Occupations and Terms of Reference › Flight nurse (critical care)
Universal terms of reference · POS-248 · version 1.0 · status: draft · next review 2027-10-27
Flight nurse (critical care)
To give critical care nursing in flight, so that critically ill patients are kept stable and safe during transfer.
Each part of this page links to the related trainings, competencies and policies. The links are the same for every facility, so an organisation can see at a glance what a role requires and what it is trained in.
Job description
Job summary. You give critical care in flight. You monitor and treat critically ill patients, manage equipment, lead the in-flight team on nursing care, and hand over to the receiving team.
Reports to: Medevac operations director.
Leads or supervises: Flight paramedics.
What you do on a typical day
- Monitor and treat patients in flight.
- Manage equipment and oxygen.
- Lead nursing care with the flight team.
- Hand over to the receiving team.
- Complete mission nursing records.
Working conditions and demands
- Flights are confined and noisy.
- High-acuity patients.
- Long duty periods.
What good looks like
- Patients are kept stable.
- Equipment is managed safely.
- Nursing records are complete.
Place in the organogram
Reporting line, from the top: see the organogram on the Occupations page. The lines above and below this role are listed in section 3.
1. Golden rules
These rules apply in every setting.
- The right patient gets to the right care, at the right place, without avoidable delay.
- Patient safety comes before speed, cost or convenience.
- Clinical handover is complete and recorded every time.
- Vehicles, aircraft and equipment are checked and fit before every journey.
- Crews work within their scope of practice and call for help when out of their depth.
- Every incident and near miss is reported, and learning is shared.
- Staff and patients are protected from violence and harm during transport.
- Confidential patient information is protected in every journey and record.
2. Identification
| Item | Detail |
|---|---|
| Position code | POS-248 |
| ISCO-08 | 2221 (skill level 4) |
| ESCO | to map |
| Department | Medical evacuation |
| Facility types | Hospital, Ambulatory, Transport, Medevac, Fitness, Aesthetic |
3. Reporting line and working relationships
Reports to: POS-246. Supervises: POS-249.
| Works with | Nature of the relationship |
|---|---|
| Flight physician (medevac) | Joint in-flight care. |
| Medevac operations director | Mission and readiness. |
| Pilot (air ambulance) | Flight safety. |
4. Key accountabilities
| Domain | Accountability | Evidence of delivery | Checked | Linked competencies | Linked trainings | Linked policies | Standards |
|---|---|---|---|---|---|---|---|
| Care | Gives critical care to standard in flight. | Care audit at standard | Monthly | C-01 | T-07 | POL-SAFEG | 2 |
| Equipment | Checks and manages flight equipment before each mission. | Equipment checks recorded for every mission | Daily | C-02 | T-05 | POL-INC | 2 |
| Handover | Hands over completely to the receiving team. | Handover audit at standard | Monthly | C-03 | T-07 | POL-DATA | 2 |
5. Decision rights
| The post holder decides | Consults or escalates |
|---|---|
| Nursing interventions within protocol in flight | Deterioration that needs flight physician decision (flight physician) |
| Order of in-flight tasks within the protocol | Clinical concerns needing immediate medical decision (flight physician) |
6. Qualifications and experience
| ID | Qualification | Mandatory | Validity |
|---|---|---|---|
| Q-01 | Registered nurse licence, current | Yes | per regulator |
| Q-02 | Critical care or flight nursing certificate | Yes | Lifetime |
| ID | Experience | Minimum years | Mandatory |
|---|---|---|---|
| E-01 | Critical care nursing experience | 4 | Yes |
7. Training requirements
Recommended common practice. Each facility adapts the list to its national law. Essential items apply in every setting; recommended items apply where resources allow.
| ID | Training | Tier | When | Validity | Linked policies | Linked competencies |
|---|---|---|---|---|---|---|
| T-01 | Facility induction | essential | at_entry | Once | POL-WHISTLE · POL-EQUAL · POL-DATA | – |
| T-02 | Safeguarding adults | essential | periodic | Every 3 year(s) | POL-SAFEG | – |
| T-03 | Safeguarding children | essential | periodic | Every 3 year(s) | POL-SAFEG | – |
| T-04 | Data protection and confidentiality | essential | annual | Every 1 year(s) | POL-DATA | – |
| T-05 | Incident reporting and open disclosure | essential | periodic | Every 2 year(s) | POL-INC | C-02 |
| T-06 | Governance, accountability and assurance | recommended | periodic | Every 3 year(s) | – | – |
| T-07 | Emergency and major incident command | essential | annual | Every 1 year(s) | POL-INC | C-01 · C-03 |
| T-08 | Speaking up, inclusion and equality leadership | essential | periodic | Every 2 year(s) | POL-WHISTLE · POL-EQUAL | – |
8. Health, fitness and language
| ID | Requirement | Frequency | Tier | Minimum in low-resource settings |
|---|---|---|---|---|
| H-01 | Immunity to vaccine-preventable diseases relevant to the setting, documented at entry | At entry or as set | essential | Documented hepatitis B status at entry |
| H-02 | Tuberculosis screening at entry, then as the national rule requires | At entry or as set | essential | Symptom screening at entry and after exposure |
| H-03 | Fitness-to-work assessment at entry and after serious illness or injury | Every 12 months | recommended | Fitness check at entry |
| Language | Level | Mandatory |
|---|---|---|
| Official language of the country of practice | professional | Yes |
| English | working | Yes |
9. Competencies by level
| ID | Competency | Foundation | Practitioner | Expert | Assessed by | Revalidate | Linked trainings |
|---|---|---|---|---|---|---|---|
| C-01 | Critical care nursing | Cares under supervision | Cares independently | Designs critical care standards | Care audit | Every 12 months | T-07 |
| C-02 | Flight equipment management | Uses equipment | Manages equipment | Designs equipment standards | Equipment audit | Every 12 months | T-05 |
| C-03 | Nursing handover | Gives handover | Gives complex handover | Designs handover standards | Handover audit | Every 12 months | T-07 |
10. Performance evaluation
- Probation: 6 months, with a sign-off review (recommended value).
- Appraisal: every 12 months against the competencies and indicators below.
| ID | Indicator | Target | Data source | Frequency |
|---|---|---|---|---|
| PI-01 | Equipment checks recorded | 100% | mission records | Daily |
| PI-02 | Care audit at standard | 100% | audit results | Monthly |
| PI-03 | Handovers audited | 100% | handover audit | Monthly |
11. Career ladder and promotion
| Level | Role | Minimum experience to move on | Qualifications | Competency minimums | Trainings required | Assessment |
|---|---|---|---|---|---|---|
| Executive | Flight nurse (critical care) | 4 years (recommended) | Q-01, Q-02 | C-01 practitioner, C-03 practitioner | T-07 | Executive appointment and performance review |
12. Policies the post holder follows
Each policy is a standard template that the facility adopts and adapts. Templates are maintained centrally, so every facility works from the same version.
POL-SAFEG · Safeguarding adults and children
Purpose: Protect patients from abuse, neglect and harm, and make sure every concern is recognised and acted on.
Scope: All staff, volunteers and contractors.
Key rules:
Scope: All staff, volunteers and contractors.
Key rules:
- Recognise signs of abuse and neglect and record them factually.
- Report every concern to the designated safeguarding lead the same shift.
- Do not investigate alone.
- Share information only as the safeguarding procedure allows.
POL-DATA · Data protection and confidentiality
Purpose: Keep patient and staff information private, secure and used only for care and legal purposes.
Scope: All staff who access records or systems.
Key rules:
Scope: All staff who access records or systems.
Key rules:
- Access only the records needed for your work.
- Keep records secure; do not leave screens or paper unattended.
- Do not share information without a lawful basis.
- Report any breach to the data protection officer within 24 hours.
Linked trainings: T-10 · Review every 12 months · Template 0.1 (draft)
POL-WHISTLE · Speaking up (whistleblowing)
Purpose: Let staff raise patient safety or conduct concerns without fear of reprisal.
Scope: All staff.
Key rules:
Scope: All staff.
Key rules:
- Raise a concern with your line manager or the named speaking-up officer.
- If that route fails, escalate to the board or the national regulator.
- Retaliation against anyone who speaks up is a disciplinary offence.
- Concerns are recorded, investigated and the outcome given to the person raising them.
Linked trainings: T-01 · Review every 12 months · Template 0.1 (draft)
POL-EQUAL · Equality, diversity and inclusion
Purpose: Give every patient and colleague fair access, respectful treatment and reasonable adjustments.
Scope: All staff and patients.
Key rules:
Scope: All staff and patients.
Key rules:
- Treat every person with dignity regardless of background.
- Make reasonable adjustments, including interpreters, for language and disability.
- Report discrimination through the speaking-up route.
- Monitor access and outcomes by group.
Linked trainings: T-01 · Review every 24 months · Template 0.1 (draft)
POL-INC · Incident reporting and open disclosure
Purpose: Report and learn from incidents and near misses, and tell patients honestly when things go wrong.
Scope: All staff.
Key rules:
Scope: All staff.
Key rules:
- Report every incident and near miss the same shift.
- Give the patient and family an honest account and an apology where appropriate (open disclosure).
- Take immediate action to protect others.
- Learn: contribute to the review and follow the agreed actions.
13. Standards that name this role
14. Record history
| Date | Change | Approved by |
|---|---|---|
| 2026-10-27 | Draft record, batch 1 of the position build | Awaiting approval |