Firefighter/Paramedic for a large city department here. The way our department operates, we are a combined fire and EMS system, running two FF/PMs on every transport unit. Only about 30% of our department are qualified medics, and many of those are officers riding an engine or ladder. If you are a firefighter/medic, 90% of your time is spent on a medic with very few Engine days. Its a broken system with no fix in sight. Meanwhile those without their PM card ride an Engine or Ladder and take a fraction of the run volume. Once you have your P card, you have to keep it for at least about 10 years before it can be "dropped" or you get promoted. Its a constant battle try and keep enough certified paramedics on the street. I came here with my P-card, so it was inevitable which route my career was going to take.

I've been in the fire service and EMS for the past 7 years here and other places. For the most part, I loved every minute of it. I've worked downtown, college campus area, the ghetto, the suburbs, big departments and small departments, and for the most part its all been fun. I've worked at busy and slow houses, and always enjoyed being busy. I like EMS, I love being a firefighter.

6 months ago I was forced to a lower income suburban area occupied by mostly Somali and Nepali immigrants, as well as lower income white and black folks.  The abuse of the EMS system in the district is rampant, way worse than other areas that I have worked. The transport times are long (20-30 minutes). We average around 18-20 runs a shift. There is almost always a language/cultural barrier. I feel myself slowly spiraling into the crusty burnt out medic I swore I would never become. I'm drinking too much at home, never sleep well, and my jaded attitude is affecting my personal life. I never feel up to working out anymore because I am constantly tired, so my once stellar physical fitness has slowly declined. I'm not exactly a fan of riding with one of my coworkers at this station so that doesn't help either. It seems like every day there is more CE or professional education that the higher ups want complete on top of the enormous run volume, some of which I have to do in my off time to avoid reprimand.  

Meanwhile I have non medic peers tilling a ladder truck every shift, sleeping every night, and actually making fires. These are the guys with no previous fire experience who got lucky taking the civil service test. Meanwhile I worked hard and got my certifications and get rewarded with an extra 8% pay and 90% of the run volume.

Thanks for listening to the rant. I hate people who constantly bitch, and especially avoid doing so at work, but I had to get my frustrations off my chest, even if its in an anonymous forum. There are guys out there that have been in my situation much longer so I like to keep that in mind, and rode tough medics for 10+ years of their career. I get paid very well here compared to other departments, our equipment is nice, and the schedule is better than most. Still, I can't avoid how the run volume and demographics of the area is starting to affect me personally and professionally.  

Anyone else out their deal with burnout in their career? How did you cope?

First of all, it doesn't sound like this is any failure or shortcoming on your part, it's a leadership failure in your department.  I've never been a fan of working double medic trucks, I'd much rather work with a strong EMT than another medic.  The EMT can take the BLS calls, I take the ALS.  Some days I get screwed that way, some days my partner, but it evens out in the end.  If your department is that short on medics, it needs to force the "guys tilling a ladder truck" into EMT school and put them on a bus once in a while to give the FF/medics more fire shifts.

I came to a point many many years ago as a "burned out EMT" that I either had to go to medic school and stick with it, come what may, or get out of the field altogether.  Obviously I chose medic school, and haven't looked back.  I've had to make some of my own opportunities, but being a medic ended up taking me around the world, literally, and the chance to see and do some really neat stuff that I never could have done if I had made the wrong decision to go to some sort of 9-5 job.  For me it was the right decision, and I haven't regretted it at all.  It was just a matter of putting it in my head that I was going to do it and make it, and that's what it took for me.

Brother I feel for you. I rode my first fire apparatus and ambulance in October of 74. I spent a good part of my career in EMS in Maryland in a high volume department. ultimately it drove me away from the fire service. I did end up in non fire ems and there seems to be some sanity in an agency that's primary goal is to provide ems. I m not sure after all of my experience I would say there is such thing as burn out. I think its an unrealistic expectation we have in our carriers or call it being idealistic in a unbalanced system. I kept in touch with my peers over the years and they all made chief and seem extremely unhappy in where they ended up. Its like they had to give up to the un fixable ems system. My only advice to you is to give up on something that is trending down. Call it the job stock market, dump it for something going up. Good luck to you.

The guys on the box get screwed but usually that's shared out. Most fire-based EMS I've been around requires everyone on the FD to be an EMT and officers are required to be medics (there are quite a few medics due to the pay increase) to share the load around and everyone gets stuck in the box at some point. The double medic truck seems strange too, an EMR could drive the truck and help take the load off the medics. It sounds like the whole system is set up screwy.

Your department needs to get away from double medics. Medic and EMT is perfectly adequate. That being said, and mind you my department isn't nearly as busy as yours, but you have to remember why you fell in love with the job. If you don't love it anymore maybe it is time for a change of scenery. Maybe that is a new department, maybe it's a new line of work. I am not one to tell people to start packing, but this profession is a calling, when it becomes a job it starts beating on you. Don't ruin your life over it if it is just a job to you. I work on a QRV for a month (ALS quick response vehicle) then go back to my normal station for a month splitting engine and medic time. I still love it, and I only got two engine days this month due to transfers. Maybe you change departments, start working at an ER if the money loss is not palatable. Either way, if you are burning your life to the ground around you you aren't helping yourself or your patients.

ETA- I just re read that and it sounds awful. So... Let me rephrase a little. I would definitely still consider looking for a new department that doesn't ride you hard and put you away wet. But, mainly you need to find things positive in the job and hold onto them. Otherwise it begins to feel pointless. Also, if you are a good medic, being in a shithole area they are probably in more need of a good medic than the snooty uptown area that calls you for Muffy and her upset stomach. You will probably do more good there than in a good area. The other thing is this, is it being overworked or is it the calls. I ran a one month old cardiac arrest that didn't make it Monday night/Tuesday morning and it just brushes off of me. If that is the problem, it is time to talk to someone. If your department offers EAP use it, even if it is just burn out, give them a call and talk to a professional, there is no shame in if. And talk to your supervisor, see if he can hook you up with consecutive days on the engine, I find it helps to do a couple in a row on there to break up the feeling of always being on a box. Either way, good luck and put down the bottle, it doesn't help anything.

I have no problem with a double medic box if you have the resources.  You guys do not have the resources.

If you really don't think it will ever change, you might have to.  New station, new dept or promote and change your dept from within.  

Good luck.

You could move to my dept, one of the only ones I know of where the city is against the FD taking up any EMS duties

Not a question of resources when I've worked double medic.  I just prefer to work with a good EMT, and have crew roles better defined.  In other words, you don't have two medics either trying to step on each others toes to either do the interesting calls or pawn off the BLS calls onto each other.  One chief and one indian instead of two people who both think they're chiefs.  Too many medics in a system can also lead to the degradation of perishable skills.

We usually swap every call or split the shift hour wise. First 12 second 12 etc.  My favorite is after bedtime first one who is fully clothed and touches the box first gets to be the basic.  

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Gents, thanks for the replies. I still love the job, but I had just gotten off a tough shift when I wrote that and needed to vent to some folks who get it. Hopefully in another 2 months I am going to get transferred back to my old station that had a different demographic and had a level 1 trauma center in its district. We were busy but always managed to have a good time on the box.

I would totally agree that running two medics on every transport vehicle is outdated. If it were up to me, we would run an EMT and a medic on every transport vehicle, and two medics on every engine, which is completely opposite of how we have it now. Why take a medic out of service to drive a BLS patient to the hospital? Why not just keep him on the engine and ready for the next real run? I came from a 1 P one B system at my old part time job and it worked great. Unfortunately though the union is against a one P one B system saying its a reduction in care (I think they are just looking out for the old heads riding ladders), and the administration just wants to move back to a two tiered system with ALS and BLS transport vehicles, which I think is a step back in time.  Time will tell if anything changes, and if the changes will make it better or worse.

Its still a great department, and they do firefighting better than just about anywhere else in the state IMO, but the EMS system is outdated and its destroying morale. The department leaders care more about politics and the bottom line and don't have the balls to make the right decisions for the community and its firefighters. But with 4 years on I'm about to make top out pay and be vested. After five I can take the promotional so I think that's the route I'm going to try and go and stick it out in the mean time. I always have to keep it mind there are thousands of other dudes that would like to be in my shoes.

As long as you still love the job you can stick out just about anything. Seriously though, don't pick up the bottle for a while, that alone may help your energy levels. Also, take a day and go teach. It sounds stupid, but it gives you some appreciation for where you started and where you are now, which will probably help you gain a little perspective and give you a slightly better mindset. Glad you got over the hump though. Hope you get the transfer back to your old house.