Career Overview: What I Do As a Paramedic
It is all too easy to take for granted that emergency workers are ready to rush to you with just a phone call. Paramedics, emergency medical specialists, and other critical care specialists are ready and waiting to help, and this is rarely an easy job.
Not all emergency medical jobs are created equal, and not all incoming calls involve life-threatening injuries, but it is an intensive field that often requires long hours of work. To learn more about this area, we spoke with Lt. David F. Pettplace, FF, CCP, IC, who works as a paramedic and instructor.
Tell us a little about your current job and how long you have been doing it.
I have been working in the emergency services of Michigan for almost 10 years. I started out as a volunteer firefighter. Then he became an ambulance doctor, then a paramedic, then an “intensive care paramedic and instructor in the provision of emergency medical care.”
What prompted you to choose your career path?
This was not planned. At the time, I really didn’t have a particular direction in my life. I just stopped playing in a band and from that moment in my life I moved on. I once asked the local fire chief if he needed help in the department. He told me that if I got my hair cut and removed all the metal from my face, I could join the volunteer department. So I turned my death metal gear into gunshot gear. I was not one of those kids who grew up wanting to be a firefighter, and I never had a family in the fire department, it was just the motivation behind the moment that changed my life. For a long time I thought that the meaning of life is to help others, so it seemed to me a suitable option. I decided I wanted to try my hand at this career, which required being an “emergency medical technician” at the time, so I went to EMT school. Around 2007, the economy was going to hell, so most public service jobs were virtually non-existent. It also meant that I lost the job that I had at the time.
It just so happened that I really liked medical work, and I focused on it. I became a paramedic and now work full-time in an ambulance agency.
How did you get a job? What kind of education and experience did you need?
To become a paramedic, you must first be a paramedic. From there, you can upgrade to the Paramedic Program, which is now mandatory for college (at least in Michigan). I went to school for about 4-5 years to become an intensive care paramedic. Emergency medical services require a government license, which you can apply for after your final school or government testing.
Critical Care is more focused on transporting patients from one hospital to another, often using drugs or medical devices that are outside the scope of a paramedic’s practice. This may include chest pumps, ventilators, and some heart devices such as balloon pumps.
Many outsiders may not know that there is a difference between an EMT and a paramedic, but it’s like comparing a nurse to a doctor. You now have an in-depth education in physiology, pathophysiology, cardiology, pulmonology, pharmacology and neurology. You can also practice skills such as intubation, IV / insertion (in the bone), and medication.
When you work in an ambulance, you follow protocols drawn up by doctors and approved by the state. These are guidelines that suggest a minimum of what should be followed and evaluated for patients (for example, all unconscious patients with chest pain, shortness of breath, nausea and vomiting, or weakness require a 12-lead ECG).
What are you doing besides what most people see? What do you actually spend most of your time on?
EMS performance can indeed be variable. Some people work in hospitals and simply transport patients from one hospital to another or to nursing homes. This could be a basic emergency room or an intensive care unit for intensive care patients. Others operate in city systems where you can make many calls but are no more than five minutes from the hospital. Others, like me, work in rural areas, where we may not have many calls a year, but sometimes we can be with our patients for longer than an hour. Each of us does different things with the same goal – to heal and transport the sick and the wounded.
What misconceptions do people often have about your job?
In my experience, many people call us ambulance drivers, which is like calling a police officer a police car driver. The general public often thinks that all we do is get people to the hospital. While this is certainly part of the job, and as it was when the emergency room started – roughly two decades ago – we have now moved on to delivering the emergency department to the patient. The emergency department does very little that we cannot in the short term. If a patient has cardiac arrest, there is nothing that we cannot do. We often “work” with these patients at the scene until something changes: either we have spontaneous circulation back, or we decide that medical intervention can no longer help the patient. There are patients who really need lights and sirens because there is nothing we can do, like stroke patients.
Paramedics are additional doctors, just like a paramedic or nurse practitioner. We are their eyes and ears in people’s homes and on the roads. We bring the patient’s history with us to the emergency room.
Many people often think that it is all about the blood and guts. Fortunately, these calls are rare. In most cases, we turn to geriatric patients who suffer from acute or chronic illness and need help on this day. It’s more like picking Granny off the floor and making sure she’s okay than car accidents (most of which are also uneventful).
What’s your average uptime? Is this a typical 9 to 5 situation or not?
At my agency, which is more rural than urban, we work around the clock. Sometimes by day. I just finished my 48 hour shift. I have 48 off, then I turn it back on at 24, 24 off, then turn it back on at 24. Last week I worked 72 years in a row. No, it doesn’t make sense. We work 96 hours a week at my agency, most people at EMS work 48 hours, often 12 hour shifts. And yes, we sleep at night if there are no calls.
What personal tips and shortcuts have made your job easier?
I’m not sure if there are any shortcuts that might be helpful in EMS, but some of my advice is that every patient should be treated the way you expect from their family and that we did not call emergency help. people called us on their worst day and expect us to help them. To do this, you need to remain calm and act professionally. Be flexible. Something will change, be it the patient, the job, the medicine, or the industry.
What are you doing differently from your colleagues or colleagues in the same profession? What are they doing instead?
I spend a lot of extra time reading emergency medical and medical journals. Since I am also an instructor, I often plan training for my next meeting or upcoming classes. Medicine is constantly changing and the way we work at EMS is no different. I try to keep everyone updated on new information. I am also involved in quality assurance and improvement, so I read all reports that our staff write, check that our protocols are followed and that our patients are treated correctly. Because of this, I am often seen as the bad guy, as I fix people’s mistakes or show people where they can get better.
What’s the worst part of a job and how do you deal with it? I guess working as a paramedic is incredibly stressful!
The worst work in EMS is with children. I do not mean it in the words “I do not like children.” I really enjoy being around them and I am always happy to be around them. But on good days, we don’t see children. When you see children being run over and killed by cars, heart failure or abuse, it is very difficult and can haunt you for a long time.
People who work for EMS have very high burnout rates, most people don’t last more than a year or two before moving on to something else. It takes a lot of physical effort and many of us, myself included, are overweight. We don’t sleep well. EMS also has a high rate of divorce, alcohol and drug abuse, and higher levels of post-traumatic stress disorder than the military. I was diagnosed with PTSD myself, and as a result I have premature hypertension, nightmares, poor diet and insomnia.
What is the most enjoyable part of the job?
Knowing that we are helping people. Sometimes the days just start to blend together and it’s easy to get fed up. Running to alcoholics, psychiatric patients and drug seekers is getting old and some people stop caring for them. Keeping good calls is important: the day we saved a child’s life or helped someone’s grandmother get off the floor. When people thank us (which, frankly, is surprisingly rare), it’s nice. We recently had a patient who had a motorcycle accident with a head injury and a collapsed lung. We were able to save his life, and he came to our office to talk to me. He was difficult to deal with at the scene due to a head injury, but he was able to fully recover. The look on his face when I told him that I was a paramedic that day was wonderful.
How much money can you expect at your job? Or what is the average starting salary?
EMS payments can be very different. In my area, EMT wages are often below the minimum wage. Working full-time as an intensive care paramedic at my agency, starting from the beginning, pays about $ 45,000 a year (don’t try to calculate that versus 96 hours a week, it’s depressing). I work for a city agency and receive very good benefits and pension, but most are not so lucky. Unfortunately EMS is still very young. We are mostly young children and it will take some time before we receive the same salary as US nurses. Personally, I am honored to be the one someone calls when their life has become a living hell.
How are you “progressing” in your field?
As I said, you start out as an EMT, then you can go to a paramedic and then to Critical Care (this is not another license, but just further education). The difference between an EMT and a paramedic is huge. It’s like going from nurse to doctor. You not only know what to do, but why. Now you can do things that can kill the patient if you don’t know what you are doing. If you want to move on, it can be tricky as there is still a lot to do. Becoming an educator is always rewarding, but in Michigan it [requires] a government license, just like your medical license, so it’s more like teaching. Depending on your employer, you can become a field training officer, supervisor, or manager. Being a medic can be very frustrating – suddenly hitting the ceiling.
Some paramedics aspire to become nurses and some as paramedics or therapists.
What do people underestimate / overestimate in what you do?
I think a lot of outsiders underestimate EMS, right down to the point where they need an ambulance. For most people, we can be annoying. We made them stop or something. Many people think that we are often taxis and just come to take a family member to the hospital. When I start assessing and asking questions, I am often told, “The hospital has all this information.” And while that may be true, I don’t have access to it, and I’m going to take care of their loved one for the next hour or so, which could all be important to me.
What advice would you give to those who want to become your profession?
This is a great job and very rewarding if you enjoy helping people. If you are here to be at the forefront of the suffering of others, or because you think it will be lights, sirens, blood and guts, then this is not the place for you. It is not an easy job and you have to be able to handle terrible challenges. Ambulance – part ambulance doctor, part social worker, part counselor and part detective. This is a labor of love, and I could not imagine anything else.
This interview has been lightly edited for clarity .