Greatest Contributor to Burnout in EMS

[Tigger]

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.

 

[cfd3091]

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?

 

[46Young]

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.

 

[VCEMT]

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.

 

[usalsfyre]

...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.

 

[BNB]

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...

 

[46Young]

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.

 

[R99]

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

 

[FourLoko]

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.

 

[Luno]

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...

 

[Veneficus]

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.

 

[socalmedic]

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.

 

[jemt]

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.

 

[DrParasite]

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

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.

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.

 

[Aidey]

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.

 

[46Young]

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.

 

[Maine iac]

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.

 

[RocketMedic]

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.

 

[Tigger]

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.

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.

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.

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.

 

[46Young]

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.