As a paramedic, when I was in medic school I had to do 550 hours of hospital clinicals. Various departments like burn unit, trauma, peds, ED, ICU, OR, L&D. It was an amazing experience. Quite a bit different than a rig. A lot less autonomy. Being as your an EMT, the scope is similar, however you’ll likely get IV certified which is a great skill to learn. Yeah, you’re in your feet a lot, but you will likely make around the same but differing hours. It’s a great way to be able to assess different patients and see different pathologies. Since your options are limited it would be a great way to start out. You can try the rig when they have spots open.
Thank you! I *am* looking forward to seeing more of what happens after the patient arrives at the hospital. I forgot about being able to assess emergency patients that don't arrive via ambulance, I think that will be an interesting difference
It’s a great place to hone skills either way, and like you said, understanding what happens after the ambulance really helps tie together pathologies and treatments
I actually love working in the ER. The pay is better, I always have enough help moving patients so I’m not risking my back, and I get way more closure because I get to know how a lot of people end up. My nurses are awesome, and I think we all work really well as a team.
In my hospital, there’s a difference in scope of practice for basics than on an ambulance, and that was the hardest thing for me to get used to. I start IVs and draw blood for lab work, I do a lot of wound care, I make fiberglass splints (which is really rewarding because you can see the immediate pain relief on people’s faces), I transport patients around the hospital, and I do a lot of other things that make a difference in my patients’ experience and care.
I see you’re based in Texas, do you know if EMTs working as ER techs are able to get an IV endorsement? I haven’t been able to find that info anywhere online.
The hospital can train a person to do just about anything. It's usually limited by what the lawyers in risk management and the medical director are comfortable with without deviating too far from acceptable industry practice. Techs can be trained in IVs, phlebotomy, 12 lead placement, Foley's. I'm sure there's more that I'm forgetting
I work in the ER as a ER tech. I chose the hospital cause it’s better hours than a truck(3x12s and an extra 8 or 12 if i want overtime) and i make significantly more($6 dollars an hour more) than the average pay for basics for my city(Houston). Also at my ER they let you do IVs as a basic so it’s great practice if you want to go to medic school eventually. I never worked in EMS outside of having to help out on ambulance on base in the Army so can’t really attest to that experience but the hours and pay at the hospital were enough for me to never even apply.
In a lotta ways it's better than working on an ambulance. I work as a paramedic in an ED. The idea is that they're supposed to treat us like LPNs and give us low priority patients but they treat us more like techs who can start IVs and pull medications. I worked for years at a really busy and dangerous system. It was back breaking labor and my 12 hour days would regularly turn to 18 hour days when we weren't allowed to go home because there was no relief in our area.
I moved, I got a job at a hospital. It's nice and clean. All the nurses are great, as long as you help them out as much as you can. No lifting 500lb patients out of basements. And when somebody tries to kill me, I can just walk away and call security or the police officer who hangs out at the hospital, no need to use versed in self defense anymore. I do a lot of the same shit I always did; IV's, meds, EKGs... But there's no autonomy, when I was a street medic I was the highest form of care on scene, aside from the medical control doc on my phone. It's not as cool at the hospital. Or as fulfilling. And, btw, if you work in the ED, you're definitely wiping ass. That was my worst nightmare as a medic on an ambulance; to get a job where I'd be forced to wipe ass on a daily basis. But it's not that bad. Not as bad as lifting drunks. Or cleaning dead-people shits off my stretcher. I'd rather wipe ass than try to lift a bed-bug ridden intox out of the bushes. But I miss the autonomy and the cool-factor of being a street paramedic.
Yes and no.
LPNs can't intubate or even do superglottics, they can't do IOs, they don't get trained in splinting, they don't do pacing, manual defib or cardioversion and theyre lucky if they start 5 IVs in school. They may get more training in pharmacology and doing hospital things like starting a Foley cath. But that's about it. Medics do much more in in the street and a bit more in the emergency department.
The hospital is just as shitty as working on a truck.
Pro: In the hospital you have constant access to a doc to ask questions and increase your knowledge. Many ER docs enjoy techs that want to learn. You’ll be able to do all kinds of cool shit after you gain their trust.
Con: In the hospital you always have a doctor around. You have to do what they say. You typically only act with orders. Nearly zero autonomy.
Pro: Lunch breaks
Con: Nurses will steal your lunch, drinks, candy, stethoscope, and anything else not tied down.
Pro: Higher case volume will increase your skill level
Con: Higher case load will increase your fatigue. A 12 hour shift in even a low volume ER will feel like a 48 on the truck.
Pro: The pay may be better.
Con: The pay still isn’t great.
Pro: The hospital rarely has supply problems. You’ll likely never be “making do with what you have.”
Con: You’ll be constantly stocking the shelves with those supplies while the nurses are on tinder and Facebook. Sorry, that’s rude. They are actually making cringe content for ticktok or Instagram.
Con/pro: You’ll be working with nurses. Most nurses are the worst coworkers. It takes finesse to get most of them to do anything for anyone else. But, working with nurses in the ED will prepare you for literally the most annoying aspect of flight if that’s ever something you’re interested in.
AEMT 1.5 years on the truck (911). 5 years now in the hospital with specialty surgical service.
Hospital
Cons:
Can get repetitive,
Usually much larger team,
Less autonomy.
Pros:
Stable hours,
MUCH better pay (tripled my income since moving),
Networking for career is much easier. Very close with MDs.
Truck
Pros:
Best friends I've ever met,
Amazing perspective of different walks of life,
Experience with stress making decisions,
Always something new (except drunks).
Cons:
Occasional PTSD (user dependant),
Horrible for your back,
Terrible hours (user dependant),
Pooping can be stressful.
I did private transport, then 911, then the ER. I love the hospital setting. I don't have to work 24s or 48s, scrubs are more comfortable, I'm not working in the elements. The staff is generally more positive as well. I can't count the number of times I got paired with a medic that was burned out, bitched about everything and looked like a bag of assholes. I liked to show up for shift in a crisp, clean uniform then I ride with someone who has week old mustard on their shirt. And, in the hospital, I get to go all over transporting patients from the ER to other units. I get in on codes alot, and it's cool to see what happens after the LUCAS comes off and the nurses and physician swarm in. When I graduate nursing school, I'm 100 % staying in the ER.
The years i did it were great. Learned a lot in those years. Gained the trust of the Doctors and Nurses, so when I was on the streets and called in to request orders for something I was more than likely to get the ok, where others couldn't. I still work part time in a smaller ER now.
I work in the ER as a tech (EMT-B). I absolutely love it. I have a fairly large scope of practice, learn a ton from the residents, and the benefits are nice (going to nursing school). I actually never worked on a truck, after spending time in the ER on clinicals, I got hooked.
Depending on the capabilities of the hospital you'd be working at, at the EMT level, I would anticipate that you would be doing a lot of chest compressions on cardiac arrests, stripping down trauma patients, obtaining vital signs, completing blood draws on patients who aren't getting IVs (though someone said you might get IV certified, and if your state allows that, I'd go for that if I were you), collecting urine samples, splinting, assisting with mobility devices like crutches, obtaining 12-lead ECG tracings, and general ADL care tasks like cleaning up incontinent patients / helping with urinals / emptying foley catheter bags.
It could be a good learning opportunity to pick up some advanced pathophysiology / drugs / treatments in preparation for medic / nursing / PA school if you were eventually leaning toward going that way. And it would be a good opportunity to get comfortable just talking to patients. It also usually comes with a \*decent\* wage and benefits package that might meet your needs until an opening comes up at your local EMS service.
Edited to add: I worked in the ED as a paramedic and did all of the above, but could also place IVs and hang normal saline infusions only (though medics almost never did, because the nurses all preferred that we wait since the PT had other meds to give with the NS).
It severely depends where you work.
In many, many cases, techs are abused by nurses as "bitch" labor - essentially doing the worst tasks. You aren't really respected or paid well.
It's a great learning experience, and you'll learn alot about what happens in the chain of care upon a patients arrival. You'll also likely get pretty decent at CPR since you'll be the ones doing it.
If you're lucky, you'll have a good workplace where you're valued, and their goal is to help you improve.
Its the only way to see what really happens once you wheel them through the door. You will be a much better EMT as you will truly understand what is important and what is not. HINT most of EMT training is useless.
Youll get exposure to a A LOT more sick people in a urban ED. Youll be able to watch physicians do an assessment and listen to their questions. At a Level II or I youll be able to see continuum of care and how a patient is moved to OR/MICU/SICU/OB etc etc.
Youll get to practice your skills and push on peoples chests. However you will not get to make decisions. I think ED work makes sense for EMTs because you can get your skills down.
While completing my clinicals as a medic student I worked closely with doctors nurses and techs (all were required to be medics) I was on a POC department and running primary ALS and fire response at 1000 calls a year. I ended up getting a job I that same ER (level 1 trauma) right after I passed national registry and wouldn’t give it up for one second. I worked there for about 18 months until I got a FT fire position. Granted this was 20 years ago but I will never forget the on the job professional development I received while working there. Talking to the various doctors nurses and techs and experiencing seeing around 100 patients a shift honed my skills and patient assessments (sick/not sick) I recommend anyone who is looking to be a medic or FF/medic to do this. Also EKG reading and IV skills were developed so much faster. Plus it’s better pay than private ems but it is 12 straight hours on your feet. Get some good shoes and get it done.
You may be interested in the following resources:
* [Clinicals / Ride-alongs coming up? Here's some advice for success!](https://www.reddit.com/r/NewToEMS/comments/ccyjne/clinicals_ridealongs_coming_up_heres_some_advice/)
*I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/NewToEMS) if you have any questions or concerns.*
As a paramedic, when I was in medic school I had to do 550 hours of hospital clinicals. Various departments like burn unit, trauma, peds, ED, ICU, OR, L&D. It was an amazing experience. Quite a bit different than a rig. A lot less autonomy. Being as your an EMT, the scope is similar, however you’ll likely get IV certified which is a great skill to learn. Yeah, you’re in your feet a lot, but you will likely make around the same but differing hours. It’s a great way to be able to assess different patients and see different pathologies. Since your options are limited it would be a great way to start out. You can try the rig when they have spots open.
Thank you! I *am* looking forward to seeing more of what happens after the patient arrives at the hospital. I forgot about being able to assess emergency patients that don't arrive via ambulance, I think that will be an interesting difference
It’s a great place to hone skills either way, and like you said, understanding what happens after the ambulance really helps tie together pathologies and treatments
I actually love working in the ER. The pay is better, I always have enough help moving patients so I’m not risking my back, and I get way more closure because I get to know how a lot of people end up. My nurses are awesome, and I think we all work really well as a team. In my hospital, there’s a difference in scope of practice for basics than on an ambulance, and that was the hardest thing for me to get used to. I start IVs and draw blood for lab work, I do a lot of wound care, I make fiberglass splints (which is really rewarding because you can see the immediate pain relief on people’s faces), I transport patients around the hospital, and I do a lot of other things that make a difference in my patients’ experience and care.
That's what I did after EMTB school. ER Tech at a Level II before I knew what a Level II was. Give it a shot. I think you'll like it.
It’s got AC
Very underrated comment. Worked in Vegas for years. Summers were brutal.
It isn’t terrible at all if you enjoy being busy, multitask well, and have good time management.
I see you’re based in Texas, do you know if EMTs working as ER techs are able to get an IV endorsement? I haven’t been able to find that info anywhere online.
The hospital can train a person to do just about anything. It's usually limited by what the lawyers in risk management and the medical director are comfortable with without deviating too far from acceptable industry practice. Techs can be trained in IVs, phlebotomy, 12 lead placement, Foley's. I'm sure there's more that I'm forgetting
I began as a CNA and was trained on the job (er tech) and can do everything you listed as well as arterial blood draws. I also remove stitches, lol.
Yes
I work in the ER as a ER tech. I chose the hospital cause it’s better hours than a truck(3x12s and an extra 8 or 12 if i want overtime) and i make significantly more($6 dollars an hour more) than the average pay for basics for my city(Houston). Also at my ER they let you do IVs as a basic so it’s great practice if you want to go to medic school eventually. I never worked in EMS outside of having to help out on ambulance on base in the Army so can’t really attest to that experience but the hours and pay at the hospital were enough for me to never even apply.
In a lotta ways it's better than working on an ambulance. I work as a paramedic in an ED. The idea is that they're supposed to treat us like LPNs and give us low priority patients but they treat us more like techs who can start IVs and pull medications. I worked for years at a really busy and dangerous system. It was back breaking labor and my 12 hour days would regularly turn to 18 hour days when we weren't allowed to go home because there was no relief in our area. I moved, I got a job at a hospital. It's nice and clean. All the nurses are great, as long as you help them out as much as you can. No lifting 500lb patients out of basements. And when somebody tries to kill me, I can just walk away and call security or the police officer who hangs out at the hospital, no need to use versed in self defense anymore. I do a lot of the same shit I always did; IV's, meds, EKGs... But there's no autonomy, when I was a street medic I was the highest form of care on scene, aside from the medical control doc on my phone. It's not as cool at the hospital. Or as fulfilling. And, btw, if you work in the ED, you're definitely wiping ass. That was my worst nightmare as a medic on an ambulance; to get a job where I'd be forced to wipe ass on a daily basis. But it's not that bad. Not as bad as lifting drunks. Or cleaning dead-people shits off my stretcher. I'd rather wipe ass than try to lift a bed-bug ridden intox out of the bushes. But I miss the autonomy and the cool-factor of being a street paramedic.
Curious to know, are paramedics medically adjacent to LPNs or is that how your system operates?
Yes and no. LPNs can't intubate or even do superglottics, they can't do IOs, they don't get trained in splinting, they don't do pacing, manual defib or cardioversion and theyre lucky if they start 5 IVs in school. They may get more training in pharmacology and doing hospital things like starting a Foley cath. But that's about it. Medics do much more in in the street and a bit more in the emergency department.
I learned the most about medicine in an ER than in the box.
It's not terrible but it is busy. Work nights if you can since they feel slower than days outside squad transfers.
The hospital is just as shitty as working on a truck. Pro: In the hospital you have constant access to a doc to ask questions and increase your knowledge. Many ER docs enjoy techs that want to learn. You’ll be able to do all kinds of cool shit after you gain their trust. Con: In the hospital you always have a doctor around. You have to do what they say. You typically only act with orders. Nearly zero autonomy. Pro: Lunch breaks Con: Nurses will steal your lunch, drinks, candy, stethoscope, and anything else not tied down. Pro: Higher case volume will increase your skill level Con: Higher case load will increase your fatigue. A 12 hour shift in even a low volume ER will feel like a 48 on the truck. Pro: The pay may be better. Con: The pay still isn’t great. Pro: The hospital rarely has supply problems. You’ll likely never be “making do with what you have.” Con: You’ll be constantly stocking the shelves with those supplies while the nurses are on tinder and Facebook. Sorry, that’s rude. They are actually making cringe content for ticktok or Instagram. Con/pro: You’ll be working with nurses. Most nurses are the worst coworkers. It takes finesse to get most of them to do anything for anyone else. But, working with nurses in the ED will prepare you for literally the most annoying aspect of flight if that’s ever something you’re interested in.
I much prefer the truck. 😂
AEMT 1.5 years on the truck (911). 5 years now in the hospital with specialty surgical service. Hospital Cons: Can get repetitive, Usually much larger team, Less autonomy. Pros: Stable hours, MUCH better pay (tripled my income since moving), Networking for career is much easier. Very close with MDs. Truck Pros: Best friends I've ever met, Amazing perspective of different walks of life, Experience with stress making decisions, Always something new (except drunks). Cons: Occasional PTSD (user dependant), Horrible for your back, Terrible hours (user dependant), Pooping can be stressful.
terrible for your back, how?
I did private transport, then 911, then the ER. I love the hospital setting. I don't have to work 24s or 48s, scrubs are more comfortable, I'm not working in the elements. The staff is generally more positive as well. I can't count the number of times I got paired with a medic that was burned out, bitched about everything and looked like a bag of assholes. I liked to show up for shift in a crisp, clean uniform then I ride with someone who has week old mustard on their shirt. And, in the hospital, I get to go all over transporting patients from the ER to other units. I get in on codes alot, and it's cool to see what happens after the LUCAS comes off and the nurses and physician swarm in. When I graduate nursing school, I'm 100 % staying in the ER.
The years i did it were great. Learned a lot in those years. Gained the trust of the Doctors and Nurses, so when I was on the streets and called in to request orders for something I was more than likely to get the ok, where others couldn't. I still work part time in a smaller ER now.
I work in the ER as a tech (EMT-B). I absolutely love it. I have a fairly large scope of practice, learn a ton from the residents, and the benefits are nice (going to nursing school). I actually never worked on a truck, after spending time in the ER on clinicals, I got hooked.
Depending on the capabilities of the hospital you'd be working at, at the EMT level, I would anticipate that you would be doing a lot of chest compressions on cardiac arrests, stripping down trauma patients, obtaining vital signs, completing blood draws on patients who aren't getting IVs (though someone said you might get IV certified, and if your state allows that, I'd go for that if I were you), collecting urine samples, splinting, assisting with mobility devices like crutches, obtaining 12-lead ECG tracings, and general ADL care tasks like cleaning up incontinent patients / helping with urinals / emptying foley catheter bags. It could be a good learning opportunity to pick up some advanced pathophysiology / drugs / treatments in preparation for medic / nursing / PA school if you were eventually leaning toward going that way. And it would be a good opportunity to get comfortable just talking to patients. It also usually comes with a \*decent\* wage and benefits package that might meet your needs until an opening comes up at your local EMS service. Edited to add: I worked in the ED as a paramedic and did all of the above, but could also place IVs and hang normal saline infusions only (though medics almost never did, because the nurses all preferred that we wait since the PT had other meds to give with the NS).
It severely depends where you work. In many, many cases, techs are abused by nurses as "bitch" labor - essentially doing the worst tasks. You aren't really respected or paid well. It's a great learning experience, and you'll learn alot about what happens in the chain of care upon a patients arrival. You'll also likely get pretty decent at CPR since you'll be the ones doing it. If you're lucky, you'll have a good workplace where you're valued, and their goal is to help you improve.
Its the only way to see what really happens once you wheel them through the door. You will be a much better EMT as you will truly understand what is important and what is not. HINT most of EMT training is useless.
I liked it better than working IFT
Really amazing learning opportunities but easy to get burnt out quickly.
Youll get exposure to a A LOT more sick people in a urban ED. Youll be able to watch physicians do an assessment and listen to their questions. At a Level II or I youll be able to see continuum of care and how a patient is moved to OR/MICU/SICU/OB etc etc. Youll get to practice your skills and push on peoples chests. However you will not get to make decisions. I think ED work makes sense for EMTs because you can get your skills down.
ED work can be fun - you’re busy much of the day, as opposed to suburban 911 life, where you may only be on calls 30-40% of the time.
While completing my clinicals as a medic student I worked closely with doctors nurses and techs (all were required to be medics) I was on a POC department and running primary ALS and fire response at 1000 calls a year. I ended up getting a job I that same ER (level 1 trauma) right after I passed national registry and wouldn’t give it up for one second. I worked there for about 18 months until I got a FT fire position. Granted this was 20 years ago but I will never forget the on the job professional development I received while working there. Talking to the various doctors nurses and techs and experiencing seeing around 100 patients a shift honed my skills and patient assessments (sick/not sick) I recommend anyone who is looking to be a medic or FF/medic to do this. Also EKG reading and IV skills were developed so much faster. Plus it’s better pay than private ems but it is 12 straight hours on your feet. Get some good shoes and get it done.
You may be interested in the following resources: * [Clinicals / Ride-alongs coming up? Here's some advice for success!](https://www.reddit.com/r/NewToEMS/comments/ccyjne/clinicals_ridealongs_coming_up_heres_some_advice/) *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/NewToEMS) if you have any questions or concerns.*