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On a 48


Kaisu

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I am on the second half of a 48 hour shift. Our crew of 3 (1 EMT/1 Paramedic on each of 3 rigs) ran 30 calls the first 24 and are well on our way to another 30 today. I am still new enough that I LOVE the experience. I'm not a fan of recliner time - I get paid to run calls and I like them. I converted a patient from vtach to sinus, diagnosed a DVT, overruled fire when they wanted to take a refusal (they wanted to get back to the superbowl) and transported the patient, was the only person on scene (with my partner) able to talk a drunken rape victim to accompany us to the hospital, and 14 other calls of various severity.

I also found out that a 17 year medic with the company is walking away from his 3 years to go to get 20 because he just can't take the meat grinder anymore. I was shocked and saddened because he is my goto guy on this shift.

The input I would appreciate from all of you is:

1- what kind of career longevity can I expect if I continue this?

2- what is the value of the experience I am gaining with tons of calls vs. the risks of running with this kind of volume?

3- should I start planning an exit strategy?

4- I love this job - what else can I do if you think the answer to 3 is yes?

Any of your comments would be greatly appreciated.

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1- what kind of career longevity can I expect if I continue this? you can last a long time in this business with the numbers you are talking about but you will get burned out and no-one likes a burnt out kaisu

2- what is the value of the experience I am gaining with tons of calls vs. the risks of running with this kind of volume? the value of the experience you get is knowing that you can do better with a company that puts more than one or two trucks on to cover 30 calls in a 24 hour shift. I work for a service that runs 8-12 calls a day and we have 2 trucks on every 12 hours.

3- should I start planning an exit strategy? Dear Dear Kaisu, I think that some of us have been pushing for you to get an exit strategy from this company long before you asked this question

4- I love this job - what else can I do if you think the answer to 3 is yes? you can be just as happy as the next person running less calls, being treated like less of a piece of meat and have some time for your family. I've already pm'd you previously offering you to come to where I work, we have a open medic position that won't last forever

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1- what kind of career longevity can I expect if I continue this?

I would not expect much longevity at that pace. Regardless of how young you feel, your body is going to let you know soon if it has not already. You can not go for very long having sleep cycles continuously screwed, eating at irregular times, eating poorly while on the road, stress on stress off, no time for your own personal outside life.

I did the kind of things you talk about but I was 18 when I started working EMS full time. I lasted several years and had a blast as it is all very exciting and new. It took me a long time to realize no matter what, the calls will always be there and there will always be someone else to fill your slot. You need to find a balance and this job is NOT giving it to you. Most employers know the mentality of us EMS folk and they know they can push and push us and we will usually take it. When we stop taking it, they simply replace us...it is simple for them.

Having said all that, I will never go back to a system with a high call volume and 24 hour shifts. Once I took a break from that type of schedule and started enjoying life a little, I realized how much I had given up over the years. I wish all newbies would read this and take it to heart, it is invaluable information. But unfortunately a lot of us do have that hero or martyr mentality and we sacrifice everything in our lives, including ourselves for a job that will never thank you.

2- what is the value of the experience I am gaining with tons of calls vs. the risks of running with this kind of volume?

If you have been running tons of calls since you started, you now have enough experience to realize you know what you are doing and are fairly competent in most situations you will encounter. There is not much benefit to running one after another, especially when the transport times are short. The real education and experience now will be seeing how long you can manage a critical or complex medical patient. When your transports last 30 minutes to hours, there is where you will start gaining more experience. As for now, and if I am wrong please say so, most of your calls are probably starting to seem similar to one another, You have those few unusual ones such as you listed...those are your highlights, but tell me about all the calls in between those; was there anything special about them which contributed to your overall "experience" factor?

You run yourself ragged and you will make a mistake. I have made many mistakes in my career, we all have. Some were do to lack of knowledge/experience and some were due to lack of sleep. I have written of them on here before, but trust me, if you continue at this pace you will make an error. Let's hope it is not a fatal one.

3- should I start planning an exit strategy?

I have never accepted a job and not had an exit strategy...LOL. I know it sounds paranoid or alarmist but it has saved my butt several times over the years. I always have something lined up, I stay networked and can be employed just about anywhere within a couple weeks of my choosing so.

If you mean exit strategy for getting out of EMS, under it's current state I encourage everyone to have a plan. Either get yourself educated and move up the chain or move out of the business into something entirely different

.

4- I love this job - what else can I do if you think the answer to 3 is yes?

The job is great. It can be a lot of fun amongst many other things. I do not regret the years I have spent performing it, but if I could do it over, I would certainly do it differently. I am glad you refer to it as a job. Again, as I have said before....EMS is what we do, it is not who we are. Do not let the job define you, do not let it consume you.

There are tons of other things to do as a paramedic which I have found as equally rewarding outside of the ambulance.

I have worked in the ER, Level I Trauma centers, PCU and ICU, flight, amusement parks, water parks, hyperbaric chambers, wound care centers, mobile insurance tech (collect samples and do physicals), instructor at various schools/colleges, and disaster response. These are all jobs I have held on the side (so I could turn down overtime), or jobs that I have worked full time when needing a break from EMS. Each time, the transitions were not an issue...when I was ready to return to the streets, I was very easily hired and after a shift or two it was like riding a bike.

Do not think there is nothing else out there for you. I barely scraped the list of all the places a paramedic can work outside of EMS. Now if you wish to leave EMS altogether, decide if you are going to stay in the medical field. Obviously you know if you choose to do so, then again the choices are various and plenty. Nursing seems like a sensible route. One of my previous partners decided to go to nursing school at the age of 53. He had enough of the ambulance, his sleep being interrupted and missing out on his grand kids. He didn't think he would succeed but now here it is 4 years later and he is a very good RN. He had many doubts and fears of leaving EMS as it was all he knew, but once he got away from the crazy shifts and the physical demands and constant stressors, he is so much happier.

He also works as a travel nurse in the city he lives in which is very convenient and he no longer needs to work OT.

Anyways, I hope some of that rambling helped you, if not, it is all I got. :)

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Go kaisu Go ! You can make it as long as you want to, its all in your frame of mind. Happy people find a way to be happy in the most miserable of circumstances, miserable people find a way to be miserable in the most happy of circumstances. I wouldnt do 48s forever, but while you are still young, go for it, just make sure you save some of that money you are earning.

One of the transitions I made, was to just stay awake my whole 24, and sleep the next day. I found that just getting 20 minutes of sleep here and there made me bitchy, whereas if i came in knowing i would be up the whole 24, i was a happy camper.

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Go kaisu Go ! You can make it as long as you want to, its all in your frame of mind. Happy people find a way to be happy in the most miserable of circumstances, miserable people find a way to be miserable in the most happy of circumstances. I wouldnt do 48s forever, but while you are still young, go for it, just make sure you save some of that money you are earning.

Pssstt, I know you don't know everyone's background here but Kaisu is 50 years young. Just FYI, :)

She is however a relatively new COLLEGE DEGREED Paramedic!!!

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thanks, not sure why i thought she was so young, i guess it was because she is still idealic and loves her job.

No worries, she just started recently, less than a year ago so of course she is "still" excited.

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You sound just like me early in my career. I'm proud of you being so ambitious and willing to use each experience as a learning one. Keep it up. But to prevent burn out, try not to do too many 48's very often. My first full time job right out of high school was 24hrs a day, six days a week. We lived at the ambulance building. For the first nine months I was really into it. But eventually it did start wearing me down physically. So I learned the hard way to pace myself.

As long as you stay eager to learn and committed to EMS you can have good longevity in the field. Keep it up and more power to ya.

And, oh yes, if you do start to feel some burn out or feel over whelmed, talk to someone. Get whatever off your chest. We are also here for ya. Come to almost any of us.

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Honestly each person finds out what works for them. If you are happy you will last. It sounds as if your service is to busy for long shifts. Becoming tired and frustrated may lead to burn out. In my case I work long shifts used to work 14-24's on 7-24's off for 2 years, but we averaged 2 calls a day or about 8 hours in the ambulance per day. So we got rest. That still started to take the joy away from me. Now I work at my full time job about 8,9 24's evey 28 days. If I decide I want to work I do 2 or 3 24's a month at my part time. I now have fun again as I still have plenty of time for me and my family.

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