DAYTON, Ohio Shauntel Hass worked as a registered nurse at a hospital when she decided to take her career in another direction. Upward.

The 35-year-old Mountain Home, Idaho, native joined the Air Force and spent her first day in training this month at the U.S. Air Force School of Aerospace Medicine at Wright-Patterson Air Force Base, Ohio. There, she will earn flight nurse status, a job that will likely jet her across continents and oceans to care for wounded soldiers returning from battle.

Before boarding a U.S. military plane to treat wounded servicemembers, medical teams from the Air Force, Army and Navy earn the wings on their flight suits at the school, which was transferred to Wright-Patt three years ago as part of the Base Realignment and Closure commission.

Reporters from this newspaper this month accompanied members of the Air Force Reserve 445th Airlift Wing, based at Wright-Patterson, on a 12,000-mile journey to Bagram Airfield in Afghanistan that also included an evacuation and transport of 11 wounded patients from Ramstein Air Base in Germany to Joint Base Andrews in Maryland.

The reserve wing has an aeromedical team, drawn largely from the ranks of civilian health care professionals in the Miami Valley.

Patient care at high altitudes has its challenges part of the training at the School of Aerospace Medicine. The school graduates about 300 flight nurses and technicians from its weekslong aeromedical courses each year.

"What we're teaching them is how to take those skills and those capabilities and how to step it up to a point where they are going to be working in an environment at 35,000 feet, which is very unusual," said Lt. Col. Karey M. Dufour, the Wright-Patt school's flight nurse course director and contingency operations chief.

"When you take a patient up to altitude, those stresses of flight really do make a big difference in how we treat our patients. There's certain considerations that we have to make. Otherwise, our patients can really deteriorate very quickly."

Critical care teams of flight doctors and nurses tend to the most severely wounded troops.

"The patients we take in the air are more critical than you're ever going to see in any level one trauma center because of all of the multiple trauma that they have," said Lt. Col. Elena Schlenker, the school's director of critical care courses, which graduate another 125 students or so a year.

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Military medical teams earn wings at Wright-Patt aeromedical school