Private Ambulance Services

About 40 percent of all emergency medical technicians work for private ambulance services. Private ambulances handle most non-emergency patient transfers, such as trips to nursing homes and transfers from one hospital to another. They carry patients who cannot drive, handle discharges from hospitals and also respond to some emergency calls. Since private ambulance companies are required to have at least one EMT in every vehicle, it is usually fairly easy for a certified EMS professional to get a job. Unfortunately, the round-the-clock nature of these companies means their EMTs often work very long shifts, and working conditions vary widely from company to company. On average, emergency medical technicians employed by private ambulance services work 45 to 50 hours weekly. Private ambulance services also tend to pay less than hospitals and municipal fire and rescue departments.

Fire Departments

EMTs employed by municipal fire departments are a key part of municipal emergency response systems. They respond to emergency scenes alongside police and firefighters and provide the most immediate medical treatment, often before ambulances arrive. Many EMS professionals find this line of work particularly rewarding because they work alongside other emergency professionals to help people who are in immediately life-threatening situations. Working at a fire department does mean long hours for the emergency medical technicians, typically 50 per week. It also means exposure to violent and sometimes dangerous situations. Pay scales at fire departments vary: typically, EMTs who work in big cities earn more than those in suburban or rural areas. On average, municipal fire and rescue departments pay their paramedics more than hospitals and private ambulance services.

Hospitals

Large hospitals with their own ambulances employ emergency medical technicians to transport patients in those ambulances. In addition to responding to the scene of emergencies, these EMS professionals work in the emergency department itself, assisting with triage, diagnostic and treatment tasks. Working in a hospital gives EMTs a chance to work directly with doctors and nurses, which can be an outstanding opportunity to learn more about medicine. Indeed, many physicians and nurse practitioners started their medical careers working as emergency medical technicians in hospitals. As with local fire rescue departments, working at a hospital means exposure to emergency situations, which can prove stressful and dangerous. Hospitals tend to pay more than private ambulance companies, but less than fire rescue departments.

On-Site Paramedics

Some emergency medical technicians specialize in providing on-site medical care at large events, such as concerts, conventions, trade shows and sporting events. Rather than being called to emergencies as they occur, these EMS professionals are on call in case a medical emergency arises at the event. Focusing on events allows certified EMS professionals to work comparatively normal hours, since they are most needed during the day and in the early evening. Because only a fraction of events actually involve a true medical emergency, this type of work is also much less stressful than working for a hospital or a municipal fire department. On the other hand, many EMTs want to be involved in actual emergencies, and on-site work may not appeal to those professionals.

Flight for Life

Flight for Life, a pre-hospital care service, specializes in emergency helicopter transport of patients who are in particularly critical condition or who cannot be reached by traditional ambulances. EMTs who work for Flight for Life and similar organizations help critically injured patients who need specialized care, such as burn victims and injured children. The excitement of working on helicopters of other aircraft, plus the sense of importance that comes from helping people in need who are out of the reach of ordinary emergency transport, appeals to many certified EMS professionals. It is important to note, though, that emergency medical technicians who work on helicopters require a high level of training; they are often called upon to place and monitor chest-tubes or aortic balloon pumps and even perform certain emergency surgical procedures.

Urgent Care Clinics

Clinical work doesn’t immediately come to mind when people think of paramedics, but in fact, urgent care clinics can use many of the skills a certified EMT has to offer. Taking patient histories, applying bandages, assessing symptoms and conducting triage are all tasks that EMS professionals can perform, and they always needed when dealing with urgent care patients. EMTs who work in urgent care settings find that their advanced life support skills are usually unneeded. However, they gain familiarity with laboratory work and experience dealing with patients on a more personal level. Working in an urgent care clinic is a relatively low-stress work environment for certified EMS professionals, with fewer hours and fewer nights and weekends as compared to working in emergency response. Furthermore, working alongside doctors and nurses presents a tremendous learning opportunity.

Opportunities exist for certified emergency medical technicians in a wide range of settings. Traditional EMT settings, such as hospitals and municipal fire departments, tend to subject EMS professionals to a high degree of stress, but also tend to pay very well. Lower-stress opportunities, such as private ambulance services and urgent care clinics, are also available, though the compensation is typically less. When seeking a job as an EMT, it is important to take into account the salary offered, work conditions, hours to be worked and opportunities to learn and grow towards future career opportunities. Instead of feeling constrained by the traditional job description of a paramedic, certified EMS professionals should explore every opportunity to find jobs that suit their individual qualifications, personalities and future plans.

This video from Dave at FireFighterMedic.com gives some great insight into various EMT work locations.

http://www.youtube.com/watch?v=5UKOdz88_hA

There are certain key personality characteristics that can make or break your career as an EMS professional. Many of these can be learned, however, some are just part of our internal DNA. In this article, we’re going to take a look at a few critical skills that aren’t taught in the classroom that can lead to your success in emergency medical services.

Teamwork

Perhaps the single greatest skill you can posses that will help you shine as an EMT that you aren’t going to be taught in a training program is teamwork. When you’re in the field, you’re going to be working with a wide range of other medical and emergency personnel and your ability to work well with new people under demanding circumstances is a key asset in being an effective EMS professional. The emergency medical technician may interact with hospital staff, firefighters, police officers, and responders from other agencies all in one call. Being able to work well with others while smoothly following protocol will serve you well.

Stress, Emotional Resilience, and a Strong Stomach

The nature of this career demands that you work well under pressure in a wide range of circumstances and environments. First and foremost, being able to remain focused and calm while seeing patients in extreme pain is a skill that cannot be prepared for until you’re working in the field. EMS professionals deal with individuals who are often in horrid circumstances and having the mental ability to conduct proper assessments and follow the right course of treatment while another human is in this state can often require time and experience.

Furthermore, another trait that is learned through the course of experience is the emotional resilience necessary to mentally separate from traumatic events. This doesn’t mean that a successful EMS professional is robotic and uncaring. However, as any emergency responder will tell you, it takes practice to leave work at work in this career. Professionals across all emergency professions will tell you that developing the ability to separate yourself from the events that occur during your shift takes time and experience. Even then, if you spend an entire career in this industry, there will be certain events that will stick with you for a lifetime. Knowing how to process the emotions that go along with repeated exposure to traumatic events will be another important skill.

Accepting the Consequences

With every job comes times that mistakes are made and situations which could have been handled in a more professional manner. If an accountant makes a rounding error in a calculation, financial reports may be incorrect. When an EMS professional makes a mistake, it can have grave consequences for the patient. This isn’t intended to scare you out of pursuing a career as an EMT or Paramedic. However, should you choose this path, you do need to accept the responsibility that comes with being an emergency responder. If proper protocol is followed, you can be confident that the majority of the time, you are offering the best course of action for your patient. The successful EMS professional will be mindful of his or her duty and take that responsibility seriously.

Details and Organization

Another skill that is absolutely critical to your success is the ability to pay attention to details and stay organized, even under pressure. Being a detail-oriented individual is not a pre-requisite to beginning a carer in emergency medicine, but it is a key element in becoming an effective responder. There are stringent reporting requirements for patient assessment, treatment, and transport and you need to be able to accurately record many details while in the field.

Additionally, being able to maintain organization is critical to ensuring proper patient care. Whether you’re working as part of a transport team or a response unit, it is essential that you can keep supplies and equipment well-maintained and stocked to make sure that you have what you need to offer treatment for a wide range of calls.

Interpersonal Skills

Effective communication is a skill that also comes into play for the emergency medical services professional in a wide range of interactions. Most importantly, the ability to communicate with patients in a clear, concise manner while they are in a great deal of duress will help you keep your patient calm and aware of what you’re doing and why. Communicating with a patient who is experiencing trauma is not something you will have the opportunity to practice until you’re in the field, but over time you’ll find your communication skills adapting to the demands of the job.

Furthermore, these communication skills are essential when transporting patients to a receiving care facility. Being able to brief the staff members on the receiving end of a transport, such as the staff at an emergency medical department, will be a key component in the end to end care of the patient.

Taking a look through these skills, which ones do you currently have? Are there some that you need to develop? By understanding some of the factors that make an effective EMS professional that you won’t be taught in the classroom, you can begin preparing now and deciding whether or not this is the right career choice for you.

This video from Dave over at FireFighterMedic.com offers some great insight into some of the personal qualities that can help you succeed on the job.

http://www.youtube.com/watch?v=271HoeT6xH8

Volunteers get a chance to develop new skills and gain valuable knowledge about how healthcare is administered in other countries. They are given the opportunity to work with local healthcare professionals as well as volunteers from around the world.

On a personal level volunteers are able to immerse themselves in local cultures. They have the opportunity to learn about local customs, cuisine and lifestyles. Volunteers normally work around 40 hours a week giving them plenty of time to explore the region. They may get a chance to shop at local markets or visit natural sites like Victoria Falls in Zambia.

Volunteering can provide life changing experiences for many people. Travel alone has a tendency to broaden horizons and view the world differently. Volunteers get to experience new places and make a real difference in the lives of people they help.

Where to Find Volunteer Opportunities

There are a number of really great programs available for volunteers. EMT professionals may find some of the program more limited to healthcare in general rather than emergency services. However, apart from transporting EMTs may find they are able to use their other skills such as taking vitals, administering medication or educating patients.

Volunteers in the healthcare field are normally required to provide their identification and healthcare-related credentials. EMT volunteers should also be physically fit as the job involves lifting over various kinds of terrain. They should also be able to relate to all kinds of people. They should demonstrate patience, competence and integrity with their patients in order to earn the trust of the local population. EMT volunteers should also have excellent verbal, non-verbal and written communication skills.

Interested volunteers can look online to find a number of excellent volunteer programs in need of healthcare professionals. Some of the programs looking for volunteers in healthcare include:

• A Broader View
• International Volunteer IQ
• Rustic Volunteer and Travel
• United Planet
• Work Experience Abroad

Locations that Need Volunteers

There are a number of countries around the world in need of healthcare volunteers. Some of these countries include:

• Asia: Cambodia, China, India, Nepal, Philippines, Sri Lanka, Thailand and Viet Nam
• Africa: Cameroon, Ghana, Kenya, South Africa, Rwanda, Tanzania, Uganda and Zambia
• South America: Argentina, Chile, Ecuador, and Peru
• Central America: Costa Rica, Guatemala, Honduras, Belize and Nicaragua

Possible Patients and What to Expect

Volunteer programs include training and orientation that is specific to the location and population. These programs will also provide volunteers with their basic necessities such as accommodations and meals. Many of the accommodations include staying with host families. Staying with host families is an excellent way to really learn about the culture and local customs. Meals are normally provided three times a day.

There will certainly be some cultural differences that volunteer EMTs will encounter. Program orientations should help direct volunteers on learning the nuances of social expectations. Volunteers will likely encounter a very low literacy rate among the populations they serve. In some countries volunteers will encounter a high level of specific illnesses and disease. For example, HIV is highly prevalent among countries found in Africa, Eastern Europe and Central Asia.

Hospitals and clinics may be understaffed, medication and vaccines may be limited and even basic medical supplies may be in short supply. Volunteers will learn how to adjust and work in various environments under different conditions than back home. Even with these obstacles the rewards of helping others far outweigh the challenges.

This video from ABroaderView.org highlights a medical mission in Zambia which is staffed by medical volunteers from around the world.

http://www.youtube.com/watch?v=WhygY_oKdXY

From the inauguration of the NREMT in 1970, the role and identity of the emergency medical technician (EMT) have solidified within the context of the health care system. States must issue guidelines for EMT training and certification that meet or exceed federal standards. This resulted in improving quality among this class of first responders. Furthermore, graded categories of EMTs now exist, including EMT-Basic, EMT-Paramedic and Paramedic levels of expertise. Needless to say, education and EMT training are comprehensive, as are methods of evaluating candidates. Included among the evaluation components is the psychomotor examination.

The importance of the psychomotor examination in discerning professional competence can not be understated. The cognitive portion of the NREMT exam provides a measure of the candidate’s grasp of theoretical knowledge. Alternately, the psychomotor section tests practical knowledge, facility with equipment, reaction times, communication skills and assessment abilities. In fact, the current version is the end-product of a process begun in the 1990s by the NREMT to assess practical aptitudes relative to revised EMT training curricula. As the organization states on its web site, a psychomotor foundation is essential to understanding the “whys, hows, and sequencing of all steps in each skill…”

Divided into seven parts, the psychomotor exam often utilizes a simulated flesh-and-blood patient to test the candidate’s competencies. First among the segments is a simulated assessment of a trauma patient. The candidate is given a hypothetical scenario and expected evaluate the scene of the incident; determine the extent of injuries; perform necessary resuscitative procedures; get a brief history from the patient (if able to speak); and perform a physical examination that may vary in degrees of detail. The next test division involves ventilatory management, where the candidate must treat respiratory stress while monitoring the pulse at the carotid artery. Use of supplementary oxygen and the bag-valve-mask device is evaluated here, as is dexterity with endotracheal tubes.

The examination continues by testing the abilities to deal with cardiac arrhythmias and accurately discern the measurements of an electrocardiogram . Intravenous therapy and medication administration comprise the fourth portion of the test. Under this heading, the prospective EMT is called to insert a patent IV line into the arm of a mannequin. Upon completing this task, the candidate must then administer a dose of medication, contingent on the scenario given. Another module involves verbal interaction and communication with a patient, where the examinee is tested on the ability to relate to the patient and to extract vital medical information.

The psychomotor evaluation is concluded by two final sections. First, the EMT aspirant demonstrates expertise in pediatric service. Ventilatory management procedures are repeated, this time under a scenario with an infant patient. Insertion of a line to administer bone marrow treatments must also be performed. Finally, EMT training is evaluated through tests of basic skills: stabilizing patients with spinal trauma, managing those in shock and controlling the loss of blood. Successfully completing these rigorous challenges is a credit to the training received.

The EMT Training and Career Headquarters was recently fortunate enough to briefly speak with Christopher Garrison, 32, an EMT-Basic in the Dallas-Forth Worth metro area. We asked Chris a few questions about his journey, life in the field, and what he views as the challenges for any aspiring EMT. We great appreciate him taking the time to respond to our questions…enjoy!

EMT Training and Career Headquarters: Chris, how long have you been working as an EMT?

Christopher Garrison: I received my certification in 2009, so I’ve been in the industry for right at 2 years now.

EMTTACH: How’s it going so far? Do you enjoy the work?

CG: It’s the right place for me to be. I’m not the type to sit at a desk all day, I need to be on the go. I’ve always had an interest in the medical field and an aptitude for science. I’ve also always been the type of person that’s cool under pressure. I tend to really thrive when others around me are in a state of panic, so that ability to focus and follow procedure when I’m in a stressful situation was initially what led me to this career.

EMTTACH: Do you work for a public or a private agency?

CG: Right now, I’m employed with a private ambulance service here in the Dallas-Forth Worth area. I’d rather not mention my employer publicly, but it’s been a good company to work for.

EMTTACH: How long did it take you to find work after your EMT-B program?

CG: I actually had a lead on a company that was hiring right before I received my cert, so I was basically employed right out of training. I think I got pretty lucky, because [other EMT candidates] in my class were having a tough time with the economy coming out of a recession. I’d say overall though, it’s a pretty good field to be in if you want to sort of stay isolated from the big unemployment spikes and layoffs.

EMTTACH: What’s been the best part of this line of work for you?

CG: I’d say the schedule. When I’m on, I’m on, and when I’m off, I can be at home and just escape and spend time with my family. I’ve pretty much got it made right now since I’m doing four twelves from 6:00am to 6:00pm with three days off. Not to mention, after being in the field and getting a feel for the work, I can’t really picture myself working outside of this industry. It’s where I need to be.

EMTTACH: Our web site audience is primarily made up of aspiring emergency medical technicians who are looking for information to get started in the career. Any advice for someone who’s looking to get a foot in the door?

CG: I’d say you need to know if it’s the right job for you. While it might not take four years of med school to get a job, it’s not for everyone. I’ve talked to a lot of folks who are like “Well, I was laid off and I’ve been trouble finding a job, maybe I should start looking at training courses”. To me, it’s either in your DNA or it’s not. I don’t see it as the kind of career you get started in just to make ends meet while you’re looking for something else to do. It takes a certain type of person to handle the demands of what we do and you’ve got to know if that’s you.

EMTTACH: So you plan on sticking with it?

CG: Definitely. Like I said, it’s the path for me for now and I just can’t picture doing anything else.

EMTTACH: Any tips for someone who’s ready to start their EMT training?

CG: I’d say more than anything, just get involved and take part. The worst thing you can do is sit back during clinical and just watch what’s going on. Get in there and volunteer every time you have the opportunity. If you think you’re going to learn everything by sitting back and watching, you’re going to be in for a rude awakening when you’re in the field.

The EMT Training and Career Headquarters would like to thank Chris for volunteering his time to answer our questions. Stay tuned for more interviews with emergency medical services professionals in the coming months.

A college degree is not required to work in EMS but a high school diploma or GED is necessary before beginning EMT training. It is absolutely important that you have solid reading, math and study skills in order to succeed as an EMT or paramedic. If you are currently a high school student or know someone in high school who is interested in pursuing a career as an EMS personnel, it is important to know that biology, chemistry, math, computer and technology courses should be focused on. After completing high school you can complete an EMT program, which typically lasts several months, at community colleges throughout the country. Upon completion of the EMT training program, you will be eligible to take a standardized State exam in order to earn licensure. Testing for State licensure does not require a college degree. You may want to consider pursuing a longer paramedic program, which will increase your earning potential. Testing for paramedic licensure also does not require a college degree.

Working as an EMT or paramedic can be an incredibly satisfying experience since you would be directly helping others in a variety of ways. As the baby boom generation continues to age and require extensive medical attention, the demand and job prospects for EMTs and paramedics will remain high. A college degree is not necessary to take required standardized state licensure exams to become an EMT or paramedic. It is necessary to earn a high school diploma or GED and complete post-high school training program in order to be eligible to take the licensure exams.

If you are interested in volunteering as an EMT, an excellent source for potential opportunities is VolunteerEms.org, an online directory listing possible options for you. You can also contact local universities and community colleges for potential opportunities. Volunteering as an EMT is an excellent way to gain some important real-world experience, which can help your future job search. If you are pursuing a job in the medical field, volunteering as an EMT is an excellent step to gain valuable experience and impress prospective employers. While the Bureau of Labor Statistics anticipates very strong job prospects for EMTs, it may be possible, given the challenging economic circumstances, that you may not be able to immediately secure employment. This could make volunteering as an EMT a very attractive option that would prevent your resume from having any gaps. The obvious disadvantage of working as a volunteer EMT is that you would likely not receive any compensation for your grueling work. Volunteering as an EMT can be a major time commitment and it may just not be feasible for you to spend so much time doing something that does not provide immediate compensation. Working as an EMT exposes you to a higher risk of possible injuries which also makes volunteering less appealing.

It can be incredible satisfying volunteering as an EMT. You will have the opportunity to help those in need on a regular basis. It can be very fulfilling to provide medical care to others. Volunteering as an EMT will provide you with valuable real-world experience that can pay dividends if you want to pursue a career in the medical field. The major disadvantage of volunteering as an EMT is that you will likely not receive compensation and this just may not be practical for you. You really must weigh the experience you can acquire volunteering as an EMT with the fact that you will not receive compensation for your hard work in your decision.

Most States will require some key components as part of EMT reciprocity: Your current certification must be valid in the State it was issued, your current State has training requirements that at least match the general requirements for the State you are moving to and you can provide documentation of course completion for your certification. It is in your best interest to be NREMT certified, as most States will require a written examination if you are not NREMT certified. A good number of States will waive certain testing requirements if you are NREMT certified. If you are not NREMT certified, you must be prepared for at least some testing requirements in the State you are transitioning to.

There are several States that do not recognize National Registry at the EMT-B level: Delaware, Georgia, Illinois, Maryland, Massachusetts, New York, Oregon, Pennsylvania, Vermont, Virginia, Utah and Wyoming. There are also a number of States that do not recognize National Registry at the EMT-P level: Alaska, Delaware, Georgia, Illinois, Maryland, Massachusetts, Oregon, Pennsylvania, South Carolina, South Dakota, Virginia, Utah and Wyoming. It is important for you to understand this if you are transitioning to one of these States.

Life brings about various opportunities, challenges and circumstances that may force you to make a move. As an EMT, you have current State certification and you must do some research to understand whether or not the State you are transitioning to will accept and recognize your certification. Each State has different criteria it will use to make the determination. It is absolutely in your best interest to be NREMT certified in order to minimize the potential hassles and pitfalls with EMT reciprocity.

If you have completed the EMT-II or EMT-III program and want to advance your career by discovering how to become a paramedic, you can complete an EMT to paramedic bridge course. This bridge course will expose you to such advanced fields as medical emergencies, trauma, cardiology and respiratory care. There are usually requirements as far as how many classroom hours must be completed in order to successfully pass such a bridge course. You can also expect to complete a significant amount of lab work and clinical rotations in an EMT to paramedic bridge course. If you have a busy schedule and must continue working as an EMT while making the transition, you may choose to complete an online EMT to paramedic bridge course. The advantage of such online courses is that you have greater latitude in designing your own schedule. Online courses will be centered on PowerPoint presentations, videos and online lectures that can be recorded for later viewing. Once you successfully complete an EMT to paramedic bridge course, you may take the NREMT Paramedic certification exam. You must meet the standards in such areas as patient-assessment trauma, ventilatory management, cardiac management skills, and IV and medication skills.

If you are interested in advancing your career from EMT to learning how to become a paramedic, you may want to research in EMT to paramedic bridge courses that are available. You must be prepared to devote significant time to both classroom and lab work. If you do happen to have a very busy and loaded schedule, you may want to consider completing the classroom portion online. Transitioning from an EMT to paramedic can really be worth it in terms of the salary you can command.