Editor’s Note: This article originally appeared in the EMS1 industry report, “What Paramedics Want in 2026: The provider roadmap for EMS leaders.” Explore our full coverage in the What Paramedics Want resource hub.
Burnout is often presented as stemming from a lack of personal health and wellness resources, but EMS providers are pushing back on that framework with their responses to the What Paramedics Want in 2026 survey.
Providers consistently identified staffing shortages, excessive workloads, poor scheduling, low pay, ineffective leadership communication and insufficient recovery time as primary drivers of burnout — challenges that cannot be addressed through wellness education alone.
Staffing remains a top concern
One of the most common themes among respondents was staffing concerns. Many said that too few providers, too few ambulances and high call volume leave crews without enough time to recover between calls.
Others called for agencies to hire more personnel, reduce mandatory overtime, limit holdovers and place more units in service during peak demand.
One respondent summarized the issue simply: “Adequate staffing would solve most of our burnout.”
Providers also cited constant posting, move-ups and system-status changes as a source of stress. Several said the lack of downtime between calls makes even routine shifts feel unsustainable.
Notable comments:
- “Staffing benchmarks need to be beyond the minimum number of people needed for response time compliance.”
- “Increase staffing to cover surge capacity.”
- “Don’t wait until we’re understaffed to start hiring; be proactive.”
| MORE: Attract, engage, retain: Recruitment as a strategic advantage in public safety
Fatigue is both a wellness and safety issue
Scheduling was another major theme cited in the survey responses. Respondents called for shorter shifts, more predictable schedules, protected rest periods and alternatives to 24/48 schedules.
Some specifically supported 24/72 schedules or limits on back-to-back shifts. One notable response called for agencies to prevent providers from working consecutive shifts across multiple EMS employers.
That answer points to a larger workforce issue: fatigue is not always contained within one agency. In many communities, EMS providers work for several organizations, making total hours difficult to track.
Notable comments:
- “Every agency should have a 24/72 schedule and allow rest/sleep during downtime.”
- “Better schedule; I need to be home more to fix my personal life.”
- “Switch to a schedule that maintains a balance between work and off-time that is conducive to a full career in EMS.”
| WATCH: Sleep, safety & fatigue: Improving EMS health with Dr. Dan Patterson
Compensation shapes perceptions of value and respect
Many respondents said compensation does not match the demands of the job. Comments linked low pay to turnover, staffing shortages and a sense that EMS is undervalued.
Providers asked for higher wages, stronger retirement benefits, better injury leave and improved mental health coverage.
The sentiment was not just about money; respondents described pay as a sign of whether their organization values the work and the people doing it.
Notable comments:
- “Increase benefits, especially health insurance.”
- “More adequate pay, better benefits, in particular retirement benefits, so we know there’s a light at the end of the tunnel.”
- “Increase pay and benefits to cut down on the amount of hours needed to make a living wage.”
| MORE: Pay paramedics a thriving wage to end the retention crisis
Leadership trust is central
Another strong theme across the responses was frustration with leadership. Providers said burnout gets worse when field staff feel ignored, micromanaged or excluded from decisions that affect their work.
Respondents asked for clearer communication, more leadership visibility, better accountability and more respect for field experience.
Several comments suggested the disconnect between administration and crews is as damaging as call volume. Providers want leaders to understand what work conditions are like on the street before adding new expectations.
Notable comments:
- “Need well-defined leadership under a singular command structure that doesn’t contradict itself.”
- “A change in leadership from a micromanager to a team-driven focus.”
- “Stop agreeing to do more with less while leaders lay their heads on pillows at night and the crews pay the price!”
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Wellness programs need to be useful, not symbolic
Although skeptical of framing burnout as a wellness issue, providers did not reject wellness programs outright. Many asked for better access to counseling, peer support, post-critical incident support and mental health leave.
But respondents were also wary of programs that do not address root causes. The comments suggested that agencies cannot solve burnout with wellness messaging while maintaining unsafe staffing, excessive overtime and poor schedules.
Notable comments:
- “We need more and better mental health resources at no/cheap cost to the provider.”
- “Offer mental health resources without the stigma.”
- “Promote conversations and awareness of provider burnout and mental health.”
| MORE: 5 reasons why your wellness program is failing
Bottom line: Feeling overworked but undervalued
There is no single issue that causes burnout. Rather, it is the culmination of small stressors over the course of a career: too many overtime shifts, low pay as the cost of living rises, inadequate staffing and resources, and increasingly dangerous calls without stigma-free mental health support.
The survey responses show providers are asking for practical changes: more staffing, better schedules, fair pay, trusted leadership and meaningful recovery time.
The takeaway for EMS leaders is clear — burnout prevention cannot rely only on resilience training or employee assistance programs. Those supports matter, but they are not enough if the work system remains overloaded.
For many providers, the path to less burnout starts with a better-run organization.
