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‘We love this job — and it’s hurting us’: Paramedic Sophie on EMS burnout and culture change

From mental health to pay equity, influencer and flight medic Sophie Fuller opens up about the pressures of working in EMS and why it’s time to stop normalizing harm

In this episode of EMS One-Stop, Sophie Fuller — better known across social media as Paramedic Sophie — joins host Rob Lawrence for a candid, energizing conversation about what it really feels like to work in EMS right now: pride, the pressure, the burnout, and the culture issues that too many providers have been taught to silently absorb.

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Sophie is a critical care ground paramedic, flight paramedic, educator and president of the Tennessee Association of EMS Providers (TAEMSP), and she brings a provider-first lens to everything from leadership visibility, to mental health and pay equity.

Together, Rob and Sophie dig into why Sophie started creating content in the first place (hint: burnout and the need to connect), how social media can be used as a force for good, and what “healthy” EMS culture should look like in practice. Sophie shares practical advice for crews and leaders alike:

  • Be human
  • Say the uncomfortable thing
  • Stop normalizing harm
  • Build systems that “care back” for the people doing the work

Memorable quotes

  • “We’re just working in systems that haven’t yet learned how to care back for the provider.” — Sophie Fuller
  • “Management by walking about. Don’t be stuck in the office. Don’t say my door is always open because that relies on people coming in to see you. Get out and go and see them.” — Rob Lawrence
  • “We love this job and that distracts us from the fact that it’s also hurting us.” — Sophie Fuller
  • “Just because it’s normal doesn’t mean it’s healthy.” — Sophie Fuller
  • “We confuse trauma with tradition.” — Sophie Fuller

Additional resources:

Episode timeline

01:00 – Rob introduces Sophie Fuller (“Paramedic Sophie”) and frames the influencer vs. “effluencer” concept
02:14 – Sophie’s origin story: graphic design → hospital tech → EMT → volunteer fire → paramedic → critical care → flight
06:16 – TAEMSP: why Tennessee needed a provider-level association and the shift toward legislative advocacy
08:05 – Why she started with social media: two full-time 911 jobs, low pay, burnout and the need for an outlet/connection
09:32 – Defining EMS burnout: the “jar on the shelf” and cumulative strain that becomes chronic fatigue
13:26 – Sophie’s guidance to providers: vulnerability, telling the truth and not letting naysayers silence needed conversations
16:00 – Sophie’s message to leadership: don’t be the “Wizard of Oz” — show up, communicate and stay connected to crews
20:26 – EMS culture: self-sacrifice, silence, “earning your place through suffering,” and confusing trauma with tradition
23:10 – Sophie’s book “The Next Shift”: a field guide to “learn, lead and last” in EMS
26:03 – Mistakes and “just culture”: reporting, mentoring, anonymous reporting systems, and learning vs. blame
32:08 – Closing challenge: stop normalizing harm; speak up for culture and patient care
33:14 – Where to find Sophie online and how large her platform has become

Previously on EMS One-Stop

Rob Lawrence has been a leader in civilian and military EMS for over a quarter of a century. He is currently the director of strategic implementation for PRO EMS and its educational arm, Prodigy EMS, in Cambridge, Massachusetts, and part-time executive director of the California Ambulance Association.

He previously served as the chief operating officer of the Richmond Ambulance Authority (Virginia), which won both state and national EMS Agency of the Year awards during his 10-year tenure. Additionally, he served as COO for Paramedics Plus in Alameda County, California.

Prior to emigrating to the U.S. in 2008, Rob served as the COO for the East of England Ambulance Service in Suffolk County, England, and as the executive director of operations and service development for the East Anglian Ambulance NHS Trust. Rob is a former Army officer and graduate of the UK’s Royal Military Academy Sandhurst and served worldwide in a 20-year military career encompassing many prehospital and evacuation leadership roles.

Rob is the President of the Academy of International Mobile Healthcare Integration (AIMHI) and former Board Member of the American Ambulance Association. He writes and podcasts for EMS1 and is a member of the EMS1 Editorial Advisory Board. Connect with him on Twitter.