Why your EMS action film is recruiting the wrong people

Videos of technical rescues, tactical medics, and raging fires overshadow the realistic expectations of our profession

We’ve all seen it, and most of us have felt it: Job fatigue, burnout, stress — whatever we want to call it.

We have witnessed it in colleagues, friends, bosses, and sometimes in ourselves: EMTs who once loved their jobs complaining every time dispatch sends them on another run. Firefighters angry to be on the scene of another “BS” call. Paramedics who think BLS care is below them.

At the Pinnacle EMS conference last summer, former Toronto EMS Deputy Chief Alan Craig spoke about “compassion fatigue.” He emphasized the need to be aware of compassion fatigue, its signs and symptoms, and how to cope with it. He also said we must teach compassion, not take it for granted. These are all important skills for any EMS leader. But what stood out was Chief Craig’s discussion of matching expectations with reality for new members of our profession.                                                                                   

Look at the EMS and fire department recruiting videos on YouTube. Think about the brochures you’ve sent in the mail, the posters you’ve seen displayed at conferences, and the pitches that your recruiters give to potential employees.

EMS expectations vs. reality

Do those videos show EMTs getting up in the middle of the night for a patient whose stomach hurts? Do they show paramedics feeding someone’s dog, helping a woman back into bed, or contacting social services to arrange extra help for an elderly man who can’t take care of himself?

Chances are they don’t. Like departments where I have worked and volunteered, your videos probably have fast-paced rock music in the background, footage of ambulances racing through the night with lights and sirens, and videos of technical rescues, tactical medics, and raging fires.

Your recruiting pitch probably includes phrases like “Every day our paramedics save lives” and “Thousands of times each year, people call on us when a life is on the line.”

Fire-based EMS agencies are probably guiltier than others — how many fire departments have recruiting materials that spend more time or space showing fires and swift water rescues than EMS care? Even when EMS is portrayed, the patient is often lying on a backboard with a crushed car nearby, or paramedics are intubating and performing CPR.

Next time an EMS provider you know complains about running a 911 call that is not a life-threatening emergency, think about how we have set him up to fail — before you chastise him. Did he grow up watching Emergency!, like so many of my mentors did, and expect every call for help to be a life or death situation? Did he watch videos on YouTube, like so many of my contemporaries did, and expect every day to be filled with cardiac arrests, vehicle entrapments, and house fires? Or did he listen to our recruiting pitches, like so many of our newest candidates, and expect to be performing RSI and responding to active shooter events during their first shifts?

EMS and the fire service should not stop telling potential employees and volunteers that our profession is exciting, or that they’ll have the chance to save lives. But we also need to align their expectations with reality to ensure that we attract the right people.

Tell applicants that we impact people’s lives every day, sometimes by pulling them from burning cars or defibrillating them, but more often simply by holding their hands, listening to their stories, or reassuring them that everything will be okay.

Until we match expectations to reality, we only have ourselves to blame when our newest volunteer or our veteran employee spends more time complaining about their job than they spend actually doing it.

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