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Teamwork, communications skills and creative training have always been the hallmarks of this program. Standard briefing and debriefing procedures that bring us together at the beginning of each shift and after each call are designed to generate discussion on mission task requirements and to focus the team on mission accomplishments.

The education and communication process that the Nightingale Flight Crew uses to combine diverse individual expertise into a successful group dynamic has been closely examined by other departments in the hospital network as a guide to safe and effective patient care. By examining this process, the hospital network is looking to implement these standards to promote clearer communications and interactions between all hospital disciplines. This in turn will provide improved patient safety and satisfaction as well as decrease the potential for errors inside and outside of the hospital system.

Although Nightingale's statistics over its 40 year history are impressive, it is the program's absolute commitment to training and safety that makes this service notable. This commitment began at the program's inception. More recently, the Nightingale team developed specific protocols and procedures to safely transport COVID patients, and was the first in the region to transport a COVID positive patient for advanced care.

Nightingale pilots were instrumental in writing national standards for landing zone safety and they worked tirelessly to find solutions for many early concerns over the air-medical industry's abysmal safety record. In addressing program issues, it was unanimously agreed that to be truly safe and productive as a flight team, the crew had to participate in each call to his or her fullest potential. This would mean communicating, supporting and understanding each other's particular discipline as well as their strengths and weaknesses. This sharing of knowledge began then and continues today.

We believe this is one of the things that make Nightingale unique and a leader in the industry. Crew training and safety begins from the moment of hire and continues with each mission. When a new flight crew member is accepted, he or she must complete ground school with the pilots. Ground school consists of intense training in such diverse subjects as flight physiology, weather, FAA regulations, aircraft and equipment, communications, passenger handling, safety, emergency operations, and flight familiarization. Training also includes the history and safety of air-medical programs, aerodynamics, navigational procedures, night flights, survival, refueling procedures, observer duties and the program's mission profiles.

The intensity of this effort has provided a solid foundation for a new crew member to build upon. The training syllabus continues well after formal ground school and orientation ends and is constantly reinforced to all crew members during standard crew shift change briefings. Having completed ground training, the new member is then oriented with a flight nurse and paramedic for a minimum of 12 weeks. During this phase the trainee observes and participates in patient care while gaining greater helicopter experience through staged hospital and scene flights.

The staged training is coordinated with outlying hospitals and EMS agencies and is structured to provide operational training for those agencies as well as the new crew member. The training allows our flight crews to interact, improve, and resolve mutual conflicts or issues with community first responders without the stress and time constraints that occur when caring for a patient. The staged evolutions have become learning tools for the entire crew as well as the agencies that we service. The overall effect has been the emergence and maintenance of a safer and more productive operational environment.

Nightingale Crew members maintain expertise not only in aircraft safety, but also in safely caring for their patients. Medical crews follow regional standards and utilize protocols written specifically for the Flight Crew. The flight crew also trains quarterly at the simulation lab with the operational medical director to assure skill expertise. Medical crew members have a combined average experience of more than 20 years in emergency and critical care as well as individual specialty certifications in flight, critical care and emergency care. Specialty certifications are encouraged and supported by the program as it is felt that advanced training can only enhance the seamless transfer of care that Nightingale strives to maintain with its outlying agencies and hospitals.

Nightingale's commitment to excellence includes those that we serve. Crew members share knowledge by conducting safety training with First Responders. We offer free continuing educational classes to local hospitals and EMS providers. We also encourage EMS, fire and hospital personnel to participate in Nightingale's ride-a-long program. This “bird's eye” view of our working environment helps to foster a better understanding of the complexity of EMS helicopter operations. That in turn serves to promote safety awareness for all who are involved in the transports.