When the call comes in, Mike Fadale and Blake Shrider spring into action. As a flight nurse and flight medic, they are part of an elite team of air medical professionals who provide life-saving care to the most critically ill and injured patients. It’s a high-stakes, high-pressure job, but for Fadale and Shrider, it’s a calling they’ve been chasing for decades.
For as long as he can remember, Fadale has been obsessed with helicopters. As a child, he was given a medevac keychain and told it was a key to a helicopter. He slept with it every night, dreaming of one day soaring through the skies as a flight nurse. Now, over 25 years into his medical career, that dream is a reality.
Fadale’s passion for aviation and emergency medicine collided when he landed his first flight job, an experience he describes as an “overwhelming feeling” of finding his true calling.
“Day one of the job, I was like, ‘This is it. This is exactly what I wanted to be doing,’” he recalled.
Fadale’s journey to the air medical field wasn’t without hurdles. After years as an emergency medical technician (EMT), he attended nursing school, gained critical care experience in the emergency department, and eventually secured a flight position. The hard work paid off.
“I’ve changed services since then and now work for a service that does a little bit of everything, from micro-preemie babies to adult patients on mechanical circulation devices,” Fadale said. “It’s been a learning curve, but I absolutely love it.”
Shrider’s path shares a similar beginning. He fell in love with emergency services early, initially just wanting to “drive an ambulance” before discovering a deeper passion for patient care.
“When I went through schooling to get my EMT certification and my first job, I fell in love with helping people and seeing the other side of things. It really drew me in,” Shrider said.
Like Fadale, Shrider steadily climbed the ranks, starting as an EMT, advancing to paramedic, and becoming a flight medic in 2013. Over the last four years, he’s also taken on the role of field training officer, mentoring the next generation of EMTs and paramedics within his agency.
“I work ground critical care and also fly on our helicopter,” Shrider said. “I get to train new EMTs and paramedics and develop education.”
Both Fadale and Shrider agree that a career in air medical services demands unique skills and qualifications.
For nurses, the journey often starts with three to five years of experience in the emergency department or intensive care unit.
“It varies by state. In Pennsylvania, I have to hold a pre-hospital registered nurse certification, as well as certified emergency nurse or critical care registered nurse credentials, and I’m required to be a certified flight registered nurse as part of our CAMTS [Commission on Accreditation of Medical Transport Systems] accreditation,” Fadale explained.
The extensive certifications and training reflect the high level of expertise needed. Flight nurses must be skilled clinicians who can provide care in the unpredictable environment of helicopter transport.
Paramedics face similar challenges, typically needing three to five years of experience in a high-volume 911 system.
“We get some pretty sick patients, so having well-rounded exposure puts you in a good place to start in this field,” Shrider said.
Beyond clinical expertise, air medical professionals must navigate the job’s unique demands.
“It’s a lot of hurry up and wait,” Shrider said. “On a good day, if you don’t do anything, that’s good because nobody needed you. But as it gets busy in Florida with the influx of seasonal residents, it’s not unheard of to do three to five flights and work 12 to 15 hours.”
Mental health is another critical challenge in the air medical field, often compounded by a lingering stigma that discourages professionals from seeking support.
“We’re always considered the best and don’t need help because we’re the ones helping others,” Fadale said. “We need to break down those barriers.”
Adding to these pressures is the ongoing workforce shortage plaguing the air medical industry. The demand for qualified pilots, mechanics, and clinicians continues to grow, making recruitment increasingly difficult. Meanwhile, financial pressures further compound the strain.
“Helicopters aren’t cheap, and neither are pilots, nurses, or medics,” Shrider said. “Healthcare in general faces so many financial challenges. Balancing finances while maintaining a safe, reputable operation is tough.”
Despite these hurdles, Fadale and Shrider remain passionate about their work. Their dedication led them to ECHO, a volunteer-driven organization supporting and educating flight crews.
“I fell in love with ECHO’s motto: ‘For flight crews. By flight crews,’” Fadale said. “It’s about sharing knowledge, education, training, and practices. It’s different from any other organization or conference I’ve attended.”
Shrider echoes Fadale’s sentiments, describing his first experience with ECHO as a “really awesome conference” that left him “blown away with the content. People were presenting about stuff that they’re passionate about, to make this line of work safer and better.”
Inspired by ECHO’s mission and the camaraderie of the air medical community, Fadale and Shrider have now taken on new roles within the organization. Fadale previously served on ECHO’s board, helping to launch the Flight Crew Assistance and Support Team (FAST), while Shrider has been an instructor for the Future Flight Crew program, which aims to prepare the next generation of air medical professionals.
Now, Fadale and Shrider are channeling their passion into the Valor Flight Crew Podcast, a collaboration between ECHO, Vertical HeliCASTS, and Vertical Valor magazine.
“ECHO promotes bringing the industry together,” Fadale said. “That’s the goal of this podcast — sharing best practices and uniting agencies.”
Shrider added that the podcast aims to “keep that energy and passion going” from the ECHO conferences year-round, providing a platform for open and honest discussions about the industry’s challenges and opportunities.
“We’re all one. We wear different suits and work for different agencies, but we share the same goal: providing the best, safest care and making it home,” Shrider said. “Collaboration helps us grow and learn from one another.”
Looking ahead, Fadale and Shrider see a bright future for the industry, with advancements in care and technology driving progress.
“I think you’ll see more robust guidelines and tools to provide top-tier care during transport,” Fadale said.
Their unwavering commitment and optimism reflect the spirit of the air medical community. Despite the challenges, Fadale, Shrider, and their peers continue to push the industry forward, delivering critical care to those who need it most.
Listen to the latest episodes of the Valor Flight Crew Podcast here.