How to Become an EMT

I will always remember a woman I met one day when my partner and I stopped to refuel the ambulance. I went inside to grab something to eat. While standing in line to pay, the woman behind me asked me if I was an EMT. Of course, I was in uniform and my ambulance was just outside, but I politely acknowledged that I was in fact, an EMT. She acted like she had just bumped into a movie star or some other famous person, and went on and on about how much she respected EMTs. She asked me how to go about becoming an EMT, so I gave her a general description of the requirements and where she could follow up for more information. Then she said something along the lines of, “I think I would make a great EMT, as long as I don’t have to see any blood. I can’t stand seeing blood.” I thought to myself, “reality check, EMTs deal with blood, sometimes a lot of it.” But I didn’t say anything more, just wished her luck and went on my way. That’s when I realized that most people have no idea what working as an EMT actually entails.

Becoming an EMT

Working as an emergency medical technician (EMT) or Paramedic can be a very rewarding career. No two days are ever the same, your job is helping people, and the general public holds EMTs and Paramedics in high regard.But becoming an EMT or Paramedic is not as easy as some people may think. Here are some things to think about if you are considering this as your career.

The first thing you need to know is that each state, and sometimes each region within a state, have different rules, regulations, and requirements. My experience is based on my employment in California. Be sure to contact your local EMS agency for more specific information.

Educational requirements. You must of course, have at least a high school education. Then you will need to take a full semester course just to get certified as a “First Responder” (Fire fighters have to pass this course also.) Then you will take another semester to get your EMT certification. These classes are usually available at a local Junior College.
While most of your training will be in the classroom, much of it will also be conducted outdoors, using real equipment and role-playing practice. This is where many people fail.

The clinical information taught in the classroom is very specific and covers a lot of material. The examinations are not easy, and you must study the material thoroughly. The “hands on” aspect is just as important. A lot of time is spent role playing, practicing various techniques on fellow students. If you have a hard time putting your hands directly on another person’s body, regardless of their gender, or have issues with others doing the same to you, then this career is not for you. In the field, you will need to do a very thorough hands-on examination of your patient as part of your assessment, and you very well may find yourself not only seeing blood, but exploring the body to discover where it is coming from.

Getting the Job

Once you have passed the educational requirements and receive your certification, it is time to find a job. You will probably have to pass a pre-employment physical, including testing your ability to properly lift heavy weights. If you are going to drive an ambulance, you have to get an ambulance driver’s license. There are generally three ways to work as an EMT. If your ambition is to become a fire fighter, many agencies require you to be certified as an EMT before you even start your fire fighting classes. EMTs are also found in the emergency rooms of most hospitals. There, they are hired as an ER Technician. The cool thing about working in an ER is you get to stay indoors, not having to deal with the weather. You will also see a wider variety of cases. ER Techs seem to get better pay and benefits than the rest. You won’t be using much of your emergency medical skills, because the nurses and doctors will be doing that. You may find yourself being more of a “gopher” and assistant. The third place to work is for an ambulance company.

Some people think of EMTs as nothing more than ambulance drivers. In truth, there is much more involved. There are several types of ambulance companies. Most are either “for profit”, “non profit”, or “municipal”. Within those categories, you also have BLS (basic life support) and ALS (advanced life support.) A BLS ambulance usually has a crew of two EMTs. One drives, while the other rides in the back with the patient. These roles are usually changed between each run. In a BLS ambulance, your primary job is to take a stable patient from one place to another while monitoring the patient’s vital signs and well-being. For example, taking an elderly patient from a nursing home to the hospital, or transporting a patient from one hospital to another. There are a lot of “for profit” ambulance companies that contract their services and do nothing but BLS runs.

ALS ambulances usually operate as part of the 911 emergency system. They are the ones who respond to traffic accidents and medical emergencies. But in this case, the EMT assists the Paramedic at the scene, then drives the ambulance. The Paramedic is the one who will ride in the back with the patient. The primary difference between an EMT and a Paramedic is the level of training. In addition to all the duties of an EMT, a Paramedic is also trained and certified to give medications and narcotics, start IVs, intubate patients and perform other advanced skills.

What’s It Like?

The working conditions can be rough. Emergency Medical Services (EMS) operate on a 24/7 basis. The weather can be really nasty at times and has to be really severe before they will not let you go. I’ve driven through floods when no other vehicles were allowed to even try. It might be sweltering, both inside and outside, but if your patient is cold, you have to turn up the heat.

The work can be very physically and emotionally demanding. You may work various shifts, often with mandatory overtime. Your viewpoint on obesity in our society will change radically after you have had to load a few obese patients onto your narrow gurney, and you have to lift them up into the ambulance. Some of your patients will be psychiatric patients, some will be drug and alcohol abusers, and others may have dementia or Alzheimer’s disease. Some will be very young, or very old, and often severely injured. Some will be bleeding, increasing your risk of exposure to blood-born diseases. Your patient may actually die. Your drunk patient may urinate or defecate while lying on your gurney. People will puke in the back of your ambulance, and often on you as well. When the run is complete, you will most likely be the one who has to clean up the mess.

Patients can become belligerent and want to take out their anger on you. The worst work related injury I ever had was from a little old lady who weighed less than 100 pounds. She had fingernails like a cat and she used them very effectively. EMTs and Paramedics have a tendency to have a very high opinion of themselves and can be difficult people to work with. You will rarely have the choice of who your partner will be. Unfortunately, EMTs are, in my opinion, very underpaid for the services they provide. The flip side is that you can make a pretty good living because of all the holidays you will have to work and the overtime you will put in.

Those are some of the bad aspects of the job. Here are some of the good ones. Being directly responsible for saving someone’s life is very gratifying. Patients and their families generally are very grateful for what you are doing. I have had complete strangers walk up to me and thank me for doing my job. I’ve had little kids run up to me like I was Santa Claus, wrapping their little arms around my legs to give me a hug. You will meet and interact with a very diverse population. The majority of your co-workers are very dedicated, professional, and a pleasure to work with. You will also meet and work with police officers, firefighters, doctors, and nurses. Soon you will be on a first name basis with them. The job can be very exciting. Nothing beats driving Code 3 (lights & sirens) across the Golden Gate Bridge.

So if you are still interested in a career in EMS, be sure to talk to others who already work in the field. Make sure you are physically and mentally fit for the job. Weigh the good versus the bad aspects of the job. If you are still ready to go, then do it!

Additional Career Pathways

Paramedic

While it is possible to go straight from EMT training into Paramedic training, it is extremely rare and only a very few succeed. It is much better to work as an EMT for a few years before you even consider applying for Paramedic training.

Nursing

Some of the best nurses I have met were former EMTs and Paramedics. The hands-on field experience is priceless. If you are really into EMS, you can train to be a flight nurse on helicopters and fixed wing medical transports.

Other Medical Specialties

If you decide you like working in healthcare, but aren’t cut out for working as an EMT, you can still use your training and experience to train in several specialties such as Radiology Techs, Physical Therapy Techs, Cardiac Telemetry Techs, and Operating Room Techs. Working as an ER Tech for a hospital can be beneficial, as most hospitals are quite willing to fund your education in exchange for promising to continue working for them.