One question I get all of the time is “What is it like to be a paramedic?” There are a few places that you can work as a paramedic in the peninsula of Florida. I have heard that things are different in other places, but this is how it is here. I described it 9 years ago, if you want to compare.
Most new paramedics want to work flight. The glamour of riding around in a helicopter is pretty alluring, but due to weight restrictions on helicopters, they generally won’t let you be a flight medic if you weigh more than 150 pounds. Flight medics typically have at least 5 years of experience with a 911 service to even be considered for the job.
The next best thing is running with a 911 service. Running with a 911 service is not as boring or routine as other jobs, so that is where nearly all paramedics want to work. The catch is that nearly all 911 EMS on the Florida peninsula is run by fire departments. The pay is pretty good with 911 service, so the competition is fierce. There will be 200 or more applicants for each position, so getting hired for one of these jobs is difficult. Starting pay for a dual (fire, paramedic) certification paramedic is currently about $50,000 per year.
Then there are hospitals and doctors’ offices. They are largely avoided by paramedics because nurses have managed to get employers to prohibit paramedics from giving medications. The reason is that nurses don’t want to be replaced by paramedics making less money. Hospital paramedics are also prohibited from inserting endotracheal tubes, because doctors make several hundred dollars for doing them. They aren’t going to let an hourly employee perform a procedure that a doctor can do for the price of a Lexus payment. So many medics (especially new ones who want the excitement) don’t take these as full time jobs. What winds up happening is the paramedic gets to do all of the things the nurse doesn’t want to do. You start IV lines, draw blood, bathe patients, change adult diapers, collect stool and urine samples, run ECGs, fetch drinks for patients, and other gopher work. A medic in a busy emergency room can expect to walk 20,000 steps (over 8 miles) per day. Starting pay for a hospital medic is around $36,000 a year with no experience.
There are also the theme parks. Most of the work there is simple first aid, with a few emergencies, and a bit of employee health. There are the big ones: Disney, Sea World, Universal, and Busch Gardens. There are smaller ones like Lego Land, Cypress Gardens, and even water parks like the now defunct Water Mania or Wet N’ Wild. Starting pay at these places can be odd, because some require experience, and quite a few only hire part time paramedics who already work elsewhere. Starting pay is between $18 and $23 an hour.
The paramedics who get the least pay and respect in this area are the ones working on non emergency transport ambulances. The pay is low and the working conditions are poor. Shifts are long, normally 12-14 hours each. You do not get a station to sit in on those times where you wait for your next call. You sit in the truck and wait. No reading, eating, sleeping, watching movies on your electronic devices, no texting, no phone use, and no drinking of anything except water. (Not even coffee) These jobs are easy to get, but turnover is high, and most people don’t stay for long, using this place to get experience and move on. These positions are where many medics who can’t get a job elsewhere wind up. Most medics work one of these jobs at some point in their career, but strive to get away from as soon as possible. If you work at one of these for more than 2-3 years or so, most employers will assume that there is a reason why you can’t get a better job and will avoid hiring you out of general principle.
One manager at a private ambulance company told me that his crews were not allowed to eat during shift, because he doesn’t pay them to eat, he pays them to haul patients so he can make money. Expect no meal breaks for the entire 12 hour shift. Another told me that patient care is secondary to keeping the customer (nursing home, hospital, etc) happy, and that the patient was just cargo, and no one cares what cargo thinks. One of my former EMT students was told by an employer when he complained about working conditions, that for every EMT that was working there, there were 7 more looking for a job, and if he didn’t like it, he could be replaced tomorrow. Starting pay for a transport medic averages $32,000 a year. In contrast, a kid right out of high school can get a job at a fast food place for $25,000. Delivery drivers for places like Sysco are making $50,000 a year.
A person aspiring to be a paramedic who isn’t a firefighter is better off going to nursing school. An RN has the same amount of schooling as a paramedic, but makes about double the pay.
That and burnout mean that only half of all paramedics are still working as paramedics five years later. The half of paramedics that leave generally eventually become nurses or respiratory therapists, the rest usually leave for other professions. I know one that became an ice cream man.
Even becoming a firefighter paramedic is a tough road. About half of the people who spend two years becoming paramedics and another six months becoming firefighters never get hired by a fire department. They wind up either moving on to other careers or taking jobs like non emergency ambulance jobs as they wait for the big break that never comes.
I got lucky. I spent two decades running 911 calls with fire departments. I have worked in all of the settings above (except flight- I am too heavy): three hospitals, four different fire departments, two doctor’s offices, three different theme parks, and two different ambulance companies. Each had its plusses and minuses. The biggest minus for most is pay, closely followed by poor working conditions.
In Florida, a nurse can challenge the paramedic exam and become a paramedic, but a paramedic can’t challenge the nursing exam. I can say with all honesty that nursing school doesn’t teach you anything that you didn’t already know as a paramedic. Even so, nurses who began their careers as paramedics make better nurses, especially if you are working in the ED.
