Longevity in EMS

Yesterday I caught EMS Educast episode 148, where Greg Friese, Bill Toon, and Rob Theriault discussed ways to prepare students for a long career in EMS with their guest Lori Sizer.  I was a guest on EMS Office Hours about a year ago about the same topic.  Now that I’m entering my 13th year in EMS, here are a five ways that I think EMS educators can promote career promote longevity:

Give Students Realistic Expectations.  I believe that overall, our EMS education systems fail to give students a realistic expectation of what types of patients that they will encounter most.    Let them know that many of their patients will be ignorant, smelly, and not very sick.  Teach them that each call is an opportunity to make a connection with someone and help them feel better.   Hammering skills in lab scenarios that cover less than 10% of the patients they will encounter sets them up to be disapointed with 90% of the calls they go on. Clinical rotations at nursing homes, dialysis centers, and psyciatric facilities would help with this.   

Teach About Living Below Their Means, and Warn Them About Overtime.  Whether it’s overtime at one EMS job, or multiple part-time jobs, I continue to be amazed at how many hours people spend working.  When payments for houses, cars, boats, or whatever else depend on additional income, teach them that extra EMS work becomes a life-long prison sentence.  Let students know that the quantity of time spent at work directly affects the quality of care that that they will deliver, and their quality of life away from work. 

Teach Them About Balance.  Whether EMS is a full-time job or volunteer hobby, there will always be spots on a schedule somewhere that need to be filled and calls that needs to be handled.  At least some of the time they will need to say no.  One of the reasons I still enjoy EMS work so much is that I sedlom work more than my scheduled 48 hours a week on a truck.  Thom Dick writes that EMS is a great career to love, but it will never love you back.  Family and friends are needed for that, and they will need your students. 

Promote Sleep.  In EMS we treat sleep like a luxury, especially after night shifts, but our bodies need it.  Neglecting it when you’re young sets us up for heart disease, high blood pressure, diabetes, and mental illness when you’re older.  If your lifestyle depends on extra work now, being sick all the time will makes that impossible.  Teach your students never to  never count on getting sleep while they’re at work either.  Even at the slowest station assignments, they’re never more than 5 minutes away from the middle of hell.  That’s why Thom Dick also recommends never to schedule anything before noon after working at night.  It is good advice.

Promote Curiousity.  One of the complaints about EMS is that EMT and paramedic certification comes with a narrow skill set and no career ladder.  The job today will be the same tomorrow and five year from now.  It doesn’t have to be that way.  EMS  is just a generation old, and we’re starting to figure out what works and what doesn’t.  We’re learning that treatment once thought to be benign, like high flow oxygen, is probably harmful for most people we give it to.  We’re learning that objective assessment findings, like a STEMI or a high lactate level can dramatically improve their hospital course, even if we don’t have a tool to fix those problems yet.  Rob mentioned that he still has a child-like curiosity, even after 30+ years as a paramedic.  I wish more educators would promote curiosity in their students.  Have them question what they are taught.  Give street level practitioners the tools to research practices, prove what works and what doesn’t, and implement changes.  That would bring another level of satisfaction to EMS work.

I believe that there has never been a more exciting time to work in EMS.  I hope that as educators we give students the tools to share in that excitement, and have a long, rewarding career.


  1. Lori Sizer says:

    Hi Bob. Thanks for sharing your insight. This is a perfect example of the dialogue I was hoping to stir up. Just to get educators thinking about the subject. So many stressed practitioners are undetected due to the notion ‘He’s just been in the business for a while…etc.’ The key really is to ‘paint the picture’ from the very beginning including preplanning for stress relief and culturing optimism (if that can be taught :0). I really appreciated the read. Lori Sizer

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