I had a chance conversation with an EMS official from another state.
Like everywhere else, EMS in his state is having a hard time recruiting and retaining EMS providers. Some areas offer grants to people who want to take EMT or paramedic training, but can’t afford it on their own. They will receive grants to attend school with the proviso that they work in EMS for a period of time after they are certified. The program has had some success, however often people will leave the field after they have fulfilled their obligation.
A lot of people leave the field to go into law enforcement or go to work at a fire department that doesn’t provide transport just first response service. Others leave public safety altogether and thus the field loses an experienced provider.
There are a number of reasons for this including schedules, pay, benefits, and burn out from dealing with ill, injured, and dying patients on a constant basis. Some don’t want to go through the recertification process which requires refresher courses and continuing education classes on top of that course. The process is time consuming and most providers have to pay for classes. Even agencies such as my former service, which provide paid training have the same issue. A lot of the retraining is tedious and repetitive. It’s the nature of the business, but that doesn’t make any difference.
Personally, I think the time of working 24 or longer hour shifts has passed, but there are those who like the extra time off that those schedules provide. Still, it’s a grind to work nights, weekends, and holidays. Plus some services have mandatory overtime and of course the nature of the world is that providers are mandated when they have something planned for their day off.
The person I was talking with said that he thinks it’s possible that EMS is not suited to a long term career. It’s likely, he said, that after five to seven years it’s reasonable for people to leave the field.
This is not the first time that I have heard this. Back in the 1980s we had an administrator that was hired to reorganize my service. He had a lot of in hospital experience as an administrator, but had never worked in an EMS system.
I got to know him pretty well and we had some interesting conversations. One day we were talking about the lack of a career ladder in EMS. There are only so many supervisory and management positions in even larger systems. Unlike the fire and police services, there are not a lot of none care provider jobs in EMS.
The truth is that for most people the career ladder in EMS is more of a career step stool.
Many of the people I worked with had college degrees and eventually went on to other fields. I worked with EMTs and paramedics that went on to be lawyers, doctors, nurses, police officers, fire fighters, and just about every other field that you can think of.
The administrator said that likely was the normal course of an EMS “career” and advised me to start thinking about moving on to some other field. I already had bachelors and masters degrees, but wasn’t interested in moving on to something else. As a result, that was the best advice I ever got that I didn’t follow. In retrospect, it was likely a mistake.
Several years later I went to paramedic school and became certified. I was talking to a friend one day and he suggested that I should think about medical school. I knew myself well enough to know that the 12 year grind of a pre med degree, medical school, and residency was something for which I was not suited. Even if I could afford the decade plus of having essentially no income, I’d be well into my 40s by the time I was able to practice at the attending level.
My friend had the right idea, but in retrospect it was for the wrong profession. What I should have done was go to nursing school. There are a LOT of opportunities in nursing, many of which don’t require clinical experience. Yes, one has to pay their dues working in a clinical setting, but after a relatively few years research, management, and administrative opportunities arise.
Alas, I was too young and foolish to understand all of that and continued on my career path. Although it may sound so, I don’t regret that because I was in one of the best places to be a career EMS provider. Still, I certainly would have had a different, maybe even better path if I had been wise enough to pursue a nursing degree.
In retrospect, both the state official I spoke with this week and that long ago administer were right. For most people there just isn’t a path to a long term career in EMS.
My son always says that starting with the first day on a new job, one should be looking forward to their next job and planning to get there. He’s a smart kid.
My advice to anyone entering the field of EMS is to think of it as an intermediate step on a career path to something better. EMS gives one a great deal of education and experience which can be applied to other fields. EMS requires multi tasking, analyzing a problem, and developing and implementing a plan to fix a problem. That’s a valuable skill in any field.
It’s certainly something to think about and you body will thank you for it years later.
Interesting context, and EMS does tend to burn out people. The worst are the paramedics ‘required’ to be firefighters and assigned to engine companies. They get few interactions with patients, lose skills, and are frustrated with the BS in the fire community.
We have a couple of smaller fire departments that assign medics to engine companies. One of them operates the engines at the AlS level when they have a medic to put there. The other can, but to this point hasn’t done so. A third has enough medics to rotate them off the ambulance for 3 months at a time.
OTOH, some clients have providers who became paramedics just because they knew that it was the fastest way to get hired as a fire fighter. While on the ambulance they do a good, in some cases excellent job as medics. However, as soon as they can find a department that needs fire fighters and doesn’t run an ambulance, they jump ship.
Gone are the days when someone would get on a fire department and stay their for 30 or so years and until they retire. One guy I used to work with at my old agency has been on four departments since he left. In his case it’s his personality, not so much advancement. And of course the chiefs are eager to get rid of him, so they give great references.
A friend of mine who was a career school teacher in a big city system talked about this sort of thing with teachers. Every year principals would move their duds along. He referred to it as “The Dance of the Lemons.”
Now it’s like musical chairs, but there are way more chairs than players.