How can you guys stay in EMS?

[sir.shocksalot]

I had an epiphany today. Maybe it's been in the works for a while and it just hit me today: Why do I keep doing this job?
I think I know why. I love the work, but I hate the job. The job is now getting so bad that I just can't stomach the work anymore. I like my employer, I do, but I hate the career.
Today in Colorado a reputable ambulance company just lost a large county contract to a competitor, putting many excellent medics out of work. A fire department recently forced an ambulance contract out to bid from underneath an excellent county ambulance provider. Several other fire departments are taking over ambulance contracts, including one from a non-profit that had been serving an area for over 40 years.
Where am I going with this? Well this all points to the fact that there is NO job security in EMS. Even if you are a 3rd service provider that has been in an area for years, the FD can still come and take your jobs. Furthermore, the educational requirements to be a Paramedic keep going down and down. The 2 best paramedic programs in CO just decreased their requirements from 1 year of college anatomy and physiology to a 3 credit hour intro to A+P course. I went to a conference full of doctors, nurses and paramedics; it quickly became obvious that the dumbest, least respected people in the room were paramedics.

What keeps you guys that have been doing it for a while going back to work? Personally all this stuff going down in CO just reinforced that I have to hurry up and get a degree in something useful. How do you old timers (respectfully) keep doing it? Is it because of the work? Is EMS more stable in other states? Are some providers not smart enough to do other work?

I am honestly curious if there is some secret to this job, because I am quickly getting fed up with being a paramedic.

 

[Chimpie]

I think you need to find the right agency/department, or look into what you do next.

How can you improve EMS?
How can you improve an agency/department?
How can you improve the training?
Maybe it's time to move to management.
Maybe it's time to start doing something related to EMS but out of IFT/911.

 

[firetender]

Hasn't it always been a kind of "Not want to but have to" sort of a thing until you get to the point that it would hurt less to get out than it would to stay in?

You're right, there appears to be less material sense to stay in these days than it did back in the 1980's. Then, the strongest thing we had going for us was we had hope for the future because we believed we were actually building a profession for ourselves.

Are you saying that hope is dead?

My experience is that it takes a lot of drive to stick with the work. The drives can shift over time, too.

Like maybe I stayed in it for a couple years because I really loved the idea of helping others. Then, for the fun of mastering new techniques, and yes, the rush. For sure, a few just for the challenge of getting the systems in my areas stable. Another few for the fight to unionize. In fact, however, it was the culmulative beatings in the politics of it all that burned me out, more specifically, got me drummed out.

I never burned out on patient care, perhaps because I felt like a human amidst a very human experience that fascinated me. I became enamored of the miracle of maybe once every six months really making a difference in someone's future. That was enough to keep me in the game way beyond the, at the time, burnout average of 3.5 years!

You know I'm not lying when I say EMS captivated me. Just look at me! I'm still milking the experiences of 25 years ago. But I also had to get here by getting out. And unfortunately, that may be the case with you, as well.

Perhaps in order to make full use of the value of this life experience you need to get distance from it. No matter how you look at it, EMS builds character, life-skills and, if you let it, depth that is transferable to most anything you'll choose to do in the future.

I hear the career frustration, but underneath it all I'm picking up another, deeper and more personal level for you.

Yet, I agree with Chimpie in that I was highly motivated to change the system I was in, and that WAS a major fuel for me that kept me in the game as well. IMHO making EMS a real profession is STILL worth fighting for and could be the motivation you (and all of us!) need. And I also think the time is right.

You're just articulating the edge that most of us slide across at numerous times in our EMS careers; "Lord, please help me find another reason to stick with this!

I'd actually prefer to hear you say, "Here I am now, how do I best use where I'm at for the good of others?"

 

[Epi-do]

I think once the initial lure of the job wears off, the answer to "why do I stay" varies for everyone. For some, it may be the drive to change what they see around them - to make EMS a profession respected by others, to increase educational standards, etc. For others, it is the challenge of figuring out those rare puzzles that are presented to us so very rarely, yet often enough to keep them going. Maybe it is the chance to be the one there offering compassion/hope/a helping hand/a friendly ear/whatever the person waiting at the door needs from us. For me, it is simply that I can't imagine doing anything else ever again.

I've been doing this at one level of training or another for 12+ years now. Yes, it is longer than some, but not nearly as long as others. While it may sound cliche, I honestly feel that this is a calling for me - what I was meant to do. Before making the jump to EMS, I had jobs that I liked, in fields that paid well. I could have easily made a career out of a couple of them. However, something was always missing, and I always felt restless, no matter how much I liked where I was working, who I was working with, or what I was doing. I no longer have that restless feeling. It is simply the feeling of just knowing I am in the right place for right now.

I have plans for the future to continue my education, receive a paramedicine degree, and work my way into teaching and becoming a better advocate for my chosen profession.

Maybe it is time for you to look at the options you have available to you, where you are right now, and consider taking the next step in your journey through EMS. Whether that is considering teaching, advocacy, or moving on to something totally different, only you can say. There is no shame in walking away and trying something new, if that is what you truly want to do. On the flip-side, staying simply because you don't know where you should go from here, ultimately will bring you to a place where any positive feelings you still have about EMS will be gone. You are the only one that truly knows what the right answer is.

 

[wandering_idiot]

Well, first off it sounds like CO is giving the shaft to paramedics. But remember that this profession isn't that old and is still going through growing pains. More is expected of us on calls than before and we are having to take more non-emergency calls than 40 years ago; now some areas are having medics treat on scene and release.

EMS has always been the red-headed stepchild of medicine and, for that, we are looked down on in the hospital setting because we get dirty and don't work in a controlled environment where everything is nice and orderly and climate adjusted. However, if the attitude of the other healthcare providers in that area is as you say, it sounds like they are the ones with the issues and not the medics. The majority of providers I've met and worked with around the world are usually very polite and respected our jobs- I've even had a couple of docs and nurses admit that they couldn't do what we do everyday. They work in a perfect world environment where there is always enough of whatever is needed.

There are smart medics and the not-so-smart, just as there are smart docs and nurses and the... well, you get my point. But they aren't helping the situation by making the requirements easier... it sounds like maybe they're just trying to fill a large gap in providing service and are loosening the requirements.

I agree that it seems like medics are taught the what-to-do and less of the why-do-we-do-this. Maybe this 'transition' NREMT is trying to put through will help out on that.

Maybe you should consider a different avenue of the job. Teach, management... there are several areas where you can put your experience to good use and maybe even have a greater effect on the patients by taking care of their medics first.

Whatever you do, I wish you the best of luck in your endeavors.

 

[crazycajun]

In the 20 + years I have been in EMS, I can honestly say I have never asked "Why do I stay". I have watched many things evolve in EMS and am excited about the changes that are still to come. I do this job not for the money, not for the glory nor the rush. I do this job because I love helping people and truly believe it is why I was put on this earth. I have met many people in my career. I have always told them the same thing. If you ever have to ask yourself if you made the right decision to get into EMS then it is time to get out because it was never right to begin with. I believe with all of my heart that EMS is the MOST important part of emergency medicine and healthcare in general. I believe that ED's could have a ton less staff by simply allowing us to do more in the field. Of course that requires additional education but I have been an advocate for years. I get great satisfaction in knowing that I make a difference in someone's life each and every day I work. It doesn't matter how much money I make or what my friends have that I don't. Material things just don't matter to me if it would mean I would have to switch careers.

 

[terrible one]

Bummer I thought CO was one of the better states for EMS, oh well

 

[MrBrown]

Brown is deeply saddened by such developments.

Based on Brown's experience it seems that the dumbest, lowest common denominator is the goal to shoot for in the US: no matter what it is. Brown has worked several non EMS jobs in the US and it seems a common theme is the old joke of you can get what you need to do it out the Weet Bix box.

Who knows, but Brown bet those bloody fire unions and the New World Order have something to do with it.

 

[Sandog]

In the 20 + years I have been in EMS, I can honestly say I have never asked "Why do I stay". I have watched many things evolve in EMS and am excited about the changes that are still to come. I do this job not for the money, not for the glory nor the rush. I do this job because I love helping people and truly believe it is why I was put on this earth. I have met many people in my career. I have always told them the same thing. If you ever have to ask yourself if you made the right decision to get into EMS then it is time to get out because it was never right to begin with. I believe with all of my heart that EMS is the MOST important part of emergency medicine and healthcare in general. I believe that ED's could have a ton less staff by simply allowing us to do more in the field. Of course that requires additional education but I have been an advocate for years. I get great satisfaction in knowing that I make a difference in someone's life each and every day I work. It doesn't matter how much money I make or what my friends have that I don't. Material things just don't matter to me if it would mean I would have to switch careers.

Can I just say, well said? Bravo ...

 

[MrBrown]

We have been leaving people at home and referring them elsewhere (i.e. besides ED) for nearly forty years .... and it hasn't significantly reduced the number of people going to the emergency department.

 

[Joey]

Can't say I'm all that suprised as lots of crews are not very professional around Denver. I've been flipped off by a ambulance crew at DG as well as another crew at St. Anthony...we were in a ambulance from a different company. We were also out at Craig Hospital doing a transfer once and had a less than pleasant interaction with yet a ambulance crew. No brotherhood of EMS exists in Denver.


One thing for certain in private EMS is change, you have no guarantee your contract will be renewed or that another company will not take over...Now it's up to your company how they will handle your job...the ambulance company I worked for would help find placement for you at other operations so you would not loose your job. Sure you might need to move, but you would still have a job with that company.

So what changes are a coming in Denver area EMS?

 

[Hockey]

Why?

Easiest and coolest job ever

 

[TxParamedic]

Hmmm... All I can sugest is find your spot. What I mean is, I worked for a couple of years in the urban private EMS world and didn't care for what I saw I moved to a rural system and twenty years later I'm still here. I found my spot! It has been very rewarding to work in a situation where I know my patients even if it hurts sometimes. When my grandmother died I worked her, When my daughter broke her leg on a trampoline I was on duty. I've been the medic on the truck and I've been a pt on the same truck withen 2hrs! Hometown EMS may not be for you but I bet there is a "spot" for you somewhere.

Good luck.

 

[sir.shocksalot]

Thanks for all the replies. I have to say I was just a little frustrated with the whole thing yesterday. I can honestly say I still love my patients, and I still love patient care and I have a hard time imagining giving it up to do anything else.

Firetender: I agree that we all probably get near burn out at some point in our careers. Patient care is still more than enough for me to keep in the business for the time being, the day I stop caring about my patients is the day I need to go. But maybe your right, I probably need to focus my frustration on doing something for the career as opposed to throwing in the towel. (BTW I loved your book and it should be mandatory reading for all medics and people coming into EMS).

Wandering: I think we are the red-headed step child of everything. There are times we are expected to be ambulance drivers, and other times doctors. We don't only have the problem of public ignorance, but professional ignorance as well. How many times has a nurse or doctor been oblivious to our capabilities? Maybe we need to not attempt to educate the public until we educate our professional colleges.

Joey: Sorry to hear about your experience, DG medics sometimes have egos the size of their ambulance. I have been yelled at years go by DG medics years ago because I took their parking spot at the hospital (there is no designated DG parking spot). The few that are jerk-offs there ruin it for those that are professional and polite; my theory is that DG has too many burn outs.

Thanks again to everyone. I don't think I'm outward bound from EMS anytime soon. I just gets frustrating watching the profession take one step forward and one and a half steps back. I just got a survey from NAEMT yesterday and gave them quite an earful about how they are doing nothing for the profession other than taking my money. I think TxMedic has it right, I think once you find your spot in EMS it gets a lot better.

 

[usalsfyre]

...it quickly became obvious that the dumbest, least respected people in the room were paramedics...

How many times has a nurse or doctor been oblivious to our capabilities? Maybe we need to not attempt to educate the public until we educate our professional colleges.

How many are oblivious, or how many are responding to the idiocy of our colleagues.

Education is important, but how about we just get our coworkers not to act like tools? Toning down the "lifesaver" bit we have in our current education would help tremendously in m view.

 

[jgmedic]

How many are oblivious, or how many are responding to the idiocy of our colleagues.

Education is important, but how about we just get our coworkers not to act like tools? Toning down the "lifesaver" bit we have in our current education would help tremendously in m view.

This. If we had more emphasis on pathophys and on managing the often chronic conditions that lead to the "emergent" call to EMS, we might tone down the lifesaver attitude and maybe flush out some of the whackers that get into this field for all the wrong reasons. :censored::censored::censored::censored:, I'd settle for a mandatory beginning science program before entrance at this point.

 

[Sasha]

Because I am a masochist, I guess!

 

[wandering_idiot]

I don't know if there's a thread on this already, but aren't there entry requirements for paramedic school aside from just having your basic usually?

I had an entrance exam (like another Basic exam) and two interviews before I got accepted.

 

[sir.shocksalot]

I don't know if there's a thread on this already, but aren't there entry requirements for paramedic school aside from just having your basic usually?

I had an entrance exam (like another Basic exam) and two interviews before I got accepted.

Depends on where you go. When I went to school it was a year of college anatomy and physiology, a year of EMT basic experience, an EMT-B exam, a basic EKG exam, the HOBET exam, and an interview with the medical director and course coordinator.
However another school who's paramedics I frequently encounter has two requirements: 1)NREMT-B 2)Pulse

 

[18G]

I stay mainly because EMS is all I know. I became an EMT at 16 and started working in EMS at 18 (now 33). I do enjoy the work, the challenge, the continual learning and application of the knowledge and skills.

It does sometimes become draining but it's worth it. I know I can't go anywhere else right now making what I do with the good benefits. And the workload really isn't that demanding either most of the time.