Continuing in EMS?

ericchick13

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Looking for some advice, working as a full time emt currently at a decent ALS 911/ transports company. Want to get my medic, but I constantly hear from other seasoned medics to do something else before it’s too late, like nursing. No way in hell could I do nursing but I wouldn’t mind doing some sort of health care associates degree, but is it possible to go to community college and work ems full time?
 

mgr22

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I recommend you get a degree -- any degree -- if you can; not because it will necessarily make you a better healthcare provider, but because it will count for something across a broad spectrum of potential employers. How much it counts depends, obviously, on the particular circumstances of your job search, but degrees often create opportunities for those who have them.

Now, you're going to hear things like "book-learning doesn't make you a better paramedic" and "college doesn't teach you common sense." Say those are true; you still won't necessarily know how the knowledge you gain during your studies helps you in business or everyday life. If I were interviewing two people for the same job and both seemed capable, but only one had a degree, I'd probably hire the one with the degree.

Working full-time while going to school is hard but doable with enough motivation, a supportive family and an understanding boss.
 

DrParasite

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1) it is possible to work full time and go to school.

2) many paramedics will tell you do something else; however, how many of them are taking their own advice and looking to do something else? There are many reasons to go into nursing (better pay, better working conditions, better advancement potential etc), but if you would hate the job than it's not worth it. A lot of people will tell you to get out of EMS (it suck, the pay sucks, the job sucks, management sucks, this company sucks, you get the idea), yet they still do it day in and day out, and are senior member of their organization... if it sucks that badly, why are they not doing something else?

Since you seem young let me ask you a question: When you get hurt on the job, injure your back and can no longer lift, what do you want to do?

Degrees are awesome, once you have one, it can rarely be taken away. The same can't be said for an EMT or paramedic certification.
 

johnrsemt

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I have people ask me how I worked FT and went to School FT time, and my answer is "I don't know" I worked on average of 70 hours a week, had 16 hours of class and 32-48 hours of clinicals a week.

Get a degree; most of your general ed you can do online now, makes it way easier. Most medic programs work around EMS work; and most EMS jobs will work around Medic school.
 

RocketMedic

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I've gotten an AAS, 2x bachelors and a master's degree while working full time.
 

wanderingmedic

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I am a paramedic. I am also a RN.

My best advice, don't waste your time and money on paramedic school. Most places don’t pay medics more than 15-20/hr, yet the cost of initial and continuing education is nearly the same as an RN or RT. As a brand new RN in the ED, I made over $30 /hr plus another $4 /hr in undesirable shift differentials. As a paramedic FTO with CCT and 911 experience, I pretty much topped out in my area at $16/hr. Yes, you can do medic school and work full time, but why? There is no money in EMS, and no upward mobility or room for clinical advancement.

If you want to build a career, EMS is not the place to do it. Pay and benefits are abysmal, and the responsibility and hours can be soul-crushing. There are limited career options for medics other than the road or as a nursing assistant at the hospital. Worst of all, Medics are still seen as the stupid step-children of healthcare. As a medic, you’ll be poor, disrespected, and without any retirement plan.

Nursing, on the other hand, has diverse clinical opportunities from primary care, to specialized care such as neuro intensive care, to invasive operating room stuff. You can also go on into advanced practice in nursing, and practice independently with your own patients. Best of all, most hospitals offer good retirement, benefits, and great hourly wages. Moreover, nursing is respected, and people know you do something more than drive an ambulance.

I would not trade the time I served on the road as a medic for the world. But, if I were to do my life over again, I would NEVER have spent the time and money on a career that I ended up basically abandoning for nursing. I still work the road part time as a Medic, but I am a career nurse. Interestingly, one of my RN friends recently completed a Medic Program for fun (OPERATIVE PHRASE: FOR FUN). He wanted to serve his community on the rig as a medic, and wanted to try to get into flight. But, he was under no illusion that EMS would pay his bills or support him in life. He too is a career RN who happens to work as a Paramedic on occasion.
 

Tigger

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I am a paramedic. I am also a RN.

My best advice, don't waste your time and money on paramedic school. Most places don’t pay medics more than 15-20/hr, yet the cost of initial and continuing education is nearly the same as an RN or RT. As a brand new RN in the ED, I made over $30 /hr plus another $4 /hr in undesirable shift differentials. As a paramedic FTO with CCT and 911 experience, I pretty much topped out in my area at $16/hr. Yes, you can do medic school and work full time, but why? There is no money in EMS, and no upward mobility or room for clinical advancement.

If you want to build a career, EMS is not the place to do it. Pay and benefits are abysmal, and the responsibility and hours can be soul-crushing. There are limited career options for medics other than the road or as a nursing assistant at the hospital. Worst of all, Medics are still seen as the stupid step-children of healthcare. As a medic, you’ll be poor, disrespected, and without any retirement plan.

Nursing, on the other hand, has diverse clinical opportunities from primary care, to specialized care such as neuro intensive care, to invasive operating room stuff. You can also go on into advanced practice in nursing, and practice independently with your own patients. Best of all, most hospitals offer good retirement, benefits, and great hourly wages. Moreover, nursing is respected, and people know you do something more than drive an ambulance.

I would not trade the time I served on the road as a medic for the world. But, if I were to do my life over again, I would NEVER have spent the time and money on a career that I ended up basically abandoning for nursing. I still work the road part time as a Medic, but I am a career nurse. Interestingly, one of my RN friends recently completed a Medic Program for fun (OPERATIVE PHRASE: FOR FUN). He wanted to serve his community on the rig as a medic, and wanted to try to get into flight. But, he was under no illusion that EMS would pay his bills or support him in life. He too is a career RN who happens to work as a Paramedic on occasion.
All of the downsides that you posted do not apply to many, many paramedics. Currently the biggest issues I have is pay, but as a new medic I am less than 10k from my nursing colleagues and have, in my mind, a more desirable schedule. There are also several employers that pay better locally. My benefits blow both of the hospital networks' out of the water and our retirement is way better. And we aren't even a pension based service. As for education, my schooling was paid for 100% by my employer aside from my effort into getting a grant for some of it. Even if I was to pay for, it would have cost me 7k, throw in another two and you have your AAS. Not a bad deal. I looked at "second degree BSN" programs and yea, those are not 7k.

As for "poor and disprected," spare me. We have an awesome relationship with the hospitals who actually hire paramedics and allow them to operate under more than the average paramedic scope. Even as a street paramedic, I have great relationships with our ED providers and we are not a small system. The clinical education and standards here are high, even for the dreaded AMR.

I have no doubt your experience as portrayed is true and valid. But that is not what the world looks like for every paramedic.
 

Peak

ED/Prehospital Registered Nurse
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I worked full time when I got my BS in bio and then my BSN, so you can certainly work full time while in school. You are going to see a lot less free time but that is the trade off that you make.

The reality is that there are pros and cons to every field in healthcare. Depending on why you don't want to be a nurse you may run into a lot of the same concerns in other healthcare fields.

One of the most frequent hesitations/concerns about nursing from EMS is that you lose independence; the reality is that all members of the healthcare team work together and in reality there is no single king of the castle. RTs are just about as reliant on physician orders as nurses, PAs have supervising physicians, docs are subject to hcahps and their own medical leadership, we are all subject to the limitations of insurance companies and the health care system in general, and so on. Managers work to make their numbers look good for directors, who in turn work to impress their VPs, for their three letter acronym suits, for the investors/board of directors/county, and so on. The reality is that, especially in ED/critical care, health care is a team sport; the techs, RTs, RNs, PAs, APRNs, Docs, social work, therapies, et cetera all work together to try to acheive a common goal.

I also often hear that they don't want to help people use the bathroom/"wipe a**"/other terms. Since I'm not going into hoarder homes and cat sh.. filled houses I'm not that worried about the trade off; and everyone gets their turn at the nastiness whether it be wiping a patient, intubating those who don't believe in oral hygiene, disimpacting stool, pelvics, hearing the worst experience you can imagine in therapy, or whatever else it may be be.

I think I would suggest making a plan on what you are trying to acheive and then figure out what degree will help you get there. I don't think medic school is bad value for money, but I make 2-3 times now than when I was a fire medic in a small department and in that sense nursing school was a great value. I also have a much larger/rapid/achievable clinical ladder than in fire (LT, Captain, assistant chief, chief; medical officer?; lateral to a larger/better paying department?) RT doesn't seem like a bad gig, just don't get trapped into one of those for profit programs. Therapies, social work, and psych in my opinion are underpaid given the level of education that they need. For just an associates though I would highly suggest either medic, nursing, or RT; I don't think an associates in some kind of health care leadership or clerical program will help a whole lot in EMS (either from a leadership or financial perspective) without at least having your medic.
 
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DrParasite

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About 3 years ago, I was looking at paramedic school with an immediate bridge to nursing school..... Even had my eye on an ICU spot, with a RN who told me once I passed my boards she would get me a spot on her unit.....

However, there were several things that made me decide against nursing school (aside from being offered my current job):

1) getting a good entry level RN job can be tough; every hospital wants nurses, however they all want experienced nurses. In the areas that I was looking at (ED, ICU, etc), they wouldn't' consider a new grad. And before you ask, EMS experience (particularly at the BLS/911 level) doesn't count in the eyes of many within the hospital.

2) The old joke is a nurse can't fart without a doctor telling her it's ok to do so. We all know this is an exaggeration, but paramedics have a lot of freedom to do what they want (within their guidelines), can decide treatment paths, and consult with a doctor if necessary; many nurses have a lot more online medical direction (IE, the doctor needs to be there to tell them what to do, or has to be consulted before something is done), compared to standing orders.

3) EMS is knows as Earn Money Sleeping, and many EMS crews will often complain about doing "stand up" shifts, where they are running from call to call to call for the duration of their shifts. Many nurses will spend all 12 hours of their shifts on their feet. Between going from patient to patient, getting stuff, charting, I understand why after 12 hours, their backs hurt. Most EMS crews get waaaaaay more downtime than their nursing counterparts; some just don't utilize it properly.

4) I knew waaaaay too many unhappy nurses, nurses who were treated like crap by Ahole doctors (just because they could), and nurses who were expected to do too much with not enough resources. So its not like EMS sucks, and once you go into nursing, it becomes a utopia.

My old EMS partner told me that he wanted to be a cop. Then he got into a massive MVA, requiring extensive rehab and ended up going to nursing school, doing ER nursing for a bit, and is now a MICN for a hospital based EMS system. And he presented at the last EMS conference in NJ, which was pretty impressive. Best I can tell, he's happy.
All of the downsides that you posted do not apply to many, many paramedics.
They might not apply to all paramedics, but they do apply to many many. I think you those downsides would apply to many, with the exceptions being the few.
As for "poor and disprected," spare me. We have an awesome relationship with the hospitals who actually hire paramedics and allow them to operate under more than the average paramedic scope. Even as a street paramedic, I have great relationships with our ED providers and we are not a small system. The clinical education and standards here are high, even for the dreaded AMR.
You're thinking too local, and too micro; as a whole, EMS is poor when it comes to pay (working 60 hour weeks among all their jobs) and disrespected, at least among the healthcare community. We all know there are EMS systems out there that are exactly like that.

When I was an EMT in NJ, we had an awesome relationship with the Level 1 trauma center ER staff (it helped that we worked for the same hospital). We also had an awesome relationship with the other hospital in the city. Personally, I was on a first name basis with several nursing directors and head nurses (and a few doctors, including our medical director), and when I came in with a sick patient, there was no holding the wall. They treated us with respect, and we treated them with respect.

But I also know that if I went to a local doctors office on a 911 call, I was seen as just the ambulance drivers, whose sole job was to take the patient to the hospital.
 

wanderingmedic

RN, Paramedic
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1) getting a good entry level RN job can be tough; every hospital wants nurses, however they all want experienced nurses. In the areas that I was looking at (ED, ICU, etc), they wouldn't' consider a new grad. And before you ask, EMS experience (particularly at the BLS/911 level) doesn't count in the eyes of many within the hospital.
This greatly depends on locality. I was able to get an ED job as a new-grad RN with Medic experience. Most of the EDs in my area actually prefer to hire the graduates of the local community college's Medic to RN program, even though they only have their AAS. But, I have heard stories of new grad RN ADNs only being able to get SNF jobs. It just really depends on the area.

2) The old joke is a nurse can't fart without a doctor telling her it's ok to do so. We all know this is an exaggeration, but paramedics have a lot of freedom to do what they want (within their guidelines), can decide treatment paths, and consult with a doctor if necessary; many nurses have a lot more online medical direction (IE, the doctor needs to be there to tell them what to do, or has to be consulted before something is done), compared to standing orders.
Definitely true. But, this too depends on where you work. The ED I'm in gives nurses a great deal of autonomy, and we actually have a pretty big set of standing orders we can choose to follow. We also respond to Rapid Response and code blue calls within the hospital, and on those calls we are really empowered to operate independently and obtain retroactive orders for whatever we needed to do.

In the hospital I work at, most of the time RNs are empowered to order and execute interventions, and then just report them to the MD. I would note that I find nursing much more fulfilling because I have more diagnostic data and interventions available to me (eg labs and radiology), and I have literally an entire pharmacy open to my use. Just because an MD needs to put their name on something, does not mean a RN cannot order it. Yes, a MD must ultimately sign off, but if you have a good working relationship with the docs, they will give you a LOT of leeway in what you do.

For instance, I had a patient come into the ED with jaundiced sclera and a CC of RUQ abd pain x2 months, progressively worsening up to presentation. On exam it became apparent he had a high risk of Hepatitis A due to his social hx. The doc was tied up with a central line, so I quickly ducked in and let the doc know “I got a 30 YOM with undiagnosed liver failure. I’m ordering an abd US, abd CT, labs, and potentially a HIDA scan pending results. I’m also going to do some Zofran and Ketorolac for pain, plus NS bolus as needed and albumen pending labs. Sound good?” The doc’s response, “Thanks, I owe you cookies.” Just because a doc has to give you the okay, doesn't exclude you from clinical thought or implementing advanced interventions.

I also really enjoy the psychosocial aspect of nursing. I genuinely like working with families and patients, and addressing their holistic needs. Something that is difficult to do in EMS when the protocol's solution to most problems is "transport."

I only share this to illustrate: nursing is different from EMS. Yes, nursing is not for everyone, and neither is EMS. I think I found that I eventually got bored of EMS because of the limited interventions available to me, and limited options for advancement. Seeing patients in the hospital completely reignited my excitement for medicine, and I love caring for people as a nurse. If I ever get tired of the ED, I can go to psych, or a plethora of other specialties. I am also pursing a NP, which EMS has no equivalent for.

So, back to you OP. You sound like a smart person, and I am sure you will do well in whatever you choose. You might want to shadow some RNs and Medics in your area to see if one field stands out to you. At the end of the day, you can always change course like I did, but I do not think that is very desirable if you can avoid it. Think long-term, and try to get into whatever will best set you up for a career in what YOU are passionate about.
 

Tigger

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You're thinking too local, and too micro; as a whole, EMS is poor when it comes to pay (working 60 hour weeks among all their jobs) and disrespected, at least among the healthcare community. We all know there are EMS systems out there that are exactly like that.
I don't think it's particularly micro. Many places to make a real living working EMS in Colorado. Maybe not RN money, but an easy living. And if you're willing to participate in the front range fire rat race, that pay quickly outpaces nursing.
 

Peak

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1) getting a good entry level RN job can be tough; every hospital wants nurses, however they all want experienced nurses. In the areas that I was looking at (ED, ICU, etc), they wouldn't' consider a new grad. And before you ask, EMS experience (particularly at the BLS/911 level) doesn't count in the eyes of many within the hospital.
I started as a new grad in the ED, and many of the hospitals around here hire new grads into the ED. We look at it as the ED being a sub-specialty and we would rather teach ED habits from the beginning than correct floor habits. There is definitely regionality to this, and many do have to move if they want to start in a specialty unit.

2) The old joke is a nurse can't fart without a doctor telling her it's ok to do so. We all know this is an exaggeration, but paramedics have a lot of freedom to do what they want (within their guidelines), can decide treatment paths, and consult with a doctor if necessary; many nurses have a lot more online medical direction (IE, the doctor needs to be there to tell them what to do, or has to be consulted before something is done), compared to standing orders.
This depends on where you work. Often when we intubate patients the docs ask us what sedation we would prefer, when we start pressors (especially if we are on our second or third) our docs are asking us which ones we want next, when a patient is vomiting, when I resource upstairs and help with a difficult access patients I tell the docs that the patient needs a PICC/Midline/EJ/central line and they put in the orders. In the ED I have a good enough relationship with our docs that if I feel a patient needs something (labs, meds, radiographs, U/S, and so on) I present the case and ask if they want me to put in the orders as verbals and they say yes. Critical care and ED nurses have so much more independence and respect than other nurses, but this sentiment is much more true on the floors and other non-critical care areas.

3) EMS is knows as Earn Money Sleeping, and many EMS crews will often complain about doing "stand up" shifts, where they are running from call to call to call for the duration of their shifts. Many nurses will spend all 12 hours of their shifts on their feet. Between going from patient to patient, getting stuff, charting, I understand why after 12 hours, their backs hurt. Most EMS crews get waaaaaay more downtime than their nursing counterparts; some just don't utilize it properly.
I certainly had more free time when I was in fire, but we were relatively low volume. As a nurse if my responsibilities were done and I didn't have work to do I can do whatever I want. There are shifts where we are running non-stop, but our local EMS has that too. We've also had nights were a few of the local crews come in the ED and we are low census so we just watch movies or TV shows together and BS (while the 911 EMS system is based out of another hospital our ED is actually a post for a few of their crews). Considering that my downtime comes with running water, heating/AC, and good WIFI I think mine is better quality than most of the EMS crews who get posted in random spots around town.

4) I knew waaaaay too many unhappy nurses, nurses who were treated like crap by Ahole doctors (just because they could), and nurses who were expected to do too much with not enough resources. So its not like EMS sucks, and once you go into nursing, it becomes a utopia.
I miss EMS to dabble just a bit, but I also don't deal with the general public when I do. I don't miss it enough to ever go back full or even part time, although I do know a few nurses who have, but it was largely that they missed the independence.
 
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Peak

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I don't think it's particularly micro. Many places to make a real living working EMS in Colorado. Maybe not RN money, but an easy living. And if you're willing to participate in the front range fire rat race, that pay quickly outpaces nursing.
It's hard to get on a big department that pays well, I tried for quite some time. I had applied to multiple large departments without success, and got to repeatedly hear about some guy that got hired on springs fire with zero public service or medical experience.

It should also be pointed out that until you become and officer you are subjected far more to getting permission to do things than as a nurse in the hospital. I didn't choose my assignments at the station, I didn't get to chose our attack on structure fire, I didn't get to choose what I was doing at an MVC. Other than medical scenes fire medics don't really have that much independence, and even then most of the scene management is still ran by the officer.
 

Remi

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Looking for some advice, working as a full time emt currently at a decent ALS 911/ transports company. Want to get my medic, but I constantly hear from other seasoned medics to do something else before it’s too late, like nursing. No way in hell could I do nursing but I wouldn’t mind doing some sort of health care associates degree, but is it possible to go to community college and work ems full time?
Definitely possible to go to a community college full time while working full time. Lots of us have done it. It's not easy, but it is very doable.

Not a heck of a lot of good health care career options out there at the 2-year degree level. At least not if you are uninterested in nursing. A two year degree full of science and other gen-ed courses will make a good foundation for a bachelor or higher degree, but it probably won't secure you a good job.

If you want to get your medic, get your medic. Why are you listening to people who try to dissuade you from what you want to do? You can have a good career in EMS if it's what you really want, and especially if you are willing to relocate to where the good jobs are. And unless you are already up there in years, you can probably go to paramedic school and still have quite a while before it's "too late" to do something else.

Consider going to paramedic school and also working towards a gen-ed degree that will be useful if you decide to do something different.
 

StCEMT

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If you don't want to be a nurse, don't. That's how we get **** medics, is people that use it as a promotion to a fire engine and don't care about the medical side. You're not gonna be the nurse we all want taking care of our family if you obviously aren't wanting to actually be there.

EMS isn't a great career in a lot of places. However, there are plenty of places that it can be. I've met a couple medics who break 100k and they aren't pulling 80 hour weeks to do it. Some departments have great retirement plans. Other have great education benefits. They exist, you just have to find them.

As far as school....you can. It will be a kick in the balls, but it can be done. One of my best friends currently works full time and goes to school on top of it.
 

RocketMedic

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School is totally doable
 

Qulevrius

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2 jobs (one of them F/T) plus school. I’m still alive, GPA isn’t total **** & even have time to post this.
 
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