Managing the pregnant retrievalist
Royal Flying Doctor Service Western Operations, School of Medical and Health Sciences, Edith Cowan University
Prof. Stephen Langford is Director of Medical Services of the RFDS in Western Australia and Adjunct Professor of Medical & Health Sciences at Edith Cowan University where he oversees a Postgrad Diploma in Aeromedical Retrieval. He has been a member of the society since its foundation, and was awarded Australian of the Year Local Hero WA in 2016 for his contribution to aeromedical retrieval in WA. Last year, the University of WA published his book, 'The Leading Edge'.
Pregnancy in female flight nurses, predominantly working in the fixed wing environment, has been an infrequent but recurring issue for some decades. With increasing numbers of young female doctors employed in retrieval roles, dealing with the pregnant retrieval doctor is now a more common occurrence. With a diversity of rotary wing, fixed wing and long distance jet operations, the occupational implications have become more complex.
There are a variety of standard physiological factors to consider in pregnant crew working in the aviation environment. In addition, the medical retrieval role adds elements such as mobility, restraint, emergency egress and infection control to the potential hazards.
The capacity of the staff member to perform safely in the flight role and not place patients at risk must be added to the potential risks to the pregnancy. Long distance flights and remote area operations also raise specific problems, as does the rotary wing environment.
Management of staff needs to deal with contemporary employment practices, avoiding discrimination but protecting the employer from claims for injury and patients from adverse outcomes. Modest sized aeromedical organizations do not necessarily have ‘light duty’ non-flying roles for doctors, nor do assertive specialist trainees wish to adopt them.
If a retrievalist in early pregnancy develops complications, how are the interests of the employer, employee and our patients best managed? The case of a pregnant retrievalist is used to highlight the many issues which require careful consideration.