Want to be a paramedic? Get ready for a world of pain…
In Australia, being a paramedic almost universally means going to university for 3 years, ending up in a load of debt, going on weeks of unpaid clinical placement, and then having poor job prospects at the end of it. What was once a fairly specialised degree with practically guaranteed employment has turned into a factory pumping out products for an oversaturated market. The same thing happened with nursing. The “shortage” isn’t in actual positions – it’s a resources need. We need more paramedics, but we don’t have the positions for them. Blame politics, budgeting, or short-sightedness. But that’s the grim reality. So, before you embark on a degree and career of paramedicine, what should you expect?
You probably won’t have a job at the end of it, or if you do, it’s not likely to be in the city.
Normally once you’ve finished your degree, you’ll pick up a graduate placement, which typically lasts 12 months. These are usually temporary appointments, frequently with a 3 month extension. At the end of it you become fully qualified – and essentially the same as every other paramedic in the service of that clinical level. That means that when there are positions available in your area, you typically don’t get any special status. Graduate placements are now highly competitive and your GPA is only a gatekeeper – far more important is how you appear during interviews, scenarios, and psychometric testing. It isn’t all about being clinically competent – it’s about who is likely to follow the rules and present a good face to the public (since ambulance services are all state-operated in Australia).
Assuming you do get a graduate placement, chances are many of you will have to go out into regional areas – where you will struggle with moving to a new environment, typically away from family and friends, and occasionally into areas where there’s very little going on. The local social life might revolve around the pub and nothing else. At the end of it, you might pick up a position – or you might not. Those who don’t often go into casual employment. And it’s not all bad news if you’re casual – provided you’ll work at any station in your city, you can usually find a shift.
But don’t pick the degree if you think it’s guaranteed employment. Once you’ve got a permanent position in a service, it’s hard to get kicked out (and you can even disappear into secondments/other positions for months at a time, and still keep your original position!). Getting your foot in the door? That’s the issue. And your degree is pretty much useless for anything else, too.
You’re staring a lifestyle, not a career.
I can’t overstate this enough. If you become a paramedic, you will be doing shift work. My standard roster is 12 hours a day, 2 day shifts and 2 night shifts, with 3 days off. Occasionally I get a run of 10 hour days. Sometimes I get 4 or 5 days off. Sometimes I only get 2 days off. The roster rotates. For several weeks I’ll be stuck working weekends. I have to turn up about 20 minutes before my shift starts, and it almost always gets extended by another 30 minutes. Add on an hour travel time (collectively), and my typical work day is nearly 14 hours long. While you’re on a block of shifts, you basically do nothing but work. There is no room for social events. You basically go to work, come home, and go to bed. Repeat until RDOs roll around.
Also your roster can change at random. You can get redeployed to other stations. You can apply for leave (and leave in my service is fairly generous, up to about 8 weeks a year!) but they can refuse it without any other reason than “operational need”. If a friend is planning a wedding 6 months from now on a weekend, you can’t say if you’ll be there or not. Nothing is set in stone.
You’ll have trouble keeping in touch with friends – you’ll frequently work Friday or Saturday nights, or you’ll be too tired to go out and see them. You’ll miss important family events. Your family will feel neglected. You’ll disappear for a week or so while working hard. You’ll come home and be tired and crabby. It’s just the way it goes, unfortunately.
You frequently don’t get a break during a shift… at least in the metro areas.
Go to a quiet country station and you might spend an entire shift washing the ambulances, watching TV, playing football with the local coppers, or having coffee at a cafe. Go to the metro region and your first job is already waiting for you, and you’ll work right through to the end of your shift (and frequently beyond it). You might be able to grab a little bit of downtime, but this is a luxury and someone usually finds some way to fill it up with extra bullshit to do. You will be hungry, or need to take a piss, or extremely tired, or more likely all three at once. If you do get that magical hour or so of downtime (and don’t get me wrong, it can happen) then the job is great. There’s an awesome feeling kicking back at station, watching TV, and getting paid for it.
But you earn that privilege by having to attend mandatory training programs, keeping your skills up, keeping your station tidy, and being out for the entire day pretty much every other moment you’re at work. Things like regular lunch breaks or toilet stops don’t exist. People keep on calling!
You’ll never stop learning.
There are a lot of paramedics who learned their clinical practice guidelines and very little outside of it. These vocational paramedics are good at their job, but the best ones didn’t stop learning and sought to find out more about the various conditions they went to. The university degree was designed to foster more of that attitude, and it has more or less worked. If you want a job with no extra commitments, then this isn’t the one for you. You’re going to need to keep learning as you go along, whether it’s due to mandatory training programs, mandatory certificate of practice requirements, or just taking the initiative on your own. If you don’t, people will suffer.
It’s dangerous and frustrating.
We go to everything, and I mean everything. We go to the worst possible traumas and arrests, and we also go to stubbed toes and people who want their medication labels read out to them. We go to people who have a minor flu-like illness, with 3 cars parked out the front and four family members, who then proceed to drive behind the ambulance and follow you to hospital. We go to all sorts of stupid shit. And there’s nothing you can do about it. You want to slap these people, yell at them for wasting your time, and how they’re going to clog up an already overworked emergency department. They are the reason why hospitals are ramping or on bypass, the reason why you never get a break on night shift despite nearly running off the road at 3AM trying to drive out to their house for a minor laceration. But you can’t say anything.
We also go to dangerous shit. You walk into scenes that could blow up at any moment – house parties, brawls that have “calmed down”, drug dens, dark alleyways… and it isn’t even always obvious. You can be assaulted in a rich person’s home because their 18 year old daughter got absolutely shitfaced and decides to pick a fight with you. You go to road accidents where motorists won’t slow down and will come close to hitting you. Even driving is a hazard – your lights and sirens won’t protect you, people won’t stop for you and traffic lights are your worst enemy. Few respect you. You have to have your guard up all the time. The police will help you, but when they’re still 10 minutes away and you’re bailed up with a drunk intent on stabbing you, it’s small comfort.
You have to have a sense of humour while deep in nightmares.
I once went to a case where a patient was basically about to die – bleeding out internally, absolutely nothing we could do, just a ride to hospital for them to declare her dead. She arrested just as we arrived at the hospital. Did we sit there and have a cry about a life lost? Nope! We thanked her for waiting until we got to hospital to go into arrest, and then laughed it off as the worst day we’d had in a few months. “It can’t get any worse than this!” we chuckled as we drove off to our next job.
There isn’t much room for compassion. Life can be short and nasty. Sometimes life is unfair. People rarely thank you. People will blame you when a terminal patient inevitably dies. You will hear sad stories from a load of people. Some things will make you angry. You just have to deal with it.
It’s still a rewarding job.
Does the job suck at times? Yeah, you bet! You get shit on (literally), you start to lose your friends, it’s dangerous, and you’re on a constant cycle of exhaustion. But it’s also pretty damn rewarding. You can make a difference, even if it’s just a small one, in somebody’s life. You can actually change someone’s world. Sometimes you are the only person who at least appears to care about someone. You might literally be their lifeline. On that rare occasion you swoop in and bring someone back from the brink of death, you can pat yourself on the back as having done a good job. Healthcare and death is a fundamental truth of the world – the King and the pawn all get sick, and you will be there for all of them. There aren’t many jobs like it.
So with all that said, do you really want to be a paramedic?