Just passed my national Now what ?


Forum Probie
Finally got my emt Certification and i want to know what i do next? Should i volunteer to get experience? I would like to do 911 but idk if they hire newbies. I have an interview for a commercial ambulance company but they don’t pay too well.


Forum Deputy Chief
You're gonna have to be more specific on where you're at, as systems can change, sometimes drastically county to county, even town to town.

I'm assuming you've already gotten state certified (and any additional local requirements your LEMSA has...*cough LA/OC *cough cough*)....but yeah, private companies aren't exactly known for paying well...many areas your looking at minimum/just above minimum wage for EMTs. Typically govt services pay more (but are conversely harder to get into)


Forum Asst. Chief
First, lets cover the basics. You’ve had your emt card for an hour, but you want to go right out and start saving lives? This is the part of this occupation that irritates me(and most of us). You don’t have any real idea on how to run an EMS call, yet you want to get right out there and be the hero. How about maybe earning your stripes, learning the business from the ground up and being part of the team? Is that maybe a good idea?

Now, to answer your questions, in some places, a first day EMT can get hired on a 911 truck. In somplaces they cant because only medics do emergencies, only fire does emergencies, that company doesn’t have 911 contracts at all etc. there are a million variations.

Commercial EMS generally pays crap, but is the stepping stone your feet must cross to progress onward in many(most?) places. You don’t take the job because you’ll get rich, you take it so as to gain the experience the next job wants. You don’t learn much about saving lives doing transfers, but you learn how EMS works. The schedule, the lifestyle, daily routine, the simple mechanics of a day in the life learned in an environment where your screw ups aren’t likely to cause a problem. If you don’t check your portable suction on your IFT truck, chances are nothing bad will happen. If I do the same, somebody might suffer for it. That’s just one example.

You bring up volunteering, which by its very nature pays nothing, as if its a better option than commercial EMS. Here’s the problem with that line of thinking.

One, money. You wont make any, and you’ll likely spend yourself into the poor house. Gear, t shirts, a first in bag for your car, raptors, a jake strap. The list of crap you’re most likely going to buy is endless.

Two, experience. If your area is running primarily(or totally) volunteer EMS, chances are its a low volume system. You’ll have another job which may or may not permit you to take off at the drop of a tone, and if not you’ll be unavailable for calls a lot, so you’re not going to get a lot of experience, at least not quickly.

Three, you’ll essentially be competing with every other member of your department for calls, unless its one of those towns that lets whomever show up, and even then what do you think you’re going to do as the ninth emt on a back pain call. So unless you live across the street from the station, or you spend your free time hanging around(now you’re not getting paid and you aren’t even doing anything useful), you’re only going on a percentage of the calls.

Four, acuity. The vast majority of EMS calls are BS. 14 years doing this in many different systems, I probably have less than fifty really serious “oh my god” calls. Most of what you’ll do is nonsense. Added to what I’ve already said, its going to be a really slow burn to get from day one volley emt to employable in a real EMS system.

Five, staffing. Most high volume high acuity system don’t use basic on the front piece unless they’re using a tiered system. There are primary BLS jobs out there, but their in the minority and thus competitive to get and the guy with even a year of commercial BLS is a better choice for the job than you.

Take the IFT job, learn the business, and start plotting your next move. Maybe you’ll go o medic school. Maybe you’ll take the fire test. Maybe you’ll work for a bit and get hired directly by a municipality. Who knows, but I’d be willing to bet your chances are going to be better with every day of experience you add to your resume.


The fire extinguisher is not just for show
OK, so you will get many people's opinions on what do to, and some people (like the poster above me) are generalizing, and are wrong.

Lets start with the basics: you just got your EMT card; congrats. now get a job on an ambulance, if that is what you want. Believe it or not, many people get their EMT certificaiton with no intention of ever working on an ambulance.

Where are you? your location makes a huge difference as to what options you have available to you. If you are in SoCal, where FD runs the 911 system, your odds of getting hired on a 911 truck are slim. If you are in NJ, or anywhere else where it's a tiered system, your chances improve.

Also, if your system runs all 911 trucks as dual paramedic trucks, the odds of you getting hired as an EMT are 0; that's just how it is. So you need to decide on what you want to do.

Commercial / for profit ambulance companies are where many people start. they pay crap, often treat their employees like replaceable people, and are a stepping stone until you can go somewhere better. You might do 911, you might do IFT, you might do CCT, you might do nursing home 911, it all depends on what that particular place does.

Now, should you volunteer somewhere? I say absolutely. @hometownmedic5 might disagree, but I will address all 5 of the points that were made:
one, money. yes, you won't make any money. you will gain experience, you will meet others in the industry, and you will learn how things are done. so while yes, you won't get a paycheck, you will gain stuff that will benefit you in your career. And you don't need to buy all that equipment; in fact, most volunteer agencies will provide you with the stuff that you need to do the job.

two, experience. my first volunteer EMS agency ran 4000-5000 calls a year, between 2 ambulances 24/7. I can also tell you that I've have busier volunteer shift than paid shifts, where often I didn't turn a wheel during a 12 hour shift; at my volunteer agency, I usually got at least 3 calls, and up to 8 calls in a 12 hour shift. We had set shifts, and recalls for any time the on duty crew was on a call. You didn't leave your job for calls, but if you are on shift on a night shift, or weekend, you typically weren't working.

three, sure, if you don't have assigned crews, and it's always a scramble. most agencies stopped that in the 90s. I'm sure they still exist, but more places are setting up duty crews so you don't have 40 people responding or being alerted for every call at 3am.

four: while most calls are taxi rides (and it's even worse in the cities), I've had more than my share of sick patients. the more calls you go on, the more sick patients you will see. doesn't matter if your paid or volunteer.

five: tiered systems do exist. it all goes back to where you are located, and what opportunities there are for you in your area. I can tell you if you are not in an area that lets EMTs do 911 calls, than you won't be able to do it. So you would either have to relocate to an area that does, or accept that you can't do 911 as an EMT.

Here the bottom line: like with almost all jobs, the more experience you have, the better the job you can get. you won't get a great job, but having experience significantly increases your changes of getting hired at the good jobs. In my entire career, there has been only one EMS job that I ever interviewed for that I didn't get, and it was a IFT job for a ****ty company. I did get the PT 911 job that I applied for a few months later. Few places want to hire newbies, many providers don't want to work with a newbie (except FTOs, who ask to train new people). That's how it is.

If you want a good job in EMS, you need experience, and the only way to get experience is by getting on the truck. Accept the volunteer job to gain some 911 experience, and if offered accept the commercial ambulance job to make some money and learn how the IFT system works, as well as to learn what it's like to work for an EMS company. I know my volunteer experience helped me gain my first and second 911 jobs (I was only at the first one for about a year, before getting hired at the second, much larger and better paying one for the for the hospital).

In my career, I've been a volunteer 911 EMT, a paid IFT EMT, a paid 911 EMT, a paid 911 EMS dispatcher, a paid IFT dispatcher and I can say that every job I was in gave me experience to help me elsewhere in my EMS career. But everyone starts somewhere, and getting that first job is usually the hardest.
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