Maybe it is time for something new

I had a visit from my (former) partner Slimm the other day. He said he had a day off, and he wanted to take the trek up to my neck of the woods. I’ll always take an excuse to see my buddy, and our kids play well together. So the ladies and children went to the playground and did what kids and mothers do at the playground.

Slimm and I sat down in my living room and had a drink, and I told him that I have been thinking that I am done with EMS. “Why?” was his question, followed by “what are you going to do next?”

A good question, without much of an answer.

I’ve given this EMS thing sixteen, almost seventeen years of my life. That’s quite a long time for someone my age, and longer than many people I work with. I certainly have more years in EMS than any coworkers my age. I started in EMS in high school, after all.

It’s been a good ride, but I really think it is over.

Over the next few hours or so, we discussed our futures, specifically mine. Mostly we discussed how I came to this realization that EMS wasn’t for me any more.

“But you’re a good paramedic” is one argument I heard. But it isn’t about being good. It’s more about being happy.

I can’t point to a single occurrence, but more of a sequence of events. Kind of like when you know a relationship with a girl is going nowhere. You try, but she isn’t interested any longer.

When I first started at Local Ambulance, people listened. Management was interested. They were excited to hear my ideas, my personal and professional goals, and we worked together to accomplish some of them.

But lately that’s changed.

Over the past several years, I’ve had many meetings with members of senior management or administration. I’ve brought dozens of ideas to them, from how to improve and establish a critical care program, to courses we could offer for continuing education, to beginning a community paramedic program. Each time I’ve been fed like a puppy on a leash, and then let go. Some of my ideas have been implemented, but have all failed. Maybe it is because I wasn’t a part of the implementation, and maybe not.

Maybe I’m just tired and in a rut. I’ve spent a long time focusing on other, different projects within EMS, and maybe I need to focus on just being a paramedic for a little while.


Part of me feels bitter, and I think it is rightfully so. I really don’t know if every service would be the same, but I can’t think that they would be.

Maybe I’ve reached a pinnacle of progression in EMS, and there simply isn’t any more room to go up. Maybe there is more room for growth, but not where I am now.

I like being a paramedic, but at the same time, I don’t like being a paramedic anymore. This is really a strange situation I find myself in.

Slimm thinks I should stick it out some more. He tells me that the grass isn’t always greener on the other side.

“It is if they fertilize it properly.”


  1. Well, this might be a shocker to some, but you’ve got me almost at a loss for words. Was reading this, and damn if it wasn’t like I’d written this. The similarities are downright creepy to say the least. I completely understand where you’re coming from.

    There’s the biggest problem. So much good in this line of work, but so much that is wrong and those in charge don’t want to fix it, even when they take the time to identify a problem and publicly announce there is a problem, and that they won’t be doing anything to fix it.

    I don’t think another fenced in yard is going to be significantly better either, but then the questions begs itself.

    What next?

    When I figure that out I’ll make sure to let you know.

  2. Too bad. Besides the tough personal issues for you to work out, I’ll miss one of the more amusing EMS blogs out there…

    Good luck figuring it all out!

  3. Been there, too. In fact, I jumped ship 6 years ago, and have struggled with what’s next, since. I did take a job with a wilderness/remote medical group, traveled with them, and had fun. However, it was a 6 month deployment, and I was mentally and emotionally drained afterwards. But, it was different, a lot different, with different issues, problems, people, constraints and terrain. Just a thought, if you still like being a medic. This summer, I am working on a chartered fish cruise in AK. Here’s to looking to the future. You are not alone. Stay safe, and take care. Peace.

  4. Tough reading that. Been there. I used to work as an inner city paramedic. I loved being a medic and was pretty good, but after several years I got really bored with it all. Even shootings didn’t really excite me much and the most of the calls were bullshit. I saved myself by doing two things; I started exercising and I went back to school. The exercising helped my body deal with the chemicals induced by stress and the schooling gave me a purpose and a focus. For exercise I just ran, that’s all. Not marathons or anything serious, just a couple miles twice a week. For school I went to get a management degree so I could become a supervisor and show these idiots how it should be done. It worked. I got my MBA and I’m now the boss in a sweet EMS agency and couldn’t be happier.

    Once I moved to the dark side (management) I found I could have a broad and positive effect on the newer people and it was very satisfying. They really respected and looked up to me. I kinda dug that. Anyway, sorry to hear your troubles. Take control of your life or life will take control of you and before you know it you’re 45 and stuck because you make too much money to go anyplace else. Good luck and I hope you keep writing.

  5. Lots of opportunities to be in EMS without being on the ambulance…management, education, product training, sales, writing, etc.

  6. wow – am so sorry about the burned stuff. 🙁
    in a way I get it… I have been in the same field for 30+ years now (piano tuning –a very different field ) & am just now beginning to get a wee bit bored. I never, ever, thought that would happen! [facepalm] cripes, what to do??? with a shop & all those tools…. can’t move (hubby refuses)….
    But at the same time that boredom began to set in, my husband was settled quite well in his 2nd (or 3rd?) career, the kids are grown & gone, & i finally have a chance to do what I want… and what I want to do is, take care of people. I fell into the first responder course kinda on a lark, LOVED it totally, & then tried the EMT course… am hoping to pass that soon & (crossing fingers) maybe get to serve somewhere. I’m in a rural area so most services are BLS & volunteer. I got to serve 5 months on a teensy town service (under 300 people, but 2 ambulances!) & I loved it. Had to step down ’cause the others — who of course had moire seniority — needed more hours. Bummer. I was so lost, so rudderless…
    So I am really sad you feel burned out !!!!!
    would you be a mentor to us newbies?? would you tutor people like me who are absolutely brand-new to this (regardless of age) ? maybe you can teach! My instructor is way too over-committed, we are basically teaching ourselves out of the book with occassional words of advice from the prof. 🙁 NOT how I want to be. I want to be top dog at what I do. I’m a top-notch tuner, & I want to be a top-notch EMT. It’s hard to teach yourself something; you’re never quite sure you have it right….
    could you be an advisor to TV /movies? They need someone who knows the way it is. How about summer camps? Cruises? short-term missions trips? (need not be religious)
    I sorta wish you’d tackle the used ambulance industry, & make rigs really safe to drive for a change — check out the European ambulances, eh ? Become a lobbyist & get laws passed that would benefit us… collect out-dated stuff from services & pass on the good stuff to missions or inner-city free clinics or reservations.
    You are a walking, living well of knowledge & better yet, experience; OH how i wish I could pick your brain! Come live at my house for 2 weeks & tell me your stories. I’ll host my EMT classmates in the evenings, you’ll have an audience that appreciates you & needs what you’ve got.
    Shoot, man —- you’re needed. If you’re not appreciated where you are, go elsewhere – but don’t disappear. Please.

  7. Flash Larry says:

    I’ve been thinking about this one since you first posted it but I didn’t want to respond until I had time to think about it.

    As you know, I’m on the downhill side of 40 years being in EMS. For me, it’s never been the patients that were the problem. I’ve always accepted the fact that we’re not really needed for 95% of what we do – except to provide a ride or perhaps a more comfortable ride than they patient might otherwise have had. As far as “saving lives,” I’m aware that we don’t really save many lives, though the ones that I have truly saved are memories that I treasure. There are different kinds of needs in the lives of people and we are there to meet those needs. They’re just not necessarily the needs that we were told that we’d be meeting when we started all this and when we were in school. In a very real way, it’s not the job that we thought it would be.

    For the most part, I’m comfortable with that, though the nature of “patient care” is changing radically in many respects. One of them is the “demand” and “customer” process. By “demand,” I mean that there are many patients now who consider us their servants to do whatever they want. They aren’t really sick enough for an ambulance but they know that we’ll transport them and insurance will pay for it or they won’t pay the bill anyway so they call. When we arrive, the entire call is, “I need you to do this,” “I need you to do that,” as if we have become a personal servant. By “customer,” I mean the position of the ambulance company that all these people are “customers,” and that they expect us to please the customer. The worst offense is not poor patient care, poor attendance, poor attitude, poor compliance, but annoying any person, or even worse, any facility where it might affect business.

    Here’s how all that comes together: bariatric patients. I’m not going to get into a debate here over the “disabled” and “medical issues” of bariatric conditions. Most of the people I see are just people who stuffed themselves until they got fatter and fatter, ended up becoming progressively limited and disabled and finally unable to care for themselves. Their condition is their own fault, created by their own acts over decades of poor health behaviors. But now that the patient weighs 450 lbs. and bedridden, they are no longer able to accept the fact that they cannot keep on living as they have lived. They insist on being in their bed in a back bedroom of the house where the bariatric stretcher won’t fit and they expect is to maneuver them in various ways to where they can be placed on the stretcher. Dealing with then is a matter of continuing demands and continuing complaining throughout the entire encounter. But, you can’t upset them because Medicare pays $1500 for a two way trip they tell me. So we’re stuck with these people going to dialysis and doctor’s appointments.

    And that brings me to the second issue today and that’s the management of EMS, which is almost uniformly poor and unrealistic. Take these bariatric calls. Let’s see what we can do to avoid having to send two units to these calls. “The patient has a Hoyer lift.” Except the Hoyer lift doesn’t lift the patient high enough to go on the stretcher at the position at which it will roll into the ambulance. And the bariatric stretchers are not electric, so one person has to lift the carriage while the other has to lift the stretcher into the ambulance alone. Impossible. But they try to assert that it can be done. This is just an example but you, CCC, provide another one. I’ve been in this business, as I said, for over 35 years. I have a college degree. I have been an instructor in everything that it’s possible to instruct (though I don’t do it now). Since I don’t want to be in management (that’s a different discussion), I’m on the street, but do any of these managers that come and go in here ever sit down and get my perspective based on my experience. It’s never happened in the past 20 years. They care about one thing and one thing only, and that’s the bottom line. As they told us when they bought out our local service, “The bottom line is the bottom line.” They’ve proven that to be absolutely true.

    I could go on and on. Supply issues, the schedule nightmare, ambulance maintenance.

    Oh, there’s this one. In a nearby service, they have a “one hour” limit on all calls. No excuses are accepted for taking over one hour to run an emergency call. There is no leniency. Time to call, time on scene, time of transport, time waiting in the ER: the total can’t be more than one hour or the crew is penalized.

    And then there are the hospitals (and other facilities) with just plain nasty people. One hospital in my service area with a charge nurse who is just plain ugly to everyone. Refuses patients (with her, “we’re on diversion” is her response 80% of the time), literally yells at EMS personnel in the ER. But we’re proscribed from responding at all. Why? The ER is a potential “customer.” So there’s that abuse.

    The point is, CCC, “I like being a paramedic, but at the same time, I don’t like being a paramedic anymore,” is a sentiment that I can completely understand. Since I’m in the partially-retired phase of my career, I am not faced with it all the time and I know I can walk away when I’m ready. That freedom means a lot, though I would certainly look at doing something else if it emerged and worked for me, I doubt it ever will because no matter how good you are, you get old enough and management is looking for someone younger they can hang out and party with. You, CCC, on the other hand, are not in the “retirement” block and so you’re in a sense trapped in it, unless you walk away into something else.

    I think it’s not that you don’t like to be a paramedic. You don’t like having to deal with all the foolishness that surrounds the front-line provider in the world of what is called paramedicine. And, of course, in a real sense, you are being wasted in the position that you’re in because your knowledge, background and intelligence should qualify you for something more. And that goes unappreciated every day, while people who are less intelligent, less perceptive, less creative and therefore less trouble rise higher and higher.

    I’m not one of those who would try to convince you to stay where you are. Only one or two of the best of the best that I’ve known have continued at the provider level or further than a low level of management. Some have been corrupted by being raised to higher administrative levels and sold out to “they system.” The best are no longer in the business.

    You said that the issue is not whether or not you’re “good” at it, but whether you’re “happy” doing it. That’s important – very important.

    I wish you well, and I hope that you find a place where you can be happy and make the kind of contribution that you are equipped to make. It will be a loss for pre-hospital care if it’s not somewhere in that arena.

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