Lt. Col. Kristen D. Barby, USAF, NC, SFN, AG-CNS BC, has spent much of her military career caring for patients thousands of feet above the ground.
During some of the most active years of U.S. military operations in Iraq and Afghanistan, Barby helped transport wounded and ill service members from Germany to the United States aboard military aircraft. On some missions, she and her team cared for as many as 50 patients during a nine-hour flight to Maryland, with additional travel to Texas when needed.
For Barby, these flights revealed something fundamental about military nursing and leadership: when the stakes are high and conditions unpredictable, nurses must be prepared to make sound decisions, trust their training and draw on the expertise of the team around them.
Today, after 19 years of military service, Barby is helping prepare the next generation of nurses to lead through those same kinds of high-stakes moments. As the first chief nurse of the 375th Aeromedical Evacuation Training Squadron at Wright-Patterson Air Force Base in Ohio, she combines her passions for nursing, flying and teaching.
Her career offers a window into the essential role nurses play in military medicine, and the opportunities a nursing degree can open in places few might imagine.
The idea is not relying only on yourself. Utilizing your team, utilizing the expertise that’s around you, and having self-awareness around your own strengths and weaknesses.
A nursing career that took flight
Barby never planned to join the military. In fact, she entered college on a softball scholarship and didn’t have a clear goal for her future. She considered teaching before discovering nursing, a profession that offered the combination of science, teamwork and service she was looking for.
After graduating, she worked in a cardiovascular step-down unit at the University of Kansas Medical Center. But she was also drawn to the intensity and unpredictability of flight nursing.
“I wanted that opportunity to travel, and to get those educational opportunities. I wanted to become a flight nurse,” she recalls. “Specifically, I wanted to be a part of a Critical Care Air Transport (CCAT) team.”
A conversation with an Air Force recruiter introduced her to military flight nursing, and she decided to commission.
Her path wasn’t entirely straightforward. Her first assignment was on a medical-surgical unit rather than in the critical care environment she had envisioned. She continued advocating for the opportunity to fly and eventually secured a position in aeromedical evacuation.
In 2009, she arrived at Ramstein Air Base in Germany, where she would spend three years helping transport patients during a particularly demanding period for military medicine.
From there, her career took her across the world and into remarkably different nursing roles. She helped coordinate medical transportation throughout the Pacific region, cared for pilots and cadets at the U.S. Air Force Academy, earned a master’s degree as a clinical nurse specialist and returned to aeromedical evacuation as an instructor and leader.
Through it all, one passion remained constant.
“Flying has been my passion,” she says. “I love deploying, I love training. It’s how I can support the mission.”
Leading when stakes are high
Aeromedical evacuation allows military medical teams to move patients by aircraft to facilities where they can receive the care they need. Flight nurses are central to that mission, combining clinical expertise with the ability to deliver care amid the unique challenges of air travel.
Unlike a hospital, an aircraft has limited space, equipment and personnel. Nurses must understand how changes in altitude affect patients, how to safely operate medical equipment onboard and how to respond when a patient’s condition changes thousands of feet above the ground.
But Barby sees the mission as something larger than transportation.
In 2011, while stationed in Germany, she lost a close friend who was serving as an Army Ranger. She remembers a conversation with his father that helped crystallize the importance of military medical teams.
“My boys wouldn’t be able to do what they’re doing without knowing that somebody’s going to come get them. Somebody’s going to come take care of them,” she recalls him saying, underscoring that military personnel undertake dangerous missions knowing, if they are injured, trained professionals stand ready to reach them, stabilize them and help bring them home.
For Barby, being part of that commitment gives her work a profound sense of purpose.
Preparing for the moments that matter most
Today, Barby’s focus is on preparing other nurses and aeromedical evacuation technicians to deliver that same level of care.
At the 375th Aeromedical Evacuation Training Squadron, students learn to transform military transport aircraft into environments capable of supporting patients. They practice configuring the aircraft, utilizing safe-to-fly equipment, managing oxygen and electrical systems, understanding the physiological effects of flight and responding to simulated emergencies.
The goal isn’t simply to teach procedures. It’s to build the judgment, confidence and teamwork required when a real emergency unfolds.
One of Barby’s favorite sayings, which she keeps on her whiteboard, captures a philosophy that applies both to the military and to nursing.
“We don’t rise to the occasion, we fall to the level of our training.”
Repeated exposure to challenging scenarios helps nurses recognize their responses to stress and develop the ability to act effectively under pressure.
Equally important is learning to rely on others. Barby emphasizes crew resource management, an approach to communication, decision-making and teamwork that helps aviation and medical crews operate safely.
“The idea is not relying only on yourself,” she says. “Utilizing your team, utilizing the expertise that’s around you, and having self-awareness around your own strengths and weaknesses.”
The lessons extend well beyond military nursing. In any care environment, preparation, self-awareness and trust among colleagues can make the difference when the unexpected happens.
Finding purpose in the unexpected
Looking back, Barby sees a career shaped by opportunities she never anticipated when she first considered nursing.
Her advice to nurses beginning their careers is to embrace those opportunities, particularly when they feel uncomfortable.
“It’s okay to fail,” she says. “Just learn from it.”
She remembers being hesitant to put herself forward early in her military career. With experience, she has come to appreciate the value of volunteering, taking risks and attempting things that initially seem beyond reach.
This Veterans Day, Barby’s story is a reminder of both the indispensable role nurses play in military service and the remarkable possibilities within the profession.
From caring for patients in flight to preparing others for their most challenging moments, her career reflects the impact nurses can have wherever their skills, curiosity and commitment take them.
The views and perspectives attributed to the individual featured in this article are shared in her personal capacity and do not necessarily represent the views of the Department of the Air Force, the Department of Defense, or the United States Government. Reference to her military rank and title is for informational purposes only and does not constitute or imply official endorsement or sanction by the Department of the Air Force.
