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The Art of EMS
by Steve Whitehead

Why you should quit your crappy EMS job

There are great EMS employers out there, but finding them takes time, and the willingness to take risks on the unknown

By Steve Whitehead

“The only thing standing between you and your goal is the bullshit story you keep telling yourself as to why you can’t achieve it.”

— Jordan Belfort, 'The Wolf of Wallstreet'

In the summer of 1997, I moved to the San Francisco bay area to be closer to my fiancé. The four hour commute between my apartment and the love of my life had become too problematic, so I took a job with a small mom and pop ambulance service in a semi-rural area south of San Jose.

It was hands-down the worst EMS job I ever had. On my first day, I was given an oversized, unwashed shirt from a former employee and placed on a medic unit with no orientation and minimal introductions.

The ambulances were in terrible condition, and the stations were worse. The local emergency room was shocked when I arrived with basic patient care accomplished and delivered a professional hand-off report. When our unit was cancelled enroute to a call, the owner of the company frequently came up on the radio and demanded that we continue to the scene to collect billing information from the caller.

A few short months later, I washed and ironed that same oversized uniform shirt and politely turned it back in. Everything in my experience told me to move on. That was my fourth EMS employer and I’m now on my seventh. It took seven tries to finally find the EMS job of my dreams.

Unhappy? Do something about it

Today, I earn excellent pay and have outstanding benefits. I work for an employer who is well-respected in the industry and the expectations of my job performance are high. I work along-side experienced and motivated professionals who constantly challenge me.

There are great EMS employers out there, but finding them can take time and getting hired can be a competitive process.

When I tell people how happy I am in my EMS job, I frequently hear the comment that I’m lucky.

I’m not lucky.

It was hard work getting to this place and I was willing to do something that very few folks in EMS seem to be willing to do: quit my job and go get another one when I wasn’t satisfied. I was willing to combine dissatisfaction with action. In EMS we often have plenty of dissatisfaction that results in very little action.

Show me a crappy EMS employer and I’ll show you a bunch of unhappy employees who refuse to leave for one reason or another. Perhaps they feel that they are hopelessly tied to that particular region of the country. (They’re not.) Maybe they feel like things are going to get better if they just wait long enough. (They won’t.) They’ve also convinced themselves that things are no better anywhere else in EMS. (They are.)

But at the heart of the matter, after all of our explanations and rationalizations, the reason we stay with crappy EMS employers is something called loss aversion.

An experiment in loss aversion

Loss aversion is a pretty well-known psychological concept. Economists call it “the endowment effect”. The basic premise is that we place a much higher value on the things which we already possess than on things that we would like to possess. Loosing something that we already have has a much more profound psychological effect on us than gaining something new.

Take this basic economic experiment as an example: Students in a college class were randomly divided into three groups:  sellers, buyers and choosers.

Students in the seller group were given coffee mugs decorated with their college logo and allowed to set a price for which they would be willing to sell their mug. The buyers were given the option to buy one of the mugs with their own money. The choosers were able to either get a mug or a sum of money that they felt would be equivalent compensation for not getting a mug.

The results demonstrate human loss aversion perfectly. Byers were willing to a buy a mug for an average of $2.87. The choosers were willing to take $3.12 instead of a mug. The sellers were willing to sell the mugs for an average of $7.12. The surprising result is the difference between the choosers and the sellers. Both groups are making the same choice, have a mug or have a sum of money. The only difference between the two groups is that one group already has a mug in their possession.

Simply having the mug in their hand and knowing it belonged to them made the sellers value the mugs twice as high as the choosers. We are hard-wired to avoid loss much more strongly than we are designed to seek opportunity and gain. This is the way our brain works and it’s the reason why you won’t leave your current crappy EMS job.

Embrace the unknown

I bring this up for two reasons. The first one is that there are a bunch of EMS employees who are highly dissatisfied with their EMS work environment but they are held back from finding their happiness by the power of loss aversion.

It’s tough to admit it to ourselves. It’s hard to say, “Look, I know this employer treats me horribly, pays me too little and works me too hard, but I’m scraping by and I’m afraid of moving on much more than I’m afraid of my tiny apartment and my overdue VISA bill.”

The unknown can be scary. It’s not just that way for you. It’s that way for everyone.

The second reason that I bring it up is because loss aversion isn’t good for EMS either. Those groups of loyal EMS employees who stick around regardless of how bad working conditions become keep crappy EMS employers in business. Awful companies depend on loyal employees. This is why they foster fears of retribution if employees seek other jobs and fail. They need you to stay.

If the EMS workforce demanded fair pay and good working conditions and voted with their feet when better opportunities presented themselves, all EMS employers would be forced to compete for employees. As it stands, all the bad companies need to do is hang out a shingle and then convince people that they are the only opportunity in town. Loss aversion does all the rest.

What’s your EMS dream job?

Regardless of your current level of job satisfaction, when was the last time you looked at any other opportunities in our industry?  Let’s do a little experiment. Look under 'Jobs’ on, and click on at least three; some should be jobs that you are qualified for and others ones that are out of range for your current level of training and experience.

For each job that you read, ask yourself, “What if…?” What if you decided you wanted to be a paramedic in Ohio or a medical device sales representative in California? What are the job requirements for the positions that sound appealing to you? What kind of a degree would you need to join the EMS faculty at the University of Hawaii? Could you start working on that right now?

Pay particular attention to the jobs that list their location as “nationwide.” That means that you could do that job from anywhere. You could probably do that job from where you are sitting right now. I’m not saying that you need to apply for a new job right now (though perhaps you should.) Just overcoming your personal loss aversion enough to explore what opportunities are out there can be a refreshing exercise. We should all do this more frequently.

When you’re done looking at the EMS1 jobs page, I’d like you to ask yourself, “To what degree is loss aversion keeping me from fulfilling my goals in emergency services?” Then ask, “How long am I going to let it hold me back?”

Goals stated publicly are much more likely to be acted upon. Before you leave, write a comment and tell us what your EMS future holds.

About the author

Steve Whitehead, NREMT-P, is a firefighter/paramedic with the South Metro Fire Rescue Authority in Colo. and the creator of blog The EMT Spot. He is a primary instructor for South Metro's EMT program and a lifelong student of emergency medicine. Reach him through his blog at or at
The comments below are member-generated and do not necessarily reflect the opinions of or its staff. If you cannot see comments, try disabling privacy and ad blocking plugins in your browser. All comments must comply with our Member Commenting Policy.
Steve Wirth Steve Wirth Thursday, August 14, 2014 3:16:53 PM This is an absolutely dead-on-point commentary. Sometimes it takes "guts and gumption" to know when to say it is time to move on. You've said that so well, Steve, and with the research to back it up!
Mario Newman Abatiello Mario Newman Abatiello Thursday, August 14, 2014 3:42:01 PM Wow it's scary how your first ems jobs resembles my first ems job. I know my end goal the problem is the money to make that a reality
Bruce A Mills Bruce A Mills Thursday, August 14, 2014 3:57:38 PM I will quote Steve Wirth from this past June " What you allow is what will continue " Life's too short to remain miserable or in a bad place . Go go now go very fast
Jon Gull Jon Gull Thursday, August 14, 2014 5:06:22 PM This is incredibly relevant to my life right now. I hate to say that my EMS job is not terribly bad most of the time. Good ambulances, decent living quarters. But these past few months I've been constantly dealt a bad hand and have not been happy there. I do not want to be one of the people stuck at this place for 3+ years. So I'm taking it as a sign to move on and take my skills elsewhere. I just have to find where to go.
Ty Kitchens Ty Kitchens Thursday, August 14, 2014 5:41:38 PM Thanks for this read. I needed it!
Jeff Wallace Jeff Wallace Thursday, August 14, 2014 6:26:51 PM ATCEMS. My land of milk and honey. Thanks I am newly refreshed for the fight ahead.
Gary Walter Gary Walter Thursday, August 14, 2014 7:51:45 PM And. .. you're not tied to EMS, or even a street position.
Matt Dionne Matt Dionne Thursday, August 14, 2014 10:45:14 PM Working in the Gold Coast of Costa Rica, start a medic program, and get donated ambulances for service to all, visitors and locals
Chris Rummery Chris Rummery Friday, August 15, 2014 4:54:06 AM I'm currently on my first EMS job with a private company. We have old equipment, understocked and understaffed and no many how many incident reports I submit, it seems like nothing gets fixed. While working a 36 hour shift recently the boss came in while I was napping around 2pm. We were running transports all night and my first 24 was just that, 24 hours with no downtime. He poked me on the chest to wake me up and asked, "so is this what I hired you for?" Talk about frustrating. I start Paramedic school on Thursday and couldn't be more excited! My dream EMS job would be to get on with any county/city service and become a CCP with a fire department. Oh and maybe part time as a ski patrol medic.
Paul Ingersoll Jr. Paul Ingersoll Jr. Friday, August 15, 2014 5:20:03 AM Very true!
David Ford David Ford Friday, August 15, 2014 5:23:13 AM Dont do it
Allyson Delfino Allyson Delfino Friday, August 15, 2014 7:17:44 AM Wow this is amazing, I'm going through this at this very moment and bam I come across this article. Thank you!!!
Richard Moyle Richard Moyle Friday, August 15, 2014 7:23:23 AM This is very true. I started with a mom and pop service that was understaffed and under stocked with a lousy reputation. I did it as a second job from the FD. In 12 years I moved from driver to Assistant Director while creating supply manager, risk manager and assistant director along the way. Things are still far from perfect. I needed 911 time for myself which helped me too. I stay because I can still influence and make a difference. Though not perfect, it is changing. However, one must look at the situation. If you are totally unhappy and in a dead end the only option you have is to do what is best for you and your family. If currently unhappy start looking and preparing but don't fall into the trap of being a crappy EMT because your service is crappy. Use the experience as a learning opportunity and a stepping stone to something better.
Bob Peterson Bob Peterson Friday, August 15, 2014 9:08:47 AM Holy crap, you just perfectly described the EMS employer in Maine that I just left.
Gronn Morgan Gronn Morgan Friday, August 15, 2014 9:35:15 AM Amazing serendipity with this article. Just 2 weeks ago, I decided to leave my crappy EMS job and uproot my family and move across the country. The only thing for sure? I have an interview with an EMS company at the other end. The rest is unknown and scary, but I'm not letting that stop me anymore. I couldn't agree with you more!
Richard Moyle Richard Moyle Friday, August 15, 2014 1:37:24 PM I left out one important fact. Though not perfect, I like my service and am proud of what it has become over the years. The service is a function of the people. Good people equals good service. Never stop improving.
Joe Hall Joe Hall Friday, August 15, 2014 3:09:25 PM I AM IN THAT POSITION RIGHT NOW
Dennis Marty Dennis Marty Friday, August 15, 2014 9:29:59 PM i find this to be very true. I ran into four members of my shift that decided to mutiny on me when I went out on medical leave and through the grape vine I found out that they had gotten together and made up some lies and complaints and was working toward getting me fired when I came back off of medical leave. I beat them to the punch and resigned my supervisor position. I now work for two ambulance services on a part time basis and it has turned out to be one of the best decisions that I have made in many years. I want to thank the four children that caused my enjoyment but why. there are times for changes and they are tough and you get too comfortable to leave.
Jess Bargery Jess Bargery Saturday, August 16, 2014 5:19:08 PM I feel like this article is a clear sign for me! I've done 4 shifts at a new company and I actually feel like leaving EMS because I'm so disillusioned and have no confidence left. On my second shift, I witnessed an FTO "restrain" a 17 year old patient with such force, she gave him a black eye. The EMT I'm supposed to be working with won't talk to me because he doesn't want a new partner. And 2 other medics tore into me for an hour about how slow I was being on our emergency call, and I needed to move faster. 1 of them let go of C-Spine when we were log rolling the patient and told me as lead medic, I should have picked up on that, and I obviously wasn't ready to take charge. The ambulances have peeling paint, cracked windshields, and we have no benzodiazepines or pain medications. Thank you for your article. I'm quitting Monday!
Joseph Faaita Joseph Faaita Saturday, August 16, 2014 6:06:34 PM Where was this article 20 years ago? :)
Allen Usrey Allen Usrey Saturday, August 16, 2014 7:52:33 PM So as I see it per Steve Whitehead, if you work for a service that isn't up to par, leave it. I think you should at least give it a chance and work with the staff and try to improve things first not just jump ship. I got into EMS to help people in need, I know the pay isn't the greatest but I do take pride in the care provided by every service I have worked for and I hope they feel the same. I wonder how long Mr. Whitehead will be at his employer since he averages 2 and half years per provider he services? I have seen great attitudes improve many services. Most of the owners I have known are willing to work with crews if they are made aware of issues, Lucky i guess. Sorry if I offend some but sometimes what the "crappy" services needs is someone to step up and be a leader.
James Willbrandt James Willbrandt Saturday, August 16, 2014 8:12:05 PM It's EMS there is no money in EMS, worst job I ever had. To think we had to spend 2 years in college to make min. wage. all the schooling of a nurse with the pay of a paperboy. what a waste of time , and money.
George McNeil George McNeil Saturday, August 16, 2014 8:29:01 PM My dream job is working with Wake County EMS.
Angie Evans Johns Angie Evans Johns Saturday, August 16, 2014 8:53:27 PM Right on! Totally agree with this point of view!
Filippo Antonio Cibotti Filippo Antonio Cibotti Sunday, August 17, 2014 12:13:06 AM Dead on.
Nina Gorjaczew Nina Gorjaczew Sunday, August 17, 2014 10:18:50 AM I did this very thing 2.5yrs ago. Move clear across the country for better pay and work experience. Now things seem to be moving in a direction I'm not fond of so it may be time to look into other options again. It's scary relocating but it's also exciting and somewhat satisfying if the company has everything you've been looking for. This article couldn't have been more correct.
Lisa Leonardo Lisa Leonardo Sunday, August 17, 2014 7:57:28 PM Kevin Gee, you need to read this!
Doug Zalud Doug Zalud Monday, August 18, 2014 4:02:31 AM Been through this. Coworkers actually told me that they couldn't quit because they couldn't leave the misery for this or that reason. They laughed when I said I was going to quit. Well, since then, I've had two jobs stateside before getting a job overseas. Very good pay and benefits, but working conditions are only okay. But the experiences it has given me has more than made up for the conditions. It has given me the opportunity to get hired in other overseas positions, or just about anywhere I would apply back home. Definitely worth the risk. Just like the motto of the British SAS says: "He who dares, wins."
Doug Zalud Doug Zalud Monday, August 18, 2014 4:02:54 AM Been through this. Coworkers actually told me that they couldn't quit because they couldn't leave the misery for this or that reason. They laughed when I said I was going to quit. Well, since then, I've had two jobs stateside before getting a job overseas. Very good pay and benefits, but working conditions are only okay. But the experiences it has given me has more than made up for the conditions. It has given me the opportunity to get hired in other overseas positions, or just about anywhere I would apply back home. Definitely worth the risk. Just like the motto of the British SAS says: "He who dares, wins."
Keith Stille Keith Stille Monday, August 18, 2014 8:55:13 PM Wow ... Great points from an individual not from the business side which changes monthly
Jerry Breneman Jerry Breneman Tuesday, August 19, 2014 10:18:05 PM He'll learn... Lol
Laurie S. Karafin Laurie S. Karafin Thursday, August 28, 2014 1:20:39 PM Steve, I think you are spot-on with this article! I have been in those situations, and am now on my umpteenth EMS job (and happy for once!). No amount of talking, arguing, and such will change the minds of a crappy service. Particularly being female, I get the "oh, she's just PMSing" response. Awesome, thanks.... Even the fed-up employees were way too scared to leave - well, not me! EMS providers definitely need to find a service that is well worth it!

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