western states
- Duration: One to four years
- Accreditation: Commission on Collegiate Nursing Education (CCNE)
The University of Alabama in Huntsville – RN-to-BSN
This online program is designed for the candidate seeking a flexible, 100 percent online course that can take one year or less to complete the pathway from RN-to-BSN. Obtaining a BSN is a crucial step toward flight nurse certification, and the program requires that RN status is maintained while working through the courses. The program includes seven courses that add up to 26 credits. In addition, there are six start dates throughout the year to meet the needs of busy candidates.
- Location: Huntsville, AL
- Duration: One year
- Accreditation: Commission on Collegiate Nursing Education (CCNE)
Thomas Edison State University – RN-to-BSN, ABSN, MSN, DNP
Students seeking an online RN-to-BSN, MSN, DNP, or accelerated BSN degree program can find their pathway to flight nursing at Thomas Edison State University. The master of science in nursing or MSN degree has a 36-credit minimum that focuses on direct care core, electives, specialties of interest, and a practicum. The MSN requires two years of nursing experience and a BSN from an accredited program. Students can transfer up to 12 credits from prior programs.
- Location: Trenton, NJ
- Duration: 15 months
- Accreditation: Commission on Collegiate Nursing Education (CCNE)
- Tuition: $411 per credit (residents); $535 per credit (non-residents)
Online Flight Nurse Continuing Education Programs
Flight Bridge ED – exam prep and continuing education
Flight Bridge ED offers affordable and flexible online and in-person options for certified flight nurses seeking certification or continuing education. The required content and knowledge to pass the CFRN exam can be daunting, and this course offers candidates in the field an opportunity to find success before the exam.
Critical care paramedics and nurses helped fine-tune the content for the focus to be as honed in as possible. Some topics covered include oxygen physiology, flight physiology, neurological emergencies, and cardiac physiology, among many other critical issues. In addition, the course offers one year’s access to course content on a 24/7 flexible timeline.
- Location: Bowling Green, KY
- Duration: Self-paced; one-year license
- Accreditation: Better Business Bureau (BBB); Kentucky Board of EMS Critical Care; Wisconsin Critical Care Paramedic Endorsement
How Long Does it Take to Become a Flight Nurse?
Aspiring certified flight nurses can expect the process to take around 11 to 12 years, including high school. It takes approximately four years of high school, four years for bachelor’s completion, two to three years for acute care clinical experience or a master’s degree, and a certification exam.
Flight nurse certification requires RNs to have a minimum of a BSN. However, some FNs opt to complete a master’s program to make their education more robust and competitive in the job market.
How To Become a Flight Nurse – Step-by-Step Guide
Step 1: Graduate from High School or Complete a GED (Four Years)
High school is the first step to becoming a flight nurse. The traditional route for high school can take four years, and the GED option can take up to one year. Both options provide a high school diploma and allow candidates to move towards secondary education after completion. During a candidate’s high school years, taking courses in science, STEM, mathematics, health roles, and anatomy helps provide a layered background to draw upon later in a nursing career.
Step 2: Complete a Bachelor of Science in Nursing (One to Four Years)
Completion of a BSN is an essential step on the pathway to flight nurse work. A student with an associate’s degree in nursing can earn a BSN through an RN-to-BSN degree completion program. A BSN provides education, clinical practice, and fieldwork that prepare future nurses for success.
A bachelor of science in nursing (BSN) typically takes four years. One-year accelerated BSN programs are available for those with a bachelor’s degree in a non-nursing field.
Step 3: Become a Registered Nurse (Timelines Vary)
Many state requirements vary for registered nursing status, but one thing remains the same: the background work required for RN licensure. Earning an associate’s or bachelor of science in nursing from an ACEN- or CCNE-accredited program is required for RN licensure, completing a criminal background check, and passing the National Council Licensure Examination (NCLEX-RN).
Step 4: Gain Work Experience (Two to Three Years, Minimum)
Flight nurse certification recommends 2-3 years of nursing experience in ER or ICU settings. This is because flight nurses need to know they can work under intense pressure, collaborate with colleagues, make informed decisions, and continue working in high-intensity, stressful environments for prolonged periods. In addition, gaining experience in these two hospital wards prepares flight nurses to work under pressure in high-stress aircraft environments at altitude.
Step 5: Complete a Graduate Degree in Nursing (Two to Four Years)
This step is optional along the pathway toward FN work. However, an MSN or DNP can provide additional training and specific practice for FN work. Many FNs have specialty training in adult-gerontology acute care, pediatric acute care, and neonatal intensive care.
Step 6: Obtain National Certification for Specializations (Timelines Vary)
The Certification for Flight Registered Nurses (CFRN) is approved through the Board of Certification for Emergency Nursing (BCEN). The process for passing this exam requires candidates to do the following:
- Set up an account
- Check eligibility that includes holding an RN license (two years of ER and ICU work experience is recommended but not required)
- Complete an application
- Apply and provide payment
- Become approved
- Schedule the exam date and time
- Study and prepare for the exam
- Complete the exam and obtain the results
Step 7: Obtain State Licensure (Timelines Varies)
There is no specific licensure for flight nurse work; however, hospital- and military-based positions may require the following certifications:
- BLS: Basic life support
- ACLS and PALS: Advanced cardiovascular life support and pre-arrest (heart failure) states in children
- PEPP: Pre-hospital medical information for the emergency care of infants and children
- PHTLS/TPATC/TNCC/ITLS: One completed trauma course
Step 8: Maintain Certifications and State Licensure (Timeline Varies)
RN licenses expire on the applicant’s birthday. How long an RN license is valid depends on the requirements of the individual state board of nursing. For example, RNs in Oregon must renew every two years and submit seven hours of continuing education in pain management.
What Do Flight Nurses Do?
Flight nurses provide immediate care to critical health management patients. Some daily specifics of what flight nurses do include:
- Communicating with dispatch and hospital staff
- Evaluating patient illness and care needed
- Continuing education for in-flight health trauma care
- Checking in-flight medical equipment and performing maintenance
- Taking inventory of medication, tools, and instruments
- Abiding by in-flight regulations and assisting the pilot in specific duties required
- Communicating ETA for arrival and care team
- Maintaining detailed lists of medicine
- Continuing care after patients are admitted
- Implementing critical care interventions for patients
Flight Nurse Certifications
A flight nurse requires advanced certification beyond a registered nursing (RN) license. Below is a list of certifying organizations and flight nurse certifications.
American Association of Critical Care Nurses (AACN):
Board of Certification for Emergency Nursing (BCEN):
How Much Do Flight Nurses Make?
The average salary for registered nurses is $98,430 annually, which breaks down to $47.32 per hour. RN salaries vary due to education, experience, and work environment. The BLS (May 2024) showed the following wage percentiles for RNs:
- 10th percentile: $66,030
- 25th percentile: $78,610
- 50th percentile: $93,600
- 75th percentile: $107,960
- 90th percentile: $135,320
The BLS does not track data salary specifically for flight nurses. However, Payscale.com (Oct. 2025) shows that flight nurses earned $85,700, based on 117 self-reported salary profiles. In addition, Salary.com (Oct. 2025) offers even higher rates of compensation for flight nurses at $94,850 per year, the middle of a range from $82,661 to $107,784 annually.
Flight Nurse Career Alternatives
Flight nursing can be one of many specializations in an RN’s career. Here are some nursing specialties that pair well with flight nursing.
Become a Clinical Research Nurse (CRN)
Those flight nurse applicants seeking a varied pace of work could find an alternative in clinical research nursing. This role requires nurses to observe, document, and collect data in clinical research trials. CRNs help ensure that the clinical trial complies with state, federal, local, and international regulations. They typically work directly with research participants to monitor, check, complete paperwork, and organize follow-up proceedings.
- Typical Education: BSN, MSN, or DNP
- Licensing or Certifying Organization: Association of Clinical Research Professionals (ACRP)
Become a Hospice Nurse
Trauma and nursing go hand in hand. While flight nurse work is focused on actionable care in the air, hospice involves support and care for terminally ill patients and their family members in an aircraft, hospital, or home-based setting.
- Typical Education: BSN, MSN, or DNP
- Licensing or Certifying Organization: Hospice & Palliative Credentialing Center (HPCC)
Become a Travel Nurse
Travel nurses work with the public across the country to fill in the gaps in nursing care in many locations. Travel nursing is similar to flight nursing regarding the fundamentals of training, but the intensity of the position and hours vary.
- Typical Education: BSN, MSN, or DNP
- Licensing or Certifying Organization: RN license, state-specific license requirements, and additional certifications depending on position descriptions
Kimmy Gustafson
WriterAt HealthcareDegree.com, Kimmy Gustafson has delivered in-depth and insightful articles since 2019, aiding prospective students to navigate the complexities of choosing the right healthcare degree. Her recent work includes topics such as the ethics of gene editing and physician assistant’s fight for autonomy.
Kimmy has been a freelance writer for more than a decade, writing hundreds of articles on a wide variety of topics such as startups, nonprofits, healthcare, kiteboarding, the outdoors, and higher education. She is passionate about seeing the world and has traveled to over 27 countries. She holds a bachelor’s degree in journalism from the University of Oregon. When not working, she can be found outdoors, parenting, kiteboarding, or cooking.
Rachel Becker
WriterRachel Becker is a freelance writer who enjoys life in the PNW. She holds a master’s degree in education and taught in elementary classrooms for twelve years. When she is not running around after two toddlers, she makes time for daily movement, running two blogs, and reading.