The “What Paramedics Want in 2025” Report clearly showed that burnout is the No. 1 issue plaguing our field. EMS leaders around the country already knew this, of course, but seeing the numbers so clearly displayed in the report, we now have the opportunity to contemplate both the “why?” and the “what now?” questions that arise after a study like this is released.
| ON DEMAND: End the burnout cycle with proven initiatives to create a more sustainable EMS culture
I’ve already heard and seen a lot about the chronic issues we are very familiar with that lead to this burnout, e.g.:
- Chronically poor recruitment and retention
- The need for more culturally sensitive mental health care and better employer-driven wellness services
- The increase in call volume and more difficult medical landscape in our patients
As a paramedic and labor leader, I have seen the burnout cycle play out before my eyes — both in my coworkers and within myself — hundreds of times in my 15-year career.
In reality, I don’t think a single one of us has burnt out from the same combination of factors.
For some, it is the long hours, need for multiple jobs or overtime to make ends meet, and routine mandated shift holdovers.
For others, it is the way they are treated by patients and hospital staff.
For many, it’s being assigned too many calls in a short period of time without the proper down time or processing in between.
Others burn out from the constant paperwork.
The reasons are endless.
It’s important for us as a field to recognize that the exact causes of burnout are necessarily unique to the individual, but that doesn’t mean that we can’t still address it.
‘I didn’t sign up for this’
As an EMS labor leader, I’m quite familiar with asking the question, “What do paramedics want?” In fact, the process of labor-management collective bargaining is always an experience of identifying the factors that are leading to the highest levels of burnout and lack of satisfaction, and working together to address them — both for the good of the workers and by extension, the good of the agency that needs a fully-staffed workforce.
Anyone who has engaged in a successful contract negotiation can likely relate to this. On the labor side, we provide management with perspective on what causes their workforce the most stress and ask them to fix it in specific ways.
When things work well, we are listened to and the common good is addressed within the confines of what management believes they can “afford” (whether financially or operationally). When things break down, there is almost always a disconnect between our needs and understanding of what matters.
I have pondered these questions of “why” and “what now,” drawing from my experiences of collective bargaining. I attempted to properly define workplace burnout itself, in recognition of the fact that the causes and thresholds for every individual vary as much as their reasons for getting into EMS in the first place. The simplest way that I’ve been able to understand it is that burnout is a result of a disconnect between someone’s expectations of what they “signed up for” and the reality of the job.
Said differently, “I didn’t sign up for this” is a typical sentiment behind someone’s burnout, whatever the cause. I’ve certainly said it during my low points.
| MORE: Burnout in EMS: Recognize it, fight it, overcome it
Addressing burnout honestly
So how do we address burnout through collaboration?
- First, by being honest about what to expect and holding to those standards. If promises are being made (or contracts are being signed), we all have an obligation to keep those assurances and not deviate from them. For example, a shift within a defined timeframe remains that way, and any “unless,” such as getting a 911 call 20 minutes before the end time, should be properly defined and explained to the workforce (ideally as early as during their application process).
- Any areas of policy where there is nuance or a lack of clarity should be properly defined and expectations built. Ideally, these changes will be made with worker feedback and involvement in the process. Employees need to feel heard (not just listened to or placated) and the more involved they are, the better they will feel when positive changes towards progress are made.
- Any identified issues that are outside the direct control of workers and employers (e.g., poor treatment from hospital workers) should still be addressed head on, and with leadership showing that they are taking steps to address them and that they will defend their employees.
- The conversations must be continuous and responsive. What matters today might not be what matters tomorrow. What fixed a problem this year, might not be an effective solution next year. We cannot get complacent and we must be in a continuous collaborative process with one another to ensure that expectations of the work are meeting the reality of the day-to-day.
I believe — based on my experiences of collective bargaining and observations on how successes and failures impact the membership — that EMS workplaces that meet these four goals will have the highest retention of their workforce and lower rates of burnout. But the only way to know for sure, is if we try.
