Flying the doctors

Ninety years may have passed since that first flight, but the heart and soul of the RFDS remains in Queensland. From their headquarters at Brisbane International Airport a fleet of 17 aircraft are monitored and controlled in a carefully orchestrated operation that protects people living across the 1.85 million km² state.

The Queensland Section alone flew over 7.52million kilometres in the past year. This was achieved by a staggering 23,135 flight hours with 11,359 patients accessing the vital service. The service is supported by a team of highly motivated people whose skills range from doctors to mechanics, fundraisers to pilots.

Flying for the Doctor

A team of skilled pilots are essential to the success of the Flying Doctor. In Queensland the pilots are based at a number of locations across the state, including Charleville, over 700km west of Brisbane.

Here, six pilots and a team of doctors and nurses cover the western most parts of the state utilising a single Beechcraft King Air. The Senior Base Pilot at Charleville is Nick Tully who joined the RFDS in 2014.

Having grown up in remote Queensland, working for the RFDS had been an aspiration for Tully for as long as he can remember. With a large family living so far from major cities and towns, Tully like most people living in the bush has an acute understanding of how important the service is.

“RFDS was a big part of our lives, with 8 boys and 2 girls all out doing things like riding motorbikes, there were accidents and most of my family had been flown out by RFDS at some point,” Tully told Australian Aviation in January.

“We all looked up to them as the all-encompassing guardian angel. That’s how it is for people living in the rural communities, the RFDS is a lifeline.”

Tully’s flying career stated in aerial mustering where he clocked up 800 to 1,000 hours per year. This four-year stint saw him flying across seventeen stations in a single-pilot environment, which quickly accelerated his skills and expertise as a pilot.

It’s this early experience with rural flight that taught the young pilot the skills and discipline required to fly for an aeromedical service.

“The biggest benefit for me was flying remote and rural to start with. I grew up remote so this is what I wanted to do. But I had to make a choice to go out day after day and do those hours, single pilot in the remote areas,” Tully explains. “This is what taught me how to be a good RFDS pilot. The more remote flying you can do, the better.”

After a move to Western Australia Tully exchanged his aerial mustering career for a role at the Goldfields Air Services in Kalgoorlie. Here he flew larger two-pilot aircraft and gained further skills in the coordination and cooperation required by a multi-person crew.

Tully realized his aspiration to fly for the RFDS when he joined the Central Section (South Australia and Northern Territory) in 2014 flying Pilatus PC12s. But his heart remained in Queensland, so when the opportunity arose to return to his home state he took it up and hasn’t looked back.

No ordinary pilot

The pilot’s role at the Flying Doctor is unlike nearly any in the aviation industry. Flying as a solo pilot across the vastness of Queensland might sound lonely; but pilots at the RFDS work hand in hand with the doctors and nurses during aeromedical retrievals to ensure the highest chance of a positive health outcome for each patient.

“This job isn’t the same as the pilot you see on your commercial flight. We are flying as a single pilot but when the aircraft is on the ground we’re out there helping with the medical retrieval,” comments Tully.

“Patient loading is the pilot’s responsibility and I always go along to the hospitals to lend a hand, such as collecting gear or assisting the nurses with the patient transfer. It’s a very diverse job and also very satisfying.”

And unlike commercial flights where the destination is known at the time of departure, the nature of the work undertaken by the Royal Flying Doctor means that Tully and his team are often required to make changes on the go.

“The nature of aeromedical retrievals means there is sometimes ad-hoc tasks and changes on the go. For example, we may be mid-flight and then need to divert unexpectedly to another location due to a medical situation that has developed since we took off. It’s a great challenge and exceptionally rewarding for a pilot.”

‘We may be mid-flight and then need to divert unexpectedly.’ Nick Tully

Some of the challenges facing pilots include the distances across Queensland, as well as a need to keep on top of fuel levels, particularly when faced with diversions when urgent medical situations develop while the aircraft is in flight. As such, flight crews at RFDS ensure a maximum diversion capability is maintained, to ensure they can get patients safely back to the base each and every time.

While the quintessential image of the Flying Doctor is the savior in an emergency situation, the work done by the service is extremely varied. In fact, emergency aeromedical retrievals forming just one part of the work of the RFDS in Queensland.

Other key activities include regular visits to 85 remote communities, a fly-in GP service that helps around 95,000 people and 6,500 remote health clinics throughout Queensland. This leads to a wide range of flight profiles on any given day.

“On most clinic flights I fly with a doctor and a nurse. We fly in the morning, run the clinic and are back home in time for dinner. On hospital transfers, it’s often myself and a nurse, while on the priority aeromedical retrievals we will carry the medical personnel that are required for each specific situation, and we are away for an unknown amount of time. Every one of those retrievals is different and we need to manage fatigue to keep things safe.”

Important Work

Fourteen Beechcraft B200 series aircraft form the backbone of the Queensland aeromedical service. Fully pressurised and with a maximum cruising altitude of 35,000ft they are able to offer a stable ride, which is important for both patient comfort and the delivery of care.

Each aircraft contains a bespoke medical fit out, transforming the interior into a flying intensive care unit. Two stretcher beds as well as an array of associated medical equipment make the cabin of the aircraft look like a modern hospital, while the standard passenger door has been replaced by a custom cargo door allowing for quick and easy loading of stretchers and equipment.

The aircraft are equipped with extra batteries as a backup for medical equipment, an oxygen and suction system and a special intercom that links the cabin to the flight deck for communication in-flight.

The complexity of this fit out along with the nature of the work can be daunting to new starters at the RFDS. However, Tully says that the training provided to pilots at the Queensland Section helps recruits learn to prepare for the task at hand, which is key to a successful flight.

“Someone’s life may depend on you so it’s natural to want to rush out and get going. But the only way to ensure a successful flight is to take the time needed to prepare. The training at RFDS in Queensland prepares us for this. Take a step back, take a breath, plan the flight and complete all the checks. That’s a big part of our success.”

And despite years of real-life experience, there are times when even experienced RFDS pilots have to take stock and remember their training, especially when the retrieval is of a critical nature.

“When you get a critical retrieval, especially a child, it adds an extra layer of stress to the team. The instinct is to get going, quickly! But we have been conditioned not to rush and put safety first,” Tully explains.

“You don’t mess around; but we go through the correct steps to plan the flight as best we can to ensure that once we arrive we can offer the patient the highest chance of a successful retrieval. That makes all the difference.”

Successful Challenges

Challenging flying conditions is part of the job for RFDS pilots, and goes hand in hand with the type of work undertaken by the service. The urgency of aeromedical retrievals can often lead to landings in unexpected places, or diversions in-flight to pick up victims of accidents and injuries.

“Dirt strips can be a challenge, but that is what we are trained for. Sometimes it might be an approved road landing strip that the Police will close off for us in an emergency,” Tully comments.

Fortunately, the RFDS maintains a strong connection with the local community in Queensland. This bond ensures locals are willing and able to assist when needed.

“Sometimes there’s no lights so we are contacting the station or those on the ground to light up a station strip for us. Sometimes this is done with tins filled with sand and diesel and we’ve even had runway lights made up of toilet rolls set alight to guide us in.”

And the complexity of the job doesn’t stop with a successful landing. Once the aircraft is safely on the ground, the medical side of the operation kicks into action. A successful retrieval requires the total commitment and cooperation from the entire team, which is supported by a positive and supportive culture at the Queensland Section.

Rewarding Career

The high intensity of aeromedical retrievals is matched only by the variety of the flight profiles that pilots such as Nick Tully face. The Royal Flying Doctor Service covers a vast distance, with Queensland Section handling fights to some of the most remote locations in Australia.

“You get every different type of flying when working for the Flying Doctor and it goes from one extreme to another,” Tully comments.

“On any given day we could be taking off from a remote strip in the bush and within a few hours we could be on an ILS approach into Brisbane International Airport. That’s two extremely different styles of flying but in the RFDS we regularly get to experience that kind of diversity.”

A big part of the success of the Royal Flying Doctor in Queensland over the last ninety years has been the supportive culture that has been built. From its headquarters at Brisbane Airport out to the most remove bases such as Mount Isa and Longreach, the team work together as one in an inclusive and open atmosphere.

Nick Tully believes that such a culture is essential when operating the aircraft, as it ensures that pilots, doctors and nurses are supported which ultimately benefits the patient.

“RFDS in Queensland has developed a very strong team culture. Onboard the aircraft I may be the only pilot but we aren’t alone – there’s a nurse aboard every flight, sometimes two, and on high priority flights a doctor will fly with us too. While the pilot gets on and flies the aircraft, there’s a team approach to the retrieval or transfer and this is all designed to achieve the best results and outcome for the patient.”

After all, a commitment to caring for those in the bush by providing a mantle of safety is the lasting legacy of John Flynn; a legacy that is in safe hands with Nick Tully and his colleagues.