To Stay Or Go: Paramedicine As A Career


By:  The Musing Medic (@TheMusingMedic)


The Grass Is Always Greener

Most everyone is aware of the old adage “the grass isn’t always greener on the other side”.  And this rings true when considering a career in EMS versus moving up the medical hierarchy to another profession within the field.  I have made it no secret that my end game is becoming a physician but I certainly have considered other avenues.  But why should a paramedic consider a change of scenery?  I have identified the two reasons that make the most sense to me.


One Important Reason To Consider Is Finance

Probably the most obvious choice is financial considerations.  Paramedics and other pre-hospital workers earn a paltry wage that forces us to work two or three jobs with different services.  Around the Pittsburgh region, it is safe to say the average hourly wage is $15.00, give or take a dollar or two.  If a paramedic was to earn their RN certification, this would boost their hourly wage to around $22.00 to $25.00 as a brand new nurse.  Considering the average number of hours worked per year is a bit north of 2,000, that adds up to an additional $20,000 per year.  And that is just working one full-time job.  If they add on a part-time or per diem job, that number rapidly increases.  So less jobs held and increased wages is a solid reason to move from the paramedic to RN.


Obesity Epidemic Impacts Decision

Another consideration is the physical strain working as a paramedic puts on the body.  Climbing in and out of the truck, working in confined spaces, pushing, pulling, and lifting patients in awkward positions.  And let’s just put all the cards on the table here and mention that there is an obesity epidemic in the United States.  With a direct correlation between obesity and medical issues, it is no wonder that a significant number of scene runs involve a patient who is classified as overweight or obese.  Regardless of the technology available to pre-hospital crews, there is still a significant amount of lifting and the body can only take so much before it starts to break down.  Lower backs, knees, and shoulders seem to be the most common.  For a happy retirement it may be best to walk away from the pre-hospital environment before you are forced to limp away.


So What Are The Options Beyond Paramedic?

So what options are out there?  Well the quickest and most readily available path out of the pre-hospital world is nursing. Training is less than two years for a diploma or associates degree. There is a lot of versatility in the RN degree and the pay is certainly attractive.  But I think it could be difficult from moving from a very autonomous position as a paramedic to a position where autonomy is diminished and orders carried out.


PA Is An Option

Another option is Physician Assistant.  These mid-level providers are trained in the medical model and working in collaboration with an attending physician.  They diagnose, order tests, prescribe, and more. Physician Assistant programs are typically masters level so a bachelors degree is required first.  I think this is a solid forward move for seasoned paramedics.  The pay is fantastic at around $90k a year on average. Autonomy exists in spades typically but there is always a physician to bounce ideas off and consult with.  It seems like a logical extension of paramedic training.


Some Additional Options

What I left out were two other options; Nurse Practitioner and Physician.  I left these out because NP is an extension of nursing and being an RN is prerequisite for advanced practice nursing.  And I left out medical school because the duration of training and costs associated, both financial and non-financial.  After a certain age, the cost benefit declines sharply.


None of these options are the magic ticket to happiness but I think they are viable options for advancement and personal satisfaction.  So while the grass may not be any greener, maybe there is just more grass.


I’d be okay with that.


Till next time


The Musing Medic


are there any resources or businesses geared specifically toward re-tooling prehospital staff?