# If you could go back to the start of your EMS career and give yourself advice, what would it be?



## Valentinewillis (Jun 6, 2019)

If you could go back to the start of your EMS career and give yourself advice, what would it be?

-Willis, EMT


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## mgr22 (Jun 6, 2019)

Lift more safely.


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## PotatoMedic (Jun 7, 2019)

mgr22 said:


> Lift more safely.


Lift with your firefighter, not with your back.  (one of my favorite things I have seen recently)


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## Valentinewillis (Jun 7, 2019)

I dig it.


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## DrParasite (Jun 7, 2019)

Work part time in a busy urban EMS agency.  one or two days a week.  get as many patient contacts as you can.  the more patient contacts you have, the better provider you will be.

work in a ****ty system, that is grossly understaffed and underfunded, so you can keep in perspective how bad things could be.

when looking at a job, DON'T consider OT potential.  Yes, you can work 80 hours a week and make tons of OT, but if you don't want to, and just want to work your 40 hour weeks, how much of a hurting will it put on your personal finances?


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## NomadicMedic (Jun 7, 2019)

Don't wait to become a paramedic. 
Finish that degree 
Put down that cheeseburger.


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## RocketMedic (Jun 7, 2019)

Don’t speak, do run, and don’t let anger or frustration motivate you.

Also, you can’t fix stupid, lazy or uncaring.


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## hometownmedic5 (Jun 11, 2019)

No patient, no job, not even your license is worth your long term health. As soon as you are able to identify opposition to the above, it's time to make a change whether that means finding a new partner who doesn't push back when you want to call for additional help, or finding a new job when your company tells you "there's no help available and that other crew did it just fine so maybe just do the call and shut up about it". 

There are about a million ways this job is bad for your health. Identify them, avoid them when possible, mitigate them when not, and never stop believing that you are more important than your bosses wallet.


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## rescue1 (Jun 11, 2019)

Work out--even a few days a week lifting weights or jogging is better than nothing. Specifically training your back and legs since those are what you abuse every day on the truck. Relatedly, try not to get fat, as that will make the back/knees thing even harder.

Don't take abuse of the 911 system or the numerous failings of the US healthcare/social services systems personally. The sooner you accept that 80% of your job is not life and death emergencies, the happier you will be. 

Your EMT class is kindergarten level in the world of medical education. Keep reading/studying. If you're going to stay in EMS, go to medic school quickly. 

Have a backup plan, like a college degree, other skill, etc. EMS is a physically hard, low paying job in most places and has little room for advancement. Lots of people on this board went to nursing school, medical school, switched to fire based or flight systems, etc.


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## DrParasite (Jun 11, 2019)

For those that are saying go to medic school quickly, I have to disagree.  I went to medic school after 15 years in EMS.  We have a few zero to heroes in class too; several didn't make it, several made it and now don't work in EMS, and 2 are working full time in EMS.

I would have gone to medic school earlier (after working in a busy 911 system for 3 or 4 years) but I have seen too many newbie medics with no experience stumble during their first real job, get tunnel vision, develop paragod complexes, or have no idea what to do when **** goes downhill, because they just don't have the experience.

I'm glad I worked in EMS Comms for a few years, in Special Ops for a few years, as well as IFT and 911, before I even considered paramedic school. 

Now, if you are in a system where your nothing if your not a paramedic, then absolutely go to paramedic school, because your opportunities for advancement increase significantly.  Ditto completing your associates and bachelors degree.  But there are still plenty of systems where you don't need a degree to advance, and you can not be a paramedic and be an integral member of the management team.


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## hometownmedic5 (Jun 11, 2019)

DrParasite said:


> For those that are saying go to medic school quickly, I have to disagree.  I went to medic school after 15 years in EMS.  We have a few zero to heroes in class too; several didn't make it, several made it and now don't work in EMS, and 2 are working full time in EMS.
> 
> I would have gone to medic school earlier (after working in a busy 911 system for 3 or 4 years) but I have seen too many newbie medics with no experience stumble during their first real job, get tunnel vision, develop paragod complexes, or have no idea what to do when **** goes downhill, because they just don't have the experience.
> 
> ...



While I haven’t been keeping good records, my gut reaction to your post is to say that I probably have known just as many silverback basics who either failed at medic school or came out crappy medics and I know shake and bake medics who are rock stars. I think its heavily dependent on the person as an individual, the school they went to, and the quality of the support they received during their first two years or so as a medic.


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## Onceamedic (Jun 16, 2019)

go directly to nursing school....   paramedic was fun, but ultimately dead ended in career advancement, scope of practice and engagement


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## NomadicMedic (Jun 16, 2019)

Onceamedic said:


> go directly to nursing school....   paramedic was fun, but ultimately dead ended in career advancement, scope of practice and engagement



I can’t understand people who say this. 

I’ve never had an issue finding a place where I could advance, make more than enough money to live very comfortably and practice at a level where I felt like I didn’t have abroad enough scope. 

Does that make me an oddity? I guess if it was easy, everyone would do it.


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## mgr22 (Jun 16, 2019)

NomadicMedic said:


> I can’t understand people who say this.
> 
> I’ve never had an issue finding a place where I could advance, make more than enough money to live very comfortably and practice at a level where I felt like I didn’t have abroad enough scope.
> 
> Does that make me an oddity? I guess if it was easy, everyone would do it.



I agree. I think there are lots of side issues -- education, expectations, ambition, personality, family, finances -- that could get in the way of any paramedic's career, but I don't see paramedicine having to be a dead end.


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## GMCmedic (Jun 16, 2019)

NomadicMedic said:


> I can’t understand people who say this.
> 
> I’ve never had an issue finding a place where I could advance, make more than enough money to live very comfortably and practice at a level where I felt like I didn’t have abroad enough scope.
> 
> Does that make me an oddity? I guess if it was easy, everyone would do it.


I dont get it either.


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## hometownmedic5 (Jun 16, 2019)

I'm sick to death of people just assuming that nursing is the natural and inevitable progression of the career arc of an EMT. If you want to be a nurse, fine, no judgement; but why bother with the pit stop in EMS? Just so you can **** on the industry forever?


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## StCEMT (Jun 16, 2019)

hometownmedic5 said:


> I'm sick to death of people just assuming that nursing is the natural and inevitable progression of the career arc of an EMT. If you want to be a nurse, fine, no judgement; but why bother with the pit stop in EMS? Just so you can **** on the industry forever?


I love EMS, but I'm still considering nursing. If I decide flight is where I want to focus my efforts, why not get paid more to work at the same place? I also think something like ICU could compliment a full time EMS job that was truly progressive pretty well. But I also don't hate my job, so different perspective....


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## Peak (Jun 16, 2019)

The reality is that (generally speaking)  the EMS environment had a lot of room to improve for many people be it scope of practice, pay, job satisfaction, advancement, and so on.

It's easier to go to nursing school than move to some far away service or spend an entire career to eventually be able to make substantial changes that benefit the staff or clinicians. Or after a few years of school I can get a job almost anywhere, and if I don't like my job I can easily find another (almost always with a substantially better salary with a few more years of experience).

I also get to work in a subspecialties where I really like all of the patients I care for, I get a lovely HVAC controlled environment, I have a bathroom available, families love us, we are one of the most trusted professions, I feel much safer than when I was in the field (even when I pick up adult ED shifts), I have more support in managing patients (other RNs, APRNs, PAs, Docs, RTs, pharmacists, and so on), and I make about three times more than when I was on fire.

My last shift I spent most of my night caring for two very cute heart babies, had a short excursion to teach a super old school procedure that I hadn't done in over a decade (and the family was very appreciative that we were able to keep them out of the OR), and got some excitement in establishing a critical airway.


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## TransportJockey (Jun 16, 2019)

NomadicMedic said:


> Don't wait to become a paramedic.
> Finish that degree
> Put down that cheeseburger.


This. So much this


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## Onceamedic (Jun 16, 2019)

I didn't mean to imply that nursing was in any way an inevitable or natural progression from EMS.  I was speaking from a strictly personal point of view.  I have no interest in management, or in substantiating change or progression within the industry.  My interest has always been direct patient care.  EMS was killing me with the long shifts and the low pay.  I voted with my feet.  
Your mileage may vary.


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## rescue1 (Jun 17, 2019)

There are places where you can have a good job with room for advancement as a single role medic. There are, however, many many many more places where this is not the case. I would also argue that everywhere I've worked the salary for nurses has been higher, sometimes hilariously higher. It's also much easier to go from RN-->medic than vise versa--Creighton University holds a 2 week course that would let an RN take their NREMT-P at completion. Nursing also offers significantly more career flexibility if you decide to leave direct patient care or find EMS too physically demanding. It is, for better or worse, an objectively better license to have from a career standpoint. 

I'm not saying that people who become medics are wrong, or dumb, or anything like that, but I totally get why we tell new EMTs to get their RN over their medic.


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## VentMonkey (Jun 27, 2019)

rescue1 said:


> I totally get why we tell new EMTs to get their RN over their medic.


I agree, and I tell every EMT/ EMT student that comes to the airport for a tour this same exact thing.

I don’t know how often it sinks if, especially when being they’re fed the nauseatingly tiresome lines EMS offers by their instructors. And, to be fair if I could smack the 22-year old me around with some sense...

All that said, no desire to redo my “medical career”. But, ya, nursing is by far a career choice. Being a career paramedic is also a...choice.


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## Tigger (Jun 28, 2019)

I've been a medic for three years. I make about 5-7k less than an ED nurse of similar experience. I'm on a better schedule (for me at least) with much better benefits and a pension based retirement. My day to day is realistically less tiring than that of our ED nursing compatriots. The FD has management that takes care of us and is not an enourmous healthcare corporation.

I do not tell new folks to consider nursing. I think with the right mindset and a few years of grinding (much like nursing), being in a "good spot" as a medic is very obtainable. I also feel like it's a bit disingenuous to be interacting with the future of our profession and telling them to find another career.


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## StCEMT (Jun 28, 2019)

Tigger said:


> I've been a medic for three years. I make about 5-7k less than an ED nurse of similar experience. I'm on a better schedule (for me at least) with much better benefits and a pension based retirement. My day to day is realistically less tiring than that of our ED nursing compatriots. The FD has management that takes care of us and is not an enourmous healthcare corporation.
> 
> I do not tell new folks to consider nursing. I think with the right mindset and a few years of grinding (much like nursing), being in a "good spot" as a medic is very obtainable. I also feel like it's a bit disingenuous to be interacting with the future of our profession and telling them to find another career.


I don't think it is necessarily that they need to find a new career as much as it is about diversifying themselves. Keep doors open and have the ability to utilize them when they do.

I absolutely love my job. I am still excited to go to work even after years of doing this. However, if I could wave a wand and have RN in my pocket I absolutely would. That Creighton course essentially gives people the ability to do that, but the other way around. RN to P is a much simpler transition academically than P to RN. 

If I could reorganize how mine went, I would love to have done RN, challenge the P, work as a full time medic and float around an ICU part time while I build a solid CCT resume. That isn't to discourage people from this field, just to allow them flexibility and adaptability to life.


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## VentMonkey (Jun 28, 2019)

Tigger said:


> I do not tell new folks to consider nursing. I think with the right mindset and a few years of grinding (much like nursing), being in a "good spot" as a medic is very obtainable. I also feel like it's a bit disingenuous to be interacting with the future of our profession and telling them to find another career.


Hardly. My bottom line with all of them is higher education, one way or another.

But considering a lot of them have yet to take themselves seriously, and again—to no fault of their own—are often fed lies about this job, I feel it’s a disservice not to point out the endless other options that this field opens doors to.

I also don’t disagree that you can make this job a career if you find the right setup. I just don’t know of many around me that have a 3-5 year reward system without sacrifices many (most) aren’t willing to make.


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## Tigger (Jun 30, 2019)

I guess I've never come across another career (not just a job) where when asked for advice, it seems the default line is "do something else." Yes, there are infinite options out there. But if someone comes to me and says "I want to be paramedic" I'm not immediately like "you should be a nurse." Which of course is not how most of these conversations go down. But if you've been reading these types of threads for years, you might think differently. 

It's tough to say we want to improve EMS when we also do not do a great job encouraging people to get involved.


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## Peak (Jun 30, 2019)

To be fair I think that a large number of us who went from EMS into nursing do still care about EMS and advancing the field.

I was recently offered a flight job that I turned down because I like taking care of my kids in the hospital much more. It isn't that I don't like EMS but rather that I've come to enjoy many aspects of what I do now so much more. 

I think a lot of medics who end up working in the ED, ICU, PICU, cardiac units, and so on really work well in that care model. I enjoy seeking my kids when they are born and throughout their stay and their lives as they recover from their illness and thrive. I think a lot of the adult side nurses enjoy being able to get more into the disease process and longer term management rather than the minutes or hours. 

I've also known some medics who go to nursing school who just don't vibe with the nursing or hospital care models and go back to the field. I've known nurses who go to medic school, end up working exclusively prehospital, or challenge the PHRN (or something similar) since they enjoy the prehospital environment more.

I still do some prehospital stuff and quite a bit of EMS education and outreach. I'm all about advancing EMS care, especially considering how different the care is from our urban 911 3rd service compared to some of the low volume rural services. That 3rd service does a ton of internal education and training that I don't think is unreasonable to provide to all medics (and @Tigger's former full time job did the same thing in a largely rural service). I do find in disappointing how we are okay with the relatively low education level for entry is compared to other first world countries, especially given how high our bar is for nursing and medicine.


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## Tigger (Jun 30, 2019)

To be clear, I am not implying that you can't still like EMS yet go into a career path.

But it bothers be that when someone posts "hey what would you differently in your EMS career?" and I immediately hear "go to nursing school." Being a paramedic can indeed provide opportunities that nursing cannot and it just seems sad to me that we aren't even able to promote our career with much degree of enthusiasm. If your advice to new folks in EMS is to get out, perhaps (if you are still in EMS), maybe you should also follow it?


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## VentMonkey (Jun 30, 2019)

I think where I see the problem is what’s being projected versus what’s reality- 2 completely different things.

How many instructors do you know of enthusiastically implying the endless options you have as a paramedic aside from roles that aren’t in other branches of public service or medicine?

I mean I enjoy what I do, and often will tell those who ask how I got to where I am how I accomplished it, and if they so choose, how they can too.

But if we’re being honest, being a paramedic really does leave you with typically a handful of options aside from ones most have no intentions or interests in becoming. If you’re ok with this, then really that’s all that should matter.

Does it mean one should exit this field? No, it just means I’m not going to fool myself or anyone else who asks me. Does it mean they’re going to follow the advice to a tee? I’d hope not. Individuality should count for something.

Those that are destined to change a certain career field for the better are a select few. I’ve said it again, my hat goes off to them because that is no longer I. But, again, that also does not mean that I can serve no purpose as a provider.


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## CANMAN (Jul 13, 2019)

NomadicMedic said:


> I can’t understand people who say this.
> 
> I’ve never had an issue finding a place where I could advance, make more than enough money to live very comfortably and practice at a level where I felt like I didn’t have abroad enough scope.
> 
> Does that make me an oddity? I guess if it was easy, everyone would do it.



Agree 110%. Out of 5 friends who all bailed on being a medic and went to nursing school, only one of them currently remains in the nursing world. They're two very different animals and I think it's difficult to make the transition to being a nurse for a lot of people who enjoy EMS. I think this is even harder to do for experienced medics. There is also not enough money in the world for me to tolerate working in an ICU with a bunch of new grad BSN's who think they have mastered critical care medicine in a year on the unit and don't know what they don't know. This attitude is rampant in the hospital setting now a days and I can't stand it. Meh guess I'm also getting old.

I would say my advice would be:
-Take good care of your back and workout to keep yourself in top shape
-Finish the degree, just do it. It doesn't get easier as you get older
-Don't live beyond your means and count on overtime or multiple jobs
-Don't tolerate being disrespected by other healthcare workers and stand up for yourself in a professional way when warranted
-Ears and eyes open early on in your career, ask questions, focus on learning and becoming a clinically strong provider before focusing on preaching your knowledge and experience. Many people put the cart before the horse in this department.


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## Peak (Jul 13, 2019)

CANMAN said:


> Agree 110%. Out of 5 friends who all bailed on being a medic and went to nursing school, only one of them currently remains in the nursing world. They're two very different animals and I think it's difficult to make the transition to being a nurse for a lot of people who enjoy EMS. I think this is even harder to do for experienced medics. There is also not enough money in the world for me to tolerate working in an ICU with a bunch of new grad BSN's who think they have mastered critical care medicine in a year on the unit and don't know what they don't know. This attitude is rampant in the hospital setting now a days and I can't stand it. Meh guess I'm also getting old.



While I agree that nursing can be a very difficult change for medics (and likewise nurses who go into EMS), those things you point out definitely exist in many EMS systems. There are paragods in most systems, and many of them don't take a year to get there. Likewise while there are many toxic unit cultures, this isn't universal (and many new grad nurses are very lucky to start in the unit, and time on the street is no guarantee of avoiding the floor).


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## gotbeerz001 (Jul 13, 2019)

hometownmedic5 said:


> I'm sick to death of people just assuming that nursing is the natural and inevitable progression of the career arc of an EMT. If you want to be a nurse, fine, no judgement; but why bother with the pit stop in EMS? Just so you can **** on the industry forever?



Nothing the nursing profession... but it’s basically “chit and dix” all day long


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## Peak (Jul 13, 2019)

gotbeerz001 said:


> Nothing the nursing profession... but it’s basically “chit and dix” all day long



I'll remember that the next time my kid is crashing and we are cannulating to ECMO.


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## hometownmedic5 (Jul 14, 2019)

gotbeerz001 said:


> Nothing the nursing profession... but it’s basically “chit and dix” all day long



Thank you for doing your part to raise our image in the community.


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