# Greatest Contributor to Burnout in EMS



## 46Young (Feb 14, 2012)

What do you consider to be the greatest contributing factor to burnout and attrition in EMS?

Is it the pay? The schedule? The lack of career advancement? The lack of job functions other than field provider? Sleep disruption due to frivolous calls? High call volume due to frivolous calls? Working nights and weekends? Lousy working conditions such as many hours straight without a meal break, cramped vanbulance, mandatory OT, etc. Things I haven't mentioned?

Edit: For me, it's the pay, followed by lack of career advancement, then followed by the many frivolous calls. That's top three for me.


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## Veneficus (Feb 14, 2012)

I think the biggest overall contributor is the job not matching the expectations of those entering the field. 

There are many industries where people can expect to earn less but are happy.

Personally the worst for me is the glass ceiling. No matter what you do to improve yourself, no matter your efforts or successes, you earn no more money or capabilities than the trilobites who are also called paramedics.

Followed by the lack of lateral transfer. Whether it is 911, Ift, hospital, or special teams, etc. To change role you must change employer. Which often means changing pay. 

As a medic I got paid more to work in a hospital ED both in net pay and benefits than I ever did working in the field. With an average of a 40% pay cut to go back to the field, who in the right mind would inflict that on their family?


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## 46Young (Feb 14, 2012)

Veneficus said:


> I think the biggest overall contributor is the job not matching the expectations of those entering the field.
> 
> There are many industries where people can expect to earn less but are happy.
> 
> ...



All excellent points. 

With the mention of frivolous calls, I was kind of getting at your point of the job not matching expectations. And the job is definitely all about the LCD.


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## bigbaldguy (Feb 14, 2012)

I don't work in EMS but my job is great, I get paid well, don't work much have great benefits and just generally lucked out. Despite this I still work with a ton of burn outs (and I was one of those burn outs for a few years). The truth is the number one cause of burn out in any profession has much less to do with external forces than most people would like to admit.


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## firetender (Feb 14, 2012)

*Burned out is different than Bummed out*



bigbaldguy said:


> The truth is the number one cause of burn out in any profession has much less to do with external forces than most people would like to admit.


 

BBG is right on the money. All the external factors are secondary to the human experience of being jerked around by forces (seemingly) beyond your control. Burned out is about what happens inside; the loss of empathy and compassion for yourself and others. It's the experience of losing one's self-respect and ability to relate to others in meaningful and satisfying ways.

Having said that, let me step aside to hear others' reflections.


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## the_negro_puppy (Feb 14, 2012)

1) Frivolous calls/ Abuse of EMS


for example last week I did 1.5 hours mandatory overtime to drive L&S for 20 mins to take a frequent flier 200m to the hospital. Going to the same drug seekers, or ones new to you only to be told when you get to hospital. This is despite comms having logs of how many times crews have been to the addresses and telling us nothing.


2) Bed block/ Ramping

Spending up to half our day playing ED Nurse baby sitting patients on stretchers. Nurses also abuse us by making us care for patients that they would have kept in the waiting room had they presented themselves.


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## Smash (Feb 14, 2012)

A.m.p.d.s

Bloody thing won't let me capitalise the acronym.  That's annoying.  Advanced (ha!) Medical (ha!) Priority (it's all an emergency baby!) Dispatch (got that part right I guess) System (what system?)


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## triemal04 (Feb 14, 2012)

It's really going to vary widely from person to person, and even service to service.  If you had to pick one that fit in nationwide it'd probably be related to the call types and pay/working conditions.

But, I think the common theme, if people are honest with themselves is that, if you actually like what you do (and this means you hold an honest, realistic view of what you do), and are willing to relocate to do it, "burnout" should not become an issue, or only happen a small amount of the time.  And it'll probably be happening for different reasons than most people give.

My guess is that a lot of people who leave EMS because of "burnout" are leaving because they never knew what they would be doing, or held an unrealistic view of the profession.  That's not burnout, that's self-delusion.

I won't work somewhere that doesn't compensate me at an appropriate rate.  I won't work somewhere that has horrid working conditions, standards or expectations/lack of expectations of their employees.  If this means that I have to move, then I will (and have previously for various reasons).

I like working up patients, even the ones that don't really "need" my help at the moment.  It's enjoyable to me to be able to take someone in, tell the staff "they've got xy and z going on, it's probably xxxx" and then finding out later that I was right.  And I mean that for both major *and minor *complaints.

If people are actually honest and realistic and not willing to work somewhere that is not well run, I'd say the amount of "burnout" would go way, way down, and the people it happened to would have a true problem.


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## Fish (Feb 15, 2012)

46Young said:


> What do you consider to be the greatest contributing factor to burnout and attrition in EMS?
> 
> Is it the pay? The schedule? The lack of career advancement? The lack of job functions other than field provider? Sleep disruption due to frivolous calls? High call volume due to frivolous calls? Working nights and weekends? Lousy working conditions such as many hours straight without a meal break, cramped vanbulance, mandatory OT, etc. Things I haven't mentioned?
> 
> Edit: For me, it's the pay, followed by lack of career advancement, then followed by the many frivolous calls. That's top three for me.



For me, advancement(I always have to feel as if I am moving forward)

Pay(I hate to feel as if I am working hard and getting nowhere)

Moral, it is important.


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## systemet (Feb 15, 2012)

the_negro_puppy said:


> 2) Bed block/ Ramping
> 
> Spending up to half our day playing ED Nurse baby sitting patients on stretchers. Nurses also abuse us by making us care for patients that they would have kept in the waiting room had they presented themselves.



I found this very hard.  It's frustrating to be sitting as an ALS crew with an 80 year old, because, "She seems really nice, and it wouldn't be fair to leave her in chairs with all the drunks.  Wouldn't it be nicer if she could lie on your bed, etc.", then watch as a half dozen other 80 year olds get taken out of chairs.

Or sit with an abusive drunk, because, "He'll just cause problems in the waiting room".  Great, 2:1 nursing care on a guy whose major problem is his liver can't keep up with his serum ethanol.  While security sits and does soduku-all.

Then you turn on the radio, and crews are responding 20 minutes hot for a pediatric anaphylaxis, etc.

------

Edit:  

I understand this is a team game, and sometimes the ER is swamped.  But I felt like too often we were watching someone who didn't have a medical need, so that someone judged to have a higher medical need in the waiting room could be seen first.  And this is just silly.  If the issue is there's sick people in the waiting room, how's about we sit the drunk guy down, and do something useful like drawing some bloods and getting a 12-lead on the guy in chairs?

I also felt like sometimes the ER nurses didn't understand the impact of their decisions.  Sure, it must be frightening to have someone in the waiting room with abdo pain suspicious for ischemia, who you want to get evaluated.  I get that.  But if this means you now have 2 ambulances or zero ambulances, for a million people, then maybe the cost-benefit is getting missed.


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## thegreypilgrim (Feb 15, 2012)

The usual contributors (i.e. low pay, poor/unhygienic working conditions, incompetent management, sleep disruption, frivolous calls, etc.) certainly go a long way in exacerbating my frustrations with EMS.

However, the single biggest contributor to my desire to no longer be a paramedic is definitely the unprofessionalism and how it essentially reinforces and augments the other issues. For example, it makes no difference whether or not I try to improve my professional acumen and pursue things like higher education, additional training/certification, etc. I still get paid the same as the mouth-breathing troglodyte who stumbled through some 12-week fly-by-night program and has no desire (let alone capacity) to think about things beyond what's written in a protocol book.

Not only that, but there is simply no distinction afforded by others in healthcare on a professional level between the two archetypical medics. You're judged by the LCD of your colleagues, which (despite consensus that the education standards for medics are abysmally low) is an unfair and unjustified assumption that isn't likewise extended to others in healthcare.


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## Shishkabob (Feb 15, 2012)

I guarantee if 911 were used as it were intended, job satisfaction would be higher.


Followed closely by pay.  I can put up with a lot of bullcrap if I were paid $1,000,000 a year.   But more realistically, $50k starting would be good, with meaningful raises due to experience.  


Finally, hours worked.  36 hour work week, 3 days, should be the norm.


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## Handsome Robb (Feb 15, 2012)

Linuss said:


> I guarantee if 911 were used as it were intended, job satisfaction would be higher.
> 
> 
> Followed closely by pay.  I can put up with a lot of bullcrap if I were paid $1,000,000 a year.   But more realistically, $50k starting would be good, with meaningful raises due to experience.
> ...



4x10s wouldn't be bad either. That's the schedule I worked all summer at my old job. 40 hour work week but I still had a reasonable amount of time after work to get stuff done AND get a decent amount of sleep.


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## the_negro_puppy (Feb 15, 2012)

There's absolutely no way I would do the job if we received the same level of Pay as Paramedics in the U.S.


Our costs of living is much higher here however our average wage is about 45k per with most Paramedics averaging 70k with overtime.

The irony is i'm already starting to become burned out and I am not even fully qualified yet. We do 2.5  paid years here on a ambulance before we graduate.....<_<


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## DrParasite (Feb 15, 2012)

I'm gonna echo was Linuss said, and elaborate a little


Linuss said:


> I guarantee if 911 were used as it were intended, job satisfaction would be higher.


seeing sick people can make you happier since you get to use all the training and education to help people in need.  however, I will say that dealing with BS is part of the job, so I refuse to stress over it.





Linuss said:


> Followed closely by pay.  I can put up with a lot of bullcrap if I were paid $1,000,000 a year.   But more realistically, $50k starting would be good, with meaningful raises due to experience.
> 
> Finally, hours worked.  36 hour work week, 3 days, should be the norm.


I will combine these two.  50k a year is a decent salary, but reality is I want a decent salary where I only need to work 36-40 hours a week to live comfortable, as well as support my spouse and kids.  no need to work massive amounts of OT, no need to work multiple jobs, I can work my 40 hours, and go home with enough $$$ to pay my mortgage (not renting an apartment, I want to be able to afford a HOME), pay my car payments, pay for my kids education, and still afford to put food on the table and take the occasional vacation.

The last thing I want to add to burnout is working conditions.  posting and system status management sucks, being written up for stupid crap (having 23 4x4s instead of the required 24), being unable to cook a meal in a kitchen and being forced to get unhealthy fast food or the traditional Chinese/Italian meal that is eaten while on the way to the next job are all part of poor conditions that many have been forced to accept as the standard.  

These factors would be my top three contributors to burnout.


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## RocketMedic (Feb 15, 2012)

the_negro_puppy said:


> There's absolutely no way I would do the job if we received the same level of Pay as Paramedics in the U.S.
> 
> 
> Our costs of living is much higher here however our average wage is about 45k per with most Paramedics averaging 70k with overtime.
> ...



"Paid" clinicals? That makes my entire stance on mandatory college change a lot! I'll gladly go to school if I can work in my field through it.


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## Shishkabob (Feb 15, 2012)

DrParasite said:


> seeing sick people can make you happier since you get to use all the training and education to help people in need.  however, I will say that dealing with BS is part of the job, so I refuse to stress over it.



"Part of the job" or not is not the point.  Like I said, without a doubt, satisfaction between EMS, FD and PD would be higher if they were used as intended, instead of as evolved.




> I will combine these two.  50k a year is a decent salary, but reality is I want a decent salary where I only need to work 36-40 hours a week to live comfortable, as well as support my spouse and kids.



Tis why I put $50k (substitute 'decent' in your neck of the woods) AND 36hr week.  That way, if you DO need the extra funds, you can work one extra day and still have some time off.   Seeing what we see and doing what we do, time off is important.


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## RocketMedic (Feb 15, 2012)

A living wage is something that you need. Without it, on a "surviving wage", you'll never see happy professionals.


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## bigdogems (Feb 15, 2012)

Fish said:


> For me, advancement(I always have to feel as if I am moving forward)
> 
> Pay(I hate to feel as if I am working hard and getting nowhere)
> 
> Moral, it is important.



this would be mine. No matter what my career field I always push to try to be better. I am actually looking at switching agencies. Most people are going to think I'm retarded but it will provide me with much better opportunities to get to where I want to be.


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## the_negro_puppy (Feb 15, 2012)

Rocketmedic40 said:


> "Paid" clinicals? That makes my entire stance on mandatory college change a lot! I'll gladly go to school if I can work in my field through it.



We finish training with a Diploma qualification which equates to about half a bachelors. This method is slowly being phased out with University degree with unpaid clinicals then applying for a full-time job upon graduation becoming the norm.


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## Tigger (Feb 15, 2012)

As much as I really enjoy the people I work with, they contribute to burnout. Granted I work at a private predominantly IFT service; but the point often still stands in other environments.

I don't know a single basic where I work that's trying to make a career out of being a basic. It's a stepping stone to something else, medic school, other higher ed, a side job, etc, etc. The fact that everyone that everyone is trying to move along from what we're all doing makes it tough. Granted if I was a medic I think it would be a bit different, but the BLS IFT crowd is a large one rife with burnouts.


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## cfd3091 (Feb 16, 2012)

46Young said:


> What do you consider to be the greatest contributing factor to burnout and attrition in EMS?
> 
> Is it the pay? The schedule? The lack of career advancement? The lack of job functions other than field provider? Sleep disruption due to frivolous calls? High call volume due to frivolous calls? Working nights and weekends? Lousy working conditions such as many hours straight without a meal break, cramped vanbulance, mandatory OT, etc. Things I haven't mentioned?
> 
> Edit: For me, it's the pay, followed by lack of career advancement, then followed by the many frivolous calls. That's top three for me.



What he said. Your job seems just lke ours. And we love this why?


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## 46Young (Feb 16, 2012)

cfd3091 said:


> What he said. Your job seems just lke ours. And we love this why?



By selling out and going to the fire/EMS side, I solved the pay, schedule and career advancement problems, but the rest remains the same.


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## VCEMT (Feb 16, 2012)

From my observations of the people I work with, it is peers. Some do it to look cool and others to sympathize. These are para-military organizations, not goddamn McDonald's. People need to get over themselves.

I'm happy with my job. I don't take work home and I don't take home to work.


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## usalsfyre (Feb 16, 2012)

VCEMT said:


> ...These are para-military organizations...


Not really in most cases...

But I agree, the toxic work environment created by burned out peers is a big contributer to burn-out by itself.


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## BNB (Feb 16, 2012)

It's a multitude of factors...

Let's take the psychological side...majority of us are all "addicted" if you will, to the mental high we get from the job...think about all of the times you ran that badass trauma or the long transport CPR you saved etc...that feeling of accomplishing something that not a lot of people can say they have done...what about every time you are on shift, and are approached by someone while eating lunch with the phrase" you are a paramedic? I bet you see some crazy stuff?!" I bet I know what type of rush you get...it's like a Rolodex of old calls running through your head of craziness right before you respond to them...but like most "addicts" you get those withdrawls...in slow times or off time you get that feeling...you know that one smell that triggers a video in your mind of a rollover mvc you wound up intubating in the car awaiting extrication, or that child you hear crying at the supermarket that sends you back to the pedi CPR you had 2 weeks ago that after all attempts you couldn't save...when this time comes you begin to feel stressed, you seem to fight with your spouse more...lose sleep or you pick up bad habits without even realizing you are destroying yourself...

The financial aspect of it is what it is...majority of us make piss poor pay period...we put our *** on the line for less than drive thru person at jack n box, but supposedly we love the job...we work tons of OT and side jobs, wind up missing our kids functions and time with our spouses just to make a little buck..we drive long distances, or we post and that gives us too much time to think about what we could have or want financially and it kills your drive...

Advancement...face it, not many of us would leave the field to become a RN, RT or something else...and if we do, that withdrawl part typically kicks in...sure you can advance up to supervisor or there bouts...but can you go any higher? Typically no...is that deflating to the medic who has spent tons of hours in his off time gaining more certs when he could be spending it time with his family just to be told someone less qualified got the job, or he makes same per hour as the dumbest idiot in the last class while he has been a medic for 15 years...sucks? Yup...


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## 46Young (Feb 16, 2012)

usalsfyre said:


> Not really in most cases...
> 
> But I agree, the toxic work environment created by burned out peers is a big contributer to burn-out by itself.



It's true. I've worked for places where many of the employees were constantly putting the place down, acting like working there was beneath them, or were just apathetic to the whole situation. As a new person, seeing the average employee act that way, I lose respect for the organization and begin looking for another place to work.


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## R99 (Feb 17, 2012)

Lack of resources, up to 7 hours to get a break, the four day watch cycle is awful


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## FourLoko (Feb 17, 2012)

Not even a year in and only at my first private IFT company but from that side I would say: Crappy ambulances, limited supplies, not enough units = overloaded of calls with dispatchers that have no mercy. Expectation of zero mistakes with zero tolerance (people fired at the drop of a hat) all for pathetic pay.


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## Luno (Feb 17, 2012)

IMHO, the biggest contributor to burn out in EMS is the resounding feeling that you have no impact.  The pay, sucks, but you can make rent, usually...  Fire Departments suck, but hey, we're there to save patients from Fire Fighters.  Most patients suck, c'mon, you've really had a cold for two days, and you need to go to the emergency room two states over because you saw on the news that they give their patients lattes, but helping you feel better makes me feel better....  The hollow sound in your head when you realize that you've done absolutely nothing to help mankind today, but rather played taxi cab/indentured servant/kiss behind, and a garbage collector has made more money and saved more lives today than you will in your career.  It's a bitter pill to swallow when so many enter the field for altruistic reasons, and especially to help someone in their time of need... Voila... Burnout...


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## Veneficus (Feb 17, 2012)

46Young said:


> It's true. I've worked for places where many of the employees were constantly putting the place down, acting like working there was beneath them, or were just apathetic to the whole situation. As a new person, seeing the average employee act that way, I lose respect for the organization and begin looking for another place to work.



I think that demonstrates a major failure of management.


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## socalmedic (Feb 17, 2012)

I feel that the lack of a career ladder is one of the biggest problems in EMS right now. Followed closely in my case by the lack of motivation for higher education. Luckily right now I have a very knowledgeable and motivated partner which helps out alot. some of the shifts I have worked with the barely homeostacing "senior medic" have made me hate my job in only 24 hours.


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## jemt (Feb 17, 2012)

Biggest factor so far for me is doing transport EMS. I feel like I'm playing dressup as an EMT when doing transport. Nothing like sitting in a dr. office for three hours with your patient on a stretcher waiting to be seen.

911 on the other hand still gets me going and I actually enjoy it.


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## DrParasite (Feb 18, 2012)

I'd like to address this comment if that's ok with everyone





FourLoko said:


> overloaded of calls with dispatchers that have no mercy.


1) you can only do 1 call at time.  

2) you are paid to work 8 or 12 hours (depending on how long your shifts are).  As a result, you are expected to to be working for 8-12 hours, making money for your employer.  you are entitled to a 30 minute lunch break and two 15 minute breaks during your shift if you work 12s, and 30 min break if you work 8.  Don't complain if you are forced to actually work for your money, because that's what people with good work ethics actually do, which is the type of people we should be attracting, not those who want to get paid to goof around and do nothing.

3) it's often not the dispatchers who have no mercy, but when the supervisors are telling them to act that way (or else discipline the dispatchers), because the supervisors are being told by the owners that they want the dispatchers to act that way (or else the supervisors will be disciplined), and the owner wants it that way because an ambulance not on a job isn't making them money (but is costing them money in salary).  So don't accuse the dispatchers of having no mercy because the dispatchers are doing what the bosses say. 





jemt said:


> Biggest factor so far for me is doing transport EMS. I feel like I'm playing dressup as an EMT when doing transport. Nothing like sitting in a dr. office for three hours with your patient on a stretcher waiting to be seen.
> 
> 911 on the other hand still gets me going and I actually enjoy it.


That's why most people either work transport because it sometimes pays more than 911, or work transport until they get a FT job as a 911 provider, and then either work per diem in transport for extra money, or never step foot in a transport ambulance ever again.  

I am happy to say i am in the latter category.

and I will also say that you can still get burned out of 911 work.


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## Aidey (Feb 18, 2012)

Idiots, plain and simple. 

I can put up with a lot of the other stuff, but I can't deal with idiots. And I don't necessarily mean the patients. Charge RNs who never fill out the PCS right, SNF RNs who withhold Tylenol from a pt with a fever because they don't want to mask the symptoms. Or FFs who don't know the difference between zantac, xanax and xoponex. You guys get the picture. 

I don't have the energy to do my job and everyone else's.


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## 46Young (Feb 18, 2012)

Veneficus said:


> I think that demonstrates a major failure of management.



Well, in most privates, you have lower hiring standards than you would find in the hospitals and municipal employers. The workforce typically consists of kids and a few people that can't get hired anywhere else.

Besides, it's not like the employees are badmouthing the company right in front of the supervisor, unless they're ready to quit.


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## Maine iac (Feb 18, 2012)

DrParasite said:


> 2) you are paid to work 8 or 12 hours (depending on how long your shifts are).  As a result, you are expected to to be working for 8-12 hours, making money for your employer.  you are entitled to a 30 minute lunch break and two 15 minute breaks during your shift if you work 12s, and 30 min break if you work 8.  Don't complain if you are forced to actually work for your money, because that's what people with good work ethics actually do, which is the type of people we should be attracting, not those who want to get paid to goof around and do nothing.



Biggest pet peeve ever! During my medic ride along time I worked with a company where the majority of the medics would complain complain complain if they had 3 or 4 calls in a 12 hour shift. We'd sit and watch tv all night then maybe get a call and the whole way there would be "darn it all I won't know what happened at the end of the show!" 

Once, after a call the two of them were chatting it up with people at the hospital (probably been there 20 minutes after dropping off a pt) when we were dispatched to a multi MVC with roll over at like 4am. They never copied the call, dispatch called us again, I went into the ER to try and find them and couldn't, finally on the third call from dispatch they appeared and we got going. People with piss poor work ethic really annoy me.


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## RocketMedic (Feb 18, 2012)

Today, I came to work at my part-time job. I found out that Preferred Hospital management has blocked the hiring of more paramedics, that we were now expected to perform all of the tasks of a CNA so that we would avoid Medicare fraud. I can work in the ER but I'm apparently barred by corporate policy from charting or documenting what I do for a patient, leaving me totally at the hands of incompetent nurses in terms of responsibility. I'm being told by the EMS manager that only one of her employees really helps her and that I don't give her enough hours to have valid concerns, and there's no calls and not enough patients to stay busy to her standards.
I don't mind working, but when your company perpetuates the para-CNA, does shady things for reimbursement, pays poorly, and treats its full time employees who aren't part if the club like crap, there's no reason to stay. 

I'm pretty down with not coming back here.


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## Tigger (Feb 18, 2012)

jemt said:


> Biggest factor so far for me is doing transport EMS. I feel like I'm playing dressup as an EMT when doing transport. Nothing like sitting in a dr. office for three hours with your patient on a stretcher waiting to be seen.
> 
> 911 on the other hand still gets me going and I actually enjoy it.


I can agree with that. When you know that only 1/10 in calls really needs an ambulance, that kinda sucks. I knew what I was getting into and am not complaining about the IFT aspect of the job because I am still providing a service that is meaningful to someone. It's just the service that most people associate with the words ambulance and EMT.



DrParasite said:


> I'd like to address this comment if that's ok with everyone1) you can only do 1 call at time.
> 
> 2) you are paid to work 8 or 12 hours (depending on how long your shifts are).  As a result, you are expected to to be working for 8-12 hours, making money for your employer.  you are entitled to a 30 minute lunch break and two 15 minute breaks during your shift if you work 12s, and 30 min break if you work 8.  Don't complain if you are forced to actually work for your money, because that's what people with good work ethics actually do, which is the type of people we should be attracting, not those who want to get paid to goof around and do nothing.
> 
> ...



The one call at a time mentality is important. You can't look at your patient as your fifth patient of the day, you look at them as your patient. What ever happened earlier and what will happen is not relevant until the call is clear.

That said, it is in no one's best interest to have crews working back to back calls for the duration of their shift, every shift. If you're flipping burgers, you will do so close to all shift, but you're shift is not 12 hours long either. Do anything for 10-12 hours straight and it's going to take a toll on you and whoever you work with and for. I work damn hard at work, but I do expect that I will be given a little down time in exchange for doing the best job possible. My bosses recognize that, and I appreciate it. Yes, it would cost them less money to have me take an ED discharge ready now out of the ED I just transported to, but they know that sucks. Now I'm down two narratives, the truck and stretcher received only a cursory cleaning, etc etc. Instead they just send another truck and let us have a chance to do our job properly.


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## 46Young (Feb 18, 2012)

DrParasite said:


> I'd like to address this comment if that's ok with everyone1) you can only do 1 call at time.
> 
> 2) you are paid to work 8 or 12 hours (depending on how long your shifts are).  As a result, you are expected to to be working for 8-12 hours, making money for your employer.  you are entitled to a 30 minute lunch break and two 15 minute breaks during your shift if you work 12s, and 30 min break if you work 8.  Don't complain if you are forced to actually work for your money, because that's what people with good work ethics actually do, which is the type of people we should be attracting, not those who want to get paid to goof around and do nothing.
> 
> 3) it's often not the dispatchers who have no mercy, but when the supervisors are telling them to act that way (or else discipline the dispatchers), because the supervisors are being told by the owners that they want the dispatchers to act that way (or else the supervisors will be disciplined), and the owner wants it that way because an ambulance not on a job isn't making them money (but is costing them money in salary).  So don't accuse the dispatchers of having no mercy because the dispatchers are doing what the bosses say. That's why most people either work transport because it sometimes pays more than 911, or work transport until they get a FT job as a 911 provider, and then either work per diem in transport for extra money, or never step foot in a transport ambulance ever again.



1) With these web ePCR's, the reports can be faxed within 24 hours, so what does that mean? It means that the crew can be dispatched for another call as soon as they get the pt off of the cot. I did that for six months when I worked for Charleston County EMS, and it was miserable. Literally, we pull up at the ED, hit the button, and the next job is on the screen. No exaggeration. If you go over the air and say that you have to clean the rig, restock, etc. it's assumed that you're lying to get out of doing that call. Now, fast forward to 0200 (we worked 24's with some 12's), and you're trying to make sense out of a bunch of reports in various stages of completion, and sometimes you're on the station computer after you're relieved.

2) Agreed, unless you're working more than 16 hours straight. Pack your lunch and hit the bathroom before pickup or after dropoff. If you work without a break, you ought to be compensated for that missed break. Getting off an hour early after working 15 straight isn't going to work for me. Keep me on the rig for the last hour and pay me the OT. 

3) Agreed, except when the dispatchers play favorites.


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## FourLoko (Feb 18, 2012)

Maine iac said:


> Biggest pet peeve ever! During my medic ride along time I worked with a company where the majority of the medics would complain complain complain if they had 3 or 4 calls in a 12 hour shift. We'd sit and watch tv all night then maybe get a call and the whole way there would be "darn it all I won't know what happened at the end of the show!"
> 
> Once, after a call the two of them were chatting it up with people at the hospital (probably been there 20 minutes after dropping off a pt) when we were dispatched to a multi MVC with roll over at like 4am. They never copied the call, dispatch called us again, I went into the ER to try and find them and couldn't, finally on the third call from dispatch they appeared and we got going. People with piss poor work ethic really annoy me.



We only work 10s and average 6 calls a day. You can think about how long calls take where you are and do the math. In three work days I might get one lunch break that might be 30 min if I'm lucky.

I didn't blame the dispatchers because I know they're under pressure from the owner who likes to show up too often. Then again I'm sure they can learn to say "No, I'm sorry we don't have a crew this time."

Sorry you only made 5 Million this year Mr. Owner guy, I can't even afford rent.


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## ATrain (Feb 19, 2012)

46Young said:


> It's true. I've worked for places where many of the employees were constantly putting the place down, acting like working there was beneath them, or were just apathetic to the whole situation. As a new person, seeing the average employee act that way, I lose respect for the organization and begin looking for another place to work.



You just hit the nail on the head as to why I ended up quitting the first place I worked, and much more eloquently than I could have phrased it.

Both of my medic partners that I'd had during the home stretch of my employment there were just miserable, hateful people.  They never had anything good to say about work, and it's like making a run was a chore.  

It really starts to wear on you when, for 36+ hours a week you're stuck in a truck with someone who is so negative.


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## Basermedic159 (Feb 20, 2012)

I don't understand why our pay is so crappy. We are basically pre hospital ER docs. The only difference is we dont write prescriptions. I have seen many Paramedics smarter than the doctors we transfer our care to.


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## systemet (Feb 20, 2012)

Basermedic159 said:


> I don't understand why our pay is so crappy. We are basically pre hospital ER docs. The only difference is we dont write prescriptions. I have seen many Paramedics smarter than the doctors we transfer our care to.



EM physician : 4 year undergraduate degree, 4 year MD program, 5 year fellowship.

Paramedic : 6 month EMT program, 2 year paramedic diploma.


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## abckidsmom (Feb 20, 2012)

Basermedic159 said:


> I don't understand why our pay is so crappy. We are basically pre hospital ER docs. The only difference is we dont write prescriptions. I have seen many Paramedics smarter than the doctors we transfer our care to.



I would venture that this thought process is another reason to add to the list o factors that contribute to burnout in EMS. Paramedics as a class have a really high self esteem and view of what our role actually is. 

Experienced, thinking medics are really valuable resources, but they are not the same as er physicians. We function as the physician's eyes, ears and hands in the field, but by design, we are extremely limited in what we can do, the areas in which we are educated, and the impact we can have in our roles. 

I get a lot of satisfaction out of sleuthing out a good diagnosis, but I don't consider it certain a lot of times without confirmation.  Like with the ABG discussion in the CPAP thread, without he diagnostic testing in the hospital, some things ate just shots in the dark. 

Challenges our assessment skills, but keeps us humble, if we're smart. 

Anyway, my two cents is that ego is a big contributor to burnout.


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## firecoins (Feb 20, 2012)

I will contribute a little about what burns me out.  

I was working at a crappy transport company. While loading a vent patient into the rig, a supervisor certified as an EMT-B wrote me up for not wearing a company issed tie. * I was never issued a company issued tie *but that was not important. The fact that I was *loading a vented patient *into a rig was not important.  The fact is this could have been handled when I came into work not wearing the said tie when I sign out my equipment from an office with supervisors in it. They could have given me a tie and written me up when a patient was not at risk. :glare: Event like this make me speak negative about the company which I see people here have complained about. 

We as medics are not ER docs but considerings some of the stupid things non ER docs have done makes me believe I should go to med school. (those non ER docs are indeed bright people just not very good at EM)  I like my ER docs and get along with them very well.  I guess I am a bit biased.


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## RocketMedic (Feb 20, 2012)

I had an EMT-I supervisor lecture me that it was unacceptable that I didn't drop two 14s into a patient with a humorus fracture, nor did I use narcs. Completely ignored tat the patient was two and that the splint+icepack worked perfectly.

"For trauma, 18s are unacceptable" = low pay.


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## 46Young (Feb 20, 2012)

Basermedic159 said:


> I don't understand why our pay is so crappy. We are basically pre hospital ER docs. The only difference is we dont write prescriptions. I have seen many Paramedics smarter than the doctors we transfer our care to.



http://sandmansprogress.blogspot.com/2006/07/rise-of-noctor.html

Ever heard of the term "noctor?"


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## the_negro_puppy (Feb 20, 2012)

Rocketmedic40 said:


> I had an EMT-I supervisor lecture me that it was unacceptable that I didn't drop *two 14s* into a patient with a humorus fracture, nor did I use narcs. Completely ignored tat the patient was *two* and that the splint+icepack worked perfectly.
> 
> "For trauma, 18s are unacceptable" = low pay.


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## Tigger (Feb 21, 2012)

Basermedic159 said:


> I don't understand why our pay is so crappy. We are basically pre hospital ER docs. The only difference is we dont write prescriptions. I have seen many Paramedics smarter than the doctors we transfer our care to.







Skills do not necessarily equate to knowledge, as others have pointed out.


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## Melclin (Feb 21, 2012)

Neggro....I know what you mean. I've been working for a year and I can feel the seeds of burn out growing in me. 

Things that contribute to my future Falling down style massacre of people that grind my gears:

1. Ramping. I found it soul destroying working in the city when you would spend 3 hrs waiting with a pt on stretcher and know full well that because every other ambulance was waiting behind you in line, when you clear you instantly pick up one of the many waiting BS jobs waiting for ambulances, and join the back of the line you left 45 mins ago. Especially at 4am. Sometimes you'd be lucky and get a pt sick enough to go straight through or well enough to put in the waiting room, but mostly not.

2. Fatigue. The roster structure we have at the moment is simply not sustainable. Its difficult at best and murderous at worst. 

3. A lack of high acuity work. Now, no one expects to have every job be super involved and interesting. None the less, I find it very frustrating debriefing after a big job and looking at what I could have done better and thinking, yep in 3yrs when I do another job like it, I'll try and remember to do x better.

4. Politics. I don't think I need to explain this one.


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## MediMike (Feb 21, 2012)

Basermedic159 said:


> I don't understand why our pay is so crappy. We are basically pre hospital ER docs. The only difference is we dont write prescriptions. I have seen many Paramedics smarter than the doctors we transfer our care to.



I've been gone for a long time, so I don't know if we've got people trolling on here now, but this comment is absolutely retarded. (Poor adjective I know, but whatever)

We are so incredibly far removed from being doctors that it's not even funny.  Not even an urgent care PA.  Hell, an MA can probably tell you the proper ABx to prescribe for various infections better than many on here.  

Skills wise we are a combination of an ICU RN with standing orders and a doc in regards to RSI/Intubation.  That's about it.  I will agree that depending on which system you work in, there is some degree of "practicing medicine", but its not common in the U.S.  

I'm curious to know how you can qualify yourself or your buddies as "smarter than the doctors" you transfer care to.


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## Handsome Robb (Feb 21, 2012)

Basermedic159 said:


> I don't understand why our pay is so crappy. We are basically pre hospital ER docs. The only difference is we dont write prescriptions. I have seen many Paramedics smarter than the doctors we transfer our care to.



Wait really? If these medics are so much smarter why do they settle for crappy pay and long work hours rather than going to med school and getting better hours (for the most part) with exorbitantly better pay.

Yea we can do some skills that are exclusive to MDs and certain mid-level providers in certain circumstances but that in no way shape or form makes us "prehospital ER docs."

Lack of education and oversaturation of qualified employees are two reasons for "crappy pay", among other things. 

If you get a job offer and don't take it because of the salary it's no skin off their back, there are probably 100 more people behind you that will gladly accept it.


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## the_negro_puppy (Feb 21, 2012)

Melclin said:


> Neggro....I know what you mean. I've been working for a year and I can feel the seeds of burn out growing in me.
> 
> Things that contribute to my future Falling down style massacre of people that grind my gears:
> 
> ...



I feel your pain Broseph. I find that the intensity for burnout is directly proportional to  time from your last holidays. Thankfully im about to go on 2 weeks annual, been nearly 8 months since last hols. Ramping is the most soul destroying for me.


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## bw2529 (Feb 21, 2012)

For myself, as a relatively new volunteer, I consider the abuse of the EMS system as well as the incorrect prioritization of calls my biggest complaints.


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## MediMike (Feb 22, 2012)

Ahhh the abuse of the EMS system...yeah it sucks, but face it, we, along with the ED are the new gateway to primary care.  It's one of those things that people are just going to have to get on board with, hell use it as part of the effort to increase education for EMS so we can do nice neat non-transports with a decreased litigation rate/danger.  

Wake County rocks their APP's, think it's a great model for suggesting alternative transport destinations, we can do this people!


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## 46Young (Feb 22, 2012)

MediMike said:


> Ahhh the abuse of the EMS system...yeah it sucks, but face it, we, along with the ED are the new gateway to primary care.  It's one of those things that people are just going to have to get on board with, hell use it as part of the effort to increase education for EMS so we can do nice neat non-transports with a decreased litigation rate/danger.
> 
> Wake County rocks their APP's, think it's a great model for suggesting alternative transport destinations, we can do this people!



A few Chiefs at my department were looking at the APP program, but there's a problem. They fail to see how it's financially beneficial to not transport as many people who use 911 as they can. The hospitals are not interested either, since the vast majority of the county's residents have commercial insurance, and there are relatively few that are uninsured or on Medicaid. So, the hospitals make out by taking in everyone that wants to use the ED, and run the whole battery of CYA tests to boost their revenue. 

So, both the hospitals and the county's 911 service stand to lose revenue by directing patients to destinations other than 911 receiving hospitals. They fail to see the financial incentive. Sure, the healthcare system in general saves money, but the county and the hospitals aren't getting any of the benefit.

Edit: If the residents were relatively poor, with a large percentage either uninsured or on Medicaid, it would be a different story altogether.


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## MediMike (Feb 22, 2012)

I feel ya buddy.  We've hit the same issues over here.  The ED docs are all considered contractors who are paid on a production basis, so there isn't a chance in hell of it getting off the ground.  I'd feel morally deficient if I didn't at least make an effort.  

It always comes down to turning a profit rather than fixing the broken system


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## MasterIntubator (Feb 22, 2012)

My source of burnout  = upper management.  

Otherwise, the hours, the pay, the  late night "my knee hurts now" calls, etc... are all what makes me smile and enjoy my job.  I would not change a thing on the provider side.  Well... maybe the pay.  Would be nice to be financially comfortable and no bills.


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## Basermedic159 (Feb 23, 2012)

NVRob said:


> Wait really? If these medics are so much smarter why do they settle for crappy pay and long work hours rather than going to med school and getting better hours (for the most part) with exorbitantly better pay.
> 
> Yea we can do some skills that are exclusive to MDs and certain mid-level providers in certain circumstances but that in no way shape or form makes us "prehospital ER docs."
> 
> ...



Everyone dosn't have the money to just pick up and go to med school...


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## Basermedic159 (Feb 23, 2012)

MediMike said:


> I've been gone for a long time, so I don't know if we've got people trolling on here now, but this comment is absolutely retarded. (Poor adjective I know, but whatever)
> 
> We are so incredibly far removed from being doctors that it's not even funny.  Not even an urgent care PA.  Hell, an MA can probably tell you the proper ABx to prescribe for various infections better than many on here.
> 
> ...



Thats a pretty rude way to reply to a post "retarded" Really? I dont ever recall saying that I was smarter than an M.D But we have Medics smarter than *some* MD's that we transfer our care to. One M.D in particular likes to kill our pt's by removing pacing pads, darn near as soon as we cross the entrance doors. Thats just one example. I'm seriously not going to sit here and provide a flow chart explaining how " I can qualify my "buddies" to be "smarter than the doctors" we transfer care to.


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## 46Young (Feb 23, 2012)

Basermedic159 said:


> Thats a pretty rude way to reply to a post "retarded" Really? I dont ever recall saying that I was smarter than an M.D But we have Medics smarter than *some* MD's that we transfer our care to. One M.D in particular likes to kill our pt's by removing pacing pads, darn near as soon as we cross the entrance doors. Thats just one example. I'm seriously not going to sit here and provide a flow chart explaining how " I can qualify my "buddies" to be "smarter than the doctors" we transfer care to.



Perhaps this doctor has seen incompetent EMS providers, and prefers to immediately discontinue your interventions, and start their own assessment and treatment from scratch. As far as pulling the pacing pads, perhaps this doctor prefers to go with pressors instead of pacing. Perhaps their medical education and experience guides them to prefer that treatment instead. Perhaps our limited medical education does not allow us to see past the insult of a M.D. discontinuing an EMS intervention immediately.

Just a thought.


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## systemet (Feb 23, 2012)

Basermedic159 said:


> Everyone dosn't have the money to just pick up and go to med school...



I understand that education is blisteringly expensive in the US.  But I'm pretty sure that for most paramedics, it's still that they (i) lack the prerequisite courses to apply to most programs, (ii) lack the Bachelor's degree that most places want, (iii) lack the GPA, and (iv) lack the MCAT score.  We don't do ourselves any favours by training at technical schools / private colleges.

I'm not saying that I haven't met tons of people in EMS who I thought could probably have done it.  Just that there's a whole other set of hurdles to jump through before you get to applying.


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## systemet (Feb 23, 2012)

Basermedic159 said:


> I'm seriously not going to sit here and provide a flow chart explaining how " I can qualify my "buddies" to be "smarter than the doctors" we transfer care to.



Then I don't think you're going to convince anyone here that your medics are "basically prehospital ER docs".


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## RocketMedic (Feb 23, 2012)

Poor midlevel and upper management is a huge source of burnout- see Emergystat or lost AMR contracts for example. 

Nothing drives away employees like low wages and poor leadership.


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## usalsfyre (Feb 23, 2012)

Rocketmedic40 said:


> Poor midlevel and upper management is a huge source of burnout- see Emergystat or lost AMR contracts for example.
> 
> Nothing drives away employees like low wages and poor leadership.



Poor leadership more so than wages.

I make a salary that is more than fair for my education and experience. Would I like to make more? Of course.

 I'm not sure where the notion we should make north of 50k starting comes from.


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## firecoins (Feb 23, 2012)

usalsfyre said:


> I'm not sure where the notion we should make north of 50k starting comes from.


Cops have similar educational requirements in NY, an associate's degree.  A criminal justice degree is less difficult than an aa in paramedicine IMHO.  Cops have better unions and a danger factor considered in their job.  Cops whom get a bachelor's degree can advance for higher pay. 

Medical techs, ER techs, Patient care techs and simialr hospital positions pay just as much if not more than paramedic jobs. They have less training, less responsibility but have a stronger union. They can advance by becoming RNs.


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## Aidey (Feb 23, 2012)

usalsfyre said:


> Poor leadership more so than wages.
> 
> I make a salary that is more than fair for my education and experience. Would I like to make more? Of course.
> 
> I'm not sure where the notion we should make north of 50k starting comes from.



I don't think we should make more starting, but we sure as hell should make more after 20 years. $50,000 is around were our wages top out when you hit the last step of the wage scale.


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## MediMike (Feb 23, 2012)

systemet said:


> Then I don't think you're going to convince anyone here that your medics are "basically prehospital ER docs".



Ding Ding Ding


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## TatuICU (Feb 23, 2012)

For me it was :censored::censored::censored::censored:ty pay and lack of sleep.....and my wife saying that if I kept pulling 72's that I would come home to an empty house one of these days.  Sounds bad but she had been more than patient up to that point.

Oh, and people.  I got to a point where I absolutely HATED people, and I would get physically sick having to go into these houses and speak to them.  Luckily my partner was quite the character and usually stole show anyway.


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## triemal04 (Feb 24, 2012)

usalsfyre said:


> I'm not sure where the notion we should make north of 50k starting comes from.


$50,000 is an absolutely appropriate starting salary for a paramedic.  It's really not even that much when you come right down and think about it.

And for quality paramedics the least that they deserve to be making.


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## Basermedic159 (Feb 25, 2012)

systemet said:


> I understand that education is blisteringly expensive in the US.  But I'm pretty sure that for most paramedics, it's still that they (i) lack the prerequisite courses to apply to most programs, (ii) lack the Bachelor's degree that most places want, (iii) lack the GPA, and (iv) lack the MCAT score.  We don't do ourselves any favours by training at technical schools / private colleges.
> 
> I'm not saying that I haven't met tons of people in EMS who I thought could probably have done it.  Just that there's a whole other set of hurdles to jump through before you get to applying.



I totally agree!!! I would love to be an M.D, and my specialty be an anesthesiologist. BUT....It'll never happen. I'm only 22 but I don't have the money or the time... : (


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## emtvic17 (Feb 25, 2012)

Entering the field for the wrong reasons, I believe if you have an honest desire to help people in need, youll have a fulfilling career in EMS. Thats just me.


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## cruiseforever (Feb 25, 2012)

emtvic17 said:


> Entering the field for the wrong reasons, I believe if you have an honest desire to help people in need, youll have a fulfilling career in EMS. Thats just me.




I could not agree with you more.  Been in EMS for 30+ years.  First 8 was a vol. EMT with a small ambulance.  When I started riding with a Metro service I caught the bug to become a medic.  It is a very rare day that I do not want to go to work.  And when I do feel that way it's more than likely it would be a great day to go fishing.  

Sure there are things that upset me, stress me out.  I do not know of a job that would not.  Hope to keep doing this for another ten if the body holds up.  So far so good.


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## bw2529 (Feb 25, 2012)

triemal04 said:


> $50,000 is an absolutely appropriate starting salary for a paramedic.  It's really not even that much when you come right down and think about it.
> 
> And for quality paramedics the least that they deserve to be making.



I think $40-50k is not unreasonable, for a paramedic, depending on area.


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## DrParasite (Feb 25, 2012)

firecoins said:


> Cops have similar educational requirements in NY, an associate's degree.  A criminal justice degree is less difficult than an aa in paramedicine IMHO.  Cops have better unions and a danger factor considered in their job.  Cops whom get a bachelor's degree can advance for higher pay.


look at the stats of EMTs and Paramedics who get either injured on the job or are killed on the job.  While it might not be as bad as cops, EMS is definitely a dangerous job.





firecoins said:


> Medical techs, ER techs, Patient care techs and simialr hospital positions pay just as much if not more than paramedic jobs. They have less training, less responsibility but have a stronger union. They can advance by becoming RNs.


So I can go to a hospital with no formal education or experience, complete an in house training program, and make more $$$ than a paramedic who has a 2 year degree and some experience in the field?

damn, now I want to be med tech in the ER.  forget medic school, i can make more money with shorter time and money spent if I just become a tech.


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## systemet (Feb 27, 2012)

Basermedic159 said:


> I totally agree!!! I would love to be an M.D, and my specialty be an anesthesiologist. BUT....It'll never happen. I'm only 22 but I don't have the money or the time... : (



Are you sure?  Because there's a lot of people that overcome a lot of adversity to get into medical school.  

Not everyone goes straight from high school and gets an Honour's undergraduate degree 3.9 GPA, perfect MCAT score, stellar extracurriculars, and rich parents paying for everything. (Not to say that those people haven't worked very hard to get where they are).

You're not even that old man!


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## Shishkabob (Feb 27, 2012)

Yeah... 23 is old


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## jgmedic (Feb 27, 2012)

usalsfyre said:


> Poor leadership more so than wages.
> 
> I make a salary that is more than fair for my education and experience. Would I like to make more? Of course.
> 
> I'm not sure where the notion we should make north of 50k starting comes from.



This. I make very little, esp. for SoCal, but the management at my division is top notch and makes me not want to leave. 40k a year sounds like a reasonable step 1 pay to me.


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## crispymedic (Mar 5, 2012)

46Young said:


> What do you consider to be the greatest contributing factor to burnout and attrition in EMS?...



Well, I've been doing this for over 20 years and I am burnt to sh...

Yes, the schedule can suck some times but we mostly bring that on ourselves.

I don't buy the lack-of-advancement argument. Each EMSer chooses to move up or move out of their current employ as their needs/desires dictate. If your agency has nowhere for you to go there are always other agencies looking for superstars like yourself.

Plus, isn't an ambulance job kind of a stepping-stone kinda job anyway? If you are still an ambulance medic after 15 or 20 years then you lack ambition.

I'd say the biggest burn-out maker is just the relentless pain we see the survivors go through when their loved ones get killed. Mothers/fathers losing their children is the worst. 

Oh, one more thing. The patients that talk and die. When they are already dead it's not so bad. It's when they talk to you THEN die that really rips me to shreds. Those make me feel like I failed them.

Respectfully,
crispymedic


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## usalsfyre (Mar 5, 2012)

crispymedic said:


> Plus, isn't an ambulance job kind of a stepping-stone kinda job anyway? If you are still an ambulance medic after 15 or 20 years then you lack ambition.


Negative sir...I've been doing this ten years and still enjoy the crap out of being a paramedic, I've had the opportunity to move on but chose not to.

This attitude is part of our problem.


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## MasterIntubator (Mar 5, 2012)

An ambulance job was my stepping stone to get on a medic unit.  25 years and still cruising.... more eat up than most of our 3-5 year "veterans".

What I tell my students..... If you don't love the job... move on.


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## abckidsmom (Mar 5, 2012)

usalsfyre said:


> Negative sir...I've been doing this ten years and still enjoy the crap out of being a paramedic, I've had the opportunity to move on but chose not to.
> 
> This attitude is part of our problem.



*like*

Nobody will make it long in ANY career if they think it is stupid and beneath them. 

Whatever you do, do it with a positive attitude to the best of your ability and you'll have a good time at it. Even wiping poop, digging ditches, dishing up fast food.


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## MedicSmith (Mar 5, 2012)

I think one of the biggest reasons for attrition that I've personally seen is the lack of camaraderie among EMS personnel. It's this non-stop high-school drama, this pissing match where all the "cool" kids talk down about the "not-so-cool" kids and what bad medics they are and how they would never have done this or that, and blah blah blah. I've never seen a bigger group of insecure adults in my life, except maybe in Hollywood... Maybe. Now don't get me wrong, there is definitely such a thing as an incompetent medic. But if you listen to these vultures I'm referring to, you might think they were the only medics worth their patches. So quick are we to throw each other under the ambulance, so as to maybe fool others into thinking we walk on Normal Saline, and that our IV's just drop in, every time, that the patients WE lose were just meant to die, that we could run this system better, that we could drive the ambulance better, that we could do the nurse's or ER doctor's job better, that we simply don't care about the medical questions we don't happen to know the answers to... When the powers-that-be see how non-unified we are as a group of professionals, they see weakness. They see a bunch of back-stabbing "kids" they can just push around. It makes it easier for them to step on us, pay us less, work us longer, and ignore our wants and needs. So come on guys and girls, look at each other and see the real picture here. Everyone of us is here for the same reason, or at least we had the same reasons for showing up initially: To help. So my gosh, let's start helping our co-workers, ALL of them. 

Oh, and bathroom breaks... I think a lot of people quit because of lack of bathroom breaks...


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## crispymedic (Mar 6, 2012)

usalsfyre said:


> Negative sir...I've been doing this ten years and still enjoy the crap out of being a paramedic, I've had the opportunity to move on but chose not to.
> 
> This attitude is part of our problem.



That is all well and good but in the USA street medicine is a low level specialty. Want to stay a paramedic? Do so but get a flight medic job. New challenges, more acute patients. Or, go get your RN or MD. Or, God forbid, become a fire based paramedic and make some real money and real benefits.

There are a few really good medics in ALCO with more then 15 or 20 years on but they are few and far between. Most of them are trapped in a job they hate because they never went back to school. Forty and 50 year olds working in a 20/30 something job. I see them when I partner with them on my ambulance per diems or when I work on an engine/truck. Every time we get calls they grumble and :censored::censored::censored::censored::censored:. Then after the calls they :censored::censored::censored::censored::censored: how the pt. "sucked" or was drug seeking or whatever. These people should have left EMS years ago but they never put in the work to move up. Those are the ones who I am talking about. They know who they are and so do you.


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## abckidsmom (Mar 6, 2012)

crispymedic said:


> That is all well and good but in the USA street medicine is a low level specialty. Want to stay a paramedic? Do so but get a flight medic job. New challenges, more acute patients. Or, go get your RN or MD. Or, God forbid, become a fire based paramedic and make some real money and real benefits.
> 
> There are a few really good medics in ALCO with more then 15 or 20 years on but they are few and far between. Most of them are trapped in a job they hate because they never went back to school. Forty and 50 year olds working in a 20/30 something job. I see them when I partner with them on my ambulance per diems or when I work on an engine/truck. Every time we get calls they grumble and :censored::censored::censored::censored::censored:. Then after the calls they :censored::censored::censored::censored::censored: how the pt. "sucked" or was drug seeking or whatever. These people should have left EMS years ago but they never put in the work to move up. Those are the ones who I am talking about. They know who they are and so do you.



I really think you've accepted the assumption that real, actual grownups can't be fulfilled in a low level specialty. For sure, there is a lot of BS in EMS. But the fact is, it's a service oriented job with a lot of human contact, some required quick thinking at times, and the ability to be outdoors all day. This is a dream for a lot of people, and just the right career for many, many people who do t necessarily need to waste their skills and aptitude for EMS on "progressing" to something more higher level. 

This is the USA. The founders of our country were farmers.  A generation ago, a smart man could have worked happily for his entire adult life in a sawmill without being fed the lie that he was unchallenged or unfulfilled in a low level position.


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## epipusher (Mar 6, 2012)

I wonder, may crispymedic be referring to himself in his negative posts? I'm over 15 years in and enjoy every minute of my job. Just as an example, my last few shifts we were running slow with only about 6 calls in for the night, so we started trying to snag some runs on the southside of town. I see this as my profession, my chosen career, with my end goal to be retirement as a medic in 14 years.


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## abckidsmom (Mar 6, 2012)

epipusher said:


> I wonder, may crispymedic be referring to himself in his negative posts? I'm over 15 years in and enjoy every minute of my job. Just as an example, my last few shifts we were running slow with only about 6 calls in for the night, so we started trying to snag some runs on the southside of town. I see this as my profession, my chosen career, with my end goal to be retirement as a medic in 14 years.



One would think, given the label he chose for himself in his username.


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## Aidey (Mar 6, 2012)

I just want to add that the *****ing happens in ANY service type industry. I promise that waitresses, baristas, airline attendants etc all :censored::censored::censored::censored::censored: about the pain in the *** people they deal with. I have a friend who works in IT as a hardware/software fix it guy. Aside from the drug seekers he has almost the EXACT same complaints as we do. People call in the middle of the night for a BS issue that doesn't need a $100 tech to fix, and the issue could have been avoided if they had just followed his advice 2 weeks ago.


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## BeachMedic (Mar 6, 2012)

Aidey said:


> I just want to add that the *****ing happens in ANY service type industry. I promise that waitresses, baristas, airline attendants etc all :censored::censored::censored::censored::censored: about the pain in the *** people they deal with. I have a friend who works in IT as a hardware/software fix it guy. Aside from the drug seekers he has almost the EXACT same complaints as we do. People call in the middle of the night for a BS issue that doesn't need a $100 tech to fix, and the issue could have been avoided if they had just followed his advice 2 weeks ago.



Exactly.Our complaints tend to be the universal complaints. We're all overworked, under paid, and management sucks. For the most part, that is everywhere you go and in every line of work.

With that said, I will say that it takes a special kind of person and the right circumstances to make a career out of being a paramedic. In general, I believe a burn out timer starts for the majority of people the second they start working on a rig. It is different for everyone but to me it almost seems inevitable. I haven't hit mine yet, but I'm not going to say that I'm not thinking about, "what's next?".


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