This month, Pulse takes a look at the men and women who take their medical skills to the air. High risk, high stress and high rewards sum up the job of flight nurses, paramedics and other health care specialists who bring emergency medical assistance to people when and where they need it.

There are many variables to the job. When flight crews report to work, they never know how many or what kind of missions they'll fly that day. The next call could take them to a car crash, a fire or a hospital to pick up a patient needing more advanced, possibly lifesaving intervention.

"We can be cutting up at the base, but if a call comes in, everyone is instantly 100 percent focused," said Tina Frey, BSN, CFRN, CEN, chief flight nurse for Rescue Air 1.

Weather complicates what can be an already dangerous job. A recent headline at www.flightnursing.com read "Three dead in air ambulance plane crash on Maui."

BARRY WILLIAMS/Special

A Rescue Air 1 crew and members of the Marietta Fire Department load a burn victim for transport to Grady Memorial Hospital.

"When you hear of a crash, it's hardly ever a mechanical failure. It's usually human error, so we have a safety briefing before every flight, and we won't push the weather factor," said Mike Stevens,NREMT-P, CCEMT-P. "Three to go and one to say no" is the rule at Rescue Air 1.

"If the weather is too bad in an area, we've met an ambulance half way, setting down on a side road or shopping mall," said Nancy Constable, RN, supervisor with Children's Response Air. "Sometimes you just can't go, and you can't feel guilty
about that; it's part of the job."

A sense of urgency and the ongoing need to keep learning are constant elements of the job. "We're training almost every day, whether it's on the clinical skills side or the safety side. Everyone's skills have to be top-notch, because there's no backup," Frey said.

As with all health care professionals, compassion is the core of being a flight nurse or medic.

"Caring is what they really need. I treat them (patients) like my family," Stevens said.

"Quite frequently, I'll hold the patient's hand as we land, whether they are conscious or not. You just want them to know you're pulling for them," Frey said.

"It doesn't matter who they are or where they came from, you're just begging for them to live," added Pam Robertson, RN, BSN, program director at Rescue Air 1. "Our owners define it best when they say, 'We're in the business of family reunions.'"

You'll also want to read about public health nurse and epidemiologist Mark Simmerman's work with the H5N1 virus,
better known as bird flu. Our photographer, Barry Williams, visited Simmerman in Vietnam last month.

While acknowledging the concerns and complications of a hazardous virus that is constantly mutating, Simmerman said that public health officials worldwide are working long hours to avert a pandemic influenza crisis. "Everyone I've worked with is highly committed and doing a tremendous job," he said.

Looking ahead: The judges have been hard at work sorting through nominations, and next month we'll announce the 10 finalists in the 2006 AJC Celebrating Nurses awards.

- Do you have any story ideas for Pulse? We'd love to hear more about your career and what you do after hours. E-mail me at pulseeditor@ajc.com or call 404-526-2078.