Flight Nursing in Australia: A Hidden Profession A critical qualitative inquiry into the work of Flight Nurses in Australia

Author: Genevieve Brideson

Brideson, Genevieve, 2017 Flight Nursing in Australia: A Hidden Profession A critical qualitative inquiry into the work of Flight Nurses in Australia, Flinders University, School of Nursing & Midwifery

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Everyone recognises the iconic Australian organisation, the Royal Flying Doctor Service. However, the general public and most healthcare providers are completely unaware that 85% of the time the person caring for you in the back of the aircraft is a Flight Nurse, not a doctor. In 2014/15, 52,000 patients across Australia were cared for by a Flight Nurse working alone in the aircraft. The work of these registered nurse midwives remains a concealed, underexplored area of the nursing and midwifery professions.

In this study, I investigated the work of contemporary Australian Flight Nurses because Flight Nurses hold the key to the esteemed international reputation of excellence enjoyed by Australian aeromedical healthcare providers.

The literature review revealed several particularly noteworthy facts. But of the greatest importance was that globally, in both historical and contemporary times, Flight Nursing and air ambulance work have been pioneered and championed by women. While Flight Nursing has its origins in war, the Australian context of this nursing specialisation arose in response to the difficulties of providing medical care to people living in remote areas. The first Australian Flight Nurses commenced work intermittently from 1938, with employment of the first official Flight Nurse recorded in 1945. Interestingly, one Australian aeromedical organisation commenced in 1969 with Flight Nurses working as the sole clinician in the aircraft. This remains the case today.

I selected critical qualitative inquiry (CQI) as the methodology for this study because it is a method of inquiry that utilises multiple research genres and ways of analysis to develop a critical investigation that is constantly evolving as new theoretical insights, problems and social circumstances are revealed. The plethora of perspectives that CQI draws upon, allows for the investigation of the phenomena of interest, to be conducted from diverse frames of reference. CQI allows investigation of the ways organisations exercise their power and control via texts and language to coordinate and regulate people’s lives, as it is primarily concerned with issues of power and justice, economy, race, class, gender and other social institutions. Critical qualitative inquiry allowed me to investigate what the study informants wanted explored, situationally plotted and illuminated from their standpoint. It enabled me to dispel the invisibility and myths that surround Flight Nurses and their work – glamour, romance, excitement and heroism – and replace these with facts regarding the real work of the contemporary, professional Flight Nurse in Australia today.

I found that gender and class have impacted Flight Nurses’ work from the very beginning of the speciality. In 2017, women continue to struggle for recognition of their work and equality of working conditions against the ingrained societal values of patriarchy, the Australian Government’s contemporary neoliberalist policies and new public management strategies, and the influence of regulatory capitalism. My analysis revealed Flight Nurses to be highly autonomous, competent, registered nurse midwives whose work has been impacted deeply by the political climate of the last 30 years in Australia, which continues with the additional political challenges occurring across healthcare today. Flight Nurses’ scope of practice is extensive and variable, inclusive of all ages across the population and multiple specialities, encompassing pre-hospital, trauma, emergency and intensive care; mental health; midwifery; and primary healthcare, to name a few.

Flight Nurses’ work is affected by intensive and extensive work intensification, resulting from the Australian Government’s macro and micro economic policies. Organisational expectations that Flight Nurses will work longer hours at a more intense pace, with fewer rest breaks and variable remuneration, provide a competitive edge to the organisation. Furthermore, work intensification affects Flight Nurses’ work life balance, fatigue management, and ability to meet the organisations’ and independent regulatory authorities’ mandatory competencies.

The features of work intensification are compounded by the increasingly tight regulation of Flight Nurses’ work. One example of this is the auditing of Flight Nurses’ work occurring at numerous levels, both by the organisation and by the independent regulatory authorities.

In conclusion, Flight Nurses must be recognised as those who provide the majority of patient care in the back of an aircraft. Flight Nursing is not, as the image portrays, glamorous, romantic and heroic. Flight Nurses are highly competent, professional, experienced registered nurse midwives who provide the highest level of evidence based care in the air. Flight Nursing is challenging; however it is very rewarding for those involved.

Keywords: Flight Nursing, Flight nurse, critical qualitative inquiry, Australia, Work Intensification, Regulatory Capitalism

Subject: Nursing thesis

Thesis type: Doctor of Philosophy
Completed: 2017
School: School of Nursing & Midwifery
Supervisor: Associate Professor Lidia Mayner