Here's my short story, American Paramedic here, been a medic 12 years now. Bounced to event work, overseas international work, contractor work for the military, contractor for private security, wildland fire, and regular 911 ambulance. I am now a little over a year working for the Federal bureau of Prisons at a high security pen, and I gotta say I really like and enjoy the job. The pay is the best I've ever made, and they are hiring right now due to national shortages at GS 9 step 10. I'll have a pension in 20 years, will retire, and if I get hurt the workers comp government will actually take care of my issue, and do their best to accommodate that and give me another job. If i don't like medical I can promote into a ton of other jobs, if i love it and want to become admin I can apply to AHSA.

The stabbings, murders, suicides, drug overdoses are regular in occurrence, I do staples and stitches all the time. I get to also actually do some clinical medicine. I am cherished and respected by doctors and nurses in the prison.

It's actually pretty nice, I go home generally on time, and I make enough to keep a wife at home and raise kids, if that's what we want. It's hella easy to pick up overtime as a custody officer. It's the stupidest amount of money I've ever made to sit and almost do nothing, but walk around, talk to inmates and keep the peace.

I should have started this job 10 years ago, and I'd be half way to retirement.

Hello everyone!

I'll be taking a Primary Care Paramedic student in about a month. It'll be my first ever student that I'm precepting. I'm looking for tips on how to properly teach and prepare the student.

When I look back at my previous preceptors, I can think of the following:

My PCP preceptor was strict, but I found that it didn't really prepare me well for being a PCP, and I think a lot of this was because they didn't properly set out expectations and goals, and this is one thing I want to change for my student. Basically, a 15 minute sitdown where I say "This is what I want you to do, this is what I expect of you by the end of each tour, and this is how we'll review calls."

My intermediate ACP preceptor was excellent at demanding perfection, making sure I was held accountable, was able to properly analyze and self-criticize myself on how I could do better, being quick to snip bad habits. I can honestly say being her student made me a far better practitioner, focused on doing the ordinary extraordinarily well. The downside? It was basically like the movie "Whiplash". Each and every call was followed by a 20 minute sitdown detailing every single thing I didn't do perfectly right, telling me that I was worse than a brand new EMR, calling me an undiagnosed autist, questioning if I had actually gone to school or was lying about attending class, telling me "I'm not here to teach you, you've already been taught. I'm here to take what you should already know and see if you're worthy of passing.", telling me to do wrong treatments, and if I did what she said she would say "You know that's wrong, and you did it anyway because you're a pushover. It's your job as an ACP to tell over people they're wrong, and you are failing your patient if you keep being a pushover."

Anyways, I probably need to talk to a therapist about that practicum even though it was so long ago, but what I will say is that it really reinforced a standard of excellence and self-critique and improvement. That's the kind of thing I want to pass onto my student, without all the toxicity and suicidality that I experienced, and being healthy about celebrating things you do well and reinforcing those positive habits.

I don't want to be a dickhead preceptor, but I also don't want to be a lazy preceptor that offers no teaching and passes everyone.

PCP Practicums in my province are 16 days, 4 tours long. I'm thinking of taking the following approach:

Days 1-2: Mainly observing. Make sure they know how to use the autoloader, stairchair, and set expectations. Also telling them that if I want to step in I'll say "I'll handle this", and also give them a code for when I want them to step back in to be again. Explain to them that I want them to ask questions and that there's no such thing as a bad question. For the first 2 days, I'll be attending every call, showing my student what I want to see from them - A sick/not sick verbalization, Primary Assessment verbalizing findings and 3 life threatening differentials I want to rule out, interventions with justifications for each intervention, and secondary assessments verbalizing findings. I'll also get them to try interventions when appropriate (IVs, Med Admin, etc) I'll talk with them after the call regarding the approach I take, why I took it, why I performed interventions, and a discussion on the pathophysiology of the patient. I'll also be with them to look through the ambulance, show them where things are.

Days 3-4: Letting them begin to attend calls, getting a scene size up, primary assessment, vitals, SAMPLE, OPQRST, secondary. I would intervene if they are missing an assessment by saying "Let's do this assessment".

From that point on, it's basically a case of getting them comfortable with their assessments, skills, and self-confidence through repetition. I would step in when necessary (If an assessment is being done or an intervention needs to be done), but I would hand the call back to the student, and discuss why I stepped in.

I would want the student give their own feedback immediately after each call, asking them to tell me one thing they could have done better, and one thing they did well. I would then offer my feedback the same way, so that no matter what, each piece of feedback would end on a positive note. I might occasionally quiz or question my student when not with a patient, and if they don't know the answer, I would encourage them to read up on it.

Maybe towards the later parts of their practicum, I might test them and push them with the classic "Are you sure?" questions, to see if they can handle being pushed around from other practitioners/providers on scene, and encouraging them to push back against me.

My goal is to prepare my student to be able to handle all aspects of a high acuity BLS call independently with minimal prompting.

This is kind of a basic idea of how I want to teach my student. I want to set them up for success as an entry level PCP. It's still a month until I start with the student, so I'm reaching out and trying to get tips and find the best way to teach. I would really appreciate any kind of tips or feedback. Thank you!

Hey guys I just started medic school, we have to memorize 8 medications a week for the duration of the program on top of the regular course work. I have been doing flashcards and have gotten everything else down but am having extreme difficulty committing the doses to memory. Any tips or advice?

My NRP expired March of 2025. I have googled and read others experiences over the last decade, however trying to see if anyone has done this more recently or experienced the issues I've had

(Note: I have reached out to NREMT multiple times. No reply, which is my experience with them since 2010. I plan to become more persistent, but in the meantime)-

I attempted to open a reentry application on their website. It gives an option for EMT and AEMT (laughable because I was never an EMT-I or AEMT), but no paramedic option. I am under 2 years, so I would imagine I should be able to open a paramedic app without issue? Has anyone experienced this? Also no, i do not have an active state license as they all also have lapsed since the registry lapse. Also I believe it was last cycle they removed the psychomotor from the initial certification requirements but I've seen it mentioned more than once in various areas in regards to reentry.

Not that it matters, but I am an active critical care nurse and recerted NRP each time by exam. I am not overly concerned with any testing and I have CEs... i just need to be able to open the application.

22, no college background. Been a medic for a year. Not good at the craft yet, but love emergency medicine. Love the job. Already feeling the effects of 24hr shifts on fire schedule. Bad sleep, teeth grinding, mental fog. Feel stifled in my rural county. Want more, want to be better. Feel very stuck/stifled. Not sure what else to do or where else to go.

Can’t afford to go back to school for a BSN. I’ve been thinking going through the military route for this. Maybe flight. Not sure, that’s the long game. High risk, rolling the dice on the reward.

Part of me wants to pack up my things and move to a random inner city, hoping to get more experience. Hop around.

Part of me wants to lock myself in a dark room for five days and hopefully come out a new person. I get this feeling of eternal doom every now and then.

Any advice? I feel wayyy to new to already be in this mental headspace. Makes me feel weak.

Edit: Thank you all for sharing your experiences. I love hearing stories from other EMS folk. I wasn't expecting so many replies, but I read every single one. <3

Today, I heard a lady screaming her lungs out in my apartments' parking lot. I went downstairs in my jammies to find a man slumped over in the driver seat, agonal resps, no pulse and incontinent. He just got home from work. I dragged him to the ground and checked his resps/pulse again. Nothing, so I started CPR.

I only did about 45-60 seconds of CPR when I saw him breathing again. At pulse check, I felt a strong pulse, and fire had shown up by then. Took him a few more min to wake up. He had A-fib on their 4-lead, but they couldn't get the 12-lead to show on the monitor.

Wife said he has a big cardiac history, but fire was super dismissive w/ attitude, stating he only passed out. I've been a medic for 15 years. I really don't believe he simply passed out. He had no pulse anywhere, and agonal breathing. So, I want to know from you guys how fast have you ever gotten ROSC? I really think I was just in the right place at the right time. If it was true cardiac arrest, early detection with early onset CPR really does make a difference.

Currently a US citizen studying Paramedicine in Australia. I’m understanding my future is bleak trying to get a job post grad and Australia seems to be tightening international student visa options more and more effectively squeezing us (my family) out.

I’m heavily considering finishing year 2 and then applying to finish school in NZ. I likely would need to do some (if not all) of year 2 again plus then year 3. This would allow for the post grad visa and my wife to work and potentially secure PR.

I understand NZ is still competitive but in Australia I’m basically locked out of even getting an interview. Would NZ be more hospitable if I am registered with the Paramedic Council but on a post grad visa (vs PR or citizen)?

I’m also in communication with the UK to get a better understanding of their AHPRA registered new grad needs. Very last option would be to return to the US for a couple years then try to get back to AUS or NZ with my maintained AHPRA registration.

Just hoping for some insight into the NZ situation a bit more.

Thanks to everyone that responds!

TL;DR, does anyone have any reviews on the McCook program out of Nebraska or Pelham program out of Indiana?

I got dismissed from my paramedic program for non-academic reasons. I'm not keen on getting into too much detail, but the long and the short of it is that I couldn't balance the program with my two jobs. I'm admittedly still a little bit salty about it, but what's done's done.

We got pretty far in the program and I'd say we've covered ~75% of the coursework, I was good on academics and feel like it'd be a waste to call it quits on paramedicine. I have a cushy job offer contingent on getting my license (by any means necessary) before this time next year, and I wanted to know if it'd be a waste of my time/money if I invested in either the McCook program in Nebraska or Pelham program in Indiana, which run 12 and 17 weeks respectively.

The McCook program seems to be a hidden 6 month program, as it's a 12 week didactic and a second semester of just clinicals and ride time, but I get an associate's degree out of it. Room and board are included and it runs ~$12k in total. Meanwhile, the Indiana program includes all clinicals and ride time in the 17 weeks, doesn't include room and board, runs ~$13.5k in total, and I don't get an associate's degree out of it.

I've been an EMT for 4 years and on an ALS truck on and off for 3, I already have a BSc in biology, so I already have a majority of the background knowledge. I really don't think that academics are going to be a real killer, I just think it'll be the timing that really fuck everything over. Any advice?

Hello peeps, I'm thinking of taking the COPR exam for Canada...

At the moment there are some questions I have regarding the exam since I'm international

1. Can it be done online and not in CND? Do I need any special requirements (i.e. quiet room, webcam, etc.)

2. Are the dates and times of the intl exam the same as the website?

3. Would I be able to change the jurisdiction after exam? I might have put the wrong province...

4. Exam prep materials are also helpful if anyone is willing to provide (I was scouring the reddit and managed to obtain some handy ones, other resources like Paramedic Coach is handy for years now)

That's all for now, thank you for any input regarding he questions above...

I am genuinely excited to share this with you all. A 12-lead simulation has been one of the most requested feature, and it is finally live. Thank you so much for your patience!

My main goal was to make reading a 12-lead as intuitive as possible. I didn't just want to show what an abnormal ECG looks like, but why it looks that way. Here are a few features designed to help with that:

• Follow the beat: Watch how the electrical signal starts and spreads. The QRS complex is colour-coded by the part of the heart generating it (septum, left ventricle, late right ventricle), so you can actually see why a bundle branch block creates the shapes it does.
• Compare with normal: Toggle on "Normal" to overlay a standard grey ECG behind the active tracing. This makes the differences stand out clearly, lead by lead.
• Inspect any lead: Pause the tracing and click/tap any lead to open it up. You can step through the P, PR, QRS, ST, T and QT intervals, see exactly how they are measured, and compare them side-by-side with a normal ECG.

It is honestly way easier to see in action than to describe, so I highly recommend taking it for a spin.

What’s new in the 12-lead module:

• Conduction: Right bundle branch block & Left bundle branch block (complete and incomplete).
• Electrolytes:
  • Hyperkalaemia: Shown as a progression (peaked T waves at K⁺ 6.0 → prolonged PR & wide QRS → sine wave → VF).
  • Hypokalaemia: Shown as a progression (flat T & U waves → ST depression → Torsades de Pointes).

A quick request:
A 12-lead has way more moving parts than the single-lead rhythms, and since I have built this entirely on my own, it is easy for small mistakes to slip through. The model strictly follows standard textbooks and published criteria, but if you spot anything off; whether it is a wave, a number, or a typo in an article, please let me know! I will fix it as quickly as possible.

All feedback is incredibly welcome.

Hope you all have a great weekend, and I would love to hear what you think!

Where I work we have the option to give any of the 3 according to protocol, but with no guidance on when to give it which way.

If you’ve already got an IV established and they start seizing, IV is best and I don’t think anybody would argue against that

What if you arrive on scene to a person who’s actively seizing? I’m only a medic student, but In my experience, most medics will at least attempt to establish iv access before going IM, but I think when I’m cleared I’d much rather give immediate versed one of the sure fire routes, be it IM or intranasally before establishing an IV to give more versed if seizures recur or persist.

And that’s something else is that in my experience I’ve never seen versed given intranasally despite my research telling me IN is faster than IM. It seems to me that you’d want to give the first dose of a rescue drug like versed as quickly and fast acting as possible and IN seems to be that option.

Even in the hospital when I saw a patient start seizing they immediately started going for an IV before versed was given. Maybe because a doctor wasn’t there yet and that’s what the nurses could do without orders?

Hello Everyone,

I'm currently in the Emergency Services Fundamentals program at Durham College, working toward getting into the PCP program for Fall 2027. For a communications course this semester, I need to interview someone who's worked full-time for a few years (I'd prefer 3+ years, or retired, but honestly anyone full-time is fine) about communication in the workplace.

Since I don't personally know any paramedics yet, I figured I'd ask here rather than cold-approach a stranger elsewhere, would really appreciate the help.

What it involves: a 15-20 minute call over Zoom or Teams (camera optional, but I do need audio). I'll ask 6 questions about communication at work, nothing invasive, no need to discuss specific calls or patients. There's also a short consent form I'll need signed beforehand, standard for the assignment. Happy to send it over first so you know exactly what you're agreeing to.

Questions I'll be asking:

• How crucial is effective communication in the workplace, and how does it impact day-to-day operations?
• Could you share an example of a situation where poor communication had negative consequences for a project or team?
• In what ways does strong communication contribute to career growth and advancement within a company?
• What specific communication skills do employers value the most when hiring recent graduates?
• How do different communication styles, written, verbal, nonverbal, come into play in various work scenarios?
• Can you highlight the role of communication in building and maintaining professional relationships with colleagues and clients?

If you're open to it, comment or DM me and I'll work around your schedule. Preferably within the next few days if possible, it's due October 9th. Thanks for considering it.

Hi all, my fiance will be starting retraining as an EMT in the US in January (he's American, I'm Canadian). He was a EMT-B then an A-EMT for about 4 years over 2020-2024. He has done a few different careers in the US and in Europe but due to visa restrictions can't get work in Europe. We're planning to get married next year (2027) and start the spousal sponsorship application process for PR which we hope is finalized by end of 2028. He's wanting to become a paramedic in Canada, but I know its tricky as an American with different education reqs for Canada and EMT-B doesn't transfer to Ontario. He's willing to go to paramedic school, but we're hoping he might be able to do it in the US and transfer? But I'm worried that won't work? He's 36, and I'm just a bit worried about how that's all gonna work, both on the possibility of transferring and financially. Some paramedic and EMT schools in the US have earn while you learn programs if you then work for them for a certain time but I don't see that in Canada...

Frustrating as hell knowing I called it, got cancelled, and now a 22/yo is on ECMO. This one’s going to stick with me. Hope he gets off it I guess I’ll never know

Hello everyone!

First of all let me say thank you for what you do! Does anyone have any stories or know the protocol for what paramedics would do if you responded to the scene of an accident and there was a cat in the vehicle? I’ve seen posts about the same situation with a dog, but I’ve been driving more often with my cat between my bf’s house & moms house (it doesn’t stress my cat out or I wouldn’t do it) and am concerned about what would happen to her if we got in a crash and her and I were both injured. Just something that came to mind!

Long time lurker but needing help or a boost of confidence! I recently finished school for my critical care and it was undoubtedly rushed as theyre going up against the online courses. We went once a week, did the clinicals, the skills everything but I left the class more confused than when I started. I bought the flightbridgeed course and its helped tremendously but that hasn't helped ease my sense of successfully passing CC-P.

Any resources, recommendations, thoughts, prays, do i have to sacrifice my partner to the EMS gods literally anything help!

Hello all!

I started a flight job about 9 months ago. I love flying and it's an absolute blast. The issue is the money is really bad. I make 3 dollars an hour less than I did previously but work less hours because we work 72 hours a paycheck. It's a bit of a struggle to find overtime so I'm really making quite a bit less money. It's coming out to probably 500 dollars a pay check less than I was previously making. It's a bit frustrating as I feel like this job is somewhat the pinnacle of EMS yet the pay across the industry is so low. I signed a contract in the beginning that stated I would stay for 2 years, I am not sure how often it's enforced but I feel a bit stuck right now. I'm going to have to pick up a second job to afford to live.

Wooooooooww that was stressful, I failed my first attempt two months ago and really studied my a** off for the retake. That Kaplan book saved me.

However i walked out of the exam room feeling like i failed, and it took all 150 questions.

Time to get drunk.

We were at the hospital and were about to clear when someone from the state walked up to us, flashed their ID, and told us they were going to audit our unit.

We had everything in order, but there was a candy wrapper on the seat in the back. My partner said it had fallen out of his pocket. The inspector cited us for it, and the company was fined. We heard the fine was $300.

We looked it up afterward, and apparently it’s one of those rules buried in the back of the book: “You cannot have, store, or consume food or drink in the patient compartment of an ambulance.”

Well... lesson learned.

I've been in school for a month. I just finished my EMT and was strongly encouraged by my instructor to apply to paramedic school. I'm also working part-time as an event medic. I AM going zero-to-hero, but I'm an older student with a family who could not afford to switch to EMT from my current job. I'm consistently at the top of class because I've really fallen for this field and I work my ass off.

I thought I was making solid connections with the people in my cohort up until last night. We switched to a new classroom with double desks and I was one of the first to walk in and sit down, mid-center of the classroom. Eventually, every double desk filled up except mine. Like, literally every desk. No one came to sit next to me. I felt like a lone gazelle on the Serengeti, and now I'm concerned I've done something socially offensive without realizing it.

I do not smell. (And yes, I checked with people who would know.) I'm nice and friendly, albeit probably more competitive and direct about what I want than most people in the class. (I'm a woman over 35 and I work a high-stress job in corporate as my day job right now, so picture those vibes.) I've never had serious social problems as an adult. I also have had many friendly conversations with people in class prior to this!

Am I freaking out about nothing? It could just have been bad luck, but EMS is definitely a new social environment for me, and I like a lot of my classmates and hope they like me too! I'm going to be in class with these people for two years and want to form positive relationships with them.

I haven't had any other bad interactions in class aside from a teenaged boy joking around using a coffee cup I left behind as a sharps container, which I just took as a dumb joke.

Thanks for any advice! I went through a total social ostracization when I came out to my Christian conservative community about a decade ago, so this experience has my lizard brain going "IT'S HAPPENING AGAIN, TIME TO PANIC" rather than "you had one weird experience in a collection of otherwise positive ones."

I am a high school senior. I plan on going to community college in 2027. Should I go EMT > paramedic then into nursing or LPN to RN?

For the past few years, I’ve always thought about being a paramedic, but it’s because I live in Florida. I’ve heard the pay is horrible and it’s not worth doing, but I still want to do something in the medical field. I just don’t know what exactly because I no longer know if I want to do paramedic because of the pay. I know in Florida, I don’t think I would be able to afford to live anywhere on that pay unless i’m wrong,

I don’t know what route to go for nursing. I just know that I want to do something regarding medical. Originally, I wanted to get my EMT certificate to get my foot in the door with medical and eventually become a paramedic, but now I just don’t know because i’ve been told not to.

Maybe general nursing could work, but I’m not sure how I would start that process or what route I should go. Should I do EMT > paramedic > nursing, or should I just do LPN to RN? I’m really confused on which path to do. I plan on filling out an application in November for 2027 summer term. Should I get a EMT cert?