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Increase pay and paramedics will come? $20k sign-on bonus says otherwise

Zero takers for a $20k sign-on bonus and $25/hour points to underlying recruitment challenges beyond wages and benefits


The acceptability of a wage is relative to experience, geography, cost of living and employer desirability.

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The $20,000 sign-on bonus Cumberland Goodwill EMS (Carlisle, Pennsylvania) is offering for paramedics pops off the page.

But, according to Nathan Harig, EMS assistant chief, this eye-popping amount didn’t lead to a single applicant, though the ABC27 news story did help reach one applicant already planning to relocate to the area.

The sign-on bonus, paid out on a schedule of $5,000 per year for four years, is for a full-time paramedic position that:

  • Is paid $25 per hour (about $52,000 per year)
  • Works a 12-hour fixed Pitman shift schedule
  • Offers 100% employer-paid health insurance for the employee and family
  • Matches 5% of employee 401k contribution

The full 401k match is another $2,600 in pre-tax income, deferred and growing until retirement. A 2019 employer health benefits survey by the Kaiser Family Foundation reported the average annual premium for employer-sponsored health coverage as $20,576.

Cumberland Goodwill EMS is a CAAS-accredited 911 and interfacility transport service in central Pennsylvania serving the borough of Carlisle in the Cumberland Valley. Carlisle is about 20 miles west of Harrisburg, the state capital. For comparison, the estimated firefighter base salary in Harrisburg, reported by Indeed, is $45,075.

Why no applicants?

I suspect some of you are thinking, “52k a year plus benefits, sign me up!” And others are thinking, “There’s no way I’d work for those wages.”

The acceptability of a wage is relative to experience, geography, cost of living and employer desirability. Though I am not actively seeking paramedic work or regularly reviewing paramedic employment opportunities, the pay and benefits of this position feel competitive, the quality of life in central Pennsylvania is likely above average and this group looks pretty fun.

The top challenge to EMS reported in the 2019 and 2020 EMS Trend Report is recruitment and retention, and respondents cited low wages and benefits as the top reason providers are leaving their agencies. It is hard to know the exact reasons no one has applied for a position with a high-signing bonus and competitive wage, but here are couple of things on my mind:

Finding job-seeking paramedics or being discoverable to job-seeking paramedics is difficult, especially on cluttered national job sites like Indeed, Monster or LinkedIn. Becoming a destination employer requires growing a social media presence; building and maintaining relationships across time zones with other EMS leaders and educators; and being recognized for EMS thought leadership in digital media, print publications and conference agendas.

Changing employers is really hard. A lot of paramedics complain about incompetent leadership, poorly maintained vehicles and equipment, indifferent coworkers and near poverty wages, but are reluctant to improve their professional happiness and satisfaction by quitting their crappy EMS job. Any job change requires weighing the unknown of a new employer or, as the centuries old proverb says, the “devil you know versus the devil you don’t know.”

Moving is hard. Have you packed up your family and belongings for another city or even state? I moved two, yes two, miles north eight years ago and our lives were upended for months. We didn’t change jobs, schools, doctors, friends or grocery stores. It was still chaotic and stressful.

I am not alone in my reluctance to move or even consider moving. Americans are more locked in place than ever before. In the 1950s, 20% of the population would move each year. Now less than 10% of Americans are moving each year. In the COVID-19 era, it might be a recruiting advantage for EMS services with a low-population density service area, especially if the community offers low housing costs and good schools for displaced city residents.

EMS work is hard. COVID-19 has put EMS in the local and national news headlines like nothing before. While acknowledging the strain on EMS of COVID-19 patients, many of those articles and videos explain the other pain points of an EMS career, like long hours, high rates of burnout and traumatic stress, constant risk of physical injury, and difficulty recruiting and retaining employees. These stresses might be contributing to many paramedics considering leaving the career field rather than relocating.

What’s keeping you from changing EMS employers or relocating? How much of a sign-on bonus would lead you to change jobs? Share with me in the comments or by email.

Looking for a new EMS employer? Check the listings on the EMS1 careers page.

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 LinkedIn.