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Saving Lives Through Nursing Care at 40,000ft in The Air


As a flight nurse, I get to be the person who takes the patient’s hand and escort them where they are needed. I am placed right at the heart of the action, where things really happen. I am honoured to touch lives and improve them. And on top of that, I do this at 40 000ft in the air. Most times stepping into countries most people never knew existed.

I joined International SOS as a flight nurse in May 2008 after having worked in various emergency departments and intensive care departments in South Africa as a nurse, shift leader and unit manager. I also had the experience of working in medical marketing within the corporate world. All these experiences have helped me to become who I am today.

At International SOS, the patients we fly are from all corners of the world, they are mothers and managers, company owners and expat travellers, sisters, brothers, children, and fathers. Africa is diverse and to be a nurse working across the continent, you need to be a seasoned traveller, language consultant, family supporter, negotiator, and logistics expert.

Being a flight nurse, you need to be able to negotiate, translate, consult, support, debrief and advise. Not only to patients, but also their families. Sometimes our patients’ families stay behind, and we become the lifeline of communication whilst we travel so they know their loved one has arrived safe. We also consult and support each other, the team (pilots and medical crew) spend many hours together and we become like family with one mission, getting the patient to better care/home.

 Karien Basson picture Karien Basson picture

Most Memorable Case

In the 15 years that I have flown as a flight nurse for International SOS, there have been many experiences that are special and memorable. One of them was a flight for an American gentleman we transported from Angola. What started out as a ‘potentially simple mission’ turned out to be one of the most challenging yet rewarding cases I had ever flown. We were briefed the night before; the diagnoses were that of an elderly man suffered from pneumonia as well hypertension and cardiac failure.

Activation was 3AM the next day. Standard equipment was packed, and we did a pre-flight discussion on our medical treatment plan as well as any extras we might need.

Soyo is not a port of entry, so we had to go for a quick fuel stop in Luanda, as well as clearing customs and immigration. We then set off to our final destination, Soyo, situated at the mouth of the Congo River, in the province of the Zaïre, just north of Luanda.

We met the patient at the international apron, the area of an airport where aircraft are parked, accompanied by treating clinic personnel. They told us that he was found unconscious two days before by his colleagues, and then was brought to their clinic. He was awake now, but not really responding. He was sat on the ambulance stretcher to assist with his much laboured breathing.

The doctor did an examination and we decided that it would be best to have him intubated and mechanically ventilated for the flight. Everything was prepared.
When we were ready, I spoke with him to try and get him to understand what we would be doing with him next.

He looked into my eyes and I said to him: “We will help you to breath now, we will make you sleep and then we are putting you on the air ambulance aircraft and take you to South Africa to get better care, do not be scared” for a split second, I could see he comprehended, his eyes crinkled in the corners and he seemed to recognise me, as if he knew me and that he trusted me, he seemed relieved and grateful.The flight was very eventful, just after we loaded him onto the aircraft, he developed a pneumothorax and as a result, cardiac arrest.His heart stopped for a second time when we handed him over at the receiving facility in South Africa.

On our post flight debrief the next day, I learned that he survived, fully ventilated, but alive. I went back twice to the hospital to go and see him, but both times he was sedated and ventilated.

About a month after the flight, I learned that he was to be taken back to the USA on a fully equipped long haul air ambulance aircraft, and I went to say goodbye.I was waiting at the lift in the hotel lobby when a lady walked up to the lift with a big suitcase in her hands, I offered to help but she declined and said that it’s empty. It’s for her husband’s clothes and that they will be returning to the USA later that day. I knew then that she was my patient’s wife and when I told her who I was, she couldn’t stop crying. She just hugged me and kept thanking me. We walked into the ICU together and found him sitting up in his ICU bed, eating jelly. I was stunned, he looked amazing. When he saw me, he gave me that same look that haunted me until that day, and it said: “thank you.” And I thanked him in return for giving me the opportunity to learn and to grow, and to do what I love best.