# “Reality shock”-a qualitative exploration of helicopter emergency medical services nurses’ challenges and experiences in China

## TL;DR

This study explores the challenges and experiences of Chinese helicopter emergency medical services nurses, highlighting their adaptation struggles and the need for better support.

## Contribution

The study identifies unique 'reality shock' experiences of HEMS nurses in China and outlines specific professional and operational challenges.

## Key findings

- Nurses face adaptation challenges in the aeromedical environment due to limited space and high-altitude conditions.
- Standardized procedures and emergency response plans are lacking in HEMS operations.
- Professional identity and team collaboration improve as nurses gain more experience in HEMS missions.

## Abstract

To explore the lived experiences of nurses involved in Helicopter emergency medical services (HEMS), identifying the core challenges they encountered and their support needs.

A qualitative research design was employed. Data were collected through semi-structured, in-depth interviews with 14 nurses who had participated in at least one HEMS mission. Colaizzi’s phenomenological method was used for data analysis to extract key themes from the participants’ narratives.

Four major themes emerged from the analyses: (1) Adaptational Challenges in the Aeromedical Environment, including operational constraints due to limited cabin space and the need for both physiological and psychological adaptation to high-altitude conditions; (2) Multidimensional Safety Risk Management, emphasizing the implementation of dual safety protocols for crew and patients, as well as comprehensive emergency preparedness; (3) Professional Competency Development and Process Optimization, identifying barriers in translating theoretical knowledge into practice, and highlighting the importance of standardized procedures and effective interdisciplinary collaboration; and (4) Professional Identity and the Emotional Support Network, underscoring the value of professional recognition, experience sharing, and emotional connectedness among team members.

This study shows that most Chinese nurses encounter “reality shock” when participating in HEMS, face certain physical and mental burdens, and lack highly standardized procedures and emergency response plans during task execution. Meanwhile, their professional identity and team collaboration capabilities gradually mature as tasks progress continuously.