Nurse enjoys ‘unconventional environment’

Jon Kane works for AirMed Hawaii as a nurse, helping move patients interisland

Jon Kane Title: Flight nurse Job: Provides medical care to patients being transported by aircraft from the neighbor islands to Oahu

Jon Kane says he enjoys working in a unconventional environment. That would help explain why he works 12-hour shifts that require flying in small airplanes up to several times a day to transport patients -- many of whom are in acute condition in need of serious medical attention -- from the neighbor islands to Oahu.

Kane is a flight nurse with AirMed Hawaii, an air ambulance service established here in April 2006 by AirMed International, based in Birmingham, Ala.

Kane joined the company a year ago, after 12 years with Queen's Airport Medical Services, which had handled all "pre-hospital emergency care" at Honolulu Airport until it gave up the contract in early 2006.

Kane's first job in the medical field was as an emergency medical technician with the City & County of Honolulu. He later became a paramedic and then a registered nurse after going through the appropriate programs at Kapiolani Community College.

Kane also is graduate of Kamehameha Schools, and attended the University of Hawaii at Manoa for awhile before becoming an EMT.

Kane, 44, is married to the former Kristen Takasaki, with whom he has two sons, ages 5 and 4, and lives in Kapolei.

When I spoke with Kane last week, he had just returned from a trip to Hilo, where he and three other AirMed Hawaii employees had traveled to pick up and transport a young man who needed special medical attention in Honolulu.

Mark Coleman: How long have you been a flight nurse?

Jon Kane: Actually just for one year.

Q: How long have you been a nurse?

A: For about 14 years.

Q: Are you a paramedic or a registered nurse (RN)?

A: I'm both. I'm an RN and I'm also a paramedic.

Q: What came first?

A: Paramedic. I started off in 1990 as an EMT (emergency medical technician) for the City & County of Honolulu, for their 911 EMS (Emergency Medical Service). Then I went to paramedic school. And as soon as I graduated from paramedic school, I went to nursing school. And I was doing both for about 10 years.

Q: So how did you get this job?

A: Well, what happened is I used to be an RN for Queen's Airport Medical Services, and we basically did pre-hospital emergency care for the entire airport -- the terminals, the ramps, for all the planes coming in with any emergencies. I did that for about almost 12 years, but our company, Queen's, gave up the contract. So then a friend of mine -- her name is Alexandra Farnsworth -- she was a chief flight nurse for AirMed, and she offered me a position, and that's how I started. I've always liked to provide medical care in an unconventional environment. That's my preference.

Q: What kind of training or certification do you need to be a flight nurse?

A: We did in-house training, and, also, one thing that's really good about AirMed is that they encourage education. They'll pay for certification, and they'll pay for trips to the mainland to get education. So I actually got certified as a flight nurse. It's called CFRN (Certified Flight Registered Nurse).

Q: I almost interviewed a flight nurse about a year ago, but then the company had a fatal plane crash on one of its missions. How did that affect your outlook about your job?

A: Well definitely it made an impact, because in the two crashes that company had, I lost three really good friends. I didn't know the other people as well, but I heard they were really nice guys.

On the first flight (in January 2004) was Mandy Shiraki and Danny Villiaros. And then Marlena Yomes was on the second crash (in March 2006). So that's something that I always think about. In fact, the fourth anniversary of Mandy's crash is coming up at the end of this month. They crashed on the 31st, but they didn't find the wreckage until the 2nd of February.

One thing, too, regarding those incidents, my wife was very concerned about me flying. But our company really stresses safety. It's shown by the fact that they'll fly with two pilots all the time, not just one. And we're CAMTS certified; that stands for Commission on Accreditation of Medical Transport Systems.

Q: What kind of planes do you fly on?

A: King Air C-90s.

Q: Are those big planes?

A: Not really. They're mid-sized planes, but they're twin-engine turbo-prop planes.

Q: How many planes does the company have?

A: We have three planes here in Honolulu. The reason we're based in Honolulu is it allows our mechanics to maintain our planes 24 hours a day, which is another safety issue that is kind of important.

Q: How many people are on each flight?

A: There's the two pilots -- a captain a first officer -- and a flight nurse and flight paramedic.

Q: How often do you fly to other islands to pick up patients?

A: Well, we have 12-hour shifts, and it really just depends. Sometimes we'll fly just once, and sometimes we'll fly up to four times during the shift. But it depends, because we might have short hops, like to Molokai or Lanai or Maui, which take about 2 1/2 hours, but then there's also times when we have a really critical patient with a lot of medical stuff going on, like in Hilo, let's say, and that one call might take about five hours. So it just depends. Every day is different.

Q: Which islands do you go to the most?

A: Probably Maui and the Big Island.

Q: What is the typical situation with the patients you have to transport?

A: We transfer just about everything. Anything that the neighbor island hospitals cannot accommodate, or for which they need special treatment or evaluation, they'll transfer them out. And when I say everything, it include "neonates" (just-born infants) and pediatrics, because Kapiolani Medical Center, they have a neonate and pediatric transport team and they only fly with us.

Q: Do you ever take patients from Oahu to the other islands?

A: Rarely, but we do. Every once in awhile.

Q: What would that involve?

A: A lot of times, to be honest with you, they're going home to pass away.

Q: So describe a typical case, where you land on another island and then what? Is the patient at the airport ready to go?

A: It all depends. We either pick up at the flight line, or we'll go to the bedside at the hospital, depending on the acuity of the patient.

Q: How do you get to the hospital?

A: Usually the medics will come pick up us, then transport us to the hospital. Then we'll go back to the airport, fly over to Honolulu and reverse the process.

Q: Then what's going on while you're in flight?

A: That's where we're providing all our care. We're trying to make sure we're keeping the patient stable and safe, and getting them over to the receiving facility. Our higher-acuity patients will be on ventilators, or will have multiple IV drips going on, chest tubes, splints, in-dwelling catheters. ... And then, of course, we'll have all our monitoring equipment, for EKG, blood; it gets pretty crowded as far as the lines go, like a bunch of spaghetti. Those are our more challenging types of flights, for sure, and those are the ones that usually take the longest.

Q: Do you ever backseat pilot -- like backseat drive?

A: (Laughter) No. We got the two pilots upfront, where they belong. We just trust them. Our pilots are really well trained. They go up to our parent company in Alabama and do most of their training there. They have our trust, definitely. We trust them with our lives. They're all very capable pilots.

Q: What do you when you're not transporting a patient?

A: We have our regular down time. We still have our office duties to perform here. Primarily for my job, it's paperwork. For other people it's maintaining the equipment. Everybody has different jobs to do.

Q: What would you say is your favorite part of the job?

A: My favorite? Probably my partners -- working with my partners. I have three outstanding paramedics that I work with. I'll give you their names: Eric Kitigawa, Kelly Garringer, and Garfield Arakaki -- three guys with three totally different personalities, three different working styles, and totally different skill sets. But it's always a pleasure working with any of them. Those are my partners that I rotate through on my two-week set schedule.

Q: Do you get to enjoy the scenery much when you're in the air or are you too busy?

A: No, we get to see outside when we're going over to pick up someone. We see some of the best sights: snow on Mauna Kea, beautiful waterfalls on the Hamakua Coast. We even see whales, or even submarines coming out of Pearl Harbor. There's always something to look out at.