When is it a good time to get out of EMS

[cyfan50438]

I am an EMT-I and have involved with EMS for 13 years. I have been working full time with one hospital based EMT-I level service (actually like that one), part time with another fire based paramedic service (call must be so basic otherwise I am driving), and volunteer with another service where it could be either medics to first responders.

I took the paramedic specialist class (NREMT-P) in 2003 but had to drop out due to time constraints. Took another shot at it in 2005-06 at another college and actually got through the class, but after 2 attempts at practicals, 3 attempts at the test, 48 hour refresher, reattempt at the practicals because I ran out of time, and only one more attempt becuase I ran out of the two year time limit. I am still an EMT-I.

Since that time my confidence is at a all time low and get very discouraged very quickly when things don't go well. (IV Starts, missed decisions, and general intimidation that I now have toward paramedics). If it wasn't for the full time job where I can work in the hospital, I would have been out of EMS a long time ago. But also need to work the part time job to make ends meet.

What do I need to do to get my confidence back, I would love to take the paramedic class again but feel that I would get the same result. I run lots of calls, (approx 200 a year) so it shouldn't be a skill thing, but I am afrain to do the skills sometimes and struggle with it because I would look bad to the paramedic I am working with.

This is my first post to this forum so any advice would be helpful.
Thanks!

 

[firecoins]

an odd idea but see a psychologist. Performance anxiety can be dealt with.

 

[alphatrauma]

Those that win, KNOW that they were going to.

It sounds like you may have had (or still do) some distracting factors in your life. Or maybe (no offense) you just don't have what it takes... I honestly don't know. You may also need to re-evaluate the program that you attended. Are the instructors competent? Is the curriculum comprehensive?

Intermediate to Paramedic is not a quantum leap, as far as written/practicals go. You need to target where in the process you are stumbling. Confidence is definitely something to consider, and is a must at the Paramedic level. YOU often will be the senior provider on site and the scene belongs to you. You must be able to take control and be confident in your ability to assess and treat properly. Everyone will be looking to you for answers and direction.

Everyone misses IVs and has occasional brainfarts... ie. no one is perfect, but you cannot have a meltdown when something doesn't go as planned. Stop worrying about looking bad and focus on the task at hand. Failure, more often than not, is a self-fulfilling prophecy, so you need to get your mind right and just do it!

Considering that the Intermediate level is going to obsolete, the decision to get out will eventually be made for you if you fail to act. If this is what you want to do, grab the reins and progress. If not...

 

[46Young]

When to get out of EMS?

It's time to leave when two conditions are met:

First, you no longer enjoy going to work. You should be happy to roll out of bed, and be looking forward to your shift. If the prospect of going to work leaves you with a sense of dread, then it's time to move on.

Second, there needs to be another available position with similar benefits and salary, or at least enough to live on while you figure out the next step. You still need to eat.

It sounds like you've already psyched yourself out regarding future attempts at the P-card. Perhaps your time and energy would be better spent taking courses toward a useful degree in another area of medicine.

If you enjoy civil service, then you might enjoy work as a police officer, FF, sanitation worker, or maybe as a parks employee. These should be pensioned careers. You can usually keep your PT spot at the hospital. Where I come from, if we like the idea of a civil service position, we're taught to apply for all of the tests available. As many as possible. In the meantime, we're supposed to work and go to school, of course. If you get a job offer, then great. You can decide to take it or defer to finish school. If no one calls you, you'll have a degree, hopefully in something enjoyable and lucrative.

Taking more shots at the P-card seems like a waste at this point. If you're asking yourself if it's time to get out of EMS, you'll likely be asking yourself the same question as an EMT-P. IMO the career isn't sustainable long term unless your compensation/benefits are generous, and there are career advancement opportunities. You'll need to get off the road at some point, and lead a more normal life, not having to deal with forced OT, schedule changes, late calls, sleep disruption, lifting heavy pts in positions of poor mechanical leverage, working in inclement weather, and so on. The 10 year mark is the turning point for most, from what I hear. These career development opportunities seem to be the most available in large fire based EMS systems, and hospital based EMS systems, although the majority of advancement opportunities would be to other areas of the hospital system, and you'll need to hold a degree or two to be consodered for the position.

 

[JPINFV]

Those that win, KNOW that they were going to.

Victorious warriors win first and then go to war, while defeated warriors go to war first and then seek to win.
-Sun Tzu
The Art of War

 

[Jeffrey_169]

First one must ask why you are considering this in the first place. I believe you already answered this, but for illustrative purposes I will ask it again. It seems to me, although I could be wrong, you are simply discouraged and need a different perspective. I do not have the pleasure of seeing you personally, so this is simply speculation and conjecture, but I ask your indulgence.

It seems to me you are not experiencing a lack in interest directly, but rather a lack in personal confidence, which is understandable given the circumstances. You are obviously under a considerable amount of financial stress, and this is not easy; combine this with the lack of success in your attempts to pass the registry exam with the intimidation and lack in self esteem in the face of coworkers, you have a dangerous concoction geared only for continued failure.

Anyone can take a class and pass, but the test is difficult especially when you are already self conscious about the previous attempts, and this must be dealt with. You know your skills and you have the experience, let it work for you instead of the other way around.

Also, remember when you work for multiple agencies you learn multiple ways of doing things; short cuts, get intuition, etc. that are of no concern to the proctors at the testing sites. They want things done a certain way, and wile there is often more then one right way, they only want it the one way they are looking for.

With this in mind you will pass. Study Brady's Paramedic Standards, get a good dummy and practice, and take it easy on the test; clear your mind and remember the basics. If you have test anxiety talk to your supervisor or someone you trust to help you.

I think once you pass the test you will regain some of your lost confidence, and then you can see what happens. When someone feels intimidated by coworkers it is difficult to enjoy what you do. It is also difficult to enjoy the job when you feel you are not making a worthwhile contribution. Try that, ask for help when you need, pass the test, and then see what you think. If you are still unhappy, maybe a career change wouldn't hurt, even if it is just temporary while you figure things out.

 

[firetender]

My Brother, after thirteen years I think the wind is out of your sails. Previous comments of enjoying the work are right on and essential.

For some reason, it sounds like you are enduring now, and asking us if you think you should continue to endure, or even TEST your endurance even more by taking another stab at paramedic.

You know the answer.

There's nothing that you did that was wrong or off balance. You didn't give up, you kept pushing your limits in pursuit of the paramedic thing, and I trust you're secure in knowing you've done more than right by a lot of people in your 13 years of dedicated service.

As far as the paramedic's thinking about you, you know what? People really don't think that much about anyone else but THEMSELVES! Look at yourself; how often do you really form the nasty words in your head about someone else that you think the medics are thinking about you?

Bottom line, though, if you're really into it, keep doing it, all the little stuff is just details that you'll work out. If it's no! filling your heart anymore, wave goodbye and say "Thanks!" and you'll find some situation that fits WHO YOU ARE NOW.

But talk to live people about this, as well as using this site as a sounding board. People here GET you!

 

[NomadicMedic]

If you hate going to work, no longer receive any joy from the job and can no longer look at patients with compassion and without judgment... it's time to get out.

 

[fire_911medic]

I run lots of calls, (approx 200 a year) so it shouldn't be a skill thing, but I am afrain to do the skills sometimes and struggle with it because I would look bad to the paramedic I am working with.

Hey there, first off sorry you had that type of experience going through class. Rough times no doubt. However, couple things to address here.

1. For some reason people think (and this is chiefs and training officers included - and especially !) that it's not important to maintain skills after one graduates from school. Yeah, they make sure you have adequate skills coming out, but if you've not used something for quite a while you are going to be rusty on it. Wouldn't hurt EMT-I or Medic to have rotations monthly say 8 hours of peds, 8 hours in OR, 8 hours in ER, 8 in OB, etc - one for each month to keep skills up that they don't use on a regular basis. The better ground services I've worked with required that and I think it was a tremendous asset to their teams. I'm not familiar with the EMT-I as that level is currently unrecognized in my state, though a modified version may be shortly as the EMT-advanced.

2. You mention you run around 200 calls a year. Depending on your scheduling, transport times, etc you may not have a high volume, but truthfully that's not that high of a call volume. My average ground volume was a minimum of 7 transports daily in a 24 hour shift with average transport time of an hour - frequently more, but when averaged out it was at least 7. Working 2 shifts a week. I'll let you work out the math - 200 calls a year isn't that much to keep skills.

3. It is not amount the quantity of calls, it's quality. If you have high acuity calls it's easier to keep up your skills than with low acuity, and well unless you are working with a high level CCT program, likely you're running average acuity patients the vast majority of the time like programs all over the rest of the country.

4. Don't worry about looking bad to the paramedic unless you do something that will endanger the patient's life - a harmful intervention. A good partner will understand you're learning and be considerate of that fact. You're going to have to learn to make decisions and take control of patient care. Some will be right on, some will be in the middle, some will be bad. You have to learn how to deal with them and decide. Everybody's unsure and doesn't want to look bad, however, it's called LEARNING and it's okay. The medic's there to bail you out and teach you, but not be your babysitter. He should be there to make sure you don't kill anybody, but let you do what you can in your scope of practice. Can be a tremendous asset while going through class. Remember that.

Bottom line - take some time away from EMS and decide if this really is what you want to do. I hit this point a number of years ago, and after the time away realized I loved it. I love doing my job, and I've said the day I don't enjoy it anymore is the day I walk away (though I understand everybody has a bad day or whatever and yes there are days that I don't want to go in, but that's with any job). The vast majority of days though I like it and want to do it. If you don't like it, you're not giving the best service to your patients and that's ultimately what this job's all about. If you decide you do want to stay, don't be afraid to give the medic another go. Perhaps it was how you were reading the test, perhaps it was test anxiety, I don't know, but you might can speak with the instructors, others, whatever and if it is test anxiety, that can be worked with ! Best of luck to you and take care whatever your choice.