Would you rather...

[FoleyArtist]

(because I excel in procrastinating to studying for midterms that's in 7 hrs.)

this is all hypothetical. daydreaming my next 2-5 years after school
*full time RN will include end goal of pursuing flight
*I 100% do not wanna give up field work. volunteer or paid. I will not let it go

-Full time RN, per diem medic (ie. RM/AMR SD, AMR Riv Co, MWA Vegas)

-Full time RN, San Dimas MRT, maybe per diem medic as above^

-Pursue fire academy, Full time RN, reserve FF or reserve ff/medic (ie. La Habra Heights)

-seek Full time FF/medic, Per diem RN

at this point in life conversed with my SO moving out of California is 90% out of the question.

hail mary* Texas EMS, Houston somewhere, or ATCEMS and RN job.

I'd love to hear different points of view, pros and cons, if anyone has made choices similar to this in the past how did you do fair? and maybe this will help new comer to the field plan their futures

 

[EpiEMS]

I'm just a part-time guy...working in an unrelated field. Here's my take:

Having your RN is a good hedge for a part-time or per-diem medic job. But being an FF is not a good hedge for a medic gig. Why? Physicality of the job! RNs work in all kinds of settings and at all ages - but FF and medic jobs are tougher to sustain for a long period.

So keeping longevity and future options in mind...why not part-time RN and full-time FF/medic (or full time RN and part time medic)? That said, FF is great and all, but only if you want to be involved in suppression.

Moving out of CA seems...reasonable, especially if you're looking for non-suppression EMS jobs.

 

[FoleyArtist]

I'm just a part-time guy...working in an unrelated field. Here's my take:

Having your RN is a good hedge for a part-time or per-diem medic job. But being an FF is not a good hedge for a medic gig. Why? Physicality of the job! RNs work in all kinds of settings and at all ages - but FF and medic jobs are tougher to sustain for a long period.

So keeping longevity and future options in mind...why not part-time RN and full-time FF/medic (or full time RN and part time medic)? That said, FF is great and all, but only if you want to be involved in suppression.

Moving out of CA seems...reasonable, especially if you're looking for non-suppression EMS jobs.

Epi, EMS is predominantly fire based in socal hence ff/medic.

also i guess i should add an explanation:
San Dimas MRT is a level 2 reserve deputy job through LA sheriffs. Search and rescue. I believe its only funct. as an EMT/bls level. You get to do cool things with their air ops.

 

[EpiEMS]

Epi, EMS is predominantly fire based in socal hence ff/medic.

Yes, understood, and therein lies the root of the problem. But this is a topic for another thread.

If you don't want to have to train in/focus on/deal with folks who are mainly focused on suppression, being an FF/medic is not going to be fun.

 

[FoleyArtist]

Yes, understood, and therein lies the root of the problem. But this is a topic for another thread.

If you don't want to have to train in/focus on/deal with folks who are mainly focused on suppression, being an FF/medic is not going to be fun.

Lol, sorry i misunderstood your understanding. That was my initial aversion hence I choose RN school. but having worked part time in the ER its not the same, the adrenaline, camaraderie, etc. I've reconsidered suppression if that's what i have to do to be have a sustainable ems career in socal. as a caveat, i do not regret the decision of RN school but I have had some regrets not trying the ff/medic route and seeing it through to failure or getting hired.

 

[VentMonkey]

Finish RN school, keep your P card, gain experience in and around the ED/ ICU. Apply at some HEMS bases and proceed to enjoy the same "adrenaline rush", and camaraderie. Unless this too is not an option for you, and your spouse.

I've reconsidered suppression if that's what i have to do to be have a sustainable ems career in socal.

This is thee wrong reason to become a FFPM. It will most likely lead to burnout, and misery as fire-based EMS is, in general, approached differently, especially SoCal fire-based EMS.

 

[FoleyArtist]

Finish RN school, keep your P card, gain experience in and around the ED/ ICU. Apply at some HEMS bases and proceed to enjoy the same "adrenaline rush", and camaraderie. Unless this too is not an option for you, and your spouse.

This is thee wrong reason to become a FFPM. It will most likely lead to burnout, and misery as fire-based EMS is, in general, approached differently, especially let alone SoCal fire-based EMS.

Nope, that was the end goal as an RN. 1) i haven't done ride outs yet in HEMS. 2) I've only heard third party rumors about some of the HEMS companies, like same problems as ground private corporate amb just in the air, low pay, not paid full 24's. i've heard of 1 person leaving private ground als to HEMS and coming back to ground because they state the big corp. amb company treated them better than the HEMS company and they made more (ground ems). 3) just a fear of let down once I get there so wanted to reassess past options.

Thanks, I probably needed that reality check. almost like "the road to hell is paved with good intentions"

 

[GMCmedic]

A couple things I want to touch on here.

1. Though it is possible to be a great RN, Medic, and firefighter, youll likely just be mediocre at all 3. Focus on being great at one or two things. Being a mediocre firefigther is how you end up dead. Being a mediocre nurse or medic is how other people end up dead.

2. As @VentMonkey touched on, ED/ICU experience plus prehospital experience will go along way to making you stand out on HEMS applications.

3. Really not related but I cant stand services that dont pay full 24s.

Sent from my SAMSUNG-SM-G920A using Tapatalk

 

[VentMonkey]

@ProbieMedic I was in your exact same shoes. The major companies that are in, and around SoCal are legitimate businesses that pay their staff full-time wages, benefits, and training/ con-ed (applied with both of the big name HEMS services; oral interviewed with one, and telephone interviewed with the other).

I too, briefly, entertained the idea of becoming a FFPM for the same reason I quoted your post. There isn't a day that goes by where I regret my decision. Also, the leg work some of these guys put in just to get on with an FD, I couldn't in good conscience, see myself nabbing one of their jobs just for my personal financial gain knowing I would most likely be miserable.

I am a prehospital provider at heart--and I found out as an ED tech--while I saw how ED/ ICU nursing can be very dynamic, I could not get away from wanting that sense of independence I still get from field work. Someone made mention recently in another post about the "power" liberal protocols give them; this is true, but knowing how to utilize such powers gives you all more the upper hand, and moreover realizing that it's less about power, and more about privilege.

...long story short, if you have questions you can PM me directly.

 

[EpiEMS]

@VentMonkey and @GMCmedic, I think, hit the nail on the head:

but knowing how to utilize such powers gives you all more the upper hand, and moreover realizing that it's less about power, and more about privilege.

Spider medic, is that you?

 

[DrParasite]

Like @EpiEMS, I'm now a part time EMS guy (mostly in EMS education and fire suppression/EMS), with a full time position in a completely unrelated field.

I did know of one who who was a full time firefighter (not firefighter paramedic, just a suppression guy who did first response on an engine) and part time nurse. He graduated nursing school, and the next week started the fire academy, finished the fire academy, was assigned to a 24/72 station, and picks up shift in the ER on his days off. But he's the rarity.

I know plenty of firefighters who work as FT firefighters, and part time EMTs or paramedics. usually they worked as paramedics prior to getting hired with the FD, but some went to paramedic school while working PT in EMS and full time with the FD.

If was in your position, I would consider a few things:
1) what do you want to do? and on a related topic, why do you want to do it?
2) if you want to be a FT nurse, why? if you want to be a FT firefighter, why? money, retirement, opportunities, etc
3) I know quite a few absolutely miserable nurses. They make more money, but hospitals have their own issues. And unfortunately, many make too much money to go elsewhere without taking a huge pay cut.

I had dreams of being a HEMS paramedic, and then a HEMS flight nurse, until a friend of mine was working out west on a HEMS unit, and crashed into the side of a mountain.... at the age of 29......and a few years later, my goals have changed drastically, and I haven't set foot on an ambulance in almost a year and a half.

One other thing I have noticed after speaking to FFs who make a decent living, and EMS people who make a decent living, and nurses who make a really decent living.... even those who work at "great places to work, that everyone wants to get into...." many places look great from the outside, but once you actually get into them, you find many miserable people who are constantly unhappy about the job.

 

[VentMonkey]

Many places look great from the outside, but once you actually get into them, you find many miserable people who are constantly unhappy about the job.

I think more often than not these people are generally miserable in life. Their job is yet another scapegoat for their constant unhappiness.

True job satisfaction seems to outweigh almost any quirks at a "mostly ideal" service. Bitterness won't allow the bitter to move past having their eyes wide shut.

Typically if you're an overall happy, and content person in your life outside of work, it spills over into your job, and vice versa.

 

[rescue1]

In my personal experience, if you don't want to be a firefighter, fire academy and working on suppression units will be a miserable experience. Not to mention how extremely difficult it is to get hired in Southern CA as a firefighter. If you do really want to be a firefighter, obviously that changes, but it's something to think about.

I can only speak for how HEMS operates on the East Coast, but here a flight nurse usually must have ED and ICU experience before getting hired, so I would think several years of that would be ideal. You could still work EMS part time somewhere while that happens. Out here the HEMS jobs are pretty good though. Most of the nurses seem to stick with it.

I think a nurse with several years of ICU, ED and prehospital experience would be a pretty competitive candidate for flight programs almost anywhere, so if HEMS in LA is as crappy as you've heard (from what I remember, aren't the 911 helicopters done by county fire anyway?) you could always look just a bit further away and see what you can find.

 

[FoleyArtist]

I appreciate everyones reply. There are aspects I hadn't considered like the mediocrity and dangers of trying to excel at too many things and the different approach of socal fire/ems which I've witnessed first hand. I dunno how I managed to turn a blind eye to that.

@VentMonkey exact same shoes couldn't be more literal. from ed tech, to the original moral/ethical reason why I've been so noncommittal and withdrew from a fd dept backgrounds. I agree that er/icu can be dynamic but the autonomy is different.

 

[VentMonkey]

if HEMS in LA is as crappy as you've heard (from what I remember, aren't the 911 helicopters done by county fire anyway?) you could always look just a bit further away and see what you can find.

HEMS in SoCal is not "LA", and "LA" does not= SoCal. Sure, it's a big part of it, but it's one of several counties within a rather overpopulated region of California. Typically if you travel a county or two over you'll find full fledged HEMS services that operate just like the rest of the nation, protocols and all. My "dream" HEMS base is in Orange County, and there are several bases in San Diego County that are also most definitely worth a look for people with limited options, and set goals such as the OP.

 

[rescue1]

HEMS in SoCal is not "LA", and "LA" does not= SoCal. Sure, it's a big part of it, but it's one of several counties within a rather overpopulated region of California. Typically if you travel a county or two over you'll find full fledged HEMS services that operate just like the rest of the nation, protocols and all. My "dream" HEMS base is in Orange County, and there are several bases in San Diego County that are also most definitely worth a look for people with limited options, and set goals such as the OP.

Ah gotcha. I'm as East Coast as it gets so I don't know too much about California EMS outside LA County.

 

[Carlos Danger]

I started out as a paramedic, got into HEMS very early in my EMS career, and then became an RN. Took only a brief break from the field while I was working in the ICU's and earning my BSN, then came back as a flight nurse. Now I'm a CRNA and still have my paramedic cert. Doing some teaching with an EMS agency and trying to find a way to fit a little field work into my schedule - preferably in HEMS, but not necessarily.

So I have no experience with any of the specific agencies you listed, but my career path was similar to what you describe.

I always say that nursing and EMS complement each other really well. Depends on the schedule where you work of course, but there's no reason you can't do both.

If you are serious about a career in HEMS or CCT, I think nursing is really by far the best way to go. Of course you can find good jobs as a paramedic, but you just have way more options as a nurse, and generally speaking will make quite a bit more money.

There's no reason you couldn't do fire and nursing at the same time, again, depending on scheduling issues.

I took the test for Charlotte fire a handful of years ago. I think I did really well on the written test (they don't tell you your score), I did pretty well on the CPAT (it was just pass/fail), and with my EMS background and my degrees, I thought I should have had a pretty good chance. Was going to do fire full-time and HEMS on my days off. But I never heard back from the FD after the hiring process finished. I have a feeling that I was too "privileged" and didn't fit into their quotas, but who knows, maybe I didn't do as well as I thought. Oh well. Went to CRNA school instead.