Nurse Florence Nightingale is remembered as one of the most highly respected caregivers in the world. Her tender mercies toward suffering people earned that reputation, so it is understandable that a helicopter in service as an air ambulance bears that name.

&uot;Nightingale&uot; is the popular name by which most people recognize the bright blue helicopter. Actually, the name is &uot;Nightingale Regional Air Ambulance Service,&uot; and the helicopter is operated through Sentara Healthcare in Norfolk.

This year marks the 20th anniversary of Nightingale and it is the region’s only air ambulance, having flown more than 11,000 accident-free missions.

Nightingale also has the distinction of being the nation’s 38th air medical program, and it has transported thousands of critically ill patients across Hampton Roads. Suffolk has often been Nightingale’s destination as it flew to rescue victims in Driver, Whaleyville, Holland, Chuckatuck, Crittenden, and the downtown area. Hundreds of patients from Suffolk have been airlifted to the healing hands of trained medical professionals at a number of hospitals.

Ann Keffer, public relations specialist at Sentara, said Nightingale flies from &uot;her&uot; home base at Sentara Norfolk General Hospital, the area’s only Level I Trauma Center. The helicopter flies a 125-mile radius handling most trauma patients from car accidents, falls, burns, or gunshot wounds. From Washington, D.C. to Ocracoke Island, and from the Eastern Shore to Charlottesville, Nightingale flies more than 500 missions per year.

Genemarie McGee, director of Nightingale Regional Air Ambulance Service, said Sentara leases the BK117 helicopter, four pilots, a full-time and back-up mechanic just to keep the machine in the air.

&uot;That’s where the majority of our expenses come from,&uot; said McGee. &uot;Another thing, a helicopter is a very, very expensive machine to operate safely. We have a mechanic that does nothing but work on the helicopter and he’s on call 24 hours a day.&uot;

If the Nightingale is in for repairs, no one is left without the air ambulance service. Like rescue squads in time of need, the air ambulance services also network.

&uot;There’s one in East Carolina in Greenville, N.C., and Richmond also has one,&uot; she said. &uot;The Outer Banks has one. Essentially, we back each other up.&uot;

Aside from paying for pilots and mechanics, Nightingale also faces the expenses of paying for its medical staff and of course, medical supplies.

&uot;We are a not-for-profit system and if we do make any profit it goes back into our operating fund,&uot; said McGee. &uot;Every department is encouraged to do whatever we can to be very cost effective and to try to recoup whatever we spend. However, if we fly an indigent patient, we fly an indigent patient. We never ask about insurance. The crew never knows and we never consider whether they can pay. Our mission is to get them to a medical facility where they can be helped.&uot;

McGee noted that Nightingale only flies critically ill patients, and it is up to a doctor to determine if the helicopter leaves its landing pad at Sentara.

&uot;We work with area rescue squads to make sure we don’t get called for very small accidents… that we get called for a patient who needs to be taken to a trauma center,&uot; she said. &uot;Not just to Sentara, but we can also fly to Virginia Beach General, to Richmond, to North Carolina and other trauma centers in the region.&uot;

At times, the medical team is faced with decisions on which patient needs Nightingale most. In instances where they are to pick up a hospitalized patient for transport to a trauma center, if a call came in at the same time needing the air ambulance for someone involved in a vehicular accident at the side of the road, that patient would take priority.

&uot;Because the patient at the side of the road would need medical assistance more than the one being cared for in a hospital,&uot; she explained. &uot;We spend a lot of time training rescue squads on appropriate times to use the helicopter. We fly to the scene where patients are critically injured.&uot;

McGee also praised the pilot and crew of the helicopter, adding that she is very proud to be involved in the program.

Vicky Gray, vice president of Systems Development for Sentara, said it costs $1.7 million per year to operate the air ambulance service and the entire program is operated at a financial loss. Nightingale has yet to operate out of the red, but according to Gray, the entire Nightingale team including everyone from mechanics and pilots to nurses and medics are on a mission.

&uot;We have been on a very strong mission since we established the shock/trauma service 20 years ago,&uot; she added. &uot;We can’t look at this as a means of making a profit. We do get some donations from grateful family members and patients to help with Nightingale’s operation costs, but we basically depend upon Sentara for operational expenses. Nightingale is an incredibly wonderful program, however, and we certainly intend to continue the services.&uot;

The cost of transportation for each transport is $3,360, and Gray said Sentara is reimbursed for only about 64 percent of those trips. In some instances, the victim’s insurance pays for Nightingale’s services.

&uot;The rest are covered through Sentara resources,&uot; she said. &uot;For instance, if one of Sentara’s products makes a profit, then part of those funds are used for Nightingale services.&uot;

Keffer added that Sentara Healthcare, a premier not-for-profit health care provider in southeastern Virginia and North Carolina, is comprised of more than 70 sites of care including five acute care hospitals, a hospital for extended recovery, two outpatient care campuses, seven nursing centers, three assisted living centers, and 25 primary care practices.

&uot;Sentara also offers a full range of health coverage plans, home health and hospice services, physical therapy and rehabilitation services, mobile diagnostic vans, and ground and air medical transport services, including Nightingale,&uot; said Keffer. &uot;Sentara was ranked the number one integrated health care network in the United States in 2001 by &uot;Modern Healthcare&uot; magazine and is the only health care system in the nation to be named in the top 10 for five consecutive years.&uot;