So You Want My Job: EMT

by Brett & Kate McKay on March 11, 2010 · 31 comments

in So You Want My Job

Once again we return to our So You Want My Job series, in which we interview men who are employed in desirable jobs and ask them about the reality of their work and for advice on how men can live their dream.

Today we hear from Nate Dionne, an EMT who works for the busiest EMS system in South Carolina. He gives us a look at the job of our vital first responders.

1. Tell us a little about yourself (Where are you from? How old are you? Where did you go to school? Describe your job and how long you’ve been at it, etc).

I am 21 years old and originally from New Hampshire, although I now live and work in South Carolina. I began as a volunteer EMT-Basic in NH and moved to a busier system for the experience. I have been an EMT for over 3 years now. I now work for the largest and busiest system in South Carolina. In a nutshell, EMT’s treat the sick and wounded. This can range from “Oh my leg’s hurt for 3 weeks and I’m out of pain meds” to heart attacks, to mass casualty incidents where hundreds of people can be involved.

2. Why did you want to become an EMT? When did you know it was what you wanted to do?

I began as a volunteer firefighter, and began volunteering for my town’s ambulance as well. I enjoyed volunteering because I felt like I was part of something bigger than myself, something important, and because I was giving back to my hometown. I liked being both a firefighter and EMT, but soon I began to love EMS. I thought that doing it for free was nice, but getting paid to do it would be even better. I feel fortunate that I found a career I love while I was so young.

3. Is there a hierarchy in your job? Can you move up to different positions and what are those positions?

There are 3 different levels of EMT, Basic, Intermediate and Paramedic. EMT-Basics can take vitals, splint broken bones, bandage wounds, and administer oxygen. At the EMT-Intermediate level, you can do all of that plus start IV’s, administer fluids, and medicine to help diabetics whose blood sugar dropped too low. Some Intermediates are allowed to push certain cardiac medications and defibrillate (shock the heart). EMT-Paramedics do all of that, plus intubate (place a tube in the trachea to secure an airway), push more medications than I can possibly list, use a cardiac monitor to determine a heart rhythm and treat accordingly, and so on. With higher certification levels come more capabilities, and more responsibility.

There is usually room for advancement. There is always a rank structure which mirrors that in any other line of work. Your supervisors may be called a manager or simply supervisor or have a rank. We follow a somewhat military structure; we have 3 sergeants under a lieutenant for each shift.

4. If a man wishes to become an EMT, how should he best prepare? What is the training for EMT’s like? Do you need a degree? Are there special schools or EMT programs within a school?

Usually technical colleges are the places to find paramedic programs, where you can get all of your classes, from EMT-Basic to Paramedic. There are often EMT classes available through local EMS services or agencies. Technical colleges offer an associates degree in Emergency Medical Technology along with your Paramedic certification. Having a degree often means more pay from the start (at my service having a degree gets you an extra 5%, but it varies.) The training ranges from a couple of months (EMT-B and EMT-I) to about 2 years (EMT-B through Paramedic.) I am currently an EMT-I, and when I go back to school for my Paramedic certification, I face another year of classes.

5. Once you obtain the proper training, how do you go about finding a job?

Many services post on job-finding websites. Or look on the website of the service you’re interested in. I found out my service was hiring by word of mouth. But if you look, they’re not hard to find.

6. What’s the job market like for EMT’s? How hard/easy is it to land a job?

I’ll begin by saying there is a shortage of Paramedics in almost every part of the country. With many 911 services, they are looking for Paramedics, so it may be harder to find a job as an EMT-B or I. There are private services all over the country. Private services do non-emergent work, meaning they take elderly or chronically ill patients to doctors appointments, dialysis etc. Some private services have contracts with municipalities or other local governments to run their 911 response as well. Many towns have their own ambulance; sometimes the fire department and EMS are one in the same. Others are called “3rd service,” which is what I work for. We are owned and operated by the county, as opposed to a town or a private service. Jobs are often very competitive, especially with high-profile services. If you’re looking to make lots of money, you’re looking at the wrong profession. Most EMT’s don’t get paid well at all. Paramedics can make decent money, but it depends on where you work and your years of experience. Many EMT’s and Paramedics work two (or more) jobs.

7. What’s the retention rate like for your job? What qualities do EMT’s have that stick with the job and excel at it?

Many EMT’s and Paramedics work for the same systems their whole careers. Others jump around a lot before they settle down. Working in an emergent (911) system is pretty much recession-proof, especially when you work for a municipality or other government-type. You have to be in decent physical shape, as you need to lift patients, carry heavy equipment up flights of stairs or over long distances. To be a successful EMT you need to very dedicated to your profession; medicine is an ever-changing field, and it takes a lot of work to keep up with new equipment and techniques. People call EMS when they are gravely ill or injured, so compassion and understanding are big parts of what we do. You must be able to keep cool under pressure; remember, you are walking towards chaos while everyone else is running away.

8. There are other public service jobs that are somewhat related to your field of work-nurse, firefighter, police officer. What makes a man choose to become an EMT over other options?

Where I’m from, being a firefighter and an EMT or Paramedic are often one and the same. I would like to eventually move home and be a FF/EMT, but I need experience first. In systems where the two are separate, many people choose EMS over police or fire because, quite frankly, we make more money. In most systems, Paramedics make more than police officers or firefighters. Nurses make more money than Paramedics, but many of us stay in EMS because we enjoy being in the field, rather than the hospital. We are the first responders, the first on the scene. We treat and stabilize patients, then deliver them to the ER doctors and nurses.

9. What is the best part of your job?

The satisfaction of helping someone. To be honest, it’s not like TV, where we save a life every day. The calls where you make a difference between life and death are few and far between. But when you do, it is a wonderful feeling. It feels like your whole career is worth that one save.

10. What is the worst part of your job?

The abuse of the system. People call 911 all the time for things that do not require an ambulance. Some are lonely older folks who have no one to check on them, others are drug-seekers looking for pain meds. People sometimes use the ER as their primary means of medical care because they don’t have insurance. It puts pressure on the system, and keeps resources busy when they could be helping somebody who needs it.

11. What’s the work/family/life balance like?

Long, weird hours and low pay can have an impact on your family. I work two jobs, and therefore have an aggravated girlfriend waiting for me to get a day off. If you get into EMS after you’ve already been married, the divorce rate is very high. The key is having a spouse or significant other that understands your love of the job and your commitment to it. If you have a supportive family, you will be able to maintain a harmonious balance between work and home. Also, there is a camaraderie among EMT’s and Paramedics that is rarely found in any other profession. I have made some great friends here that I know I’ll keep for life.

12. What is the biggest misconception people have about your job?

We are not ambulance drivers. We find that term offensive. It implies we have no more training than Drivers Ed. We have trained long and hard to get to where we are. We don’t just get to drive the woo-woo truck really fast.

13. Any other advice, tips, or anecdotes you’d like to share?

In all my rambling on in this article, I may have made this job seem very hard. It is. It can be very hard. But it is also the most rewarding job in the world. I cannot imagine doing anything else with my life. My advice would be to see if you can ride along with your local service before applying to paramedic school. Chances are you know an EMT or Paramedic, or know someone who does. Talk to them about who they are and what they do.

{ 31 comments… read them below or add one }

1 Bruce March 11, 2010 at 2:53 pm

(lokg time lurker, first time poster)

As the kid of a Paramedic I understand were this post is comming from. Yes the hours are long (longer if you are in a small town) with low pay. But the rewards that my mom would get for every bad call were great, such as saving someone in dire need or helping a expecting mother get to the hospital. These men and women do not get the smount of respect the deserve, so if you know a EMT or Paramedic, tell them they are doing a great job.

2 Joe Lowry March 11, 2010 at 3:14 pm

I want to work where he does. In 95% of America, EMTs and Paramedics are paid much less than police officers and firefighters. The average pay of a firefighter with 3 years on the job in N.C. is $38,537. The average pay of a police officer with 3 years on the job in N.C. is $38,303. The average pay of an EMT-Intermediate with 3 years on the job is $34,078. (Source: http://www.payscale.com) And while this represents North Carolina, it is not much different in other places throughout the United States.

3 Seth March 11, 2010 at 3:25 pm

Joe, he said Paramedics make more than firefighters, not EMT’s. Paramedics make more than EMT’s. Check out this pay scale:

http://www.payscale.com/research/US/Job=Paramedic/Salary

4 Brew March 11, 2010 at 4:58 pm

Ryan,
I’ve recently interviewed six private-service EMT-basics and paramedics (with 2-14 years experience each) to see if I want to enter the field. This guy says the same things I’ve heard from each of them. Direct quotes:
——————–
“This ain’t a job. It’s a lifestyle.”
——————–
“We don’t get paid *$&%, but none of us do it for pay. I do it as an adrenaline junkie. You gotta work with multiple EMS services, have another job, or have a spouse working to get by with it.”
——————–
“It’s really tough on your marriage. Speaking of which, this girl [pointing at another paramedic] is my second wife. My wife at home knows that we’re a family here. We know each other like family. We rely on each other like family. Hell, we fight the same. But we can depend on each other.”
——————–
“We’re taxi drivers in most cases, but the 2% of calls that we save lives makes all the whole career worth it.”

So Ryan, help me out. How’s your experience different? I’m considering this field as a career and I could use the advice.

5 Robert Nartov March 11, 2010 at 5:01 pm

I don’t know if it’s just your state or what but here in Texas EMT-Intermediates can intubate. It’s also in the NREMT curriculum. Is it both South Carolina and New Hampshire that operate this way or just one of them?

I think it should be noted that EMT is acquired through state certification even though there is a recognized national curriculum. Some states function differently, requiring 2 years of experience as an EMT-B before moving on to paramedic. EMT-I is getting phased out in some states.

Low pay? It’s a working class job nonetheless but it’s been good money to me. Some simple lateral movement will get a lot better money (example: oil rigs or contract work). And long hours? Maybe if you work 2 jobs. Yeah sure you do 24 hour shifts, maybe 48s, but 3 shifts puts you overtime. The crazy services that run nonstop do 12 hour shifts but they’re worth it in every way. I like working 3 or 2 days a week. I usually get jealous looks.

And I will note there is a high turnover rate between some unsettling calls, high stress situations, or just moving on up in the medical field. This isn’t a job to grow old into. Many medics do Paramedic to RN programs or get a bachelors and look towards medical school for better pay and lower stress. Us young guns like the excitement and stress of 911, and you do come home with great stories to ooh and ah. For the old it gets too physical and they’ve collected the stories for their book. A lot of the quieter local volunteer EMS have the old timers there holding on to their cert at night while doing other things during the day.

6 LL March 11, 2010 at 8:46 pm

Keep in mind, a lot of the information about the various levels of EMT will be changing in the next 5-10 years. The new scheme, which is already starting to be adopted by states, will replace EMT-Basic with “EMT”, EMT-Intermediate with “EMT-Advanced”, and EMT-Paramedic with “Paramedic”. The educational requirements will change a little–for example, “EMTs” will require more anatomy than today’s EMT-Basics.

Also, the scope of practice for EMTs–and especially EMT-Intermediates–is largely dependent on their state and local protocols. In my area, EMT-Intermediates can administer all but four of the drugs that a Paramedic can, and can perform all of the Paramedic-level skills except for surgical airways.

Finally, EMTs generally get paid poorly. An EMT-Basic in my home town’s service starts at $9.80/hr. A Paramedic tops out about 24/hour. (A registered nurse, in contrast, starts out at 23/hour. And both RNs and Paramedics spend two years in school.)

7 Scott Arthur March 11, 2010 at 8:51 pm

I’ve been a Paramedic for 6 years, and a Firefighter for 10. I too started out as a volunteer. My wife will never forget the first time she called the station only to have a female voice tell her that I was in the shower–and it wasn’t creepy!

I enjoy the work as a paramedic. Currently, I’ve risen to the rank of Captain. In our service, I supervise 5 stations and about 100 EMT’s and Medics. I have earned an AS in Homeland Security.
The pay is a big issue. Paramedics have 90+% of the skill set of a Registered Nurse, are trained to work independently, and receive less than 50% of the pay of a RN. Why you ask? I believe that it’s mostly that we (EMS) are a young profession. There was no such thing as EMT’s or Paramedics until the early 1970′s. Nurses became a profession during the Civil War.
This is a very region to region outlook field. For example, on the East or West coast, it’s very rare for someone to be both a firefighter AND a paramedic. In the Midwest, it’s common (and the only way in most cases you can get a full time job at a city or county department.) In Kentucky, there are less than 4,000 paramedics for the entire state. In Ohio, there are 10,000+ paramedics.
I work for a private EMS service. Many in our field aspire to a full time job at a city/county, but the pay is low except in a few areas (very large cities like Cincinnati.)
Other people posting are correct: There are very few calls where it is truly life or death. However, the satisfaction you get from finding (and fixing!) the problem is the greatest feeling in the world.
EMT-Basic training is about 130 hours. It’s the starting point. Paramedic requires a year of college; and 500-600 hours of internship (unpaid, mind you) in emergency departments and in the field with other paramedics.
‘Ambulance Driver’ is one of the most insulting things you can say to an EMT or Paramedic.
Take care Everyone, and remember: GO RIGHT FOR SIRENS AND LIGHTS!

8 Brad Read March 11, 2010 at 10:03 pm

Great article Nate, I’m on the home stretch of a 24 as we speak. I am currently an EMT-B for a private ambulance service about 70 west of Chicago. We are the primary 911 response for a town of around 20,000 and a couple of small fire districts. So we get our fair share of just about everything you can think of. I’m also a paid on call firefighter as well. Nate is right, the hours are weird and the pay sucks, but there is no greater feeling than knowing that you helped save a life.

Cheers

9 Nate March 12, 2010 at 10:35 am

Robert- Up intil last year EMT-B’s and I’s could intubate, and I’s could nasally intubate as well. SC DHEC took intubation in all forms away from EMT’s. Medics can still do it, and most 911 systems in the state are double medic, or EMT/Medic rigs, so there is always a medic to intubate. Although it was a point of pride for some EMT’s that they could intubate better than their paramedic partner haha. In NH, where I am from, Intermediates can nasally intubate, but thats it. And SC doesn’t honor the NREMT-I99, which doesnt really matter because the Resgistry is doing away with it anyway.

10 Nate March 12, 2010 at 10:39 am

And Joe, I believe we’re hiring, so come on down.

11 Michael March 12, 2010 at 10:48 am

Also don’t forget the injuries. Many EMT’s have to stop at some point because they have back and knee problems. Damage from the climbing, carrying heavy loads of gear and people, lifting crash carts incorrectly, dealing with obese victims or patients etc. It truly is a young person’s game.

12 Robert Nartov March 12, 2010 at 11:29 am

Ah, makes sense with the intubate thing. I hate it when medical directors mess with protocols too much. I quit volunteering at one volunteer EMS over it because I felt like they were taking too many of our skills away to the point it was endangering patients. They took away our D50 and 12-lead EKGs for 5-lead (or is it 4?) along with other things because of budget cuts.

13 Nate March 12, 2010 at 2:04 pm

I would love to get nasal intubation back. I have to settle for IV’s and D50. Our medical director is very pro-EMS, and listens to what we have to say. He comes to trainings and lectures as well. Our EMT’s lack of skills is due to the state regulations.

14 AJ March 12, 2010 at 3:23 pm

There’s one thing I dont agree with in this article. The abuse of 911. Yes, the elderly call for many things, being lonely is one of them. Are there other organizations out there to take of these types of calls absolutely. But, these types of calls are the ones where you can have the geatest impact. These people are some of the few that actually appreciate what we do, and appreciate the fact we are there. Boring, yes. Tying up highly trained people, yes. A pain in the a$%, yes(especially at 3 am). Next time your on one of these calls just think no one is dying, there is no need for adrenaline, and this is a call will can take you all of 5 minutes and you can make a real difference in their lives. A call that is STRESS free I’ll do those all day long!!!!

15 Ryan March 12, 2010 at 6:12 pm

Being a fulltime firefighter/EMT-I and getting ready to get certified as a medic I can tell you that all EMTs are ambulance drivers. Unless you are in a rural area the only real use for an EMT is to take vitals, drive to and from the call, and to assist the paramedic with whatever he needs.

BUT a good EMT partner is great and can make a call go a lot smoother.

This article would have been a lot better if they just went and interviewed a paramedic instead of an EMT that is just spending time at an ambulance service so he can get hired as a firefighter.

16 Carson March 14, 2010 at 7:57 pm

I’m in an EMT Basic class in SC. What is the busiest EMS system in SC? Richland? I know they work 12s, and I work at palmetto health-Richland, so I see them a lot.

17 Bob March 14, 2010 at 8:02 pm

AJ there is an abuse of the 911 system everywhere. Look around the internet and you will find many forums, and websites that will make you laugh and deal with the stress of nonsense jobs. I have been in the 911 system in NYC for 5 years and I could write a book already with what I have seen. My wife loves to hear the stories and let me vent when I come home.

Here are some recent examples:
17 y/o female with itchy bellybutton x5 days
52 y/o male from homeless shelter who wanted to stay in the hosptial overnight and than take a helicopter to Boston for a kidney transplant in the morning.
45 y/o male who was bitten by a rat. There minute amount of blood on the tip of his finger would not be enough to check his blood glucose level.

I have wonderful partners and we just take this with a grain of salt, transport and laugh about it later when we are having a rough night.

18 Curtis March 15, 2010 at 9:46 pm

Thanks for posting this! I recently signed up to become a volunteer firefighter in my community. I’m stoked about training and getting to serve my neighbors. Does anyone have experience with volunteer firefighting?

19 Mr. Durden March 17, 2010 at 3:45 pm

So essentially you couldn’t cut it as a fireman? I noticed you didn’t have a mustache.

20 Bobby S March 17, 2010 at 10:02 pm

Our service in central TX is always equipped with a basic/medic. Sometimes an EMT-I will be there instead of the Basic. I am a Medic and almost all of the old EMT-I’s can get a line (IV) and tube (intubate) better than I can. Why? Because those are the only two skills they know how to do. You can get pretty good at something when thats all you know how to do. A paramedic in my service can push about 40 meds ( Medical Director took our Narcan last year), pace a heart, cardiovert, surgical cric, OG/NG tubes, defib, and “reduce” fractures. If you want to work in an ambulance, get your paramedic. It’s the only way to go. An EMT is so limited in what they can do. Almost every Medic I know is studying to become an RN, physician’s assistant, or wants to go to Med school. Just don’t make a career out of it. Remember Paramedics save lives, EMTs save paramedics.

21 Nate April 4, 2010 at 9:14 am

Mr. Durden, to be quite frank, I look like a pedophile when I grow a moustache. And I went to work for a busy system where I could pad my resume a bit with certs, cards, and classes (ACLS, PHTLS, PALS, etc…)

22 Nate April 7, 2010 at 4:08 pm

And Ryan, I am not an ambulance driver. I ride roughly half of the calls that we run. If not more. Any call that doesn’t need a paramedic I ride. If they do need a paramedic, then I drive. But that does not make me an ambulance driver.

23 Ryan August 13, 2010 at 8:47 am

Nate, why put an EMT-B/I in the back with a patient and have the medic drive. It is a waste of resources to have someone with the higher level of training driving to the hospital so the B can stay in the back.

24 ZH, MD August 21, 2010 at 11:26 pm

The pay is a big issue. Paramedics have 90+% of the skill set of a Registered Nurse, are trained to work independently, and receive less than 50% of the pay of a RN. Why you ask?

I don’t have to ask. Paraprofessionals earn about half of an RN’s pay because about 10% of the time, their “skill set” is inadequate. That is the same reason a PAs or nurse practitioners are supervised and make far less money than I do as a physician. Practicing “90% medicine” is unacceptable.

You may also wish to consider that for nurses, didactic and clinical training and the necessary experience require years, not hours. That last 10% is not easily acquired.

25 Nick April 28, 2013 at 5:41 pm

I’m a United States Army Medic, and part of the training you go through to become a medic is passing the NREMT test and getting an EMT-B certification. Although, in reality our training is waaay closer to Paramedic than EMT-B, as we can push any meds our unit PA “trains” us on, start IV lines, intubate, surgical cric, etc. Any young guys interested in EMS should look into the military, specifically the Army (as of when I was in training, the Army is the only branch that offers EMT certification as part of training.), as a way into the field. It gives you experience in Medicine, plus NREMT certification all while getting paid to do it. It’s a good gig!

26 Jen July 1, 2013 at 11:26 am

So I still don’t understand how the whole Shift Thing works. For example, if you are on a 12 hour shift, I guess you would just stay at the station and sleep in between calls?

And what time does a 12 hour shift typically Start and End?

What time would a 24 hour shift typically Start and End?

27 Greg July 5, 2013 at 9:48 pm

Nice article – Nate hits it on the head. I was a paramedic for 18 years before moving on in medicine. There is no other job in medicine that comes close to being a medic/EMT, and even in all of medicine, with the advent of modern EMS, even working in the ER gets a little “stale” sometimes. EMS is a lifestyle for certain, and you either get it or you don’t. Those who don’t wash out pretty quickly. Those who hang on get a ride of a lifetime.

EMS – there is nothing like it (except maybe firefighting, but for slightly different – and some of the same – reasons.

G

28 Big D July 23, 2013 at 1:36 pm

I am a FF/EMT on a career service in the Midwest. In our city fire department (21 guys), all firefighters must get EMT/B. The county runs its own EMS service in which all career people are either Para- or working towards it. They have EMTs and MICTs, but they are either part time or volunteer. With our 20K + college town we run a two tier response. 1 engine and 1 ambulance on every call. We are mostly just muscle and an extra set of hands but occasionally when we get there first we get to play. I love it. Hours of tedious boredom are worth it for that rush and feeling of accomplishment. Best job in the world.

29 jasmine c August 15, 2013 at 6:38 pm

When can you transfer to career from volunteer? Hiw long do you have to wait.?

30 Kyran Vale FF September 4, 2013 at 1:43 am

Great information. A lot of people just don’t realize how much it actually takes to be an EMT or a Firefighter these days.

31 GA September 4, 2013 at 10:47 pm

Ryan, part of being a good medic is recognizing your EMT spent good time in school to get experience and not just drive. If it is an ALS call of course the medic needs to be in the back. If it is a BLS call, however, a good medic will let the EMT (usually an AEMT or EMT-I) tech the call. The really good medics give feedback and help educate the EMT. Having the best of the best on every truck helps ensure quality care. Remember, many calls are within the AEMT or EMT-I’s scope of practice, and paramedics have been known to overwork the patient.

Paramedics save lives, EMTs save paramedics.

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