Early examination of the middle-range theory of flight nursing expertise

Reliance on expert flight nurses to move critically ill or injured patients generates considerable need for these nurses to obtain advanced education and maintain clinical expertise. The newly proposed middle-range theory of flight nursing expertise provided an initial framework to guide education and training in this rapidly changing specialty, but the framework had yet to be compared to the actual experiences of flight nurses in research. A cooperative inquiry approach was used to guide an investigation into the validity of the theory. The study consisted of two cycles of inquiry. In the first cycle, post-flight questionnaires were administered after patient missions to assess the presence or absence of each concept described in the theory. In the second cycle, individual interviews were used to further explore the flight nurses' decision-making during patient transport missions. Data collected from flight nurses about their decision-making on patient transport missions supported the presence of all the concepts in the newly proposed theory. Another concept, partner cuing, emerged as a concept to be added to the theory, while the concept decision-making, was revised to expanded decision-making. The importance of partner cuing was confirmed by flight nurses as reflecting their expanded decision-making during patient missions.