US-based Virginia Commonwealth University (VCU) Health flight nurse and paramedic Kissner MSN, RN, CEN, CFRN, NRP, provides support for the Virginia State Police's helicopter medical evacuation programs. The State Police Aviation Unit was formed on 1 January 1984 to provide for the administration and co-ordination of the department’s aviation resources. The Unit’s primary mission is to provide aircraft for search, rescue, law enforcement and medical evacuation. During its nearly 40-year tenure, the Aviation Unit has recorded more than 100,000 flight hours responding to flight requests across the Commonwealth.

In early December 2020, PAC International delivered a new Bell 407GXi helicopter to the Virginia State Police Aviation Unit. What difference has the new aircraft type made to your operations?

The Unit has been operating the Bell 407 since 2000. They have proven to be a safe, reliable multi-mission helicopter. The 407GXi is the latest generation of the 407 and has an updated dual FADEC controlled power plant and a Garmin G1000 glass cockpit. The Aviation Unit’s continued dedication to safety and program improvement considerably enhances our frontline operations.

What customizations were added to the aircraft to ensure it was fit for its multi-mission role?

In addition to the medical interior, the Unit's 407GXi is equipped with tactical radios, rescue hoist, controllable searchlight, FLIR and NVG compatible lighting. These customizations allow us to quickly and safely transition between roles as requested.

How have these contributed to enhanced safety levels for the unit?

The Garmin G1000 glass cockpit provides aircraft performance monitoring, flight, navigation, and weather data in a clear and logical format. Not only does it provide the pilot with outstanding situational awareness, but it also does the same for medical crewmembers who may be busy with patient care. In addition, the dual FADEC power plant provides a level of redundancy and increased performance. 

What proportion of the Aviation Unit’s responses are to medevac, SAR, surveillance or other law enforcement duties?

Approximately 60 per cent of the Unit's missions are medevac. The remaining 40 per cent are split between law enforcement, training, maintenance, executive transport and SAR.

You’ve also played a part in standardizing hoist operations for the State police; how difficult was this to achieve, and what was the process like?

Med-Flight 1 in Chesterfield is a collaboration of three agencies: the Virginia State Police operates the aviation division, Chesterfield Fire & EMS employs the paramedics, and VCU Health provides the nurses. Change requires self-reflection and accepting there’s always room for improvement, something all three agencies fully embraced and supported. Realizing the need for standardization across our three bases, we began with looking at our current operations by benchmarking and networking with others. The goal was to safely align our hoist program to industry standards. After identifying opportunities for growth, we elected to contract SR3 Rescue Concepts to perform an audit of our hoist operations. In addition, they integrated a customized training program for the entire aviation division that has positively impacted our operations on many levels. Embracing the SR3 motto, ‘You don’t know what you don’t know’, has elevated our program significantly.

Congratulations on your BCEN award! What does it mean to receive this recognition?

Thank you so much! Receiving this award is the highlight of my 16-year career as a flight nurse. I’m honored and humbled to be selected from such an incredible group of peers in a profession I deeply admire. 

How did you become interested in flight nursing and what position do you currently hold?  

I currently work as a flight nurse for VCU Health, assigned to the Virginia State Police Med-Flight 1 base in Chesterfield, Virginia. Early in my career as a paramedic student, I received an internship with the Carilion Clinic Life-Guard flight program and fell in love. Seven years later, I was hired by the same program as a flight nurse. I worked there for 10 years before being hired at Med-Flight 1. One of the things I love most about Med-Flight 1 is the variety and multi-mission profile.

One of your nominators described how it is not only the clinical expertise that sets CFRNs apart from non-CFRNs, but also the multilayer knowledge base, which includes safety and communications; how important is this in your role, to be able to switch between responsibilities in the helicopter?

Aside from patient care, this is one of the most important aspects of the job as a flight nurse. Flight crewmembers must be fluid and able to effectively adapt to changing situations at a moment’s notice. However, the true beauty of this feature is being part of a team that performs in harmony. I work with some of the best in the business and we hold each other accountable: it’s not me or you, but us. This role requires the confidence to speak up when you have a question or concern and is an integral component of crew resource management. The mentoring and leadership I’ve received throughout my career has allowed me to function as a reliable team member in many different circumstances. Success is not defined by a single moment, but as a culmination of what you’ve learned from previous experiences.