Greatest Contributor to Burnout in EMS

[46Young]

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.

 

[Veneficus]

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?

 

[46Young]

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?

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.

 

[bigbaldguy]

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.

 

[firetender]

Burned out is different than Bummed out

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.

 

[the_negro_puppy]

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.

 

[Smash]

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?)

 

[triemal04]

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.

 

[Fish]

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.

 

[systemet]

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.

 

[thegreypilgrim]

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.

 

[Shishkabob]

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.

 

[Handsome Robb]

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.

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.

 

[the_negro_puppy]

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.....<_<

 

[DrParasite]

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

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.

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.

 

[RocketMedic]

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.....<_<

"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.

 

[Shishkabob]

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.

 

[RocketMedic]

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

 

[bigdogems]

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.

 

[the_negro_puppy]

"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.