I’ve run my last EMS call.

For a while, at least. A good, long while. I can’t say when, if ever, I will put on a uniform shirt again. I’m not sure that I will ever call in service again, or ever step into an ambulance again.

I just can’t take it any more. I’m done.

I’m tired of the continued incompetence of my coworkers and colleagues.

I’m tired of having to follow protocols that are written for the lowest common denominator.

I’m tired of stupid policies written by people who have never worked on an ambulance, and policies enforced selectively and for no good reason.

I’m tired of being criticized by management with less experience, and a lower level of certification than myself.

I’m tired of my fellow paramedics harming patients and not facing repercussions, simply because “they show up on time.”

I’m tired of shaking my head every time I hear a new story about a new screw up.

Pronouncing people dead without touching them. Defibrillating (repeatedly) a patient in a paced rhythm who is conscious. Giving adenosine to a patient having a STEMI because the paramedic thought atrial fibrillation in the 130s was causing the problem. Giving solu-medrol to patients with pneumonia, and albuterol to patients in CHF. Giving mag sulfate to a dialysis patient having a mild asthma attack. Refusing to honor a valid, presented DNR in the presence of a family because “I think I can save him.”

I’m just so damned tired.

I love my job, I love my patients (mostly), and I love my partner. But I can’t do this any more.

I realize that these problems may be specific to my service, but I really don’t think they are. Can you honestly say that your ambulance service has none of these problems? Your service doesn’t have incompetent management or incompetent field crews?

If your service is really different from mine, are you hiring?

Right now, I’m taking at least a six-week break. I wonder if I’ll miss it.


  1. I sent this to my family and said “if u didn’t know any better you would have thought I wrote this”

    We must work at the exact same service b

  2. Come out to Australia. Although our system isnt perfect it sounds a heap better than what you are experiencing. We have “guidelines ” not protocols which can be adjusted to suit the patients needs. There is an expectation of professionalism and clinical competence. The focus is what is in the best interest of the patient. We are actively reducing the number of unnecessary lights/sirens response. Those who don’t maintain the standard are provided assistance to improve and if that doesn’t work are dismissed. After 25 years a paramedic, the last 20 on the intensive care cars and trucks I still love my job and look forward to going to work each day.

    • I’d love to move to Australia. I even have family in Perth. But it is literally halfway around the world. I probably couldn’t convince my family to move to Australia.

      But…how could a Paramedic in the States transfer to Australia? Would the country recognize my certifications?

  3. Flash Larry says:

    I don’t know at what point I learned not to care. Just not to care. I think perhaps it’s because I’m old, and I am…I have a Medicare card but I still work on the ambulance, not in management.

    It’s the not caring that I think has helped me go on. Except, I do care. I do care that day after day after day after day I come in to the same things. I care that my company has as of this month foregone any skills and written pre-hire testing – why I don’t know except what they say, “We’re afraid of being sued for discrimination.” Is it really that or is it that they need warm bodies they can’t find because the schools are putting out incompetents that have learned to game the testing.

    But I keep forcing the caring down – I just run my calls, manage when we don’t have drugs, manage when the equipment doesn’t work, manage when they send us on calls with 35 minute response times.

    Manage when they send you to the wrong location for a call – the wrong city for God’s sakes.

    I guess I work hard at not caring and just walk away from it and I guess I don’t really care about the sorry management – and CCC is right about that – because I am able, at my age, just to finally walk out and say “enough,” and just retire.

    I just throw up my hands and do what I do. It’s sad because I’m good at this, really good at it. Just like CCC who is the person I would most want to see coming my way if I needed help or my family did.

    I don’t know… it’s been a bad day today, but the strange thing is, it’s nothing unusual, it’s just the way it is every day but more so today I guess.

    So I’m in a mood. I recently saw someone write, “I’ve seen the future of EMS and we’re doomed.” If only it were true… but it isn’t. Incompetence on top of incompetence doesn’t mean we’re doomed, it means that EMS as we have known it is doomed – but EMS will go on. As a friend said once, “A big dashboard with nothing under the hood.”

    After hearing a story tonight my son texted me and said, “Isn’t it encouraging to know that our emergency medical care is in the hands of morons?”

    Not encouraging at all.

  4. I arrived at CCC following a search for “play the ball as it lies,” and read your post from four years ago by the same phrase:

    I’ve been browsing here since. Even tho I’m not a professional in your field, I can hear and understand and even feel much of what has led to this April 2016 post.

    We don’t know each other, but I hope a few things for you:

    — that the principle of playing the ball as it lies fully reveals or renews itself to and with you. A friend, a golfer, shared this line with me (non-golfer) this morning to help me work thru a challenge, to have a look at something, and to maybe know and speak my mind a little more clearly.

    — that you don’t give up your blog. Clearly, you’re not alone. The world needs us to be part of the solution, as we’re able.

    — that you’re able to fully recover. Burnout, while an incredible gift (along the lines of Dr. Gabor Mate’s book “When The Body Says No”), is a serious deal and needs massive doses of TLC from and for ourselves.

    Good luck. I’m glad you were here to be found today.

  5. I felt the same way as you. I worked for a private, for-profit ambulance service, and this was their MO. Then I left and worked for a municipal third service.

    It’s like night and day.

    I’ve read other posts/comments regarding this, and I’m sure many will not agree with me.

    But don’t take my word for it, the facts speak for themselves. Just look at the top services in the country:

    Austin-Travis County EMS
    Medic One King County
    Boston EMS
    Denver Health Paramedic Service
    Baton Rouge EMS
    New Orleans EMS
    Ada County Paramedics

    While one of these has a FD component, none of them are private, for-profit agencies. They also have waiting lists to be hired and very high retention and employee satisfaction rates, as well as some of the most advanced protocols in the country. None of them are perfect, and all of them have their own problems. None of those problems are related to patient care or provider quality.

    While some municipal EMS services are struggling, the VAST majority of them are fire-based. More importantly, based with FD’s that are dedicated to inflating their run statistics to justify staffing levels, not dedicated to providing quality EMS.

    But, then again, maybe it’s just time to move on. I’ve known a lot of people who were great providers that were much happier after they left EMS.

    Either way: Good luck, so long, and thanks for all the fish.

    • Cat Briggs says:

      I can corroborate the listing of Ada County Paramedics here in Boise, Idaho. They are amazing. After being called out to the house numerous times (mostly unnecessary) by a mentally challenged caretaker, my elderly Dad still received consistent, compassionate respect and expert help from Ada County Paramedics, and the Boise Fire Dept. Fire Fighters from Stations 4 and 10. They also were incredibly kind to us, the family, living through a difficult situation. It made no difference to them whether or not the call was valid. They were there to help. I was impressed by how they systematically and carefully evaluated each circumstance and those which needed higher care. At one point, they correctly diagnosed a cerebellar stroke (not easy, as it doesn’t present typical stroke symptoms) during emergency transport and diverted to a different hospital which specialized in neurological care. At that hospital, the intern failed to pick up on it and sent him home. I trusted the paramedics more than the hospital. I took him to another hospital and they correctly found the stroke. He lived another 7 years in fairly good health, thanks to Ada County Paramedics.

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