You're REQUIRED to work more hours than you ever have before. Lack of transparency in benefits. Example: Advertised over and over that PHI will match a 3% contribution to 401k. That's great, until you find out that if you leave before 5 years of employment you are not eligible to receive your company's matched amount. Management from top to bottom is poor. Communication between the managers of business, clinical, mechanical and aviation is fragmented and almost non-existent. Those who work in management do not have any background in business, finance, or any relevant field. Instead, most are former flight paramedics , nurses or communications dispatchers. I wouldn't trust anyone in management to run my dog around the block, much less run an air medical company. The schedule changed in September of 2017. Medical crews now work three 24 hour shifts with a period of 24 hours off in between each shift. (72 hour work weeks!) Overtime no longer exists, but if you work more than your scheduled shifts you submit bonus vouchers. After those 5 days, (usually away from home and family, especially if working at remote bases) they are eligible for 4 days off. There is no incentive given by PHI, monetary or otherwise, to work at a remote base. This schedule is so draining, I'm not surprised PHI is hemorrhaging experienced medical crews faster than even our illustrious and all-knowing CEO, Dave Motzkin anticipated. Despite company wide frustration and extremely high turnover and resignations, he has made it clear that the schedule WILL NOT CHANGE. Since every base is only staffed by 3 nurses and 3 paramedics, getting time off approved is difficult. Management wants time off requests 4 months in advance. Since many employees at PHI are not psychic and do not possess a crystal ball, this is challenging for some. Base managers are knowledgeable and supportive of staff, but are not given any authority or allowed to make any autonomous decisions. Instead they are dumped on by upper management and used as a scapegoat for all of the problems caused by ineffective and impotent upper management. If you're a nurse and looking to be promoted into management in PHI, be aware it will be a paycut....therefore a majority of management is actually former paramedics. If you want to fly just for the sake of saying you flew, this is a good option because PHI does take safety very seriously, but be aware that this overall is a poor career move and you will sacrifice many things to do it, especially in your personal life. I recommend having a serious conversation with a current employee before you sign on.