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EMS Week: What it means to be ‘Always in Service’

Around-the-clock response capability is why EMS organizations exist, but individual EMS providers need to regularly go out of service to rest and recharge


Monroe County EMS educating children on what to expect if they or someone they know is transported by an ambulance.

Photo/Monroe County EMS

This article was originally posted on May 18, 2017. It has been updated with new information.

One EMS Week theme which struck a chord with me was “Always in Service.” Like the themes from previous years – “Called to Care” and “Everyday Heroes” – the theme of “Always in Service” is under the umbrella of EMS Strong.

EMS Week is an annual celebration and recognition of EMS providers. The American College of Emergency Physicians and the National Association of EMTs lead the national campaign and enlist the support of other state and national membership associations, vendors and EMS agencies.

Here’s what I think “Always in Service” means to EMS organizations and individual EMS providers.

24/7 response capabilities

EMS agencies – paid or volunteer, public or private – are always available to the communities they serve. EMS as an organization, entity or profession has made a 24/7 commitment to the citizens and visitors in their response area. Readiness for any type of patient, simultaneous single patient incidents or mass casualty incident is at the core of our existence.

Reliability, availability and preparedness create challenges and opportunities. EMS is always in service because it has become a healthcare safety net for millions of people who access emergent care by calling 911 when they actually need non-emergent care. EMS agencies are also capitalizing on their constant availability and ubiquitous presence to expand services with community paramedic initiatives.

Off-duty response to emergencies

Our willingness to come to the aid of our families, friends, neighbors and strangers – even when we are officially off-duty – makes us always in service. EMS providers, because of their training and ability to take command in the midst of chaos, go in service when off duty. We answer the call when the flight attendant announces a medical emergency on our spring break flight. We are the first to stop at a crashed vehicle on the roadside or to begin CPR when an athlete collapses during a game or to recognize an ill juror while testifying.

Many EMS providers will shun the spotlight of recognition for performing an off-duty save, but those accolades are well-earned. Appreciate the recognition for the off-duty save, letting it encompass all of the on-duty care you have provided that didn’t likely get recognized for.

Go out of service regularly and often

“Always in Service” when applied at the individual provider level is troubling and potentially dangerous. EMS can quickly be all-consuming. Many EMS providers work two or three jobs and leave one job just to drive and start their next shift at a neighboring agency. Or they leave their EMS job, but are still an on-call with a volunteer agency for the few hours they might have at home. Even when not at work or on call, it’s easy to let EMS online social groups, CE presentations or conferences consume nearly every waking moment.

Volunteering for overtime shifts and mandated holdovers can increase work hours well beyond 50 hours per week. A two-week paycheck with 30, 40 or more hours of overtime might be a nice boost to your bank account and even a badge of honor, but the mental and physical toll of being always in service is not without risk.

We all need breaks from EMS to get eight or more hours of uninterrupted sleep, exercise without being tethered to a pager, eat a couple of meals slowly and visit with friends and family that have nothing to do with EMS. A bedtime facetime chat with your kids for the fifth night in a row, carrying a scanner while you are running errands on a day off or being home long enough for a shower and shave between EMS shifts is not a break.

Being always in service – never going out of service – as an individual EMS provider, whether physically or metaphorically, puts you at high risk for burnout, fatigue caused errors and career dissatisfaction. Regularly going out of service is necessary for your own physical and mental health. Time off from EMS can help strengthen relationships with your friends and family. Sleep and pursuit of other interests and hobbies gives you the regular restoration needed for a long EMS career. Take breaks regularly and often.

Interpreting “Always in Service”

That’s what I think it means for EMS organizations and individuals to be “Always in Service.” What do you think it means? Share your thoughts in the comments or email your interpretation to

Learn more about EMS service

Learn more about how EMS leaders perceive being always in service with these resources.

  • Check out what Michael Morse has to say about being always in service for his neighbors.
  • Scott Kier reflects on the benefits and costs of spending more than two decades always in service. Crystal Wallin writes about what an EMS career has meant for her and being always in service for the Professional Ambulance Association of Wisconsin.
  • Justin Schoor, the Happy Medic, added a comma and some perspective to always, in service.
  • Catherine Counts, on behalf of the NAEMSP, thanks EMS providers for their dedication to a dangerous profession for the New York Daily News.

Greg Friese, MS, NRP, is the Lexipol Editorial Director, leading the efforts of the editorial team on Police1, FireRescue1, Corrections1 and EMS1. Greg served as the EMS1 editor-in-chief for five years. He has a bachelor’s degree from the University of Wisconsin-Madison and a master’s degree from the University of Idaho. He is an educator, author, national registry paramedic since 2005, and a long-distance runner. Greg was a 2010 recipient of the EMS 10 Award for innovation. He is also a three-time Jesse H. Neal award winner, the most prestigious award in specialized journalism, and the 2018 and 2020 Eddie Award winner for best Column/Blog. Connect with Greg on Twitter or LinkedIn and submit an article idea or ask questions with this form.

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