7 Alternative EMS Careers: Part 2

In part two of this feature, columnist Mike Rubin discusses four more nontraditional EMS jobs. Read part one here.

Not all of us in EMS spend our careers working in ambulances. Nontraditional positions offer EMTs and paramedics experience away from the 9-1-1 world. If lights and sirens aren’t essential ingredients of your ideal job, you might thrive in industries where patient care is ancillary to the primary business.

Last month we reviewed EMS opportunities in the entertainment and hospitality fields. The emphasis on maturity and people skills is echoed this month by colleagues serving in international, industrial, hospital and laboratory settings.

International

Have you ever needed a change of scenery? Paramedic Mark Mosier of Kelso, WA, did, so he moved.

To Iraq.

“After I took early retirement from the fire department,” Mosier says, “a buddy of mine told me about a London company, Frontier Medical, that places paramedics and nurses in underdeveloped locations all over the world. That sounded pretty cool, so I e-mailed them my résumé. Twenty minutes later I had a three-month contract and reservations for a flight the next day.”

After a 13-hour trip to Istanbul and a stop-over in Dubai, Mark landed in Basra, Iraq.

“I had no idea what to expect, but I could tell right away I wasn’t in ‘Kansas’ anymore. Iraq has abject poverty. There’s sand everywhere, nobody speaks English, and people are very cautious around you. My biggest fear had nothing to do with violence; I just wasn’t sure I was the right person for the job.”

Mosier soon discovered there were plenty of ex-pats from the U.S. and U.K. who could help him adjust to Iraqi culture and customs.

“You have to be careful; you don’t want to cause an international incident by saying or doing the wrong thing. You need to constantly be aware of your situation—where you are and whom you’re around. It sounds nerve-wracking, but it’s also exciting.”

After Mark was introduced to his work environment—an oil-drilling compound with about 100 prospective patients—he began to realize he’d be operating much more independently than most stateside medics.

“It’s not really a job for novices,” he says. “You’re a million miles from home, you’re not in your own bed and nobody speaks your language. You worry you bit off more than you can chew. I think you should have at least 10 years in EMS with a variety of calls in diverse communities before working abroad. You have to be very comfortable with your clinical skills. There are protocols but no real back-up. The closest hospitals for foreigners were in Jordan and Dubai, so I was expected to treat as much as I could on site.

“Very few people came in with critical illnesses or injuries. The first patients I saw were complaining of chronic headaches, nausea, knee pain—things like that. It was more like running a clinic than doing true EMS.

“You wear different hats—you’re a counselor, a friend. You’re dealing with a pretty fragile community where people see doctors for cut fingers and headaches. I had to dial back the urgency I’d gotten used to when I was treating really sick people in a 9-1-1 system.”

Despite the cultural differences, Mosier feels the pros of working internationally outweigh the cons.

“The travel is exciting; you’re going to places you’d normally never have a chance to see. You’re making good friends with unique people from all over the world. It gives you a bit of hope for humanity.

“The pay was great—anywhere from $300 to $500 a day for a seven-day work week. That could be $15,000 a month! They just send it to your bank. I stayed on and before I knew it, my three-month contract had turned into three years.”

Hospital

You’re no stranger to hospitals if you work 9-1-1. There’s a difference, though, between delivering patients to emergency departments and receiving them there. Kentucky paramedic Kevin Hurley has done both.

“I started at Crittenden County (KY) Hospital 15 years ago, right after I became a medic,” he says. “I stayed until they eliminated my position in 2012. Now I’m back on an ambulance full time.”

According to Kevin, the biggest difference between hospital and prehospital environments is the patient backlog.

“You have calls holding in 9-1-1, but the patients aren’t right there in your face. In the ED, they’re all sitting in the waiting room.”

Nonemergent cases clog the ED as much as they do EMS. Sometimes that means hospital paramedics have little or no supervision.

“One time the ED physician was handling a code on another floor when a second code came in,” Hurley says. “I got to work that arrest just as I would have in the field, except I had a couple of extra people helping me.

“In the ED, I could do whatever I did in the field including some procedures, like chest decompressions, the nurses couldn’t do. There were also things like hanging antibiotics that I was allowed in the hospital but not in the field.”

Hurley recommends at least a year of 9-1-1 experience before transitioning to an emergency department. He says job satisfaction depends as much on attitude as it does in the field. “You can’t go into the ED with a God complex. It might be hard to get used to nurses signing for what you do, but you have to look at it as a learning experience and not get adversarial. Adjusting to hospital work isn’t so bad; maybe go back and study pharmacology a bit more because giving meds is such a big part of the job.”

Medic wages at ERs vary, but they’re usually close to 9-1-1 rates. Benefits for full-timers can be much more robust than at private ambulance services.

Industrial

When you’re half of a two-person medical team in a 1.3-million-square-foot facility, looking after employees’ mostly nonemergent needs often requires more business experience than therapeutics.

“It’s quite an adjustment from 9-1-1,” says paramedic Alan Keith, onsite medical representative at Amazon.com’s spacious Lebanon, TN, warehouse. “We have a clinic with basic first-aid stuff and OTC meds only. If we get anything serious we call 9-1-1.”

Keith was on the receiving end of those calls for 14 years. Moving to industrial medicine has been quite an adjustment for him.

“You have to change your whole mindset,” he says. “It’s a lot less aggressive, a lot less stressful here, but you can’t ever lose sight of the fact that the company’s primary business is to get products out the door as quickly and efficiently as possible.

“Mostly, my department looks for ways to improve employee safety. We also handle worker’s comp, which requires lots of administrative time. Still, medical experience is important because you’re dealing with day-to-day injuries and treatment.”

Not being able to offer advanced care can be frustrating for long-time paramedics.

“I don’t think this is a position for somebody new to EMS,” Keith says. “Ideally, you want someone with field experience who’s already gotten 9-1-1 out of their system. You’re dealing more with chronic conditions than emergent cases.”

Salaries are comparable to other EMS jobs but big-company benefits, like tuition assistance and retirement plans, can make the corporate world seem awfully attractive.

“One of the girls I work with just completed paramedic school with financial assistance from Amazon,” Keith adds.

Laboratory

Attention EMS providers: An international blood-products processing firm has openings for paramedics. The problem? I can’t mention the company’s name. I had to agree to that condition in order to interview their staff, but that doesn’t mean you can’t Google “plasma donation.” That’s the principal business where Brittiney Krahn works as training development coordinator.

“We hire paramedics and nurses to screen prospective donors, collect their blood and process it through phoresis machines,” says Krahn, 29. “It’s a booming business. We have over 100 locations in the U.S. alone.”

Krahn says she prefers to hire paramedics because of their sense of urgency.

“Medics are quicker to respond, quicker to catch problems when they’re evaluating donors. They’re not just going through the motions; they’re communicating with prospective customers and understanding their stories.”

Rob DeMeo, who worked for Krahn for a year between traditional EMS jobs, says the plasma donation industry was a completely different experience for him.

“You’re not dealing with patients—not in the conventional sense. They’re customers,” the 37-year-old paramedic says. “They come through the door because they’ve heard they can make money donating their blood, but they’re still apprehensive about getting stuck with 17-gauge needles.

“You have to be prepared for ‘donor reactions’: people vagaling down, even seizing due to pre-existing conditions. I never had anything life-threatening, but I did call 9-1-1 a few times.”

DeMeo liked being able to keep a regular schedule. Working in a climate-controlled facility wasn’t bad, either.

“It’s a stable environment,” he says. “You’re out of the weather and you don’t have to worry about getting hit by a car at a wreck on the side of the road. You even get to finish lunch.”

DeMeo admits he missed having a partner, but felt fairly comfortable a few weeks after starting. His compensation was similar to 9-1-1 with even better long-term prospects.

“I became a supervisor within four months, then was offered a traveling position training company employees in 48 states. How many EMS jobs can match that?”

Looking Back

The occupations we’ve examined in our two-part series are representative of paramedic and EMT opportunities in nontraditional environments. Experiences with individual employers vary, just as they do in 9-1-1. However, after serving in five of the seven profiled industries, I’d say a common, significant advantage those jobs have over conventional EMS is the lower stress—mental and physical—of mostly nonemergent responsibilities.

If the prospect of high-energy critical care is what gets you out of bed for another shift, stick with 9-1-1. But if you’re personable, mature, customer-oriented and well-versed in well care, you might find “alternative EMS” a nice way to broaden and extend your career.

Mike Rubin is a paramedic in Nashville, TN, and a member of EMS World’s editorial advisory board. Contact him at mgr22@prodigy.net.