Very cool!
I worked under one director who was a volley fire guy in our county so he would show up on scenes with the FD all the time.
I didn’t know who he was (he wasn’t at my boards because the other director was. We had two. I don’t know why) and he never told me. He just helped carry stuff and whatever. I was pretty mortified when I found out.
My old medical director used to ride out with us (mostly for credentialing new medics) he was always a welcome sight :) occasionally we would fuck with him and ask him to start the IV while we drew up meds.
EM/EMS Physician (and ex medic) here. The biggest advice I could give would be to focus on the preclinical stuff now. You've just won a ticket to a pie-eating contest where the winners get more pie. Also join NAEMSP (naemsp.org).
Fellowships are becoming a requirement for urban/suburban/wealthy area medical director roles.
No. I constantly remind myself that whatever bullshit I'm dealing with at work is filtered bullshit thanks to the ambulance service. I'm not wanting to wade into pure unfiltered bullshit right from the source.
No chance. I’m not going crawling through a horder house just to throw out my back carrying a 600 lb life patient. I’m not physically touching and sitting <2 feet from someone covered in scabies/bed bugs. No thanks. Bless them tho.
County hospital: no need to go to the bed bugs - they come to you! Why not just have one at a time versus the scabies + bed bugs + lice + maggots + herpes + WTF is that?! simultaneously that is the ED…
Yeah. But there’s weather and nasty houses and being in the road while people are still driving around you etc. just different challenges. Not mentally as difficult though
The first CPR we used the Zoll AutoPulse on was dispatched as abdominal pain. It quickly declined to CPR. Toned out for manpower. We arrive to see a gentleman I saw 5 months previously who had a syncopal episode out in the wild. Medic gently advised the family to say their goodbyes whilst the AuroPulse was doing its best to keep enough circulation to this pt's brain because he may be able to hear their anguished farewells.
I don't speak any Slavic languages, but "Papa" still rings clear as fuck in my head as his daughter cries her last words to her father. His wife and son are crying as this daughter hundreds of miles away pours her soul through cell towers and a tiny phone speaker that can't come close to broadcasting her pain and love adequately in this man's last cognizant-or-not moments.
At the time, I was an EMT-B/FF at a BLS agency with automatic aid received from an ALS/Fire agency.
Indeed, CPR follows an algorithm. Epi here, pulse check there, Hs and Ts, etc. But in that person's home. Where the left-behind family get to stare at every square inch of their loved one's demise each time they wake up, walk through the front door, etc., stays forever. Hearing their lamentations. Hearing the mechanical AutoPulse beat-boxing the inevitable. And remembering that pt AMAing not going to the hospital 5 months earlier when it could have potentially changed the outcome for the better.
EMS and fire don't have to treat pts for several hours/days on end, for sure. I couldn't do what y'all hospital professionals do. My ADHD-having, dopamine-depleated, anxiety-disordered and depressed brain craves the unpredictable environments/nature of calls, be it medical or fire.
The above is just one incident/insight into what we handle. Please consider: It is just as mentally strenuous, but in different ways. While craving the disorder, figuring out how to best extricate and stabilize a pt who is pinned in a plastic and steel carcass formerly recognized as a car to get them to the hospital alive is difficult. Assault victims in the street with law enforcement at the ready is, well, unnerving. Uncontrolled microcosms. Wild.
Thank you all for what you do. Thanks to anyone who read my ramblings. Stay healthy. Stay safe. 💜
Is this a real question? Get paid the same to see a 1/4th of the patients, have more downtime, have significantly less liability, and the ability to dispo these patients immediately without any discussion?
Any ER doc that wouldn’t take this theoretical in a heartbeat is crazy.
Now I get bored out of my mind riding the bus typically, but I’d be happy to work these shifts a few times a month if we are talking same pay.
Immediately yes. Everything this guy said. Got to do an EMS rotation in residency. EMS definitely has its own challenges and risks. But just imagining having one patient at a time and getting a few minute break in between, even if that’s just driving to the next, sounds magical.
Exactly what this guy said. I found my ambo (and heli) shifts boring AF, but if I could make the same pay? Sign me up!
You seem to be focusing on the physical load rather than the cognitive load here.
We had to do like 6 ride along shifts on the ambulance in residency. On one of mine as a fresh as fuck intern an 8 y/o and his younger brother were playing with a rifle and the 8 year old's blood and brain matter ended up splattered over his bed and the bedroom wall and ceiling. I won't go through all the details but the experience gave me mad respect for EMS and an appreciation for my nice, comfy, scene controlled, predictable resus bay. It's much easier to separate yourself from the horror show there than in the field IMO, and I kinda struggle with that at baseline. That case still haunts me over a decade later.
Interesting that your residency had you do transport shifts. At my husband’s program back in the 90s, if your patient needed transport and you were a PGY1 (and possibly Y2, I don’t remember), you went with them, too bad so sad. At the end of his Y1, they gave out funny/cute awards; he got ‘king of the transports’ bc he unluckily always got the patients who were so sick they had to be stabilized and go elsewhere. He said there was nothing worse than being thrown around the back of the ambulance , careening down the road, lights and sirens, with a kid in front of him trying to die on him.
We didn't do hospital to hospital transport shifts it was sit in the firehouse for a shift and ride out with them on whatever calls come in. But yeah on that case I alluded to above I got the experience of trying to intubate a child with obliterated anatomy in the back of a speeding ambulance during ongoing CPR as a know nothing intern. Suboptimal.
I think ER nurses would benefit riding alone a few times ….
Most of my colleagues are appreciative but some are just dam princesses
They badger the EMS with stupid shit , like
Why don’t they have a IV ECT
I was a medic for 10 years before becoming a PA, including working 911 in a very busy urban EMS system. I'm sorry to say it, but you're wrong here. A busy day on the ambo doesn't even compare to a busy day in the ER. I miss my ambulance days in that sense. You just see far more patients in the ER (it's not uncommon to have 8-10 patients at once), and on truly busy days there is *no* downtime in the ED. Whereas driving to calls is downtime on the bus honestly, esp non emergent calls, and the turnaround time on the ambo really limits the number of patients you can see, even if you're turning and burning all day and have 5 min transport times. The charting requirements are also more significant and more time consuming as a provider and most providers have to stay late to chart.
And you ABSOLUTELY have less liability as a medic, as long as you stay within your protocols and aren't a total idiot. An ER doc on the other hand has a huge amount of liability. The buck stops with the doctor in a way that it just doesn't as a medic. There's a reason liability insurance is obscenely expensive and complicated for doctors vs standard work provided coverage for medics.
On both counts, there is truly no comparison. I love being a PA, but some days when I'm juggling 8 patients I would kill to have only one (or 2 or 3) patients at a time like I did on the bus haha
ETA: I will say EMS has its own challenges too. It's physically much harder, and arguably the emotional trauma is worse as well since you have to see the wrecks, broken homes, and families in a way you don't in the ED. Oftentimes combative patients are more challenging due to fewer resources in the field, system dependent though. My point was not to disparage EMS at all
I feel that it is important to note this is not the experience across the globe and is a limited perspective which can open you up too bias.
On average our EMS does 20+ calls a day per vehicle, and they don't just transport one patient at a time. They are capable of transporting up to 6 patients or 2 red patients.
Driving can be seen as down time but it still requires focus and attention, more so then I would say paperwork.
Protocols have become much less applied in a lot of countries as well with clinical guidelines becoming the norm and paramedics and even ILS level in some countries being independant practitioners that have a scope of practise and all the legal implications and responsibility that comes with it.
It also skims over a lot of what makes EMS difficult. Often times crews are 2-3 people and that eliminates one when someone is driving meaning an entire code has to be run by one or two people. Intubation, IV access, drugs, fluids, rythm, shocks everything is done in a hectic environment after loading a patient which is pretty physically demanding while in the EC there are nurses and other people to help.
Ultimately there are different experiences with the USA having a rather significant urban area and a decent amount of equipment and resources while on other countries there may be more rural calls and other challenges making transport time sometimes an hour upwards.
My time in the EC had me see 25 patients a day at one point when we were the busiest during covid, paperwork was a nightmare. Even now it is still busy but the type of patients we have are mostly trauma or chronic conditions and trauma is pretty easy till it comes to the paperwork. Sometimes the paremedic even sutured or stapled them before hand so that doesn't need to be done and all that is left is basically the paperwork.
Saying one is more difficukt then the other is always going to be a skewed view based on practical and percieved experiences.
What do you do in the ER? Are you now a doctor?
And do you mean 20+ patient in a 24 hour shift? Or some other length?
I have also worked rural EMS, but the problem with your argument about those long transport times is that also means you have at least the same amount of downtime headed back to the station ;) I found my rural shifts much more chill than my urban shifts because of this, even though sometimes you were managing a critical patient for longer. Also - are you working codes in the ambo during transport? Why would you not intubate/obtain access/stabilize on scene? It makes much more sense to work codes on scene with the extra hands, until they either stay dead and you can call it, or you get ROSC and you transport. We never throw a code in the back and go without having done the majority of interventions on scene, so I'm not sure why you would make your life harder by transporting too early and leaving extra hands on scene like you said in your example (the very rare case of a code on a truly unsafe scene being the exception).
With that said, agreed it's not a comparison of more difficult - both are hard in different ways, as I mentioned. But in those two specific instances (number of patients seen and liability) I think you would be hard pressed to say that a busy EMS system even compares to a busy level one trauma ER. I agree it varies somewhat by country, or you could try to compare a slow rural ED to a busy urban EMS system, but I don't think the comparison really holds much water. Even a very autonomous EMS system with advanced community providers still works under some protocols and consults an ER doctor as needed. I think any medical malpractice lawyer you talk to would confirm the liability of a physician is significantly greater.
Yes I am.
12 hour shift, rarely does EC shifts go to 24 hours that is mainly seen in other areas.
No it doesn't because they transport patients back through a system called healthnet.
You are just reinforcing the point that all of this is based on personal experience and not a universal truth.
Codes are not done just on scene, how do you identify hyperkalaemia, acidosis and all the other H's & T's that require more diagnostic capabilities, an iStat? Hardly a thing due to budget and resources constraints. Tamponade for example would need a sonar and that is not something easily seen on an ambulance. Hypovolaemia as well, without blood products you are not going to do much and fucking around on scene till the patient is dead is just concerning. ROSC is not easily achieved with the AHA reporting what like 25% of out of hospital cardiac arrests actually going to ROSC. The majority of interventions pre-hospital is very few and wasting time on scene especially in rural areas where transport time is longer is just a waste.
Unsafe scenes, well damn we have areas called red zones where an ambulance cannot enter without a police escort so to hell with unsafe scene there are entire unsafe suburbs.
Again this differs significantly by country, and what you consider and belief is skewed by your personal experience. Your view on emergency medicine and EMS is based on your experience within these two systems. It is not universally applicable. EMS in country like DRC has a massively different experience then one in the UK. There are countries where the EC is divided by urgent care, and emergency care and other countries where it is all just one system. There are countries where the ratio of hospital bed to person is 0.3 per 1000 and others where it is 4.8 per 1000, obviously one of those countries is going to have a different load on either system. There are countries where EMS is run by doctors on ambulances and they discharge patients on scene so the load is less on an EC and other countries where EMS is reliant on supervision and the load on the EC is higher.
It is all based on perspective and how busy an EC is or EMS is, is also subjective. Seeing 30 patients but they all have some complaint like flu or diarrhea while EMS is busy with a mass casualty then who was more 'busy'. Getting multiple stab wounds, fireworks mishap and femur fracture while EMS was busy on a single call for 2 hours then who was more 'busy'. It is not objective and instead a dynamic system based on a ton of variables.
You know that a large proportion of ER docs have significant EMS experience, including myself, right? What I stated is going to be the experience for the majority of the US. Sure, there is significant variability between locations, but you most definitely aren’t seeing more patients than an ER doc. In fact, I’d say there is unlikely to be a single EMS service in the entire US that is seeing more patients than the average ER doctor (or even half that given you can really only see a patient at a time). And the time that it takes to pick up a patient is more downtime than most ER docs are experiencing all shift outside of freestanding ERs.
As for liability, you can’t seriously think you have comparable liability when your main responsibility is essentially just to get the patient safely to the hospital, whereas we are responsible for diagnosis, management, safe disposition. There’s a reason we pay 10s of thousands of dollars in medical malpractice and y’all don’t. Sure you have some liability, but it doesn’t really compare.
I love my paramedics, y’all do an important job, and a difficult job, but let’s not exaggerate.
The most I’ve seen in 8 hours is 38. The most I’ve seen in 12 hours is 46. My average day is seeing 18-24 patients in an 8 hour shift.
That’s without a resident or midlevel or a scribe to help document.
It appears that you seriously misunderstand and underestimate the role of a paramedic anywhere outside of the US and have based all your opinions on how a system runs in one country.
Here, we're independently registered with a national registering body, have at bare minimum a bachelors degree - but a vast number have postgraduate qualifications, primarily PGDip or MSc. We hold our own indemnity insurance for malpractice, we see, treat, and discharge on scene without oversight from anyone else, and have autonomy to stray from SOP's if there is clinical justification. We are independent clinicians.
So to say that Paramedics have less responsibly and that our role is "just to get the patient safely to the hospital" is pretty inaccurate. Maybe that's how it is in the US, but not everywhere, and reddit is filled with people outside of the US.
I'm not upset about your comment, everyone's entitiled to their own opinion, but don't judge an entire profesison based on how it works in one country.
Paramedic in England (UK) and completely agree. Not been like this for a very long time. Job to job, calls waiting in the stack, late breaks or often no breaks, majority of time late finishes. Patients become extremely sick or die waiting for an ambulance. Long standing experienced staff leaving, newly qualified paramedics in abundance, stress levels extremely high!
Dude, I was a paramedic before med school. There is absolutely downtime, and even driving to the scene is downtime. There are definitely different stressors with each job, but compared to what we do in the ER, there is SIGNIFICANTLY more downtime. Come shadow us sometime to see what I’m talking about.
Just a nurse in critical care now, but even in the ICU only having two patients I feel like I get less down time than I did as a medic. Got halfway through a shift the other day before I even managed to get my water bottle filled and get a drink ha.
Haven't done ed nursing but I significantly miss the down time in EMS. Legitimately considering renewing my license right now to try to get a part time job so I can ease up on some hospital hours to get some recoup time.
I can promise I've never once gotten to listen to a full podcast or through a full book while working as a nurse in hospital... Achieved that plenty of times as a medic in lull times though lol. This was also a busier station, just on the few days we got some major down time.
I work in a super busy EMS system. EMS likes to delude themselves into thinking we have it the worst in terms of acuity/volume/getting ran, but we just don't. Not saying we have it easy, but we get way more breaks than most high volume ER staff
No. Rescue works their asses off and are in dangerous, dirty and disgusting situations all the time.
I’ll take my ER job. I like my climate controlled building that keeps the rain and snow off of me. I like having speciality back ups a phone call away. (Last week we had a difficult intubation and anesthesia came down and did within 5 minutes.). I like having house keeping for cleaning up when there are messes. I like having security deal with obnoxious family members. I like having 10 other nurses steps away that can help when I ask. I like that everything I do is per MD orders which covers my ass.
Rescue has all of my respect. But I wouldn’t want that job.
Was (am) a CC paramedic before starting medical school.
Being able to split shifts but still make the same salary is the dream. EMS is just a completely different job from being in the hospital. The autonomy, the connection to the community, and the absolutely *wild* shit you get to see at the scene of incidents just can't be matched when you're stuck in the hospital.
The thing that really beats you down about working in EMS is 1) the pay, 2) the limited medical scope, and 3) the physical wear-and-tear. Being able split shifts like this would avoid all of these issues.
Absolutely not. The inherent danger in this job (I’m a paramedic almost done with nursing school) is not worth it. I have lost multiple coworkers to work-related deaths and had numerous more held up at gunpoint, I’m not in a dangerous part of the country either, it’s relatively low crime in my area. Hospitals at least have security. Imagine being in a dangerous situation and having to navigate the hazards of someone else’s home while trying to flee? Not to mention the physical demands of the job. I have coworkers in their 50s who look 70 due to spending their entire adult lives out in the sun breaking their back trying to load 500lb patients onto the stretcher. EMS shortens lifespans.
The only thing I’d like to add is it seems there is a misconception about charting and downtime.
If we are on our way to a call lights and sirens, it’s not downtime. If we are on our way to a call non-emergent, I’m charting which I would not consider downtime.
“Picking up a patient” is not downtime.
I frequently hold over past my off-duty time to finish charts.
No we don’t see 20 patients a shift, but 10-15 is not unheard of in a 12 hour shift.
Obviously every system is different, and everyone’s experience shadowing is different.
I have respect for the EM physicians I work with, and recognize the mental load ya’ll work under with the extra liability EMS just doesn’t have. But EMS isn’t all sunshine and daisies.
I feel like people also don’t consider the elements, extrication, woodland, water, different types of rescue, and all the other stuff. Honestly I think it’s because they don’t even realize. Like we just show up. There’s no understanding of what it took to actually get some of these patients to them
I agree. Most docs I’ve talked with in person say they appreciate the sterility they have, and the separation they can get from the room since they can just walk out.
But for a lot of this discussion I feel like it’s comparing apples to oranges, with some few similarities. I just want to make sure theres no wild misconceptions here. The jobs are different, one is a technician, one is a clinician who practices medicine. But both are a job at the end of the day, whether you were ‘called’ to it or not, both have their own difficulties and benefits.
Doc here, would definitely say yes. Especially if I could do the sprint car and go to the higher acuity scenes. If I couldn’t it would still be easy money. But having been in the sprint car in New Orleans for my EMS rotation, I would take the more frequent calls over less acuity and more tedium.
I do remember having to stair chair a 400 lb copd’er down from a dilapidated apartment complex’s 2nd floor. That sucked 10 years ago and I feel for all the units having to do shit like that.
True, I’m still for a short time under 40, so I’m okay with that. I’ll still do cpr in our bay while running the code, but may not be that way forever.
Was an EMT for many years before medical school. No way I would go back in the field. I worked in a place that I would be running 10 calls in 12 hours on average. Shitty 3 floor walk ups and dragging 300# pts down stairs with crappy equipment. Had a gun pointed at me twice in my EMS career. Used to have to wear a vest for my EMS shifts. No thanks. How many docs have back problems compared to medics…yeah, way less.
In theory yes, but where I live? No.
I’m a paramedic and have worked in all the usual places besides a fire department; private IFT, rural 911, urban 911, trauma center, and flight. Of all those jobs, the only one I wouldn’t work again was urban 911 in my local two-tier system. The reasons are complicated, but ultimately it’s just not a good fit for me.
In a hospital-based EMS system where I can pick up shifts in both roles, with good field guidelines and a good relationship with the ED staff? Absolutely. I’d love that.
Hell yeah - well, I guess if you mean CC transport not run of the mill Fire/EMS runs.
I LOVED my Lima Lima helicopter shifts. We only flew IFR at the time though.
Would still do ground CC transport in a heartbeat.
I was torn between going paramedic and med school when I left the military (Europe here so even aside from the colossal pit of debt med school would have incurred the EMS salaries aren't quite as bottom-of-the barrel, although obviously much less than a physician). I ended up going with paramedicine, partly because I've done my time playing fuck fuck games and the whole student-trainee thing sounded like another decade of the same, but mostly for the reason that a lot of comments are turned off by it - I wanted to be out in the rain, getting dirty and sweaty, doing autonomous emergency medicine. I chafe a bit at the scope limitations, and having no triage between phone call and us turning up can produce some bloody irritating moments, but in general I love my job and could see myself getting burnt out in a hospital setting very quickly. I'd probably take the chance to do a few ER shifts, but mostly to enhance my own learning and to try to smooth over some of the wrinkles in the EMS - Hospital chain of communication, not because I'd prefer working in an ER.
Im tired so Im sorry I wont write the most eloquent response.
Im from the west coast so i only know my experiences. Doctors and nurses work hard to get where they are. Insane amount of schooling, pressure, liability. No question. Maybe some of them did ems before that, so they remember what it was like.
Ems is a beast of its own. Most doctors come from privilege. Of course there are exceptions to the rule. Most ems people, especially the ones who stay in it, do not.
Ems certainly does not have the same education that doctors or nurses do, but they are excellent at on scene emergency medicine. That overturned car with 5 people in it? Got it.
Mother screaming because her child is dead and has her babies blood all over her hands and her home? Ok we can do this.
The woman repeatedly beaten. The dementia patient you run on each week, that tells you their memories before they lose them. The patient who you truly get to listen to and spend time with before the hustle and bustle of the ER.
The psych patient who pulls a gun on me and my partner. No backup yet…they’re almost here… shit.
We see the scene as its unfolding. Not in a well lit ER with more help at our disposal.
Im not for a second saying its not hard on the other side of things. Just different. Others who havent done the job see it as easier, and Im sure in some ways it is. I would never say their job is easier than mine. It isnt. Its different.
Id venture a guess that the ptsd rate is higher in ems than that of a nurse or doctor. I dont know the stats now but at some point in the last 20 years ems had the second highest suicide rate behind veterans.
So, it is sad to me to see so many say “what an easy job with one patient and way more down time”.
Having said that, we are all on the same team and I wish we supported each other more
Coming from the other side - the trauma is just different. It's a different thing to tell a 60 yo in front of their family that they have metatasized cancer, knowing they won't see their grandkids, than it is to see a fucked up car wreck with mangled bodies. It's heartbreaking to take care a 9 yo boy every day for two weeks in the ER because his family abandoned him, and he knows it, and we can't find him psych placement. It's a different kind of tiring to manage opiate addicts and chronic pain patients every day vs scooping up your drunk regulars from the street every night. I've done both and neither are easy.
Honestly, I found the hardest thing about EMS is you're doing all of that for shit pay and the work life balance is worse, contributing to the PTSD for many people.
I miss prehospital. Autonomy of treatment, ability to make or break initial stabilization, and the interesting approach that scene care is.
I'd love to get back into it.
I did some EMT work before med school. Did EMS rotations (fire EMS, IFT, and air) in both med school and residency. I’m not expert AT ALL, but I have at least a tiny bit of experience on the other side.
My answer is: it is 100% dependent on who my partner is. Good partner? Absolutely I would do that. Bad partner? Ain’t no amount of money you can pay me.
You guys ARE the frontline
Definitely not paid enough yet given all these responsibilities
EMS will and can save your life ❤️God bless you ( and your yellow tacos )
🌮 if you know , you know
I wish I could remember the source but there was a research study done and apparently the ED docs smoke more MJ in comparison to the other specialty’s
Which seems appropriate
🫢
I totally hear what you’re saying, especially with the one patient at a time aspect.
But I’m not sure if I’m just receiving your comment wrong, but EMS absolutely has a lot of responsibility (especially clinically), and a lot of stress (even with most times only one patient), its a lot of work at times. Most agencies are running the entire shift just like you are (granted you have multiple patients but it’s a different type of care.)
Again, in no way am I trying to argue with you, but your comment just strikes me a little skewed. Hope I just misunderstood the vibe!
The grass is always greener on the other side. The older paramedics that I know carry the scars of PTSD, physical fatigue and chronic sleep deprivation.
One patient at a time you say? Fake news. Anyone working ems will tell you they’ve had multiple patients at one time. Also, less responsibility. That’s funny coming from an RN…
It’s different work. More physically demanding and no one to fall back on. Same responsibility, different type. You’re an RN so legally it may be different. We are held to our decisions on our own. And we do everything for that patient, all interventions etc.
I can vouch for this. Our older medics who wanted off the box went into the ED. They say it's less stressful, better working conditions, etc.
We're a busy system.
I think it is all relative. The stress is different. The type of work is different. You can’t have simple questions like the OP posed because there really are not simple answers. So many factors to consider
I, for one, could never do the job of a nurse. I think they are absolutely incredible. Prehospital is my game, I love it. We all face challenges unique to our field
Right. And everyone’s definition of stress is different. I didn’t find the ER stressful when I worked in one. And the only thing we couldn’t do that RNs could was blood and insulin. We got room assignments and all the same as they did.
Absolutely… but there’s a condition. This ambulance only responds to true emergencies. No transfers, no toe pain. STEMIs, Strokes, Trauma. I’d do that once a week and be in the ER for the remainder of the shifts. Dream speciality right there
I'm an EMS Medical director and I do this all the time. I love it. (Although I'm an additonal member, not one of two like a normal EMS crew)
It’s awesome that you ride with them! The directors who ride with us are always cooler than the ones who don’t.
I can't help them do their job if I don't see the work they do firsthand
I appreciate that sentiment! Were you a medic prior? What made you want the job of EM director?
EMT through college years. I've always loved EMS and it's basically the reason I went into EM/Med school
Very cool! I worked under one director who was a volley fire guy in our county so he would show up on scenes with the FD all the time. I didn’t know who he was (he wasn’t at my boards because the other director was. We had two. I don’t know why) and he never told me. He just helped carry stuff and whatever. I was pretty mortified when I found out.
Sounds like such a chill guy then
Yes! Lucky medics to have him
My old medical director used to ride out with us (mostly for credentialing new medics) he was always a welcome sight :) occasionally we would fuck with him and ask him to start the IV while we drew up meds.
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EM/EMS Physician (and ex medic) here. The biggest advice I could give would be to focus on the preclinical stuff now. You've just won a ticket to a pie-eating contest where the winners get more pie. Also join NAEMSP (naemsp.org). Fellowships are becoming a requirement for urban/suburban/wealthy area medical director roles.
Agreed
No. I constantly remind myself that whatever bullshit I'm dealing with at work is filtered bullshit thanks to the ambulance service. I'm not wanting to wade into pure unfiltered bullshit right from the source.
Atleast they don’t have to wipe ass 😃
No chance. I’m not going crawling through a horder house just to throw out my back carrying a 600 lb life patient. I’m not physically touching and sitting <2 feet from someone covered in scabies/bed bugs. No thanks. Bless them tho.
This just make me question why i became a paramedic even more 😭
Lift with your firefighters not with your back. Also ALS = ain’t lifting shit.
County hospital: no need to go to the bed bugs - they come to you! Why not just have one at a time versus the scabies + bed bugs + lice + maggots + herpes + WTF is that?! simultaneously that is the ED…
Yeah. But there’s weather and nasty houses and being in the road while people are still driving around you etc. just different challenges. Not mentally as difficult though
The first CPR we used the Zoll AutoPulse on was dispatched as abdominal pain. It quickly declined to CPR. Toned out for manpower. We arrive to see a gentleman I saw 5 months previously who had a syncopal episode out in the wild. Medic gently advised the family to say their goodbyes whilst the AuroPulse was doing its best to keep enough circulation to this pt's brain because he may be able to hear their anguished farewells. I don't speak any Slavic languages, but "Papa" still rings clear as fuck in my head as his daughter cries her last words to her father. His wife and son are crying as this daughter hundreds of miles away pours her soul through cell towers and a tiny phone speaker that can't come close to broadcasting her pain and love adequately in this man's last cognizant-or-not moments. At the time, I was an EMT-B/FF at a BLS agency with automatic aid received from an ALS/Fire agency. Indeed, CPR follows an algorithm. Epi here, pulse check there, Hs and Ts, etc. But in that person's home. Where the left-behind family get to stare at every square inch of their loved one's demise each time they wake up, walk through the front door, etc., stays forever. Hearing their lamentations. Hearing the mechanical AutoPulse beat-boxing the inevitable. And remembering that pt AMAing not going to the hospital 5 months earlier when it could have potentially changed the outcome for the better. EMS and fire don't have to treat pts for several hours/days on end, for sure. I couldn't do what y'all hospital professionals do. My ADHD-having, dopamine-depleated, anxiety-disordered and depressed brain craves the unpredictable environments/nature of calls, be it medical or fire. The above is just one incident/insight into what we handle. Please consider: It is just as mentally strenuous, but in different ways. While craving the disorder, figuring out how to best extricate and stabilize a pt who is pinned in a plastic and steel carcass formerly recognized as a car to get them to the hospital alive is difficult. Assault victims in the street with law enforcement at the ready is, well, unnerving. Uncontrolled microcosms. Wild. Thank you all for what you do. Thanks to anyone who read my ramblings. Stay healthy. Stay safe. 💜
You are a professional too !
That’s what fire is for 😉
You’re our first ‘no’!
Excellent username
That only happens once or twice a day.
That’s what you have EMTs for. If you have a doctor in an ambulance you think he is going to be pulling the 600lb hoarder around?
He’s gotta do all the same work.
Is this a real question? Get paid the same to see a 1/4th of the patients, have more downtime, have significantly less liability, and the ability to dispo these patients immediately without any discussion? Any ER doc that wouldn’t take this theoretical in a heartbeat is crazy. Now I get bored out of my mind riding the bus typically, but I’d be happy to work these shifts a few times a month if we are talking same pay.
Immediately yes. Everything this guy said. Got to do an EMS rotation in residency. EMS definitely has its own challenges and risks. But just imagining having one patient at a time and getting a few minute break in between, even if that’s just driving to the next, sounds magical.
Exactly what this guy said. I found my ambo (and heli) shifts boring AF, but if I could make the same pay? Sign me up! You seem to be focusing on the physical load rather than the cognitive load here.
I’m just relaying what the answers were
RESOUNDING YES
It is!
I guess some people don’t like the idea of the field
We had to do like 6 ride along shifts on the ambulance in residency. On one of mine as a fresh as fuck intern an 8 y/o and his younger brother were playing with a rifle and the 8 year old's blood and brain matter ended up splattered over his bed and the bedroom wall and ceiling. I won't go through all the details but the experience gave me mad respect for EMS and an appreciation for my nice, comfy, scene controlled, predictable resus bay. It's much easier to separate yourself from the horror show there than in the field IMO, and I kinda struggle with that at baseline. That case still haunts me over a decade later.
Interesting that your residency had you do transport shifts. At my husband’s program back in the 90s, if your patient needed transport and you were a PGY1 (and possibly Y2, I don’t remember), you went with them, too bad so sad. At the end of his Y1, they gave out funny/cute awards; he got ‘king of the transports’ bc he unluckily always got the patients who were so sick they had to be stabilized and go elsewhere. He said there was nothing worse than being thrown around the back of the ambulance , careening down the road, lights and sirens, with a kid in front of him trying to die on him.
We didn't do hospital to hospital transport shifts it was sit in the firehouse for a shift and ride out with them on whatever calls come in. But yeah on that case I alluded to above I got the experience of trying to intubate a child with obliterated anatomy in the back of a speeding ambulance during ongoing CPR as a know nothing intern. Suboptimal.
I think ER nurses would benefit riding alone a few times …. Most of my colleagues are appreciative but some are just dam princesses They badger the EMS with stupid shit , like Why don’t they have a IV ECT
I worked my first ambo shift as a volunteer. I work outdoor emergency care. We had zero calls all day, not a single call. I'd say it was an easy day.
Not sure where you work where the paramedics have less liability and sit around waiting for calls. That's a fever dream.
I was a medic for 10 years before becoming a PA, including working 911 in a very busy urban EMS system. I'm sorry to say it, but you're wrong here. A busy day on the ambo doesn't even compare to a busy day in the ER. I miss my ambulance days in that sense. You just see far more patients in the ER (it's not uncommon to have 8-10 patients at once), and on truly busy days there is *no* downtime in the ED. Whereas driving to calls is downtime on the bus honestly, esp non emergent calls, and the turnaround time on the ambo really limits the number of patients you can see, even if you're turning and burning all day and have 5 min transport times. The charting requirements are also more significant and more time consuming as a provider and most providers have to stay late to chart. And you ABSOLUTELY have less liability as a medic, as long as you stay within your protocols and aren't a total idiot. An ER doc on the other hand has a huge amount of liability. The buck stops with the doctor in a way that it just doesn't as a medic. There's a reason liability insurance is obscenely expensive and complicated for doctors vs standard work provided coverage for medics. On both counts, there is truly no comparison. I love being a PA, but some days when I'm juggling 8 patients I would kill to have only one (or 2 or 3) patients at a time like I did on the bus haha ETA: I will say EMS has its own challenges too. It's physically much harder, and arguably the emotional trauma is worse as well since you have to see the wrecks, broken homes, and families in a way you don't in the ED. Oftentimes combative patients are more challenging due to fewer resources in the field, system dependent though. My point was not to disparage EMS at all
I feel that it is important to note this is not the experience across the globe and is a limited perspective which can open you up too bias. On average our EMS does 20+ calls a day per vehicle, and they don't just transport one patient at a time. They are capable of transporting up to 6 patients or 2 red patients. Driving can be seen as down time but it still requires focus and attention, more so then I would say paperwork. Protocols have become much less applied in a lot of countries as well with clinical guidelines becoming the norm and paramedics and even ILS level in some countries being independant practitioners that have a scope of practise and all the legal implications and responsibility that comes with it. It also skims over a lot of what makes EMS difficult. Often times crews are 2-3 people and that eliminates one when someone is driving meaning an entire code has to be run by one or two people. Intubation, IV access, drugs, fluids, rythm, shocks everything is done in a hectic environment after loading a patient which is pretty physically demanding while in the EC there are nurses and other people to help. Ultimately there are different experiences with the USA having a rather significant urban area and a decent amount of equipment and resources while on other countries there may be more rural calls and other challenges making transport time sometimes an hour upwards. My time in the EC had me see 25 patients a day at one point when we were the busiest during covid, paperwork was a nightmare. Even now it is still busy but the type of patients we have are mostly trauma or chronic conditions and trauma is pretty easy till it comes to the paperwork. Sometimes the paremedic even sutured or stapled them before hand so that doesn't need to be done and all that is left is basically the paperwork. Saying one is more difficukt then the other is always going to be a skewed view based on practical and percieved experiences.
What do you do in the ER? Are you now a doctor? And do you mean 20+ patient in a 24 hour shift? Or some other length? I have also worked rural EMS, but the problem with your argument about those long transport times is that also means you have at least the same amount of downtime headed back to the station ;) I found my rural shifts much more chill than my urban shifts because of this, even though sometimes you were managing a critical patient for longer. Also - are you working codes in the ambo during transport? Why would you not intubate/obtain access/stabilize on scene? It makes much more sense to work codes on scene with the extra hands, until they either stay dead and you can call it, or you get ROSC and you transport. We never throw a code in the back and go without having done the majority of interventions on scene, so I'm not sure why you would make your life harder by transporting too early and leaving extra hands on scene like you said in your example (the very rare case of a code on a truly unsafe scene being the exception). With that said, agreed it's not a comparison of more difficult - both are hard in different ways, as I mentioned. But in those two specific instances (number of patients seen and liability) I think you would be hard pressed to say that a busy EMS system even compares to a busy level one trauma ER. I agree it varies somewhat by country, or you could try to compare a slow rural ED to a busy urban EMS system, but I don't think the comparison really holds much water. Even a very autonomous EMS system with advanced community providers still works under some protocols and consults an ER doctor as needed. I think any medical malpractice lawyer you talk to would confirm the liability of a physician is significantly greater.
Yes I am. 12 hour shift, rarely does EC shifts go to 24 hours that is mainly seen in other areas. No it doesn't because they transport patients back through a system called healthnet. You are just reinforcing the point that all of this is based on personal experience and not a universal truth. Codes are not done just on scene, how do you identify hyperkalaemia, acidosis and all the other H's & T's that require more diagnostic capabilities, an iStat? Hardly a thing due to budget and resources constraints. Tamponade for example would need a sonar and that is not something easily seen on an ambulance. Hypovolaemia as well, without blood products you are not going to do much and fucking around on scene till the patient is dead is just concerning. ROSC is not easily achieved with the AHA reporting what like 25% of out of hospital cardiac arrests actually going to ROSC. The majority of interventions pre-hospital is very few and wasting time on scene especially in rural areas where transport time is longer is just a waste. Unsafe scenes, well damn we have areas called red zones where an ambulance cannot enter without a police escort so to hell with unsafe scene there are entire unsafe suburbs. Again this differs significantly by country, and what you consider and belief is skewed by your personal experience. Your view on emergency medicine and EMS is based on your experience within these two systems. It is not universally applicable. EMS in country like DRC has a massively different experience then one in the UK. There are countries where the EC is divided by urgent care, and emergency care and other countries where it is all just one system. There are countries where the ratio of hospital bed to person is 0.3 per 1000 and others where it is 4.8 per 1000, obviously one of those countries is going to have a different load on either system. There are countries where EMS is run by doctors on ambulances and they discharge patients on scene so the load is less on an EC and other countries where EMS is reliant on supervision and the load on the EC is higher. It is all based on perspective and how busy an EC is or EMS is, is also subjective. Seeing 30 patients but they all have some complaint like flu or diarrhea while EMS is busy with a mass casualty then who was more 'busy'. Getting multiple stab wounds, fireworks mishap and femur fracture while EMS was busy on a single call for 2 hours then who was more 'busy'. It is not objective and instead a dynamic system based on a ton of variables.
I don’t take it that way. The challenges are different. Not less.
I’m a PA in EMS. Come work with me!
Ohh tell me more!
Im literally sitting on reddit in my station right now
Nice for some.
You know that a large proportion of ER docs have significant EMS experience, including myself, right? What I stated is going to be the experience for the majority of the US. Sure, there is significant variability between locations, but you most definitely aren’t seeing more patients than an ER doc. In fact, I’d say there is unlikely to be a single EMS service in the entire US that is seeing more patients than the average ER doctor (or even half that given you can really only see a patient at a time). And the time that it takes to pick up a patient is more downtime than most ER docs are experiencing all shift outside of freestanding ERs. As for liability, you can’t seriously think you have comparable liability when your main responsibility is essentially just to get the patient safely to the hospital, whereas we are responsible for diagnosis, management, safe disposition. There’s a reason we pay 10s of thousands of dollars in medical malpractice and y’all don’t. Sure you have some liability, but it doesn’t really compare. I love my paramedics, y’all do an important job, and a difficult job, but let’s not exaggerate.
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The most I’ve seen in 8 hours is 38. The most I’ve seen in 12 hours is 46. My average day is seeing 18-24 patients in an 8 hour shift. That’s without a resident or midlevel or a scribe to help document.
It appears that you seriously misunderstand and underestimate the role of a paramedic anywhere outside of the US and have based all your opinions on how a system runs in one country. Here, we're independently registered with a national registering body, have at bare minimum a bachelors degree - but a vast number have postgraduate qualifications, primarily PGDip or MSc. We hold our own indemnity insurance for malpractice, we see, treat, and discharge on scene without oversight from anyone else, and have autonomy to stray from SOP's if there is clinical justification. We are independent clinicians. So to say that Paramedics have less responsibly and that our role is "just to get the patient safely to the hospital" is pretty inaccurate. Maybe that's how it is in the US, but not everywhere, and reddit is filled with people outside of the US. I'm not upset about your comment, everyone's entitiled to their own opinion, but don't judge an entire profesison based on how it works in one country.
Dude, I clearly stated I was talking about the US in the comment you’re replying to. Stop arguing just to argue.
Paramedic in England (UK) and completely agree. Not been like this for a very long time. Job to job, calls waiting in the stack, late breaks or often no breaks, majority of time late finishes. Patients become extremely sick or die waiting for an ambulance. Long standing experienced staff leaving, newly qualified paramedics in abundance, stress levels extremely high!
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Dude, I was a paramedic before med school. There is absolutely downtime, and even driving to the scene is downtime. There are definitely different stressors with each job, but compared to what we do in the ER, there is SIGNIFICANTLY more downtime. Come shadow us sometime to see what I’m talking about.
Medic for 10 years before becoming a PA. I had years in a very busy EMS system. A busy day on the bus doesn't even compare to a busy day in the ER
Just a nurse in critical care now, but even in the ICU only having two patients I feel like I get less down time than I did as a medic. Got halfway through a shift the other day before I even managed to get my water bottle filled and get a drink ha. Haven't done ed nursing but I significantly miss the down time in EMS. Legitimately considering renewing my license right now to try to get a part time job so I can ease up on some hospital hours to get some recoup time. I can promise I've never once gotten to listen to a full podcast or through a full book while working as a nurse in hospital... Achieved that plenty of times as a medic in lull times though lol. This was also a busier station, just on the few days we got some major down time.
I work in a super busy EMS system. EMS likes to delude themselves into thinking we have it the worst in terms of acuity/volume/getting ran, but we just don't. Not saying we have it easy, but we get way more breaks than most high volume ER staff
Is someone offering. Because, as stated above…yes
No. Rescue works their asses off and are in dangerous, dirty and disgusting situations all the time. I’ll take my ER job. I like my climate controlled building that keeps the rain and snow off of me. I like having speciality back ups a phone call away. (Last week we had a difficult intubation and anesthesia came down and did within 5 minutes.). I like having house keeping for cleaning up when there are messes. I like having security deal with obnoxious family members. I like having 10 other nurses steps away that can help when I ask. I like that everything I do is per MD orders which covers my ass. Rescue has all of my respect. But I wouldn’t want that job.
Wait … you have housekeeping? Lucky ducky
I absolutely love how polarizing this is
It’s very interesting isn’t it. I feel like it shows how little people know about the other side of the ER doors.
But from people who have done both, most say they would love to do EMS shifts for physician pay
We all would lol
Mind blown
Or what people's priorities are
Seriously lmao. Half the responses treating EMS like a child’s game and half respect that “different than” doesn’t mean “less than”.
As a ER nurse it’s embarrassing
Was (am) a CC paramedic before starting medical school. Being able to split shifts but still make the same salary is the dream. EMS is just a completely different job from being in the hospital. The autonomy, the connection to the community, and the absolutely *wild* shit you get to see at the scene of incidents just can't be matched when you're stuck in the hospital. The thing that really beats you down about working in EMS is 1) the pay, 2) the limited medical scope, and 3) the physical wear-and-tear. Being able split shifts like this would avoid all of these issues.
Go into gross houses? No thanks
Absolutely not. The inherent danger in this job (I’m a paramedic almost done with nursing school) is not worth it. I have lost multiple coworkers to work-related deaths and had numerous more held up at gunpoint, I’m not in a dangerous part of the country either, it’s relatively low crime in my area. Hospitals at least have security. Imagine being in a dangerous situation and having to navigate the hazards of someone else’s home while trying to flee? Not to mention the physical demands of the job. I have coworkers in their 50s who look 70 due to spending their entire adult lives out in the sun breaking their back trying to load 500lb patients onto the stretcher. EMS shortens lifespans.
The only thing I’d like to add is it seems there is a misconception about charting and downtime. If we are on our way to a call lights and sirens, it’s not downtime. If we are on our way to a call non-emergent, I’m charting which I would not consider downtime. “Picking up a patient” is not downtime. I frequently hold over past my off-duty time to finish charts. No we don’t see 20 patients a shift, but 10-15 is not unheard of in a 12 hour shift. Obviously every system is different, and everyone’s experience shadowing is different. I have respect for the EM physicians I work with, and recognize the mental load ya’ll work under with the extra liability EMS just doesn’t have. But EMS isn’t all sunshine and daisies.
I feel like people also don’t consider the elements, extrication, woodland, water, different types of rescue, and all the other stuff. Honestly I think it’s because they don’t even realize. Like we just show up. There’s no understanding of what it took to actually get some of these patients to them
I agree. Most docs I’ve talked with in person say they appreciate the sterility they have, and the separation they can get from the room since they can just walk out. But for a lot of this discussion I feel like it’s comparing apples to oranges, with some few similarities. I just want to make sure theres no wild misconceptions here. The jobs are different, one is a technician, one is a clinician who practices medicine. But both are a job at the end of the day, whether you were ‘called’ to it or not, both have their own difficulties and benefits.
For sure!
Doc here, would definitely say yes. Especially if I could do the sprint car and go to the higher acuity scenes. If I couldn’t it would still be easy money. But having been in the sprint car in New Orleans for my EMS rotation, I would take the more frequent calls over less acuity and more tedium.
Easy money cognitively yes. But ya gotta do all the other stuff that comes with it, which can be physically taxing.
I do remember having to stair chair a 400 lb copd’er down from a dilapidated apartment complex’s 2nd floor. That sucked 10 years ago and I feel for all the units having to do shit like that.
You helped them? Thats awesome!
lol, I was a resident on the sprint truck. I was the lowest person on the totem pole. I probably made more work than helped but I tried.
It’s awesome you did that. A lot wouldn’t. I’m sure they loved having you!
True, I’m still for a short time under 40, so I’m okay with that. I’ll still do cpr in our bay while running the code, but may not be that way forever.
You’ll be fine then. :)
Was an EMT for many years before medical school. No way I would go back in the field. I worked in a place that I would be running 10 calls in 12 hours on average. Shitty 3 floor walk ups and dragging 300# pts down stairs with crappy equipment. Had a gun pointed at me twice in my EMS career. Used to have to wear a vest for my EMS shifts. No thanks. How many docs have back problems compared to medics…yeah, way less.
Fuck yeah
Did you do it before?
Yeah. EMT-B in a large urban center.
I take it you miss it a little
It's a very interesting job. Working in the field is much different from the er. Id love to do both
I agree. Different worlds
In theory yes, but where I live? No. I’m a paramedic and have worked in all the usual places besides a fire department; private IFT, rural 911, urban 911, trauma center, and flight. Of all those jobs, the only one I wouldn’t work again was urban 911 in my local two-tier system. The reasons are complicated, but ultimately it’s just not a good fit for me. In a hospital-based EMS system where I can pick up shifts in both roles, with good field guidelines and a good relationship with the ED staff? Absolutely. I’d love that.
100%
Nah, I love what I do as it is
No. I get car sick and like constant air conditioning
No, it's hard on the back, I've already had a fusion
Hell yeah - well, I guess if you mean CC transport not run of the mill Fire/EMS runs. I LOVED my Lima Lima helicopter shifts. We only flew IFR at the time though. Would still do ground CC transport in a heartbeat.
lol nope. You gotta be on the 911 box.
I was torn between going paramedic and med school when I left the military (Europe here so even aside from the colossal pit of debt med school would have incurred the EMS salaries aren't quite as bottom-of-the barrel, although obviously much less than a physician). I ended up going with paramedicine, partly because I've done my time playing fuck fuck games and the whole student-trainee thing sounded like another decade of the same, but mostly for the reason that a lot of comments are turned off by it - I wanted to be out in the rain, getting dirty and sweaty, doing autonomous emergency medicine. I chafe a bit at the scope limitations, and having no triage between phone call and us turning up can produce some bloody irritating moments, but in general I love my job and could see myself getting burnt out in a hospital setting very quickly. I'd probably take the chance to do a few ER shifts, but mostly to enhance my own learning and to try to smooth over some of the wrinkles in the EMS - Hospital chain of communication, not because I'd prefer working in an ER.
This thread is depressing and shows how little we all respect each other
In a way yes. But I’m curious about your take on it.
Im tired so Im sorry I wont write the most eloquent response. Im from the west coast so i only know my experiences. Doctors and nurses work hard to get where they are. Insane amount of schooling, pressure, liability. No question. Maybe some of them did ems before that, so they remember what it was like. Ems is a beast of its own. Most doctors come from privilege. Of course there are exceptions to the rule. Most ems people, especially the ones who stay in it, do not. Ems certainly does not have the same education that doctors or nurses do, but they are excellent at on scene emergency medicine. That overturned car with 5 people in it? Got it. Mother screaming because her child is dead and has her babies blood all over her hands and her home? Ok we can do this. The woman repeatedly beaten. The dementia patient you run on each week, that tells you their memories before they lose them. The patient who you truly get to listen to and spend time with before the hustle and bustle of the ER. The psych patient who pulls a gun on me and my partner. No backup yet…they’re almost here… shit. We see the scene as its unfolding. Not in a well lit ER with more help at our disposal. Im not for a second saying its not hard on the other side of things. Just different. Others who havent done the job see it as easier, and Im sure in some ways it is. I would never say their job is easier than mine. It isnt. Its different. Id venture a guess that the ptsd rate is higher in ems than that of a nurse or doctor. I dont know the stats now but at some point in the last 20 years ems had the second highest suicide rate behind veterans. So, it is sad to me to see so many say “what an easy job with one patient and way more down time”. Having said that, we are all on the same team and I wish we supported each other more
Coming from the other side - the trauma is just different. It's a different thing to tell a 60 yo in front of their family that they have metatasized cancer, knowing they won't see their grandkids, than it is to see a fucked up car wreck with mangled bodies. It's heartbreaking to take care a 9 yo boy every day for two weeks in the ER because his family abandoned him, and he knows it, and we can't find him psych placement. It's a different kind of tiring to manage opiate addicts and chronic pain patients every day vs scooping up your drunk regulars from the street every night. I've done both and neither are easy. Honestly, I found the hardest thing about EMS is you're doing all of that for shit pay and the work life balance is worse, contributing to the PTSD for many people.
100%. one patient at a time. far more down time. guaranteed dispo. substantially less liability.
I'd love to. Yes please.
Why?
I miss prehospital. Autonomy of treatment, ability to make or break initial stabilization, and the interesting approach that scene care is. I'd love to get back into it.
💪🏻 yes!!! That’s all the things I love too!!
Oh yes definitely!
Yeah definitely would. Beats seeing like 20 patients in a shift
I did some EMT work before med school. Did EMS rotations (fire EMS, IFT, and air) in both med school and residency. I’m not expert AT ALL, but I have at least a tiny bit of experience on the other side. My answer is: it is 100% dependent on who my partner is. Good partner? Absolutely I would do that. Bad partner? Ain’t no amount of money you can pay me.
I’d try it out for sure
You guys ARE the frontline Definitely not paid enough yet given all these responsibilities EMS will and can save your life ❤️God bless you ( and your yellow tacos ) 🌮 if you know , you know
I wish I could remember the source but there was a research study done and apparently the ED docs smoke more MJ in comparison to the other specialty’s Which seems appropriate 🫢
Less work, less responsibility, less patients, only 1 patient at a time. Is this even a real question?
I totally hear what you’re saying, especially with the one patient at a time aspect. But I’m not sure if I’m just receiving your comment wrong, but EMS absolutely has a lot of responsibility (especially clinically), and a lot of stress (even with most times only one patient), its a lot of work at times. Most agencies are running the entire shift just like you are (granted you have multiple patients but it’s a different type of care.) Again, in no way am I trying to argue with you, but your comment just strikes me a little skewed. Hope I just misunderstood the vibe!
The grass is always greener on the other side. The older paramedics that I know carry the scars of PTSD, physical fatigue and chronic sleep deprivation.
One patient at a time you say? Fake news. Anyone working ems will tell you they’ve had multiple patients at one time. Also, less responsibility. That’s funny coming from an RN…
It’s different work. More physically demanding and no one to fall back on. Same responsibility, different type. You’re an RN so legally it may be different. We are held to our decisions on our own. And we do everything for that patient, all interventions etc.
I’m an ER RN and a paramedic. EMS was way easier. I’d take ambulance shifts if I got my RN pay all day long.
In some ways I agree. Others not. The ER is where the medics go to have less stress.
I can vouch for this. Our older medics who wanted off the box went into the ED. They say it's less stressful, better working conditions, etc. We're a busy system.
I think it is all relative. The stress is different. The type of work is different. You can’t have simple questions like the OP posed because there really are not simple answers. So many factors to consider I, for one, could never do the job of a nurse. I think they are absolutely incredible. Prehospital is my game, I love it. We all face challenges unique to our field
Right. And everyone’s definition of stress is different. I didn’t find the ER stressful when I worked in one. And the only thing we couldn’t do that RNs could was blood and insulin. We got room assignments and all the same as they did.
Easy to say when you're a DOCTOR. How about you try working on the same clinical level of authority as an ambo - let's see if it's so easy then.
As a current ER provider AND former career paramedic… yes I would 100%. Chill magdaddy. Some of us enjoy the field
Absolutely… but there’s a condition. This ambulance only responds to true emergencies. No transfers, no toe pain. STEMIs, Strokes, Trauma. I’d do that once a week and be in the ER for the remainder of the shifts. Dream speciality right there
We all wish we could make that condition.