Registered nurses who become flight nurses have experience in critical care, intensive care or emergency room nursing. These nurses must have the ability to think fast on their feet and react to emergencies both in the field and in-flight. Nurses must pass a rigorous physical exam in order to be considered for a position as a flight nurse. The ability to carry large and heavy packs of equipment overhead while wading through water, chest-high, is just one of the physical rigors a flight nurse may expect to encounter on the job, as well as crawling through tight spaces, working in the rain or snow in muddy and wet conditions. A flight nurse must maintain adequate supplies on the aircraft and check off all equipment before their shift. A flight nurse on an emergency flight crew may expect to have shifts of 24 hours, two to three days in a row. This can impact family life with young children and spouses. Flight nurses may also work as private duty nurses with patients who must travel by air. This specialty enjoys a high rate of pay.