How Long Can a Paramedic Stay on the Job?

How long can ambulance professionals stay on the job? Is there a natural limit to the paramedic’s ability to manage the physical demands, emotional burdens, stressful working conditions, and long hours before burnout sends them hurtling down the nearest off-ramp? And what are the tricks or hacks that might enable emergency medical services to hold onto this precious human resource, now in short supply, for a while longer?

Despite what we hear about the inevitability of burnout in EMS, some paramedics have managed to make a longer go of it, 40 years or more on the job, even into their 70s. What are their secrets to career longevity? And how do they avoid being physically depleted when retirement finally calls?

Thom Dick, who retired in 2013, started as an “ambulance attendant” while still a student at San Diego State University in 1970 before following the path to EMS school and then paramedic training and certification in the field’s early days. Along the way, he taught EMS courses and wrote several books, including People Care: Perspectives and Practices for Professional Caregivers, as well as columns for EMS World and JEMS.

When Dick started as a first aid responder, navy corpsmen and army medics returning from service in the Vietnam War were among his first teachers and partners. He credits their training and experience with helping to shape the culture of early civilian EMS programs. He quickly found that he loved EMS.

“My experience is that it’s not the stress (of caregiving) that gets in the way of a long career in EMS,” Dick says. Instead, he suggests, working conditions, service models, policies and supervision may have a bigger impact. “If you are born to it and have the talent to devote yourself to caring for sick people—barring severe injury or violent incidents on the job, you can do it.”

Talent for Dick is what others might call emotional intelligence. “That predicts your ability to interface with people. In paramedicine, you need to interact with people who are scared to death.” EMS professionals need to be able to think on their feet, but they also need something more, he says. They need to be good listeners, with a sense of humor, and they need that mysterious talent.

Dick compares this kind of talent with the special qualities possessed by experienced hospice nurses. “If you’re born to it, it can be a source of joy, whether that’s being a paramedic or any other job.” For paramedics, dealing with people who are very sick and scared, he says, “the most important thing is that you’ve got to like people.”

Kneeling Posture

When you see a paramedic working in a private home, chances are they are kneeling by the patient’s side, Dick says. “It’s a statement of humility. We never realized how universal that was until we started going to international EMS conferences and talking to paramedics from all around the world. They recognized that kneeling was what people do in those stressful situations,” he explains.

He also says routine exercise is important to remain in good physical shape. “Physically, we were still lifting people in and out of ambulances until the emergence of self-lifting cots and hydraulic lifts.” Dick had an undiagnosed heart defect which led to a stroke six years ago, although he has mostly recovered from that. While a working paramedic, he would try to jog two miles in the morning and do some weight lifting at the EMS base. “And try to refrain from too much fast food.”

He says he has enjoyed a good life and a happy one. “I’m still married to my wife of 52 years. She was one of the reasons I could stay in EMS as long as I did. She knows how much I loved it.” When they started adopting children, he gave up 24-hour shifts and transitioned into EMS education and administration. They moved to Colorado in 2001, where he became quality care coordinator, first for Pridemark Paramedics in Arvada and then Platte Valley Ambulance Service in Brighton, where he worked until retiring in 2013.

Chasing Ambulances to Driving Them

Jesses Izaguirre, 70, is now approaching his 49th anniversary working in EMS. He still does two consecutive 24-hour EMS shifts a week for AmbuServe Ambulance in Los Angeles County, mostly facility transports or sporting events and concerts at the Pasadena Rose Bowl, commuting weekly from Modesto in California’s Central Valley. But he was glad to give up 911 ambulance calls in favor of a somewhat more relaxed role. “Sometimes it’s busy. We might get eight or nine calls in 24 hours.” But other times it’s quiet enough for him to take a nap while on the job.

In the 1970s, Izaguirre was an ambulance-chasing photographer, selling photos of car crashes to local newspapers. until the local ambulance company called and offered him a job as a driver. He still takes pictures, such as for weddings or a recent 60th anniversary party. He started in EMS without much training in 1975, got into EMT school a year later, and then paramedic school in 1978—45 years ago!

What are Izaguirre’s secrets to such a long career?

“Keep your sense of humor, and don’t let things bother you—which can be hard to do when you see people who have been hurt by their loved ones,” he says. “But I didn’t do it to them. I’m there to help.” He learned his sense of humor from his mom and dad, who were really cool parents. “I’m just naturally like this.”

Izaguirre spent several years in management positions in Modesto, Stockton, Sacramento, Los Angeles, and elsewhere, while still taking occasional shifts such as filling in for staff who called in sick. His current employer, AmbuServe, wanted him to be a manager for them. “But I said: You need paramedics in the field more.” Recently, he called in sick, for the first time in 25 years, despite two previous bouts of COVID from exposure on the job, which he recuperated from on his days off.

“Have I ever experienced burnout? Some of my friends have. When I look back on doing 911 calls, that was kind of stressful,” Izaguirre says. “There are some things that you can only talk about with your fellow employees. The public wouldn’t understand some of the things we say to each other.”

He ended up with a chronic back injury, exacerbated by many years of lifting patients into the ambulance. But he says he’s pretty healthy for a 70-year-old—and is told he looks a lot younger than he is. “I was not really an athlete, although I played baseball.”

When asked when he’s going to retire, Izaguirre often answers: never, although his chronic back might have something to say about that. He’d like to last at least one more year, making it to the 50th anniversary, although his wife plans to retire after 42 years as a nurse, most of them in the emergency department. “If she retires, I probably should, too. But I enjoy my weekly commutes to Los Angeles, and the compensation is nice.”

The Back of the Truck

Kevin Badgley, 67, also spent 45 years in EMS, 40 as a licensed paramedic, until his recent retirement, in part for medical reasons. “At the time I started, EMS didn’t actually exist as we know it today. In those days, standards were few, and there was no advanced cardiac care. It was just ambulance crews, although the industry was changing. When I started, I wasn’t old enough to drive the ambulance, so I spent my first couple years in the back of the truck,” he says.

“I was working in Rapid City, South Dakota. We were running five or six calls a day. We started with a desire to help people. We got to kick back between calls, but we were getting crap pay.” Eventually, respect and recognition started to grow. He felt part of the creation of a whole new culture of EMS.

Today, Badgley says, he considers EMS a calling—not just a job. Its motivation has to come from within. “This is a full-time lifestyle commitment. You might miss Christmas or family weddings. If you can’t commit, don’t start,” he asserts. “And if you’re looking for a pat on the back, it won’t happen.” The hospitals for which he worked often made a big fuss about their helicopter emergency transport services, but not their ground-based ambulance crews.

Badgley, who lives in Kearney, Neb., population 33,000, says addictive drugs are a bigger issue in Kearney than they used to be for EMS, although he never had to confront a fentanyl overdose on the job. “It’s becoming more prevalent, and our local law enforcement now carry naloxone in their pockets.” Over the years, he taught EMS courses, including CPR, hazmat awareness, and farm accidents.

“The reward of this work is knowing you’re part of elite company—doing work most people wouldn’t consider, because of your own sense of self-worth, helping some old lady who is scared to death from her medical crisis,” he says. “My wife stood by me throughout my career, through bad calls, working for poorly run services. My kids supported me no matter how many family events I missed. I held on until age 66 and 2 months—the last one out of my original EMT class still working.”

Last year, heart disease, type two diabetes, and neuropathy finally caught up with Badgley. In 2014, he suffered a cardiac event and ended up with a two-vessel coronary bypass. “The only thing I asked afterward was how can I improve myself to get back to my calling—my work?” The year before he retired, he was hospitalized with a ruptured disk, which made going up and down the stairs with his partners and the gurney more problematic.

How does Badgley explain his longevity?

“I never worked for a large system. I knew all of my co-workers. Even when we had lots of calls, we usually had some downtime between calls for a chance to decompress afterward,” he says. “Critical incident stress debriefing helped me a little, although some people find it helps quite a lot. For me it’s not as helpful as just sitting down with my partners to discuss what happened,” he says.

“I had to come to the conclusion that I’m not a lifesaver. I’ve never actually saved a life. I’m a tool to help, but I have to give it up to God. I realized I just have to be the best I can be every time, but ultimately it’s not up to me.”