Should I go into EMS???

wow this is all sounding really hard financially but i want to do it because i cant picture myself doing anything else
 
Rick Smith said:
wow this is all sounding really hard financially but i want to do it because i cant picture myself doing anything else
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Critical Care RN?
Flight Nurse?
HEMS Doctor?

What exactly attracts you to becoming an Ambulance Officer?
 
MrBrown said:
Critical Care RN?
Flight Nurse?
HEMS Doctor?

What exactly attracts you to becoming an Ambulance Officer?
Click to expand...

I'm also curious. Just remember as it was said in this thread what you think we do from TV/movies might as well forget about. Those things don't happen as often as you think.
 
Here is Brown's last shift:

- Check vehicle
- Sit round for two hours
- Old bloke with GI bleed
- Sit round for four hours
- Taxi ride a lady from medical clinic to hospital
- Sit round for two hours
- Taxi ride a bloke from medical clinical to hospital
- Sit round for two hours
- Have a cuppa with Nana who fell over
- Sit round some more
- Go home

As you can see, it is clearly the stuff of Hollywood movies right?
 
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My last shift as a basic...

Start:

Immediate Dialysis Transfer.

Sat for 2.5 hours.

Dialysis transfer that ended up being canceled cuz guy wouldnt stop bleeding.

Cleared that call...immediately sent for another dialysis. Got him home.

Immediately sent to take a lady with cancer in the hospital.. home so she could die.

Sat for about 3ish hours. Sent to fuel. Then home.

That's a really slow day. Usually they are just back to back dialysis calls. I talked to a basic who has been working for 5 years and has gone lights and sirens 6 times and has done cpr 5 times.
 
well what really attracted me to EMS was like being out in the field assessing gun shot wounds, heart attacks, and traumatic incidents like that but it is becoming extremely apparent thats not what it is at all. I live in Dallas, Texas so wouldnt being in an urban environment like that contain a large amount of trauma as opposed to transferring diabetes patient around?
 
Rick Smith said:
well what really attracted me to EMS was like being out in the field assessing gun shot wounds, heart attacks, and traumatic incidents like that but it is becoming extremely apparent thats not what it is at all. I live in Dallas, Texas so wouldnt being in an urban environment like that contain a large amount of trauma as opposed to transferring diabetes patient around?
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Dallas is run by Dallas Fire Rescue Paramedics who go to a 24 week class and are amongst the least educated in the United States. They have no analgesia (pain relieving medicine) and are a fast taxi ride to John Peter Smith, Parkland or Methodist. They do not have a contract for patient transfer, that is what the private companies like AMR do, and respond to 911 calls .... however most of those are probably just misdirected patient transfer jobs Brown suspects.

Trauma is a horrible disease which has a profoundly devastating effect on society. There is nothing "cool" about assessing and treating somebody who amputated his arm with a rotary saw and may never be able to use it properly meaning he can't work and support his family any longer or going to a road traffic accident where the occupants have died meaning their families are going to forever be burdened with grief, anger and the untold emotional pressure of loosing a loved one.

An Ambulance Officer is many things however broadly speaking it is 98% people management, 1.9% fundamental praxis and 0.1% advanced care.

Most of the jobs you will go to are acute exacerbations of chronic disease (angina, heart disease, asthma/COPD, diabetes, renal failure etc) and are not glamorous or exciting. Despite what your poorly written textbook tells you, most patients are not in an immediate threat to life. There is nothing exciting about attempting to resuscitate somebody in cardiac arrest on the floor of their home with the family watching you when you know full well there are overwhelming odds he is going to stay dead. There is nothing exciting about having to tell that persons family their loved one is dead and Brown finds it an incredibly undignified way to die.

Do you have an interest in talking with people and building meaningful rapport with them in order to provide care? Do you have an interest in biology, chemistry and the inner workings of the body as they relate to physiologic and pathophysiologic states? Do you have an interest in continuing education? Do you think you are able to relate well to people in different circumstances and situations? Do you work well with others?

Brown thinks you should perhaps consider these things before you think about becoming an ambo.

Go spend a few shifts shadowing an ED nurse around and perhaps you get a good idea of what being an ambo is like.
 
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On the ambulance we run anywhere between 6-12 911 calls and transfers a day. Mostly 911 calls.
During the day it's more of the school calls, light car accidents, retirement house calls, transfers, etc.
Night we usually run the bar fights, full traumas accidents, stabbings, etc.
 
MrBrown said:
Here is Brown's last shift:

- Check vehicle
- Sit round for two hours
- Old bloke with GI bleed
- Sit round for four hours
- Taxi ride a lady from medical clinic to hospital
- Sit round for two hours
- Taxi ride a bloke from medical clinical to hospital
- Sit round for two hours
- Have a cuppa with Nana who fell over
- Sit round some more
- Go home

As you can see, it is clearly the stuff of Hollywood movies right?
Click to expand...


Here's todays shift:
-Check Ambulance
-Ride Around for 15 minutes
-Work an arrest in house/ambulance/ER for about 25 minutes(Pt 10-7 at ER)
-Sit around for 4hrs
-Call to S.O.B. complaint(Pt having difficulties after trying to run away from the police, Waiver)
-Sit around 2hrs down by the strip(girl watch;);))
-Do my paperwork on our 2 calls
-Quiet Sunday at the beach
 
Rick,

Heres the deal... EMS is SOMETIMES fun, and SOMETIMES exciting. Just like Brown said, most the time it's calls that are VERY non-life threatening... We are community health resources, so people call us when they done know what else to do. Sometimes its for emergencies, most the time it's for what PEOPLE THINK are emergencies. So we get arm amputations and guts and gore??? Sure, but its far from common... And again, as Brown pointed out, it can be pretty awful mentally to the patient, the family and you when it does happen.

The pay is VERY dependent on where you live. Im in Austin, and i make GREAT money. My first year here i cleared 55k. I can, if i wanted to, support my family without my wife having to work. And their are quite a few medics that i work with whose wives dont work. I was able to buy a great house my first year working here. We live a pretty good life. BUT, Im lucky. Most EMS services dont pay as well... Central Texas has several systems that pay (about the 90th percentile for Paramedics) pretty well. Some places are better, most are worse... My system has great benefits, a good schedule and a pension retirement plan. Depends on the system (company). Dallas Fire Department makes okay money, because they are part of the Fire Department. Most EMS systems are either part of the Fire Department, or privately owned companies. And the pay reflects the type of company it is. It also depends on your level of certification. EMTs usually dont make as much (because theyre level of training is lower). But as an EMT-B i was workign in a hospital and making $13.72/hour, which is decent money, since its only a semester of schooling. Our dispatchers (who are EMT-Bs) make about $38,000 starting.

Hours can be long, again it depends where you work. I work 2 12 hour shifts a week and a 24 hour shift. My 12s are at a busy station, and my 24 is at a slower station. My busy truck runs about 8 calls in 12 hours, and my 24 hour truck runs about 6 per 24 hours.


Now, that Ive said all ,Ill tell you I effing love my job!!! Its all what you make it though. If you expect to be taking care of gun shot wounds and severe multi system trauma, you'll be dissapointed. If you want to help people, youll be rewarded...

And no, Its not anything like "Bringing out the Dead", "Third Watch", or "Trauma"... The only thing realistic about those shows is that they drive ambulances...
 
MrBrown said:
Dallas is run by Dallas Fire Rescue Paramedics who go to a 24 week class and are amongst the least educated in the United States. They have no analgesia (pain relieving medicine) and are a fast taxi ride to John Peter Smith, Parkland or Methodist. They do not have a contract for patient transfer, that is what the private companies like AMR do, and respond to 911 calls .... however most of those are probably just misdirected patient transfer jobs Brown suspects.

Trauma is a horrible disease which has a profoundly devastating effect on society. There is nothing "cool" about assessing and treating somebody who amputated his arm with a rotary saw and may never be able to use it properly meaning he can't work and support his family any longer or going to a road traffic accident where the occupants have died meaning their families are going to forever be burdened with grief, anger and the untold emotional pressure of loosing a loved one.

An Ambulance Officer is many things however broadly speaking it is 98% people management, 1.9% fundamental praxis and 0.1% advanced care.

Most of the jobs you will go to are acute exacerbations of chronic disease (angina, heart disease, asthma/COPD, diabetes, renal failure etc) and are not glamorous or exciting. Despite what your poorly written textbook tells you, most patients are not in an immediate threat to life. There is nothing exciting about attempting to resuscitate somebody in cardiac arrest on the floor of their home with the family watching you when you know full well there are overwhelming odds he is going to stay dead. There is nothing exciting about having to tell that persons family their loved one is dead and Brown finds it an incredibly undignified way to die.

Do you have an interest in talking with people and building meaningful rapport with them in order to provide care? Do you have an interest in biology, chemistry and the inner workings of the body as they relate to physiologic and pathophysiologic states? Do you have an interest in continuing education? Do you think you are able to relate well to people in different circumstances and situations? Do you work well with others?

Brown thinks you should perhaps consider these things before you think about becoming an ambo.

Go spend a few shifts shadowing an ED nurse around and perhaps you get a good idea of what being an ambo is like.
Click to expand...
Ok don't get me wrong I know you are just trying to give me a peak into what your profession is really like and I appreciate that but no where did I say that assessing trauma is "cool". My reasoning behind wanting to deal with trauma is because I think it's interesting and I feel like that's a situation where you can have a major impact on someone's life.

I'm starting to feel like ER medicine would be a better route for me the only downside is the enormous time commitment.
 
Rick Smith said:
Ok don't get me wrong I know you are just trying to give me a peak into what your profession is really like and I appreciate that but no where did I say that assessing trauma is "cool". My reasoning behind wanting to deal with trauma is because I think it's interesting and I feel like that's a situation where you can have a major impact on someone's life.

I'm starting to feel like ER medicine would be a better route for me the only downside is the enormous time commitment.
Click to expand...

Dont forget that many people presenting to EDs/ER are not acutely ill. A large chunk are for colds and flus, chronic pain, drug seekers etc etc

In short pre-hospital care and emergency medicine is no way near as glamorous as seen on TV shows or movies. You do get critical/trauma/unstable patients from time to time, but the bulk of the work is how Brown described. I'm not trying to discourage you from a career in EMS / EM but trying to give you a more realistic idea of what's involved before you take the plunge. I understand your point on trauma, I enjoy trauma calls myself, but thats probably because we rarely get them here. If I went to them all the time i'd sure i'd ge sick of them quickly.

I would suggest trying to get some ride-alongs or volunteering in an ER to get a feel before you commit.
 
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Also, don't forget that on the true, honest to God super trauma scenarios and such- overall outcome is bleak normally. I'm zero and five on codes since starting this job a year ago (and personally if I could go without an arrest ever again, I'd be thrilled), and heard plenty of stories of people who got back a pulse, just to lose it again and be pronounced in the ER. This job isn't about miracles.

The vast majority of what we do falls in the "BS" category so to speak- but the way I see it, is that while it's not life threatening, it's an emergency to someone, so I'm going to treat em well. Just being nice to someone is medicine enough sometimes
 
alright gotcha so even though it's sometimes not a life threatening emergency it is an emergency to someone,i guess that is good enough for me. One more question I'm 6 feet tall and about 150lbs but im a in no way buff or muscular, can this pose a huge issue?
 
Rick Smith said:
One more question I'm 6 feet tall and about 150lbs but im a in no way buff or muscular, can this pose a huge issue?
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I'm 6'2", 160lbs on a good day, and I have no issue. That's why they invented power stretchers and firefighters.



No, the vast majority of our calls don't matter. The vast majority are "My stomach has hurt for a week" or "My hand fell asleep", or stuff that doesn't require a visit to a primary care practictionar, let alone an emergency medical intervention.

But yes, sometimes you DO get the 'good' call, though 'good' varies. 'Good' could be the call that you reassure an old lady. 'Good' could be giving pain meds to someone in severe pain. 'Good' could be delivering a baby. Heck, as bad as it sounds, 'good' could be working a code. You can go many shifts without a single 'good' call, but then in a single shift all you run is 'good' calls.


Generally, your 'good' call is probably someone elses worst day, so you need to keep it in perspective. But really, people are going to get hurt and sick no matter what, we may as well be there to help.
 
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Rick Smith said:
alright gotcha so even though it's sometimes not a life threatening emergency it is an emergency to someone,i guess that is good enough for me. One more question I'm 6 feet tall and about 150lbs but im a in no way buff or muscular, can this pose a huge issue?
Click to expand...

I'm 5'8" 145lbs soaking wet and don't have a problem. It's all about technique and using your legs.
 
Rick Smith said:
Ok don't get me wrong I know you are just trying to give me a peak into what your profession is really like and I appreciate that but no where did I say that assessing trauma is "cool". My reasoning behind wanting to deal with trauma is because I think it's interesting and I feel like that's a situation where you can have a major impact on someone's life.

I'm starting to feel like ER medicine would be a better route for me the only downside is the enormous time commitment.
Click to expand...


As someone already stated, in a real multi-systems trauma, the outcome is already very bleak for the patient, and really what they need is a surgeon, the care we are capable of providing in the field is usually just like putting a bandaid on an arterial bleed...it'll help a little bit, but not an immense (huh, I seem to use the word immense quite a bit,weird) amount.

If you really want to have a major impact on someones life then what you really need to do is show that you want to be there for the "boring" stuff (i.e. chest pain, SOB, general weakness) and show that you really do care. This job is about PEOPLE and I think that often times providers see the patients as inanimate objects and just treat the problems, not so much the patient. An effective health care provider shows the patient that they really care about being there, they provide the patient with comfort in their time of need, and they let the patient know that they're in good hands. Like Brown said, people management is the vast majority of the job and that entails not only treating the patient physically, but also emotionally...this job isn't about blood and guts, it's about compassion.

I feel lucky everyday that I have the opportunity to be a part of a patients life, even if only in a very miniscule capacity, and if you truly desire to help people with ANY problem they come to you with, then being an EMT might fit the bill. However, if gun shot wounds, multi-system traumas, and full on codes are what you're looking for, then take a trip to Hollywood because that's the only place that those are a daily occurrence.

I'll leave you with something that has really made me think in the past, it's from a member here, although I can't exactly remember who it was (sorry :sad:)

"I am fond of a saying that has become known as my "95/5 rule": 95% of EMS providers are attracted by 5% of the calls (MVAs, GSWs, codes, etc). The 5% of us who stay in it more than 10 years hang around because of the 95% of calls. A long time ago I stopped wishing for bad things to happen and started hoping for problems I can actually fix."
 
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