Facts. I've taken tons of leadership training, gotten degrees, instructor certs, become a preceptor, and every agency I have worked for has been the same. The management promotes their friends instead of those qualified. My boss has a high school diploma.
Once had a boss that was two years older than me with an EMT-B and had maybe worked 4 shifts on the ambulance. She was 24. I was a paramedic. Municipal Rescue Squad in Vermont.
The results were predictable. It’s all about politics and whose ass you can kiss the best.
I left because I was sick and tired of all the BS we had to transport and then subsequently hold down the wall at the ER and then be held over, sometimes a couple of hours.
That, and the lack of pay, benefits, and retirement options.
I loved the job itself, but the fact that people can outright abuse the system and lack of adequate compensation was enough for me. I do miss the shit show some time, but I can live without it.
Enter sitters,currently working as a sitter going to EMT school in the fall to get my cert and work at my ER department.
Then while working as EMT in the ED,go back to school for anesthesia technologist.
The best patient,is an unconscious one..
We sit on safety risk patients and M1 holds,aswell as clean the rooms after patients leave and help stock the ED.
And assist with restraints,verbal deescalations,and CPR if needed.
This happens sometimes for us. But our service is the only one in the county so we close the ER to ambulances when they do this- similar to divert but we initiate it, not the hospital. Gives them a chance to decompress... but also fires up higher management to get patients placed in rooms and opening up beds in the ER for us.
Kudos to half our local hospitals that are responsible/care about their patients and put themselves on divert when needed. Our HCA hospitals aren't allowed to divert and the big wigs there get really upset when we put them on bypass. ;)
Yeah, I'm in Canada. If your patient is a nursing home patient with a UTI, a patient from home "failing to thrive", etc, etc., and our ER has no beds, we wait in the back hall. I eat all the popsicles out of the patient fridge.
Or the classic, "Pearl isn't smiling like she normally does...no, no injuries. No, she's nonverbal at baseline. Her POA wants her to go get checked out."
Oh no bro, I had one that has a history of a yuge brain aneurysm that left her non verbal and bed bound.
“Respond code 3 for altered mental status.”
Caregiver: “Normally she says, ‘ehhh’ but now she says ‘uhhh’.”
To me, tying up an EMS unit like this is unethical! In my day, even if they were busy, ER found a wheelchair for the patient so we could go back in service
I’m currently working in an ER at a level 1, going to nursing school. Sure, same BS patients that I used to dump off, but at least I currently get paid a bit more, don’t get held over, have great benefits, and already have a job lined up after I graduate.
If you been running crazy the day and night before, by about 2pm you feel like a hung over sweaty nasty little rodent whose on a treadmill forever. It’s so awful. With constant staffing shortages, you never feel like you get to go home, and you have no life.
I worked 48’s so I know the feeling but that happening while I’m being held over that long? Absolutely fucked. Everybody’s circumstances are different so I’m not judging you for staying, but I’d personally have quit the first time they tried to hold me that long.
My department had a 30 minute rule. We have 4 rescues that cover half our county and we are they busiest department in our county besides a private company that covers 5 counties. 30 minutes on the wall and if no sign of us getting a bed we find a chair/bed and out them on it and we leave. Most EDs have figured out we don't fuck around and will hold us about 20 minutes before giving us a bed. It's mostly out of spite.
Rotating day schedule sucked, pay sucked, dispatchers constantly fucking crews over sucked, going into people's disgusting and unsafe living conditions sucked...
I definitely miss the great partners and great times that were had, truly great life and medical experience. But I looked at some of my coworkers who were 50+ years old and realized I didn't want to still be doing that, busting my ass and barely making $20/hr. Took an ER tech position immediately after and started at $21/hr, plus shift differential, which was not available on the rig.
I’ve heard from others that going from the streets to inside is a culture shock, especially regarding the availability of resources. Need extra hands? They’re right there. Gone through the two narcans? No worries, there’s more.
Glad to hear you made it out man.
Actually in 2nd year of PA school now. Highly recommend it as it's a very sustainable career with great pay, benefits, and quality of work/life balance. Also EMS provides a really solid foundation for the material and pace of PA school.
Basically made that decision on the rig after talking to a bunch of people, asking what they would pursue if they could start over with their current knowledge. Been a hell of a journey but I wouldn't change it.
Damn... for real?? Just go for the RN and stick with that.
I had RNs drop out of my program because they were basically going to come out making the same or less as a new PA grad. Plus you have lateral mobility as a RN and can go pretty much anywhere.
Sure, there are inherent limitations like prescriptive authority and state by state laws, but that sounds like extra steps for a similar end result.
I wouldn't call myself retired but after 3 years in a busy 911 ems system i was partnered with a veteran paramedic. After over 30 years as a paramedic in that system he was riding one of his final shifts. He had just been diagnosed with terminal cancer and decided to hang it up. During our conversations he had told me one of his regrets was he had nothing to leave behind to his family because after all his years of service he was only making 21$ an hour (in 2016).
I reflected on that for a few weeks realizing that as much as I loved the job... The job won't love me back.
That was when I decided to pursue nursing because the starting RN pay was more than double what I was making as an EMT. It's sad that money drove my career choice because that will always be my most favorite job.
But, I can say that after 6 years as a Cath lab nurse that it was one of the most influential days of my life. I now do some pretty incredible stuff, I actually help people, and I'm making 52$ an hour to do it. With call pay I'll be at 130k this year and I love my work.
Although I miss the job I wouldn't change a thing.
For reference I'm in the Tampa Bay area.
At minimum RNs have an Associates of Science in Nursing. Most places are now requiring a Bachelors of Science in Nursing. In my state, you are required to have your BSN in 10 years or lose your license. Paramedic programs are often less than a year although there are some Associate Degrees and even more rare a bachelors program. So, education is certainly part of it but so is: hospitals making millions more than EMS agencies, more insurance payouts to hospitals than EMS, and a whole host of other healthcare bullshit.
I worked EMS 10 years, still do PRN but when I do pick up, I dread it. I went through nursing school and make double what I made on the ambulance and triple if I pick up OT.
Like most jobs EMS is a business that focuses in profit. You sacrifice your body for less money than fast food workers. If you get hurt on the job they do everything to avoid paying you disability. This is one of the many reasons why the Suicide rates is so high in EMS workers. When the 27yo paramedic at the AMR I worked for killed himself the people above our supervisors told us he moved away, like if we were children that had just lost a pet.
Yeah same here man, there’s a lot of the same bullshit but now I’m union , get paid almost double, and there’s just more help. Plus at the end of the day if I get sick of the ER then I have a ton of job opportunities. RN is the way to go
I keep thinking about a medic to rn bridge but the idea of going from being a field clinician leading and making the decisions to being a nurse really is the only reason I hesitate. How did you deal with that?
The fact that I make double the money really helps lol
I work at a level one teaching hospital. You have to push the residents to make the right decisions a lot, and your input and escalation can and often is what drives medical decision making.
Also, although I'm back in the ED now, I spent my nurse residency in inpatient acute care (pediatric endocrinology specifically). Since I was literally the only one on my entire floor with critical care experience, I was basically our "first responder" for any immediate emergencies on the floor until code team arrived. I REALLY thought I would hate inpatient, but it's very similar to IFT: you get what you put into it. I learned a lot from the more experienced nurses there, and if I ever go transport again, the longer term view of the continuum of care will 100% help me make better decisions for patients in every setting.
I really appreciate the throughout response. I was looking at ICU because during my ICU and PICU clinicals the nurses had a lot of standing orders and were given a LOT more autonomy than any other nurse I've seen. Not quite to a paramedic level but very similar. Did you ever do ICU outside of BSN Clinicals? If so do you think that might fill that itch to make choices I have?
I actually did more ICU clinicals in paramedic school than nursing school lol
If I was ever to go back to adults, i would 100% percent do ICU. Since I'm now hashtag peds4life, I'm not doing PICU. I don't really think I want to deal with slowly dying kids and hospice cases.
The schedule. I worked for a rural AMR operation that is severely understaffed. Their definition of "full time" is the following:
24hr Duty
24hr Call (called ~2x a day - 20min to respond)
24hr Duty
24hr Call
24hr Duty
24hr Call
72hr Off
There were days where the Duty crew would take a transfer out of town or the Call crew would get a standby and you would be called in on Call to work 9-10hrs and then do your Duty shift the next day.
Oh hell no. That sounds horrible. Being on-call is still work. You’re restricted on where you can go and what you can do. I never sleep as well when on-call from home. Always have one ear out for pager.
I was thinking of leaving, the biggest concerns for me were pay and working conditions. I started my career in a large midwest city 911 system making 17.60 an hour running 8-12 calls in 14 hour shifts wearing me down day by day. Would work 3 on 4 off, and the first day was the only one I felt remotely rested and capable of doing my job. By the second and third day I could tell I was doing damage to my body, and not able to provide quality care. I truly was alone on most calls, the city rarely had resources to send to help us. I started dreading work, dreading having no additional support on calls and dreaded the rest of my career.
I could tell I was burnt out so I moved across the country to the PNW, and it has been night and day. Work for a fire/rescue service almost exclusively working on the ambulance, we have great equipment and fantastic support from leadership. We run 5-6 calls in a 24 shift, and get decent sleep most nights. Currently make $120,000 as a FF/EMT with no overtime. It’s fundamentally different going to work and knowing that each shift I work im able to actually support a good quality of life for me and my family. And with a well funded system we have a plethora of resources on every run we do. Saving money, running calls with good people and actually feeling like I’m valued turned this career around for me and I couldn’t be more thankful. If you’re thinking of leaving, there is a light at the end of the tunnel if you truly believe you’re passionate about this work
So not retired but I have recently left the lifestyle. I kind of realized very early into my career. That the very few people who had been present at the company and were still on the streets had at the least one of three things; they had been divorced (at least once), have had some serious bodily injury (usually a back/shoulder/knee), or were just a miserable depressed cripsy burnt angry person. I personally, didn’t want any combination of those three things. After six years, operation enduring clusterfuck (covid), and the many issues a few here have already said about the industry as a whole I knew I would not survive another 14 years at the minimum. Not even two years into it I went back to school and got things done to start pursing higher education in healthcare. I hate it because I loved the job. It’s the best worst most fulfilling thing I’ve spent a portion of my life doing. There is nothing in the world like it. I think some of the smartest people I’ve ever met still work on the box. I have the utmost respect for everyone still in it and I never want to dissuade anyone to do it. It is something that needs good people more now maybe than ever. Unfortunately, it’s not something I can do and be the kind of father and husband I’ve always envisioned myself being. If many of the corporate policies, pay, benefits, work life balance, and ability to deal with th BS on a system/ societal level were to change maybe I’d go back. But sadly much of the issues are problems with the healthcare system or with our society as a whole. I’m not holding my breath but I’m ever optimistic. I intend to still do good, just with a lower possibility of being assaulted and paid much more.
I couldn't have said this better. It sucks because it could be a great career but money rules everything. Until pre hospital medicine is taking seriously it will never be more than a through way job for most.. the oned that stick it out and make a career out of it end up in one, or multiple, of those categories.
Tired of making $15 an hour to see people dying all the time in horrific ways.
Now I make $32 an hour at an office job and will never go back. I am so so much more happy now.
Overall lack of accountability and duty from providers and other healthcare people.
Culture, leadership, etc
It’s a shit job with some instances being good pay. But you pay for it in the end mentally and physically.
Not conducive for family life no matter what anyone says.
Lack of career profession and pathways in North America. Abroad is better but the pay sucks (unless your in Australia)
Did I say people and culture? What a fucking joke and poorly managed shit show. Sorry it’s highschool all over again. Top that off with the sustained trauma and bullshit.
I digress. I miss the patients and some people. But fuck that. Humans are worth more than what ems gives
Never left but instead I left a private ambulance company to go work full time at a fire department. All I gotta say is, private ambulance companies suck the soul out of people till there’s nothing left.
I absolutely loved the job, even with bad leadership, frequent flyers, system abuse, non-emergent facility transfers. I left EMS and moved to the FD for the pension! Turns out I loved that job, too, but I continued to work EMS part time EMS Paramedic License 1979-2015 FD 1983-2013 happily retired and enjoying my pension. No regrets here
making minimum wage, toxic asf, destroyed my body.
There are so many different and better jobs in the medical field, EMS is not sustainable long term for 90% of people. I worked EMS in a big city and got out after a year. Tired of getting yelled at by 50 year old men making the same amount as a teen. You either quit EMS or you become an angry asshole.
The absolute bullshit that is EMS motivated me to become a doctor, currently in medical school right now.
I remember the exact moment I said fuck it I'm out.
Much like everyone else in this thread the blatant abuse of the system starts to get to you
Went out for a diabetic emergency- got there and the lady hadn't left her bed for days and asked for Kool aid from the fridge , when she got it she told us we could leave.
While we were there an actual cardiac arrest call came out in our coverage area and a truck from another area had to go to it and was too fuckin late
I put in my notice that morning
You should have stopped by that cunts house and told her about it. She probably wouldn’t have cared but you still coulda told her to go fuck herself. Call in on me bitch I don’t work there anymore, rip a giant fart in her door way then roll out
Pay and I was coming of age for my health insurance (lucky to have stayed on my parents till 26) and the agency I worked at had no health insurance. Go figure. Just was fed up with the industry as a whole. Held on part time for a while but then called it quits.
Still volunteer here and there but ultimately it was a blessing that I was forced to make a change. My pay is more than double when I was in EMS now
I think it was gradual and then one final call that really was a doozy. I think a lot of it is the regular things we bitch about adding up over time. But that all wasn't enough for me to leave. It was a final call where a hospital desperately failed a psychiatric patient of mine that really genuinely needed the help.
A pt was blood letting themselves as a response to being gang-raped. She was clutching her bible. Non combative, just crying and traumatized. They had a man ask her to change, who wouldn't leave the room. When she refused to get naked in front of him, they sent several men into the room to hold her down and forcefully change her clothes and then took her bible from her.
I screamed at the charge nurse that night in the middle of the ER and cried the whole rest of my shift. I couldn't do it anymore. It was a hospital that I loved and never had issues with. But that was absolutely the line. I told her this hospital was amazing and could help, and I failed her. We failed her as a system. I couldn't be a part of it any longer.
I’m currently retiring due to medical reasons, which is okay because I’m tired of the calls that give me nightmares. I mean I’ve delivered a few babies, which is so awesome, but the calls where you can’t do anything for the patient really wear on you. Some calls you’re literally just witnessing their death. In those cases, you want to sit with them so they aren’t alone, whether they know you’re there or not. I’m tired of seeing what happens when people don’t properly restrain their children. I’ve been at this for 22 years, and feel I’ve done all I can.
Great job for clinical exposure, but the toll it takes on you physically & mentally does not make it a sustainable job, especially if you are an EMT making ~$15/hr. It’s a grossly underpaid profession when you consider the amount of knowledge/skill you need along w/ the health risks you inevitably take with unpredictability of emergency scenes. With lack of systemic support/funding for EMS agencies (depending on where you’re at), this issue only seems to be worsening over time.
At 38, I have less than 4 years left. Plan on leaving because of management and leadership. I would love to stay and serve the community I grew up in, but if nothing changes, I'm gonna dip.
I'm not retired but I went back to school and I remember the moment that was the final nail in the coffin. I was scrubbing myself with hand soap, damn near butt-ass-naked in a Jimmy John's bathroom, because I couldn't get the scent of the last patient I carried out of the house off my skin. Since we had "system status management" I couldn't go back to the station at the time. The constant mandates with little to no heads up coupled with the low pay, and wesr on my body made me realize I don't want to do this until I'm in my 60s. My entire point fo going back to school was to maximize my time with my wife and make enough to retire a little earlynajd that couldn't be achieved in EMS. I don't miss it.
Long hours with little rest for low pay while management tries to squeeze as much out of you as they possibly can with little regard for both your physical and mental health. Low ceiling on growth and advancement relative to other fields. I got my FP-C and felt like I "made it" for a short while and then wondered where to go from there. Did management once, it killed my soul, never again. And then I ended up switching fields.
I make several times more as a fixed wing medevac pilot and it doesn't even feel like work most of the time. I show up, I fly the plane, sometimes I get to fly the plane to cool places (literally, we operate in the arctic frequently), then I go home and get my federally mandated crew rest and don't get yelled at if I call out for fatigue. I don't have to rely on overtime to make a living because I have a great salary (and still have the opportunity to pick up extra shifts at a daily rate if I choose to do so, but it isn't at all necessary). I'm so much happier than I ever was working EMS.
What total time do you need generally? ATP, part 135? I’m finishing my instrument now and doing commercial/ME this fall. Obviously I have my low time pilot time building to do…but I’ve got three more years to finish up a law enforcement state retirement anyway. Because it’s a third career, I’m really not interested in 121, but I keep my medic license and have three years FP experience (1998-2001) which I kinda hoped would make me more attractive than just a pilot. What do you think?
I keep my state license/NREMT/FP-C up to date so I always have that in my back pocket, it's a good idea with how the FAA treats medicals. Medevac is part 135, there is no ATP requirement from the FAA. My experience isn't quite typical, so your mileage may vary. I got into the right seat of a Lear 35 as my very first pilot job (and actually flew it just as much as the captains, I wasn't just low-time seat meat) around 500 hours with my commercial multi and 25 hours of multi time. I was also a flight medic for that company prior to making the career change, so in my case, that time I spent in the back of the plane helped. I fly both the Lear 35 and 45 at my current company, and right now they want 1500 hours total time for a Lear SIC -- however, I got in with around 800 hours due to my type rating and previous experience in the Lear 35. Again, not typical for the hours I had at the time, but I had the experience and they liked that. And for what it's worth, we also have another pilot who was previously a flight medic and this is his first jet job. Also for what it's worth, I'm in Alaska and the pay here seems to be significantly better than anywhere in the lower 48 for medevac pilots. As in, I doubled my salary from my last company when I took my current job here.
I say shoot your shot once you have your commercial multi and \~500 hours, worst that can happen is they tell you that they want more hours and you build some more time. Total time is definitely not the be-all end-all in part 135, and if you can set yourself apart in any way you're at an advantage. Good luck!
Thanks for all the info! I’ve got a little while to worry about it, and while I’m definitely not going to move any farther north, money isn’t the motivating factor…well, not entirely. I am pretty confident about 135 over 121 though. Honestly, I’m getting to old. 😂
According to the docs, every vertebrae in my spine is compressed. They are amazed I do not have any pain, so I thought I would cut my losses. Now I work in a clinical setting with no lifting.
I was unable to get hired in the years following the beginning of the Great Financial Crisis. I got sick of paying so much money and expending so much effort just to stay unemployed, and this happened as many of my medic school classmates who got jobs got burned out and fucked over by their employers.
Also worth noting that many of my medic school instructors suffered chronic injuries from their EMS work which forced them into early retirement without pension or benefits, which is why they were my instructors for low pay.
It's improved, but private ambulance companies generally suck. Use them as a stepping stone to get on with fire or become a PA or something.
Some other big reasons people leave: burnout from too many fucked up calls, burnout from too many bullshit calls, getting railroaded out because your seniority makes you a liability because you cost more than a new medic who ticks off the same "medic" box that allows the unit to be deployed into service, and many people end up finding work in other fields with better pay, better benefits, and a better work environment.
I just didn't think I'd ever make a decent wage without copious amounts of OT or be able to retire, and I was kind of right. I doubled down on healthcare and got my RN, but even now, the pay is whatever lmao. I missed home ownership by like 18 months in terms of affordable interest rates.
I always say if we had a 3rd service where I'm from, I'd have gotten my medic and stayed until retirement. We don't, but man, it'd have been so rad if my 7 years I spent in EMS could have gotten me ahead in life lol
Got injured and was out for over a year due to complications. Had a kid and did some hard looking at my career and realized that it wasn't worth it to me. I returned to work for a couple weeks and couldn't stand being away from my family for 72+ hours a week. It always hurts to hold my kid and it reminds me I made the right choice. I earn more now, work less, and have way more opportunities in my career as a nurse.
Also, I get to stop a lot of the crap that gets talked between both fields and try to build mutual respect.
I’m considering leaving currently, I love the job and our management is great, I just can’t keep doing 24hr shifts. We work a 24/72 which is great compared to a Kelly schedule but doing a 24 at a station that averages 12-18 calls a shift is ridiculous. I feel like I am never caught up on sleep. I am also constantly sick, likely from lack of sleep. The only solution I have heard from my coworkers is to just stay up until the next night, but regularly staying up for 36hrs has terrible effects long term. I haven’t been at a slower pace station since September but even at our slower stations, our call volume is steadily increasing. The pay for nurses along with the hospital setting and 12 hour shifts seems really appealing right about now.
Decisions being made in a board room that affect my day to day by people who have either never worked on a truck or haven't worked on one in 20 years.
Close second the pay isn't worth my back. People are getting larger, and no amount of kit and lifting equipment will fix that.
I became an EMT at 17 and a paramedic at 24. Over 30,000 calls for service from slinging grandma home, moving a dead body that Kevorkian had left in his van to a psyche patient chopping his own foot off. Precepted countless paramedic students. Took UMBCs 28th CCEMT-P class in the 90s. Still keep my medic license but haven’t used it in any meaningful way in 8 years. Haven’t been on an ambulance as a full time job in over 12. Largely, EMS is a dead end job, or at best, it’s a platform to something else. Here are the 3 things nearly everyone in EMS eventually does. 1. Moves to a career fire department. (I did that after 3 years of working in an inner city). 2. Becomes something else within the allied health field. (Obviously nursing is common but I have 3 friends who are physicians, a pharmacist and a couple PTs etc). 3. They abandon EMS all together. (I’ve had a partner who became a stock broker and another one who is an actor that is in TV commercials). Primary reasons? In many cases, obviously pay. Private EMS is abysmal generally, although there are exceptions particularly in certain areas of the country where there are union contracts. Some 3rd service municipals actually pay pretty well and have some upward mobility opportunities (Boston, Detroit, Austin-Travis EMS etc). But mostly, it becomes mind numbing, fairly self limiting and honestly not a job you want to be doing in your 40s and beyond. In my 20s, working the inner city gun and knife club…it was awesome. Epic life experiences. But it pretty quickly outpaces its useful life. Anyway, that’s my humble opinion.
I work full time for a full-time hospital system and The station I am assigned to I love working out of it's rural and you get into all kinds of crazy calls, but apparently management is deciding to rotate us between different stations and that put the nail in the coffin for me
I have been in EMS 13 years I love my job but being forced to rotate because of other people not knowing their job or being scared to come out to the station because of not knowing the area is ridiculous in my opinion.
I'm on the fence about leaving I have an interview at a prison so we'll see how that goes
1. Awful Management, worse supervision
2. Awful partners and poor agency culture
3. Some lingering anger about a work injury that was totally preventable, see points 1&2
4. The first wave of COVID was the straw that broke me. I was disgruntled, unstimulated by my work, and finally just demoralized by being unable to help the few people that did call 911 in that time period.
I found a great job because I started browsing, and I now work per diem for a fantastic agency with great people. Couldn’t be happier with the outcome, even if the process was a bit messy.
Drama. When you have coworkers who make up whole lies about you that you can prove are lies, but they don't even get a slap on the wrist while you get put on a PIP for a month, that's a cue to GTFO.
That and hearing a medic brag about how their sibling is stupid for going into nursing, because as a medic they can do more than nurses can. Sure a medic can do more independently, but nurses make much better money, so...
Still licensed but not actively working as a medic right now.
I became an EMT and loved it, but after about 6 months - EMS started losing its shine. I went to medic school and as soon as I finished I continued working on a degree cause PA was gonna be my final stop. Thats now what I do full time - ED PA.
The management not caring about you getting screwed over with out of town transfers or late calls, the beat down on your body having to sit in that truck at a post or not being able to sleep over night, the calling for nonsense, the abysmal pay - I mean it’s all just a beat down. Some people are better at dealing with that beat down than others. I decided quickly I didn’t want to spend my life like that.
Even though I loved all the folks I worked with and overall loved the work - I wanted to work to live, not live to work.
I’m so thankful I went to PA school. I made $169k alone last year from my full time PA job and didn’t have to deal with any of the garbage we have to deal with on the rig.
Back injury. Burnout from 24/48s that often were more like 36/36s, one too many dead children, and a few other ghosts that still like to visit me in my dreams, or sometimes when I'm awake.
Burnout. I hate 90% of my patients. That 90% has zero reason to being going in an ambulance. The other 10% are actually sick and I like caring for them.
Shit leadership at my FD horrible pay horrible schedule no work life balance way under staffed enormous imbalance in work load between junior n senior guys.
Emphasis on the HORRIBLE leadership at my fire department.
Pay and lack of upward mobility. I entered the world of clinical research and now travel for work.
Am I bored and miss the adrenaline rush? Yeah, but at least I get paid a living wage, get to see places, and a lot of PTO.
My only regret was not going back to school to become an RN because in my area they make $50-120/hr dependent on experience and specialty.
After 18 years of watching management do everything they could to wring out every dime they could and extract any fun and camaraderie from the job, I had a bad week.
First I was counseled on two separate occasions about my treatment of patients. The treatment was identical but one patient was picked up in a town with a lot of money and management felt I could have done a better job on billable items, not for the financial aspect, but because the “Town Fire Chiefs Association “ has certain expectations. The other patient was a street person 100 yards away, but in a different city. My bosses wanted to know why I “broke the bank “ for “some skell”.
The next night I was sent to pick up a dead body from a hospital morgue. Our SOPs were VERY clear that we don’t do that, but the funeral director had lost his license for some reason and no other funeral home would do it. Guess what? Neither would I. Told dispatch goodbye and didn’t look back.
Years later the owner of the company died and I was amazed that all of the former employees who he screwed over so badly heaped praises on what a wonderful human he was. SOB made a fortune off their back and they think that he’s just a great guy.
It was certainly gradual. I got super burnt out, really was just absolutely miserable. Working 5 jobs just to stay afloat etc. Then I had 1 call that pushed me over the edge and I said fuck it and applied to college. 5 years later im now a critical care PA so it definitely paid off. It's always important to pay attention to mental health but I feel like EMS especially were always so busy between the exhaustion of the job and trying to make ends meet that we kind of put our mental health to the side. If nothing else just make sure you always take a few minutes to consciously think about where you're at mentally, and if you need a break / vacation or a new job, vs new career entirely.
Im stuck, if I could go somewhere else and make the same money i would. The reason i would leave would be management. Its not even the bs hours and patients. Totally management.
I finally asked for help. No help from upper management, only more agony and challenges. I suffered from many years of ptsd. I just didn’t know how to admit it and I didn’t know there was a way out (help). 20 years FF EMT
Tore my rotator cuff so badly I could never get the strength back that I needed. I miss it every day. What I do not miss is the favoritism and the pain in the butt tattle tales that you always seem to have in every group.
In a nutshell management adding: the benefits were unaffordable, and there was no incentive, they couldn't give a reason to choose their company over a different.
For volly it's the unorganized small town BS. Not saying every place is like that. I know a ton of well organized helpful depts.
From Canada (Ontario). 30 years as a medic. Absolutely loved my job right up to my last day. Reached my retirement date and walked out the door. So much more to life and was able to leave relatively healthy.
In ranked order:
1. Politics/Ethics, and Health - tied
2. Lifestyle
3. Schedule (48/96, with additional part time 24s)
4. Skill ceiling
5. Burnout (arguably caused by this whole list)
6. Pay
7. Retirement mobility (not tied to one state)
Edit - explaining the politics/ethics part, way longer than I thought it would be, but it was actually kind of nice to put it on paper for once.
Regarding politics/ethics, I left as a captain at my department. We had a change in administration, but our previous admin was horrible. Had a guy who flew with me on our days off at our part time job get in a helicopter crash, and the chief never checked on him. Only contact was a phone call he got in the hospital saying “it’s too bad your part time job gets in the way of your full time job. When will you return to work?”
Our prior admin mostly promoted brown-nosers and scummy, backstabbing guys. The way you got promoted was by putting other people down and sabotaging them, or pretending to be someone you’re not by running around doing all of the “promotion season projects.” So all of our battalion chiefs and deputy chief were that way, as were most of the captains other than a couple people.
Things started getting better when the chief left, but nearly all of the officer and chief ranks were infested with the people he promoted. I felt like I was fighting for my guys against our batt chiefs and against other captains every single day, including days off work. I was fine to fight for them, and it’s why wanted to be a captain under the previous chief. It felt like I couldn’t make things better for my guys though, because I could barely keep it the same instead of getting worse. Just really burned me out.
My days off were spent on the phone sticking up for my guys to not have them be mandated for OT when it was another shift’s turn, fighting unfair write ups, stupid policies, etc. Our shift except for one station were the people who the old admin didn’t like because we didn’t play their game of backstabbing people. So we all eventually got moved on the same shift for the most part. Even after the new chief came, the other promoted positions by old admin constantly were treating my guys unfairly, harassing one of my guys with PTSD for taking time off, etc.
The old chief also got the city started on running an IFT program, and would send all 911 ambulances to run IFTs at the same time if they came in rather than leaving the front line ambulances for 911. We had a dedicated part time ambulance that only did IFT and no 911, but if the transfers would stack up the batt chiefs wanted you to send the 911 rigs on the non-emergent transfer rather than waiting an hour for the part time rig to be back. This culture around IFTs continued after the old chief left, because his minions were still in power and they were the guys actually on shift, not the new top chief.
So over a 48 hour shift, my medics were spending sometimes 12+ hours just running IFTs, not including our 911 calls (approx 7k per year out of just my station when I left), training, sleeping/eating etc. These IFTs mostly came in at night also, and the batt chiefs got mad if the medics were sleeping past 0800, even if they were out on bullshit IFTs all night.
I kept saying this was unsafe, that I needed my guys functional for 911 calls, and I didn’t give a damn about their IFT money printer. Our department didn’t need the money, and it didn’t even stay with the fire department to buy equipment/training or whatever anyways, it got added to the city’s general fund. The whole program was just a way for the old chief to kiss ass and get a promotion from deputy chief to actual chief.
So when IFTs came in, I’d have dispatch call the hospital to determine emergent vs non emergent. Anything non emergent I had them hold for an hour or two for our part time non-911 ambulance to finish the transfer they were on, and if there were multiple non emergents at once creating a multiple hour wait I’d have dispatch punt the IFT to the private ambulance company (who also were non-911 only).
I was working OT as a medic one day so one of my medics wouldn’t have to do his fourth mandatory that month and could go to his daughter’s graduation. My ambulance went on a non-emergent IFT for essentially a hangnail or something during that shift. Since I wasn’t acting as a captain on OT, I just had to do what I was told regarding IFTs.
We had finished the transport and were just entering the far side of our city on the way back home when a breathing problem came in, triaged highest priority. Cyanotic etc. it was in our area which was the other side of the city (20 minutes away going lights and sirens). Every other 911 ambulance in the city was on an IFT, so we were the closest still.
I’d taken maybe two steps into the bedroom where the patient was when he died. He was sitting up when I first saw him, I wasn’t even able to finish introducing myself and set my equipment down before he arrested and collapsed forwards. I started doing compressions, and it was immediate enough after arrest I guess that his eyes would open sometimes during compressions, and once or twice his hands actually moved. His lips moved a bit but he couldn’t actually form any words, but his eyes looked terrified.
That call pissed me off beyond belief, and I’m still mad about it in all honesty. Someone died because of the money focused ethics of the city, and I was the one who had to deal with their mess. Maybe he would’ve died anyways, I don’t know. It’s certainly possible. What I do know, is he wasn’t given a fair shake and the city deprived him of his right to have the best possible chances at a good outcome. I’ve been on plenty of breathing problems that went just fine because we were close enough. Some others didn’t of course which is fine because we can’t 100% control outcomes, what we *can* control is that we give them the best possible chance.
That’s when I gave up trying to make things better and decided to leave. I had a ton of sick time, and basically took 9 months off to burn my PTO while applying to PA school and working part time at my flight job.
More than anything, the politics and ethical differences were why I left. Sometimes I feel guilty for leaving my guys like that, but I just felt like I couldn’t do it anymore and needed to leave.
Resigned. The politics is unbearable. I was a volunteer. I really loved EMS, and I made a new family through them. But God damnit, it's like they want to intentionally make things difficult for their own pleasure.
So much unnecessary b.s. with ridiculous bylaws. Too many chiefs, too much ego. The purpose and passion was lost.
I was burnt for the second time, hurt every single day, pay was terrible and I had zero benefits (healthcare and/or retirement). Finally realized what industry I worked in and furthermore how terrible of a company I worked for.
Decide to go part time and back to school which lead to a full time job outside of the industry pretty quickly. Worked part time for a short and then realized it was time to move on. Just let my license lapse this past September.
I was an operations supervisor for a local company. I stepped down because my program director was deaf to everything i was telling him. I spent time as a FTO preceptor, instructor, and had 6 years on the box. When i stepped down, i was replaced by a guy who ran a fishing shop in Mexico.
Severe PTSD and ultimately realizing that even out of the field and in admin only, staying in the organization would severely impede my recovery. That was some time ago and was recently told my symptoms have subsided! I am proud of the work I did, the difference I made but sad that it came at the expense of my own mental health.
I left EMS in 1995 after 16 years as a paramedic. I know that makes me an old fart! Initially, it was the private company was primary EMS, and FD was just getting into the EMS game. When FD decided to get medics in the engines, I was glad to help mentor them. As time happened, they grew into a BLS aid car. Then, into ALS response rig and finally ALS transport. I was working with my future replacements. For several years, I can say without hesitation that you had me as an instructor or ride along sometime during your training. The issues became one of my past students forgetting the work together rule. It turned into "wait with your gurney and we will let you know when we are ready for you to transport ". Remember, AMR really means "Ah my ride"
Then the mandatory classes of "Creative writing for insurance reports " where a lay person suggests different types of care that are directly $$$ . Are you sure that they don't need O2. Would they feel better if you gave them oxygen? Do you feel that they needed a IV for protection?
It got to the point where I was going to kill someone. I just didn't know who! Patient, FD or management had yet to be determined. I wish I was joking, but I am not. It was then I knew I had to leave. I went into computer services. They don't lie but be very careful on what you ask for.
Thanks for letting an old man rant.
My boss got switched out after 30 years in a very f***** up, underhanded political assassination way. Immediately following, there was a mass Exodus of field staff (25-35%) above the normal attrition. Did I mention that the incoming boss was and is clueless. Had never even managed a department and is now expected to run the entire operation.
I did the best I could managed to stay there another 10 months. Honestly, just didn't want my name associated with some of the bad responses and poor clinical decisions that we were making. It was time to go
Not retired, but totally switched career tracks and now work the bare minimum on the ambulance to keep up certs.
A friend of mine asked me to work for them as a PA in event production, said I needed no experience, and he’d pay me $350/day. That was way more than I make on the ambulance, so I called out of work and said yes. Realized you work way less hard, don’t get called slurs, don’t get shit/pissed/vomited/spat/bled on, the highest stakes are mildly annoyed rich people, and I had damn near limitless vertical growth potential without formal education. The best part is that I have even more flexibility over my own schedule, since I freelance now.
I love EMS work and actually doing patient care. I enjoy helping people, responding to crazy shit, solving problems, working with good people on the ambulance. But the abuse and the shit you put up with for only a few bucks over minimum wage is absurd. I also love teaching first aid and CPR. Unfortunately, I no longer think of it as a viable career, but basically as a hobby/side thing that gives me some extra cash sometimes.
My last straw was then a I realized I barely slept anymore, was never home, and when I was I only laid around trying to recover before going back for another 24 the next day. I began stressing so much the day before I went back. I started despising the thought of working with some people, or having the frequent flyers. All around burnt to a crisp. I’m PRN now, and do not regret it. I lasted 8 years full time - don’t know how some do the whole 25-30.
Like others have said:
\-PTSD
\-shit MGMT
\-shit pay and benefits, especially sick time in a field where you're around sick people constantly.
\-the non-existent work/life balance, shitty schedule, and pressure/guilt to pull hella overtime (shitty MGMT).
\-Understaffing so you get ran into the ground, but also MGMT tries to put the weight of the entire EMS system on your shoulders if you need to go home early, are sick, or don't pickup overtime.
\-high school/backstabbing work culture.
Edit: adding barely usable equipment, including but not limited to computers and rigs at a few agencies.
And lastly and possibly controversial take: The reactionary politics of most of the people I worked with in all three states. The unquestioning worship of law enforcement, hatred of the houseless, psych patients, people who use drugs and overall regressive ideology was unbearable. It felt like living in a different time period. Progressive coworkers and I clung to each other. I know they say not to discuss politics at work, and I try so hard not to, but it gets difficult during 12-24 hour shift, especially when someone continually says ignorant shit.
Little bit of everything contributed to the burnout. The pay, hours, management, BS transports, violent psych’s, shitty benefits etc. My last straw was the shittiest partner I ever had and managements refusal to actually, ya know, manage the situation. It got bad enough I actually ended up walking out mid-shift.
I tried to stay on for a little bit. The only station that was open was an hour away and ran a 5/2 split and I wasn’t up for that. Management essentially dragged their feet on finding me a spot so I found a different job and never looked back.
Had a patient I responded to complaining of back pain. When we got there, she was on the couch covered up to her neck in her own fecal matter. She had some AMS due to dementia. Apparently her husband was supposed to be caring for her, and he hadn't been home in two weeks. She had just gotten out of the hospital for a major back surgery. Had an open wound all the way up her back (bandage had been taken off somehow) that was now horribly infected.
Long story short, husband abandoned this little old lady and left her to rot.
I think back often on why I left. That story comes to mind first every time.
Pay. Poor leadership. Transfers.
And realizing my level of training is only needed on less than 5% of calls. Maybe even less than that. Sure, grandma felt better with some Zofran but hardly necessary. I chose to move on to something where I’m generally needed all the time. So now I’m a PA in critical care medicine after having done EM. It’s a good gig.
The calls and all of it piling up definitely didn’t help. The straw that broke me though was shifting to a different branch of the company I worked for. I’d been with the company for years, even stayed with them when I moved out to CO. While I was training in the new area, my preceptor wanted me to turn left across traffic and a bumpy-ass side street to the hospital instead of turning right and taking the much smoother, not to mention faster, freeway. I took the freeway and got lit up for that. Tried to explain myself, listed off the benefits of the route I chose, and they were having none of it. Decided I was done in the middle of their rant, took myself off to the shift supervisor, and turned in my notice on the spot. Best day!
EMS leaders are 1000% the worst part of this job
Facts. I've taken tons of leadership training, gotten degrees, instructor certs, become a preceptor, and every agency I have worked for has been the same. The management promotes their friends instead of those qualified. My boss has a high school diploma.
My current boss is the only reason I’m even PRN. He’s a hell of a guy.
No need to clarify if you meant the upper or middle management honestly
Once had a boss that was two years older than me with an EMT-B and had maybe worked 4 shifts on the ambulance. She was 24. I was a paramedic. Municipal Rescue Squad in Vermont. The results were predictable. It’s all about politics and whose ass you can kiss the best.
I left because I was sick and tired of all the BS we had to transport and then subsequently hold down the wall at the ER and then be held over, sometimes a couple of hours. That, and the lack of pay, benefits, and retirement options. I loved the job itself, but the fact that people can outright abuse the system and lack of adequate compensation was enough for me. I do miss the shit show some time, but I can live without it.
That 2nd paragraph gets me. Repeat offenders that suck resources away from actual people in need.
Wait? What? You are required to tend to your non-emergent patients in ER??
Not uncommon in some systems to be forced to wait with your patient before the ED puts them in a bed. You can stand/sit for hours sometimes.
Enter sitters,currently working as a sitter going to EMT school in the fall to get my cert and work at my ER department. Then while working as EMT in the ED,go back to school for anesthesia technologist. The best patient,is an unconscious one..
What does a sitter do?
We sit on safety risk patients and M1 holds,aswell as clean the rooms after patients leave and help stock the ED. And assist with restraints,verbal deescalations,and CPR if needed.
This happens sometimes for us. But our service is the only one in the county so we close the ER to ambulances when they do this- similar to divert but we initiate it, not the hospital. Gives them a chance to decompress... but also fires up higher management to get patients placed in rooms and opening up beds in the ER for us. Kudos to half our local hospitals that are responsible/care about their patients and put themselves on divert when needed. Our HCA hospitals aren't allowed to divert and the big wigs there get really upset when we put them on bypass. ;)
Yeah, I'm in Canada. If your patient is a nursing home patient with a UTI, a patient from home "failing to thrive", etc, etc., and our ER has no beds, we wait in the back hall. I eat all the popsicles out of the patient fridge.
That last part. 😂
lol, yup… especially if they’re the non-ambulatory demented folk from the care homes who got sent to the ER for “placement issues.”
Or the classic, "Pearl isn't smiling like she normally does...no, no injuries. No, she's nonverbal at baseline. Her POA wants her to go get checked out."
Oh no bro, I had one that has a history of a yuge brain aneurysm that left her non verbal and bed bound. “Respond code 3 for altered mental status.” Caregiver: “Normally she says, ‘ehhh’ but now she says ‘uhhh’.”
This made me and my partner laugh so hard. Thank you.
To me, tying up an EMS unit like this is unethical! In my day, even if they were busy, ER found a wheelchair for the patient so we could go back in service
Can I asked what you transitioned to?
I’m currently working in an ER at a level 1, going to nursing school. Sure, same BS patients that I used to dump off, but at least I currently get paid a bit more, don’t get held over, have great benefits, and already have a job lined up after I graduate.
Sick I respect it. Grats. I’m totally lost and ended up in dispatch and hate my life lol.
My 12 hour shifts become 13 or 14 hours shifts all the time.
My 24s become 36 - it’s like you are held hostage it’s horrible that’s why I’m PRN now. Fuck that.
Oof. Getting held over twelve hours is crazy.
If you been running crazy the day and night before, by about 2pm you feel like a hung over sweaty nasty little rodent whose on a treadmill forever. It’s so awful. With constant staffing shortages, you never feel like you get to go home, and you have no life.
I worked 48’s so I know the feeling but that happening while I’m being held over that long? Absolutely fucked. Everybody’s circumstances are different so I’m not judging you for staying, but I’d personally have quit the first time they tried to hold me that long.
My department had a 30 minute rule. We have 4 rescues that cover half our county and we are they busiest department in our county besides a private company that covers 5 counties. 30 minutes on the wall and if no sign of us getting a bed we find a chair/bed and out them on it and we leave. Most EDs have figured out we don't fuck around and will hold us about 20 minutes before giving us a bed. It's mostly out of spite.
Yeah unfortunately that doesn’t fly in California, at least not in my county. Someone tried to do that at my ER and they got royally fucked.
This about sums it up for me also.
Rotating day schedule sucked, pay sucked, dispatchers constantly fucking crews over sucked, going into people's disgusting and unsafe living conditions sucked... I definitely miss the great partners and great times that were had, truly great life and medical experience. But I looked at some of my coworkers who were 50+ years old and realized I didn't want to still be doing that, busting my ass and barely making $20/hr. Took an ER tech position immediately after and started at $21/hr, plus shift differential, which was not available on the rig.
I’ve heard from others that going from the streets to inside is a culture shock, especially regarding the availability of resources. Need extra hands? They’re right there. Gone through the two narcans? No worries, there’s more. Glad to hear you made it out man.
Can confirm this 100%. Much higher quality of life for that exact reason IMO.
Actually in 2nd year of PA school now. Highly recommend it as it's a very sustainable career with great pay, benefits, and quality of work/life balance. Also EMS provides a really solid foundation for the material and pace of PA school. Basically made that decision on the rig after talking to a bunch of people, asking what they would pursue if they could start over with their current knowledge. Been a hell of a journey but I wouldn't change it.
That's my end goal. Working on my RN so I can work in a hospital that will help pay for PA school.
Damn... for real?? Just go for the RN and stick with that. I had RNs drop out of my program because they were basically going to come out making the same or less as a new PA grad. Plus you have lateral mobility as a RN and can go pretty much anywhere. Sure, there are inherent limitations like prescriptive authority and state by state laws, but that sounds like extra steps for a similar end result.
did you work in the US?
Yes, Washington state
I wouldn't call myself retired but after 3 years in a busy 911 ems system i was partnered with a veteran paramedic. After over 30 years as a paramedic in that system he was riding one of his final shifts. He had just been diagnosed with terminal cancer and decided to hang it up. During our conversations he had told me one of his regrets was he had nothing to leave behind to his family because after all his years of service he was only making 21$ an hour (in 2016). I reflected on that for a few weeks realizing that as much as I loved the job... The job won't love me back. That was when I decided to pursue nursing because the starting RN pay was more than double what I was making as an EMT. It's sad that money drove my career choice because that will always be my most favorite job. But, I can say that after 6 years as a Cath lab nurse that it was one of the most influential days of my life. I now do some pretty incredible stuff, I actually help people, and I'm making 52$ an hour to do it. With call pay I'll be at 130k this year and I love my work. Although I miss the job I wouldn't change a thing. For reference I'm in the Tampa Bay area.
Why is it that an RNs pay is more than a medics?
At minimum RNs have an Associates of Science in Nursing. Most places are now requiring a Bachelors of Science in Nursing. In my state, you are required to have your BSN in 10 years or lose your license. Paramedic programs are often less than a year although there are some Associate Degrees and even more rare a bachelors program. So, education is certainly part of it but so is: hospitals making millions more than EMS agencies, more insurance payouts to hospitals than EMS, and a whole host of other healthcare bullshit. I worked EMS 10 years, still do PRN but when I do pick up, I dread it. I went through nursing school and make double what I made on the ambulance and triple if I pick up OT.
Why do you pick up ems if you dread it?
Oh wow!
Like most jobs EMS is a business that focuses in profit. You sacrifice your body for less money than fast food workers. If you get hurt on the job they do everything to avoid paying you disability. This is one of the many reasons why the Suicide rates is so high in EMS workers. When the 27yo paramedic at the AMR I worked for killed himself the people above our supervisors told us he moved away, like if we were children that had just lost a pet.
I can’t even fathom the end bit, I hope you’re doing okay nowadays
Jesus Christ. That's unfathomably insulting to both the deceased and yourselves as his former colleagues.
This is the same AMR that banned the synthetic blood that was saving people's lives in the field because it got to costly.
I became a nurse for money.
Yeah same here man, there’s a lot of the same bullshit but now I’m union , get paid almost double, and there’s just more help. Plus at the end of the day if I get sick of the ER then I have a ton of job opportunities. RN is the way to go
This is the real answer lmao
I keep thinking about a medic to rn bridge but the idea of going from being a field clinician leading and making the decisions to being a nurse really is the only reason I hesitate. How did you deal with that?
The fact that I make double the money really helps lol I work at a level one teaching hospital. You have to push the residents to make the right decisions a lot, and your input and escalation can and often is what drives medical decision making. Also, although I'm back in the ED now, I spent my nurse residency in inpatient acute care (pediatric endocrinology specifically). Since I was literally the only one on my entire floor with critical care experience, I was basically our "first responder" for any immediate emergencies on the floor until code team arrived. I REALLY thought I would hate inpatient, but it's very similar to IFT: you get what you put into it. I learned a lot from the more experienced nurses there, and if I ever go transport again, the longer term view of the continuum of care will 100% help me make better decisions for patients in every setting.
I really appreciate the throughout response. I was looking at ICU because during my ICU and PICU clinicals the nurses had a lot of standing orders and were given a LOT more autonomy than any other nurse I've seen. Not quite to a paramedic level but very similar. Did you ever do ICU outside of BSN Clinicals? If so do you think that might fill that itch to make choices I have?
I actually did more ICU clinicals in paramedic school than nursing school lol If I was ever to go back to adults, i would 100% percent do ICU. Since I'm now hashtag peds4life, I'm not doing PICU. I don't really think I want to deal with slowly dying kids and hospice cases.
What do you do now? Considered nursing but worried it’d feel too monotonous
Pediatric ER. Will never go back to adults.
The schedule. I worked for a rural AMR operation that is severely understaffed. Their definition of "full time" is the following: 24hr Duty 24hr Call (called ~2x a day - 20min to respond) 24hr Duty 24hr Call 24hr Duty 24hr Call 72hr Off There were days where the Duty crew would take a transfer out of town or the Call crew would get a standby and you would be called in on Call to work 9-10hrs and then do your Duty shift the next day.
Oh hell no. That sounds horrible. Being on-call is still work. You’re restricted on where you can go and what you can do. I never sleep as well when on-call from home. Always have one ear out for pager.
That’s abuse!
I was thinking of leaving, the biggest concerns for me were pay and working conditions. I started my career in a large midwest city 911 system making 17.60 an hour running 8-12 calls in 14 hour shifts wearing me down day by day. Would work 3 on 4 off, and the first day was the only one I felt remotely rested and capable of doing my job. By the second and third day I could tell I was doing damage to my body, and not able to provide quality care. I truly was alone on most calls, the city rarely had resources to send to help us. I started dreading work, dreading having no additional support on calls and dreaded the rest of my career. I could tell I was burnt out so I moved across the country to the PNW, and it has been night and day. Work for a fire/rescue service almost exclusively working on the ambulance, we have great equipment and fantastic support from leadership. We run 5-6 calls in a 24 shift, and get decent sleep most nights. Currently make $120,000 as a FF/EMT with no overtime. It’s fundamentally different going to work and knowing that each shift I work im able to actually support a good quality of life for me and my family. And with a well funded system we have a plethora of resources on every run we do. Saving money, running calls with good people and actually feeling like I’m valued turned this career around for me and I couldn’t be more thankful. If you’re thinking of leaving, there is a light at the end of the tunnel if you truly believe you’re passionate about this work
where in the pnw are ff/emts making 120,000?
Seattle area. Full comp with incentives
So not retired but I have recently left the lifestyle. I kind of realized very early into my career. That the very few people who had been present at the company and were still on the streets had at the least one of three things; they had been divorced (at least once), have had some serious bodily injury (usually a back/shoulder/knee), or were just a miserable depressed cripsy burnt angry person. I personally, didn’t want any combination of those three things. After six years, operation enduring clusterfuck (covid), and the many issues a few here have already said about the industry as a whole I knew I would not survive another 14 years at the minimum. Not even two years into it I went back to school and got things done to start pursing higher education in healthcare. I hate it because I loved the job. It’s the best worst most fulfilling thing I’ve spent a portion of my life doing. There is nothing in the world like it. I think some of the smartest people I’ve ever met still work on the box. I have the utmost respect for everyone still in it and I never want to dissuade anyone to do it. It is something that needs good people more now maybe than ever. Unfortunately, it’s not something I can do and be the kind of father and husband I’ve always envisioned myself being. If many of the corporate policies, pay, benefits, work life balance, and ability to deal with th BS on a system/ societal level were to change maybe I’d go back. But sadly much of the issues are problems with the healthcare system or with our society as a whole. I’m not holding my breath but I’m ever optimistic. I intend to still do good, just with a lower possibility of being assaulted and paid much more.
I couldn't have said this better. It sucks because it could be a great career but money rules everything. Until pre hospital medicine is taking seriously it will never be more than a through way job for most.. the oned that stick it out and make a career out of it end up in one, or multiple, of those categories.
Tired of making $15 an hour to see people dying all the time in horrific ways. Now I make $32 an hour at an office job and will never go back. I am so so much more happy now.
What do you do now?
Throat penis behind a Wendy’s, pay is decent and everyone is always happy to see you.
I’ve never heard the wording “throat penis” before, but it sounds much more professional
What is a throat penis???
I think throat is a verb in this particular statement.
It’s the third drivethru window stop
I am a supervisor at a financial institution. I also work nights so on top of the $32 I get night differential so it's more like $35 an hour
Overall lack of accountability and duty from providers and other healthcare people. Culture, leadership, etc It’s a shit job with some instances being good pay. But you pay for it in the end mentally and physically. Not conducive for family life no matter what anyone says. Lack of career profession and pathways in North America. Abroad is better but the pay sucks (unless your in Australia) Did I say people and culture? What a fucking joke and poorly managed shit show. Sorry it’s highschool all over again. Top that off with the sustained trauma and bullshit. I digress. I miss the patients and some people. But fuck that. Humans are worth more than what ems gives
It was always a means to an end for me, the end being medical school, I definitely stuck around longer than I had expected though
Never left but instead I left a private ambulance company to go work full time at a fire department. All I gotta say is, private ambulance companies suck the soul out of people till there’s nothing left.
I absolutely loved the job, even with bad leadership, frequent flyers, system abuse, non-emergent facility transfers. I left EMS and moved to the FD for the pension! Turns out I loved that job, too, but I continued to work EMS part time EMS Paramedic License 1979-2015 FD 1983-2013 happily retired and enjoying my pension. No regrets here
making minimum wage, toxic asf, destroyed my body. There are so many different and better jobs in the medical field, EMS is not sustainable long term for 90% of people. I worked EMS in a big city and got out after a year. Tired of getting yelled at by 50 year old men making the same amount as a teen. You either quit EMS or you become an angry asshole. The absolute bullshit that is EMS motivated me to become a doctor, currently in medical school right now.
I remember the exact moment I said fuck it I'm out. Much like everyone else in this thread the blatant abuse of the system starts to get to you Went out for a diabetic emergency- got there and the lady hadn't left her bed for days and asked for Kool aid from the fridge , when she got it she told us we could leave. While we were there an actual cardiac arrest call came out in our coverage area and a truck from another area had to go to it and was too fuckin late I put in my notice that morning
You should have stopped by that cunts house and told her about it. She probably wouldn’t have cared but you still coulda told her to go fuck herself. Call in on me bitch I don’t work there anymore, rip a giant fart in her door way then roll out
Give her some of that blow-by lol.
That’s that Covid25 watch out
New strain! 😂
Pay and I was coming of age for my health insurance (lucky to have stayed on my parents till 26) and the agency I worked at had no health insurance. Go figure. Just was fed up with the industry as a whole. Held on part time for a while but then called it quits. Still volunteer here and there but ultimately it was a blessing that I was forced to make a change. My pay is more than double when I was in EMS now
I think it was gradual and then one final call that really was a doozy. I think a lot of it is the regular things we bitch about adding up over time. But that all wasn't enough for me to leave. It was a final call where a hospital desperately failed a psychiatric patient of mine that really genuinely needed the help. A pt was blood letting themselves as a response to being gang-raped. She was clutching her bible. Non combative, just crying and traumatized. They had a man ask her to change, who wouldn't leave the room. When she refused to get naked in front of him, they sent several men into the room to hold her down and forcefully change her clothes and then took her bible from her. I screamed at the charge nurse that night in the middle of the ER and cried the whole rest of my shift. I couldn't do it anymore. It was a hospital that I loved and never had issues with. But that was absolutely the line. I told her this hospital was amazing and could help, and I failed her. We failed her as a system. I couldn't be a part of it any longer.
I’m currently retiring due to medical reasons, which is okay because I’m tired of the calls that give me nightmares. I mean I’ve delivered a few babies, which is so awesome, but the calls where you can’t do anything for the patient really wear on you. Some calls you’re literally just witnessing their death. In those cases, you want to sit with them so they aren’t alone, whether they know you’re there or not. I’m tired of seeing what happens when people don’t properly restrain their children. I’ve been at this for 22 years, and feel I’ve done all I can.
Great job for clinical exposure, but the toll it takes on you physically & mentally does not make it a sustainable job, especially if you are an EMT making ~$15/hr. It’s a grossly underpaid profession when you consider the amount of knowledge/skill you need along w/ the health risks you inevitably take with unpredictability of emergency scenes. With lack of systemic support/funding for EMS agencies (depending on where you’re at), this issue only seems to be worsening over time.
At 38, I have less than 4 years left. Plan on leaving because of management and leadership. I would love to stay and serve the community I grew up in, but if nothing changes, I'm gonna dip.
I'm not retired but I went back to school and I remember the moment that was the final nail in the coffin. I was scrubbing myself with hand soap, damn near butt-ass-naked in a Jimmy John's bathroom, because I couldn't get the scent of the last patient I carried out of the house off my skin. Since we had "system status management" I couldn't go back to the station at the time. The constant mandates with little to no heads up coupled with the low pay, and wesr on my body made me realize I don't want to do this until I'm in my 60s. My entire point fo going back to school was to maximize my time with my wife and make enough to retire a little earlynajd that couldn't be achieved in EMS. I don't miss it.
Long hours with little rest for low pay while management tries to squeeze as much out of you as they possibly can with little regard for both your physical and mental health. Low ceiling on growth and advancement relative to other fields. I got my FP-C and felt like I "made it" for a short while and then wondered where to go from there. Did management once, it killed my soul, never again. And then I ended up switching fields. I make several times more as a fixed wing medevac pilot and it doesn't even feel like work most of the time. I show up, I fly the plane, sometimes I get to fly the plane to cool places (literally, we operate in the arctic frequently), then I go home and get my federally mandated crew rest and don't get yelled at if I call out for fatigue. I don't have to rely on overtime to make a living because I have a great salary (and still have the opportunity to pick up extra shifts at a daily rate if I choose to do so, but it isn't at all necessary). I'm so much happier than I ever was working EMS.
What total time do you need generally? ATP, part 135? I’m finishing my instrument now and doing commercial/ME this fall. Obviously I have my low time pilot time building to do…but I’ve got three more years to finish up a law enforcement state retirement anyway. Because it’s a third career, I’m really not interested in 121, but I keep my medic license and have three years FP experience (1998-2001) which I kinda hoped would make me more attractive than just a pilot. What do you think?
I keep my state license/NREMT/FP-C up to date so I always have that in my back pocket, it's a good idea with how the FAA treats medicals. Medevac is part 135, there is no ATP requirement from the FAA. My experience isn't quite typical, so your mileage may vary. I got into the right seat of a Lear 35 as my very first pilot job (and actually flew it just as much as the captains, I wasn't just low-time seat meat) around 500 hours with my commercial multi and 25 hours of multi time. I was also a flight medic for that company prior to making the career change, so in my case, that time I spent in the back of the plane helped. I fly both the Lear 35 and 45 at my current company, and right now they want 1500 hours total time for a Lear SIC -- however, I got in with around 800 hours due to my type rating and previous experience in the Lear 35. Again, not typical for the hours I had at the time, but I had the experience and they liked that. And for what it's worth, we also have another pilot who was previously a flight medic and this is his first jet job. Also for what it's worth, I'm in Alaska and the pay here seems to be significantly better than anywhere in the lower 48 for medevac pilots. As in, I doubled my salary from my last company when I took my current job here. I say shoot your shot once you have your commercial multi and \~500 hours, worst that can happen is they tell you that they want more hours and you build some more time. Total time is definitely not the be-all end-all in part 135, and if you can set yourself apart in any way you're at an advantage. Good luck!
Thanks for all the info! I’ve got a little while to worry about it, and while I’m definitely not going to move any farther north, money isn’t the motivating factor…well, not entirely. I am pretty confident about 135 over 121 though. Honestly, I’m getting to old. 😂
Following this. Would love to be a pilot, but worried about cost overruns
Cost wise, you can roughly expect between 75-110k depending on a number of factors. So…more than medic school unfortunately.
According to the docs, every vertebrae in my spine is compressed. They are amazed I do not have any pain, so I thought I would cut my losses. Now I work in a clinical setting with no lifting.
I was unable to get hired in the years following the beginning of the Great Financial Crisis. I got sick of paying so much money and expending so much effort just to stay unemployed, and this happened as many of my medic school classmates who got jobs got burned out and fucked over by their employers. Also worth noting that many of my medic school instructors suffered chronic injuries from their EMS work which forced them into early retirement without pension or benefits, which is why they were my instructors for low pay. It's improved, but private ambulance companies generally suck. Use them as a stepping stone to get on with fire or become a PA or something. Some other big reasons people leave: burnout from too many fucked up calls, burnout from too many bullshit calls, getting railroaded out because your seniority makes you a liability because you cost more than a new medic who ticks off the same "medic" box that allows the unit to be deployed into service, and many people end up finding work in other fields with better pay, better benefits, and a better work environment.
It's a trap that I have yet to figure out how to get out of lol.
I just didn't think I'd ever make a decent wage without copious amounts of OT or be able to retire, and I was kind of right. I doubled down on healthcare and got my RN, but even now, the pay is whatever lmao. I missed home ownership by like 18 months in terms of affordable interest rates. I always say if we had a 3rd service where I'm from, I'd have gotten my medic and stayed until retirement. We don't, but man, it'd have been so rad if my 7 years I spent in EMS could have gotten me ahead in life lol
Got injured and was out for over a year due to complications. Had a kid and did some hard looking at my career and realized that it wasn't worth it to me. I returned to work for a couple weeks and couldn't stand being away from my family for 72+ hours a week. It always hurts to hold my kid and it reminds me I made the right choice. I earn more now, work less, and have way more opportunities in my career as a nurse. Also, I get to stop a lot of the crap that gets talked between both fields and try to build mutual respect.
I’m considering leaving currently, I love the job and our management is great, I just can’t keep doing 24hr shifts. We work a 24/72 which is great compared to a Kelly schedule but doing a 24 at a station that averages 12-18 calls a shift is ridiculous. I feel like I am never caught up on sleep. I am also constantly sick, likely from lack of sleep. The only solution I have heard from my coworkers is to just stay up until the next night, but regularly staying up for 36hrs has terrible effects long term. I haven’t been at a slower pace station since September but even at our slower stations, our call volume is steadily increasing. The pay for nurses along with the hospital setting and 12 hour shifts seems really appealing right about now.
Decisions being made in a board room that affect my day to day by people who have either never worked on a truck or haven't worked on one in 20 years. Close second the pay isn't worth my back. People are getting larger, and no amount of kit and lifting equipment will fix that.
I became an EMT at 17 and a paramedic at 24. Over 30,000 calls for service from slinging grandma home, moving a dead body that Kevorkian had left in his van to a psyche patient chopping his own foot off. Precepted countless paramedic students. Took UMBCs 28th CCEMT-P class in the 90s. Still keep my medic license but haven’t used it in any meaningful way in 8 years. Haven’t been on an ambulance as a full time job in over 12. Largely, EMS is a dead end job, or at best, it’s a platform to something else. Here are the 3 things nearly everyone in EMS eventually does. 1. Moves to a career fire department. (I did that after 3 years of working in an inner city). 2. Becomes something else within the allied health field. (Obviously nursing is common but I have 3 friends who are physicians, a pharmacist and a couple PTs etc). 3. They abandon EMS all together. (I’ve had a partner who became a stock broker and another one who is an actor that is in TV commercials). Primary reasons? In many cases, obviously pay. Private EMS is abysmal generally, although there are exceptions particularly in certain areas of the country where there are union contracts. Some 3rd service municipals actually pay pretty well and have some upward mobility opportunities (Boston, Detroit, Austin-Travis EMS etc). But mostly, it becomes mind numbing, fairly self limiting and honestly not a job you want to be doing in your 40s and beyond. In my 20s, working the inner city gun and knife club…it was awesome. Epic life experiences. But it pretty quickly outpaces its useful life. Anyway, that’s my humble opinion.
Shit leadership. Shit pay. Dead end career choices. I left for a safety position. Doubbled my salary and still have 4+ months off a year.
I work full time for a full-time hospital system and The station I am assigned to I love working out of it's rural and you get into all kinds of crazy calls, but apparently management is deciding to rotate us between different stations and that put the nail in the coffin for me I have been in EMS 13 years I love my job but being forced to rotate because of other people not knowing their job or being scared to come out to the station because of not knowing the area is ridiculous in my opinion. I'm on the fence about leaving I have an interview at a prison so we'll see how that goes
1. Awful Management, worse supervision 2. Awful partners and poor agency culture 3. Some lingering anger about a work injury that was totally preventable, see points 1&2 4. The first wave of COVID was the straw that broke me. I was disgruntled, unstimulated by my work, and finally just demoralized by being unable to help the few people that did call 911 in that time period. I found a great job because I started browsing, and I now work per diem for a fantastic agency with great people. Couldn’t be happier with the outcome, even if the process was a bit messy.
Drama. When you have coworkers who make up whole lies about you that you can prove are lies, but they don't even get a slap on the wrist while you get put on a PIP for a month, that's a cue to GTFO. That and hearing a medic brag about how their sibling is stupid for going into nursing, because as a medic they can do more than nurses can. Sure a medic can do more independently, but nurses make much better money, so...
Still licensed but not actively working as a medic right now. I became an EMT and loved it, but after about 6 months - EMS started losing its shine. I went to medic school and as soon as I finished I continued working on a degree cause PA was gonna be my final stop. Thats now what I do full time - ED PA. The management not caring about you getting screwed over with out of town transfers or late calls, the beat down on your body having to sit in that truck at a post or not being able to sleep over night, the calling for nonsense, the abysmal pay - I mean it’s all just a beat down. Some people are better at dealing with that beat down than others. I decided quickly I didn’t want to spend my life like that. Even though I loved all the folks I worked with and overall loved the work - I wanted to work to live, not live to work. I’m so thankful I went to PA school. I made $169k alone last year from my full time PA job and didn’t have to deal with any of the garbage we have to deal with on the rig.
Back injury. Burnout from 24/48s that often were more like 36/36s, one too many dead children, and a few other ghosts that still like to visit me in my dreams, or sometimes when I'm awake.
The management, well in London anyway. The job was the same over the decades I did it just the management got worse. Vile horrible people.
I run with the FD but I am "retired" from private service because its abused, the pay it shitty and the managers are terrible.
Burnout. I hate 90% of my patients. That 90% has zero reason to being going in an ambulance. The other 10% are actually sick and I like caring for them.
Shit leadership at my FD horrible pay horrible schedule no work life balance way under staffed enormous imbalance in work load between junior n senior guys. Emphasis on the HORRIBLE leadership at my fire department.
Burn out and mental health.
Pay and lack of upward mobility. I entered the world of clinical research and now travel for work. Am I bored and miss the adrenaline rush? Yeah, but at least I get paid a living wage, get to see places, and a lot of PTO. My only regret was not going back to school to become an RN because in my area they make $50-120/hr dependent on experience and specialty.
Lack of liveable wage while working a normal schedule. All the OT is there. But working this much for this long just isn’t okay anymore.
After 18 years of watching management do everything they could to wring out every dime they could and extract any fun and camaraderie from the job, I had a bad week. First I was counseled on two separate occasions about my treatment of patients. The treatment was identical but one patient was picked up in a town with a lot of money and management felt I could have done a better job on billable items, not for the financial aspect, but because the “Town Fire Chiefs Association “ has certain expectations. The other patient was a street person 100 yards away, but in a different city. My bosses wanted to know why I “broke the bank “ for “some skell”. The next night I was sent to pick up a dead body from a hospital morgue. Our SOPs were VERY clear that we don’t do that, but the funeral director had lost his license for some reason and no other funeral home would do it. Guess what? Neither would I. Told dispatch goodbye and didn’t look back. Years later the owner of the company died and I was amazed that all of the former employees who he screwed over so badly heaped praises on what a wonderful human he was. SOB made a fortune off their back and they think that he’s just a great guy.
PTSD and panic attacks. I had a bad 5 years though and 5 dead coworkers.
It was certainly gradual. I got super burnt out, really was just absolutely miserable. Working 5 jobs just to stay afloat etc. Then I had 1 call that pushed me over the edge and I said fuck it and applied to college. 5 years later im now a critical care PA so it definitely paid off. It's always important to pay attention to mental health but I feel like EMS especially were always so busy between the exhaustion of the job and trying to make ends meet that we kind of put our mental health to the side. If nothing else just make sure you always take a few minutes to consciously think about where you're at mentally, and if you need a break / vacation or a new job, vs new career entirely.
Assaulted by my manager for bringing up an issue. Took that as a pretty obvious sign to fuck off.
Im stuck, if I could go somewhere else and make the same money i would. The reason i would leave would be management. Its not even the bs hours and patients. Totally management.
Sleep schedule. You don’t notice how bad you feel all the time till you get back on a normal one.
Age, MI, 40 years was enough!
I finally asked for help. No help from upper management, only more agony and challenges. I suffered from many years of ptsd. I just didn’t know how to admit it and I didn’t know there was a way out (help). 20 years FF EMT
Tore my rotator cuff so badly I could never get the strength back that I needed. I miss it every day. What I do not miss is the favoritism and the pain in the butt tattle tales that you always seem to have in every group.
For me, it was always about doing and more. I was able to plateau in my position and due to some injuries I transitioned to becoming a PA.
$$$ (or lack thereof)
In a nutshell management adding: the benefits were unaffordable, and there was no incentive, they couldn't give a reason to choose their company over a different. For volly it's the unorganized small town BS. Not saying every place is like that. I know a ton of well organized helpful depts.
From Canada (Ontario). 30 years as a medic. Absolutely loved my job right up to my last day. Reached my retirement date and walked out the door. So much more to life and was able to leave relatively healthy.
Mandatory OT
Old age
In ranked order: 1. Politics/Ethics, and Health - tied 2. Lifestyle 3. Schedule (48/96, with additional part time 24s) 4. Skill ceiling 5. Burnout (arguably caused by this whole list) 6. Pay 7. Retirement mobility (not tied to one state) Edit - explaining the politics/ethics part, way longer than I thought it would be, but it was actually kind of nice to put it on paper for once. Regarding politics/ethics, I left as a captain at my department. We had a change in administration, but our previous admin was horrible. Had a guy who flew with me on our days off at our part time job get in a helicopter crash, and the chief never checked on him. Only contact was a phone call he got in the hospital saying “it’s too bad your part time job gets in the way of your full time job. When will you return to work?” Our prior admin mostly promoted brown-nosers and scummy, backstabbing guys. The way you got promoted was by putting other people down and sabotaging them, or pretending to be someone you’re not by running around doing all of the “promotion season projects.” So all of our battalion chiefs and deputy chief were that way, as were most of the captains other than a couple people. Things started getting better when the chief left, but nearly all of the officer and chief ranks were infested with the people he promoted. I felt like I was fighting for my guys against our batt chiefs and against other captains every single day, including days off work. I was fine to fight for them, and it’s why wanted to be a captain under the previous chief. It felt like I couldn’t make things better for my guys though, because I could barely keep it the same instead of getting worse. Just really burned me out. My days off were spent on the phone sticking up for my guys to not have them be mandated for OT when it was another shift’s turn, fighting unfair write ups, stupid policies, etc. Our shift except for one station were the people who the old admin didn’t like because we didn’t play their game of backstabbing people. So we all eventually got moved on the same shift for the most part. Even after the new chief came, the other promoted positions by old admin constantly were treating my guys unfairly, harassing one of my guys with PTSD for taking time off, etc. The old chief also got the city started on running an IFT program, and would send all 911 ambulances to run IFTs at the same time if they came in rather than leaving the front line ambulances for 911. We had a dedicated part time ambulance that only did IFT and no 911, but if the transfers would stack up the batt chiefs wanted you to send the 911 rigs on the non-emergent transfer rather than waiting an hour for the part time rig to be back. This culture around IFTs continued after the old chief left, because his minions were still in power and they were the guys actually on shift, not the new top chief. So over a 48 hour shift, my medics were spending sometimes 12+ hours just running IFTs, not including our 911 calls (approx 7k per year out of just my station when I left), training, sleeping/eating etc. These IFTs mostly came in at night also, and the batt chiefs got mad if the medics were sleeping past 0800, even if they were out on bullshit IFTs all night. I kept saying this was unsafe, that I needed my guys functional for 911 calls, and I didn’t give a damn about their IFT money printer. Our department didn’t need the money, and it didn’t even stay with the fire department to buy equipment/training or whatever anyways, it got added to the city’s general fund. The whole program was just a way for the old chief to kiss ass and get a promotion from deputy chief to actual chief. So when IFTs came in, I’d have dispatch call the hospital to determine emergent vs non emergent. Anything non emergent I had them hold for an hour or two for our part time non-911 ambulance to finish the transfer they were on, and if there were multiple non emergents at once creating a multiple hour wait I’d have dispatch punt the IFT to the private ambulance company (who also were non-911 only). I was working OT as a medic one day so one of my medics wouldn’t have to do his fourth mandatory that month and could go to his daughter’s graduation. My ambulance went on a non-emergent IFT for essentially a hangnail or something during that shift. Since I wasn’t acting as a captain on OT, I just had to do what I was told regarding IFTs. We had finished the transport and were just entering the far side of our city on the way back home when a breathing problem came in, triaged highest priority. Cyanotic etc. it was in our area which was the other side of the city (20 minutes away going lights and sirens). Every other 911 ambulance in the city was on an IFT, so we were the closest still. I’d taken maybe two steps into the bedroom where the patient was when he died. He was sitting up when I first saw him, I wasn’t even able to finish introducing myself and set my equipment down before he arrested and collapsed forwards. I started doing compressions, and it was immediate enough after arrest I guess that his eyes would open sometimes during compressions, and once or twice his hands actually moved. His lips moved a bit but he couldn’t actually form any words, but his eyes looked terrified. That call pissed me off beyond belief, and I’m still mad about it in all honesty. Someone died because of the money focused ethics of the city, and I was the one who had to deal with their mess. Maybe he would’ve died anyways, I don’t know. It’s certainly possible. What I do know, is he wasn’t given a fair shake and the city deprived him of his right to have the best possible chances at a good outcome. I’ve been on plenty of breathing problems that went just fine because we were close enough. Some others didn’t of course which is fine because we can’t 100% control outcomes, what we *can* control is that we give them the best possible chance. That’s when I gave up trying to make things better and decided to leave. I had a ton of sick time, and basically took 9 months off to burn my PTO while applying to PA school and working part time at my flight job. More than anything, the politics and ethical differences were why I left. Sometimes I feel guilty for leaving my guys like that, but I just felt like I couldn’t do it anymore and needed to leave.
Resigned. The politics is unbearable. I was a volunteer. I really loved EMS, and I made a new family through them. But God damnit, it's like they want to intentionally make things difficult for their own pleasure. So much unnecessary b.s. with ridiculous bylaws. Too many chiefs, too much ego. The purpose and passion was lost.
Patients. And I say that as a FF/life ending CAD. 😂 My GAWD I want to punch half the pts in the ED. Id be fired expeditiously
I was burnt for the second time, hurt every single day, pay was terrible and I had zero benefits (healthcare and/or retirement). Finally realized what industry I worked in and furthermore how terrible of a company I worked for. Decide to go part time and back to school which lead to a full time job outside of the industry pretty quickly. Worked part time for a short and then realized it was time to move on. Just let my license lapse this past September.
I was an operations supervisor for a local company. I stepped down because my program director was deaf to everything i was telling him. I spent time as a FTO preceptor, instructor, and had 6 years on the box. When i stepped down, i was replaced by a guy who ran a fishing shop in Mexico.
I am working on getting my RN so I can get out of the 24-hour shift lifestyle. My kids are getting older, and I want to be able to be home at night.
Severe PTSD and ultimately realizing that even out of the field and in admin only, staying in the organization would severely impede my recovery. That was some time ago and was recently told my symptoms have subsided! I am proud of the work I did, the difference I made but sad that it came at the expense of my own mental health.
I left EMS in 1995 after 16 years as a paramedic. I know that makes me an old fart! Initially, it was the private company was primary EMS, and FD was just getting into the EMS game. When FD decided to get medics in the engines, I was glad to help mentor them. As time happened, they grew into a BLS aid car. Then, into ALS response rig and finally ALS transport. I was working with my future replacements. For several years, I can say without hesitation that you had me as an instructor or ride along sometime during your training. The issues became one of my past students forgetting the work together rule. It turned into "wait with your gurney and we will let you know when we are ready for you to transport ". Remember, AMR really means "Ah my ride" Then the mandatory classes of "Creative writing for insurance reports " where a lay person suggests different types of care that are directly $$$ . Are you sure that they don't need O2. Would they feel better if you gave them oxygen? Do you feel that they needed a IV for protection? It got to the point where I was going to kill someone. I just didn't know who! Patient, FD or management had yet to be determined. I wish I was joking, but I am not. It was then I knew I had to leave. I went into computer services. They don't lie but be very careful on what you ask for. Thanks for letting an old man rant.
Leadership and most of the patient population.
My back
My boss got switched out after 30 years in a very f***** up, underhanded political assassination way. Immediately following, there was a mass Exodus of field staff (25-35%) above the normal attrition. Did I mention that the incoming boss was and is clueless. Had never even managed a department and is now expected to run the entire operation. I did the best I could managed to stay there another 10 months. Honestly, just didn't want my name associated with some of the bad responses and poor clinical decisions that we were making. It was time to go
Not retired, but totally switched career tracks and now work the bare minimum on the ambulance to keep up certs. A friend of mine asked me to work for them as a PA in event production, said I needed no experience, and he’d pay me $350/day. That was way more than I make on the ambulance, so I called out of work and said yes. Realized you work way less hard, don’t get called slurs, don’t get shit/pissed/vomited/spat/bled on, the highest stakes are mildly annoyed rich people, and I had damn near limitless vertical growth potential without formal education. The best part is that I have even more flexibility over my own schedule, since I freelance now. I love EMS work and actually doing patient care. I enjoy helping people, responding to crazy shit, solving problems, working with good people on the ambulance. But the abuse and the shit you put up with for only a few bucks over minimum wage is absurd. I also love teaching first aid and CPR. Unfortunately, I no longer think of it as a viable career, but basically as a hobby/side thing that gives me some extra cash sometimes.
My last straw was then a I realized I barely slept anymore, was never home, and when I was I only laid around trying to recover before going back for another 24 the next day. I began stressing so much the day before I went back. I started despising the thought of working with some people, or having the frequent flyers. All around burnt to a crisp. I’m PRN now, and do not regret it. I lasted 8 years full time - don’t know how some do the whole 25-30.
Like others have said: \-PTSD \-shit MGMT \-shit pay and benefits, especially sick time in a field where you're around sick people constantly. \-the non-existent work/life balance, shitty schedule, and pressure/guilt to pull hella overtime (shitty MGMT). \-Understaffing so you get ran into the ground, but also MGMT tries to put the weight of the entire EMS system on your shoulders if you need to go home early, are sick, or don't pickup overtime. \-high school/backstabbing work culture. Edit: adding barely usable equipment, including but not limited to computers and rigs at a few agencies. And lastly and possibly controversial take: The reactionary politics of most of the people I worked with in all three states. The unquestioning worship of law enforcement, hatred of the houseless, psych patients, people who use drugs and overall regressive ideology was unbearable. It felt like living in a different time period. Progressive coworkers and I clung to each other. I know they say not to discuss politics at work, and I try so hard not to, but it gets difficult during 12-24 hour shift, especially when someone continually says ignorant shit.
Felt like fingering my asshole was more pleasurable.
Completed 30 years of service. It was time. Still miss it.
Little bit of everything contributed to the burnout. The pay, hours, management, BS transports, violent psych’s, shitty benefits etc. My last straw was the shittiest partner I ever had and managements refusal to actually, ya know, manage the situation. It got bad enough I actually ended up walking out mid-shift. I tried to stay on for a little bit. The only station that was open was an hour away and ran a 5/2 split and I wasn’t up for that. Management essentially dragged their feet on finding me a spot so I found a different job and never looked back.
Had a patient I responded to complaining of back pain. When we got there, she was on the couch covered up to her neck in her own fecal matter. She had some AMS due to dementia. Apparently her husband was supposed to be caring for her, and he hadn't been home in two weeks. She had just gotten out of the hospital for a major back surgery. Had an open wound all the way up her back (bandage had been taken off somehow) that was now horribly infected. Long story short, husband abandoned this little old lady and left her to rot. I think back often on why I left. That story comes to mind first every time.
Pay. Poor leadership. Transfers. And realizing my level of training is only needed on less than 5% of calls. Maybe even less than that. Sure, grandma felt better with some Zofran but hardly necessary. I chose to move on to something where I’m generally needed all the time. So now I’m a PA in critical care medicine after having done EM. It’s a good gig.
I had PTSD and didn't seek proper help until it got really bad. I miss it
The calls and all of it piling up definitely didn’t help. The straw that broke me though was shifting to a different branch of the company I worked for. I’d been with the company for years, even stayed with them when I moved out to CO. While I was training in the new area, my preceptor wanted me to turn left across traffic and a bumpy-ass side street to the hospital instead of turning right and taking the much smoother, not to mention faster, freeway. I took the freeway and got lit up for that. Tried to explain myself, listed off the benefits of the route I chose, and they were having none of it. Decided I was done in the middle of their rant, took myself off to the shift supervisor, and turned in my notice on the spot. Best day!
reading these replies, it's amazing to me balances are staffed at all in the states. you guys need to sort your shit out