Firefighter/Paramedic — A Most Stressful Job

May 27, 2010
A recent study released by the website ( ranked firefighting as the most stressful job in America out of 200 different occupations. How did they come up with this conclusion?

A recent study released by the website ( ranked firefighting as the most stressful job in America out of 200 different occupations. How did they come up with this conclusion?

First, they examined physical and emotional environmental factors that are required to do the job. In the physical category, they looked at issues such as crawling, stooping and bending. They also looked at the necessary functions to do the job. In the emotional factors, they examined such issues as degrees of competitiveness and contact with the public.

Other areas used to determine a ranking for the most stressful jobs included income, hiring outlook, physical demands and a variety of different stress factors. Some of those stress factors included win-or-lose situations, working in the public eye, lifting required, speed required, own life at risk, life of another at risk and meeting the public.

The survey looked at five categories — environment, income, hiring outlook, physical demands and stress — and each was given a score from 1 to 5. This final tallied number was then multiplied by the number of hours that each profession works in a week and then divided by 40, since that is the typical number of hours worked by a U.S. worker in a week. The final result is the stress number.

When the 200 professions were all scored out and ranked, firefighting came out as number one with a stress score of 110.936. The commentary with the scoring said, "Firefighters frequently work irregular or unusual hours, or remain on call throughout the night. They risk heat exhaustion, smoke inhalation and serious injury while on the job, and even the state of anticipation preceding a major threat can be highly stressful in itself. Firefighters are also sometimes required to spend long hours outdoors in bad weather."

As I read this, I thought, what about the stress that a firefighter/paramedic must endure? Now, I am not discounting the stresses of being a firefighter. But when you factor in also being a paramedic, don't they experience the same harsh challenges of firefighting, plus the difficult situations they must face when dealing with someone's life? While it is true, the actual act of fighting a fire can be and is many times very stressful; adding the rigors of being a paramedic contributes to that stress. Being a firefighter and a paramedic is obviously dangerous and difficult, if not impossible, as you cannot control everything that goes on around you.

As firefighters and paramedics, we must constantly train and prepare for the different types of emergencies we will encounter during our shift. We try to be physically fit, mentally fit and as prepared as possible for whatever may come our way. But there are others factors that contribute to the stress factors of being a firefighter and a paramedic. It is the constant wear and tear of getting up in the middle of the night to answer a fire alarm or a medical emergency. It is the dealing with and comforting of those who have lost family members to some kind of tragedy, especially when it involves children.

It is not knowing what kind of possible disease or sickness we may be bringing home to our families. It is the constant worry of making the right decision when you know other people's lives depend on your decision during a very frenzied situation. It is the constant stress of wondering whether every intersection you are driving through will be the one where someone on their cell phone and radio turned all the way up will hear the siren or see your emergency lights. It is even more stressful in the back of the ambulance, knowing you are going with lights and sirens through an intersection, sometimes unrestrained.

There are the constant stresses of continual training — not only as a firefighter, but as a paramedic. Many states require a certain amount of training and/or exams every so many years in order to maintain your license. If you do not maintain your license, you lose your job. I know some firefighter/paramedics complain when they go on a call that they do not think it is an emergency. Some even consider this a stress. On the other hand, I feel firefighter/paramedics should welcome these calls since they are less stressful and provide an opportunity to decompress a bit.

These situations and many more are what I consider to be the true stress factors of our profession. But do not get me wrong; I love my job and have loved it for 30-plus years. There is no doubt in my mind that there are many other stressful jobs and probably some that may even be more stressful than that of a firefighter/paramedic. But I feel it is safe to say that firefighter/paramedics have a very stressful job — a job I am proud to say I have made my career.

GARY LUDWIG, MS, EMT-P, a Firehouse® contributing editor, is a deputy fire chief with the Memphis, TN, Fire Department. He has 32 years of fire-rescue service experience. Ludwig is chairman of the EMS Section for the International Association of Fire Chiefs (IAFC), has a master's degree in business and management, and is a licensed paramedic. He is a frequent speaker at EMS and fire conferences nationally and internationally, and can be reached through his website at

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