Paramedic work schedules can vary from one location to another. Typically, these professionals work nine or twelve-hour shifts. In more rural areas, twenty-four hour shifts are more common. For twenty-four hour shifts, paramedics may follow the Kelly Shift Schedule, where they work one twenty-four hour shift and then have twenty-four hours off, and repeat.
The topic of shift schedules may or may not be included in your National Registry of Emergency Medical Technicians (NREMT) prep course. If it’s not, ask about it. You want to know what life as a paramedic will actually look like before you start. You should also ask your instructor questions such as which is the highest level of emergency medical services training, and what does ‘EMR’ stand for in paramedics?
If you want some insights from an emergency medical services professional on how to find a shift that best suits your lifestyle and needs, watch this video. Here, Evan (The Paramedic Coach) explains common mistakes emergency responders make when choosing which shifts to work. He’ll also help you understand the elements of shift work that can either make or break your experience working as a paramedic.
How Shifts Can Be Structured
An emergency responder agency may choose to structure its shift schedules for first responders, including paramedics, in several ways. First responders tend to work longer shifts than the average office worker.
Here are a few examples of what your shift structure could look like as a paramedic:
Twelve-Hour Shift Example
Twelve-hour shifts usually start at either 7:00 AM or 7:00 PM. Paramedics work for twelve hours and are on call for the next twelve hours. If they are called to work while on call, they are paid overtime rates.
Twenty-Four-Hour Shift Example
Paramedics who work a twenty-four-hour shift are on call for the next twenty-four hours. They are paid overtime rates if they are called to work while on call.
Common Paramedic Shift Patterns
| Shift Type | Typical Hours | On-Call Period | Key Details |
|---|---|---|---|
| 9-Hour Shift | 7:00 AM – 4:00 PM (varies) | Remainder of day | Less common, shorter workdays |
| 12-Hour Shift | 7:00 AM – 7:00 PM or 7:00 PM – 7:00 AM | Next 12 hours | Overtime if called in during on-call time |
| 24-Hour Shift | Full 24 hours | Next 24 hours | Often used in rural areas; paid rest/downtime included |
| Kelly Shift | 24 hours on | 24 hours off (rotating) | Popular schedule in fire/EMS agencies; repeating cycle |
Benefits of Shift Work
It can take some time to adjust to rotating nine-, twelve-, or twenty-four hour shifts. While not always easy, shift work does have some advantages:
- You can work more hours in fewer days, leaving you with long periods of free time.
- Much of a shift is spent waiting, not standing on your feet or walking as many hospital shift workers do.
- While waiting for a call, you are essentially being paid to eat, sleep, read, watch television, and relax.
Avoiding Shift Burnout
Paramedics need to be at their mental, physical, and emotional best. They need their strength to perform life-saving procedures and make quick decisions during chaotic moments. As The Paramedic Coach points out in this video, it’s difficult for any emergency care provider to care for others unless they are operating at their peak.
Paramedic patients depend on you to be strong during what could be a life-threatening situation. When things don’t go well, it’s essential to talk with someone who will listen to the anxiety or stress you are feeling about an accident scene or patient outcome.
Some paramedics also struggle when alternating between daytime and nighttime shifts. However, fatigue and stress can lead to seriously adverse outcomes in emergencies. Paramedics also have prehospital responsibilities that involve safe vehicle operation and public safety.
Try to secure a schedule that sticks with either day or night hours and doesn’t switch back and forth between the two. This will help your body and mind adapt to your new work schedule.
Stay positive and focus on your successes in the field. Make sure your expectations are realistic and in line with the realities of the job. Eat healthy food and get plenty of sleep. These recommendations may sound like common sense, but they will go a long way in preventing burnout and allow you to be the best paramedic you can be.
Wrapping Up
The Paramedic Coach also has resources that can help after you’ve become an emergency responder, such as How To Cope With Burnout & Mental Stress (EMS Tips). Some of our subscribers also share comments about how incorporating our stress management techniques has helped them cope with the demands of the profession.
For one, a paramedic-firefighter said, “I felt myself burning out. Irritated, even thought about quitting. But I know that I’m going to miss it as soon as I quit. Thank you for this video.”
The life of a paramedic is both rewarding and stressful, and part of that stress can be the nature of shift work. If this is the right profession for you, register for a qualified training program and check out the learning resources at The Paramedic Coach today!
