In the history of stewardesses: "In the earliest days of commercial flight, there were teenage cabin boys, and the first female stewardesses had to be registered nurses."

The 2009 book Flying Across America: The Airline Passenger Experience by Daniel L. Rust says, "*Dressed in hospital whites or military-style uniforms, a 'sky girl' of the 1930s not only served meals and soothed nerves...*

Is any type of medical certification required for flight attendants in the US or other parts of the world?

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    $\begingroup$ I don't think they were "required" to be nurses, just that they were nurses. There were very little if any "requirements" back then for cabin crew by the Civil Aeronautics Agency (CAA, precursor to the FAA) or the Bureau of Air Commerce which was in effect when the first flight attendants were used in the early 30's. $\endgroup$
    – Ron Beyer
    Aug 5, 2018 at 18:47
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    $\begingroup$ Good question, although for clarity you might consider rewording "medical certification" to "medical qualifications". When I read your question, I first thought you were asking if cabin crew need an FAA medical. $\endgroup$
    – Pondlife
    Aug 5, 2018 at 21:56
  • $\begingroup$ @ Ron Beyer - I have seen several documentaries that report the Airlines REQUIRED it as a condition of hire. In those days, a "nurse" could be someone who simply passed a Red Cross course (1 or 2 days) and there was no shortage of qualified "nurses" after WWI and WWII. $\endgroup$
    – jwzumwalt
    Aug 6, 2018 at 11:04

1 Answer 1


One of the first flight attendants anywhere, Ellen Church was also a registered nurse and certified pilot. She was unable to find work as a commercial pilot but she did have another influence on the nascent flight attendant industry: she convinced a major airline to hire only nurses.

She approached BAT (the forerunner of United Airlines) looking for a pilot's job, a futile hope for women in those days. But the BAT exec did like Church's other suggestion: that commercial airliners carry nurses on board.

Smelling a publicity coup, and figuring that on-board nurses would help quell the public's fear – very real at the time – of flying, he sold her proposal to the boys at the top. BAT hired eight nurses, including Church, for what it thought would be a three-month experiment.

These early flights attendants bore little resemblance to their modern counterparts, however

They were expected to haul luggage, screw down loose seats, help with fueling the plane and finally, at day's end, help the pilots push the plane into the hangar.

In modern aviation, trying to hire a registered nurse as a flight attendant doesn't seem to be a requirement. Here's Delta's page on hiring and it says

While specific positions will have unique requirements (example: Flight Attendant minimum age requirement is 21 years of age; see individual job descriptions), you must possess at least a H.S. diploma/GED equivalent, be at least 18 years of age, and possess current authorization to work in the U.S. to work at Delta.

The individual job descriptions are for language knowledge. None list a nursing degree as a requirement.

What changed? Well, mainly the medical profession. Nurses today have a LOT more educational requirements. Additionally, a lot more places use nurses. So nurses are in high demand now. Adding that requirement onto a flight attendant job would make the position more expensive and harder to fill.

Additionally, there might be legal liability. While simple medical devices (like AED devices to restart a heart) supplement and can prove of some limited use, imagine a flight attendant having a nursing degree and someone has a medical emergency or dies on their aircraft. Suing the airline would be a tempting. Legal liability is a very real problem here

A colleague of mine, however, was not as fortunate and encountered a much more serious condition -- urosepsis -- on a flight to London. [snip] My colleague missed her connecting flight, as did many passengers, and the other physician had to accompany the patient to the local ER because the emergency medical service worker did not want to be held liable for the IV line the ICU physician had inserted before the plane landed.


Unfortunately, liability is a very real concern, particularly in scenarios when you're not practicing in your regular clinical setting. Generally, physicians are covered by the Aviation Medical Assistance Act of 1998, which protects physicians who provide in-flight emergency medical assistance in the same way that state Good Samaritan laws do. It goes without saying that you do not have to volunteer if you do not feel comfortable with the situation or are concerned for your own safety. If you have had a few drinks or have taken sedating medications, you need to use your judgment about whether to respond.

Since you are volunteering and not technically on duty, under the 1998 law, you are covered as long as you don't engage in any willful misconduct or commit gross negligence. You should make yourself aware of the law's limitations. Many physicians feel a moral obligation to help in a medical emergency, and, thus, we can find ourselves in these situations.

If passengers leap into action to help a distressed patent, the airline avoids liability.

  • $\begingroup$ Two comments on the urosepsis scenario: 1) The paramedic who insisted on the doctor accompanying the patient to the ER because of the IV was a first-class weenie. 2) I wonder where the heck he got IV supplies on board an airplane? That's not something doctors or airlines carry. $\endgroup$ Aug 5, 2018 at 21:06
  • $\begingroup$ @CareyGregory I believe it's possible to rig one up just using salt, water, bottles and straws (it's not advisable in normal circumstances, but at 30k feet advisable gives way to necessary) $\endgroup$
    – Machavity
    Aug 5, 2018 at 21:27
  • $\begingroup$ That might be possible on a TV show, but it's just not possible in real life. At a minimum the doctor had access to an IV catheter, tubing, and IV fluids. Maybe somebody on board happened to be carrying such things as an extraordinary coincidence. $\endgroup$ Aug 5, 2018 at 22:03
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    $\begingroup$ Flights often are required to carry an emergency medical kit, with the intention that medically qualified passengers could use it in consultation with doctors on the ground by satellite phone (airlines subscribe to a service, e.g. MedLink). In the US, the contents of that kit must include IV supplies and saline solution. $\endgroup$ Aug 26, 2018 at 8:14

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