10 worst reasons for joining EMS

Check this list before you start an EMT or paramedic career

A few weeks ago, with nothing to do until the lights came back on after a storm-related power outage, I made a list of all the EMS positions I’ve had since becoming a paramedic in 1995. OK, maybe that wasn’t the most constructive pastime with tornadoes in the area, but let me show you how that mindless exercise turned out to be worthwhile.

Not counting writing, speaking and consulting, which I do as an independent contractor, I’ve held seven paying positions in EMS. I liked them all, partly because each job was much the same as I’d expected.

That connection between expectations and job satisfaction is real, according to Ambra Poggi of Torino, Italy’s Centre for Employment Studies. Poggi found workers self-reported levels of job satisfaction six percent higher when reality exceeded expectations and nine percent lower when expectations weren’t met — not surprising when I consider my own experiences.


Take my job at Brooklyn’s Lutheran Medical Center (now NYU Lutheran): It was only my second as a paramedic. I’d had less than a year’s experience when I was hired. If I hadn’t learned something about New York City EMS and my not-too-busy catchment area from senior colleagues before my first shift, I think I would have been disappointed by the lack of "good" calls, and probably wouldn’t have enjoyed my time there as much.

Here I am 21 years later, glad I had plenty of help aligning my expectations with the realities of EMS. Maybe I can do the same for some of you who are just getting started. With that in mind, here are the 10 worst reasons I can think of for choosing EMS as your career.

1. To save lives.

You’ve grown up watching "Trauma," "Chicago Fire," "Third Watch" and other Hollywood dramatizations of essential-service jobs no one really has — at least not the way they’re portrayed on TV. If you think you’re going to breathe life back into the hopelessly feeble every shift, like Rabbit and Jesse and Kim (oh my), steer clear of EMS and avoid disappointment. You’d probably prefer a better-paying job with less drama, a climate-controlled office and working elevators.

2. To make money.

Contrary to popular belief, you can make a good living as a paramedic pretty much anywhere in the U.S., but you usually have to work insane hours to do so. Even if you imagine yourself as a natural healer, chasing that dream is going to get old when you’re juggling two or three jobs and 24-hour shifts to pay your bills. Most line medics I know routinely put in much more than 40 hours a week, and not because they want to.

3. Because EMS is in your blood.

I think picking any job solely because your mother or father did it is a bad idea. I bet most parents would agree the best way to honor a family’s heritage is to be happy and succeed at whatever you do.

4. To become famous.

I spent six years as a paramedic at Opryland with lots of famous people. Guess how many of them were medics? Zero. Not that that’s a problem. I always found it best to operate in stealth mode because for most EMS providers, fame is much less likely than infamy.

5. To get a job.

It’s true there aren’t exactly barriers to entering EMS — more like traffic cones. You do need a high school diploma and have to pass a 120-200-hour EMT course, but that’s much less time-consuming than spending, say, 15 months getting certified in medical coding. If convenience is your priority, though, or you’ve picked EMS by searching Google for jobs+I+might+like, it’s doubtful you’ll reach nirvana riding an ambulance.

6. For security.

Here’s a rule of thumb for estimating how long you’ll last in EMS: take the year you were born, add the number of brothers and sisters you have, then divide by the melting point of titanium in degrees Kelvin. Not sure of the answer? Good, my work here is done.

7. For benefits.

State, county or municipal EMS benefits are generally comparable to what’s found in the corporate world, but private agencies may not offer more than legal minimums. Significant perks for part-time or per-diem positions are as rare as finding the sickest patients in the most easily accessible bedrooms.

8. To meet people.

You can count on that happening, but most of them have diseases and won’t be terribly interested in socializing once their pain meds wear off. I’ll change my mind about #8 if I ever see an online dating site called MedicMingle.com.

9. Because of opportunities for advancement.

It’s difficult for EMS providers without at least an associate’s degree to advance beyond entry-level supervision in large agencies. Also, in my opinion, health care organizations tend to be less top-heavy than non-medical firms, which means fewer management positions to shoot for.

10. To do anything exciting you see medics do on TV.

I figured I’d loop back to this because the public’s interest in EMS is so often stimulated by the entertainment industry. That’s entertainment, as in making believe. Even that groundbreaking, mid-‘70s series "Emergency!" — a major motivator for many of us on the high side of 60 — was a sanitized rendering of life in the essential services. I mean, how many responders have you seen who looked like Johnny Gage? Now we have televised documentaries following actual cases handled by real EMS providers, but after editing, even they don’t accurately portray a typical day in the life of an average paramedic or EMT.

So how does one enter EMS, an industry misunderstood by so many, with realistic expectations? First ask questions, observe operations and even participate as a volunteer if that’s an option in your area. Most importantly, prepare for days of downtime punctuated by moments of urgency. It’s not so bad once you get used to it.

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