What Shifts Do EMTs/Paramedics Work?

It’s pretty common knowledge that EMTs and paramedics are some of the most important and hardest working people in society. They’re always one of the first people to arrive at the scene of an emergency situation and save lives with their expert medical care.

If you’re reading this article, you’ve probably wondered, at some point, what kind of shifts EMTs and paramedics have to work. Is it the same as a regular 9-5 career or is it more like a crazy 24 hour shift pattern?

What Hours Do EMTs Work & What Does A Typical EMTs Schedule Look Like

Shift patterns will vary depending on the EMT or paramedic’s employer, but most places will offer 12 hour shifts, working 3 or 4 days per week.

Of course, there are some exceptions to this rule and there are always differences between different employers in different parts of the country.

In this article, we’re going to be explaining what exactly an EMT and paramedic will do on their shift, how long they’ll have to work for, and how they deal with having to work such different hours from most other people.

What’s The Difference Between An EMT And A Paramedic?

The first thing to note is that EMTs and paramedics are not the same thing. Being a paramedic is basically a step up from being an EMT and requires much more training.

Any individual can graduate from high school, train to be an EMT and become qualified in only a few months. Certification as an EMT means you can go into a number of different careers, including being a lifeguard, contract medic or physician’s assistant.

EMTs basically provide a less invasive yet advanced level of prehospital care for patients in emergency situations. For example, an EMT might only treat and bandage an open wound to keep a patient stable enough to transport to a hospital for more thorough care.

Alternatively, paramedics must have around 2 years of experience as an EMT before they can even enroll in a paramedic school. Then, they have to go through a couple of years of training and examination before they can work as a paramedic.

The main difference in responsibilities between EMTs and paramedics is that paramedics will provide more complex medical treatments at the site of an emergency situation.

For example, a paramedic might insert an IV into their patient and perform advanced resuscitations before getting them to a hospital.

Shift Patterns For EMTs And Paramedics

There are a few different shift patterns that employers of EMTs and paramedics will employ based on the demands of the area they operate in and how many staff they have available.

Because of these variations, EMTs and paramedics could be required to work only 9 hour shifts, 4 or 5 days per week, or they could have to work 24 hour shifts!

Let’s take a look at some of the common shift patterns used.

Kelly Shift Schedule

The aim of this system, as with most, is to ensure there is a team of staff working at all hours of the day. It’s a pretty efficient system, but is not popular with some workers due to each shift being 24 hours long.

It basically consists of a 9 day schedule with three teams working on different days. Here’s a quick overview of how the shift pattern works over 9 days for one team in the crew:

  1. 24 hour shift
  2. 24 hour break
  3. 24 hour shift
  4. 24 hour break
  5. 24 hour shift
  6. 24 hour break
  7. 24 hour break
  8. 24 hour break
  9. 24 hour break

The system requires at least three teams, all staggered along this structure throughout the 9 day period to ensure there is always a team working every day.

The prospect of a 24 hour long shift might not be for everyone. This system does result in EMTs and paramedics working roughly 56 hours per week, which is way more than what’s expected of workers in most industries.

Another downside of the 9 day working week is that it creates inconsistencies with the working week for pretty much every other job. It means that EMTs and paramedics using the Kelly Shift schedule will never work the same days of the week, two weeks in a row.

That can make it harder to maintain a consistent social life outside of work.

However, some EMTs and paramedics prefer this system because it allows them to get all their work done in fewer days, giving them more completely free days to arrange plans to do things with friends and family.

Also, the benefit of having a minimum of 24 hours between each shift means that EMTs and paramedics will always have plenty of time to rest and recuperate before having to work again.

48/96 Schedule

This system works in a very similar way to the Kelly Shift schedule because it requires EMTs and paramedics to work 24 hour shifts and needs to have three teams operating on it for there to be someone working every day of the week.

However, the structure of this system is very different to the previous one we’ve looked at. It operates on a 6 day schedule and requires employees to work consecutively for 48 hours with a 96 hour (4 day) break between shifts. This is how a 48/96 shift would look in a 6 day period for an EMT or paramedic:

  1. 24 hour shift
  2. 24 hour shift
  3. 24 hour break
  4. 24 hour break
  5. 24 hour break
  6. 24 hour break

The obvious downside to this system is that a 48 hour shift can be very fatiguing for any employee, let alone one that has to work in the high intensity environment of an EMT or paramedic.

However, some EMTs and paramedics do prefer this system for similar reasons to the Kelly Shift schedule. The 48/96 provides workers with more full days off, allowing them to arrange to spend time with family and friends.

Whichever system is employed, it works out at as an average of 1 shift per 3 days so the average number of hours worked per week will be the same for both.

Pros and cons of 24 hour shifts

Both of these systems are more commonly used by departments in rural areas where emergency situations occur less frequently. These are some of the main benefits and costs of working 24 hour or sometimes 48 hour shifts:


  • These shifts give you more full days off, making it easier to arrange doing things with family and friends on days off.
  • Stations that employ these schedules often provide some kind of housing and facilities for their employees. This means they can eat, sleep and carry out their everyday tasks while waiting for a call.
  • A lot of time during a 24 or 48 hour shift is spent waiting for the next call to come in. This means that EMTs and paramedics are essentially being paid to relax and unwind during this downtime.


  • A lot of EMTs and paramedics experience burnout and fatigue after working these shift lengths for prolonged periods of time, which can make it difficult to maintain a long career in the industry.
  • Every shift as an EMT or paramedic will be different, so it could be the case that workers have little to do for 24 hours which can be boring, or that they are exceptionally busy for 24 hours which can be stressful.

Other Shift Patterns

In more built up areas like towns and cities, a shift pattern is often employed that is closer to what a normal job would have.

This is because these areas have emergency situations taking place more frequently and, as a result, more EMTs and paramedics need to be hired.

Because there are more workers in these areas, the workload can be spread more evenly among them to make shift patterns slightly more regular.

Commonly, these shifts will last 9-12 hours, including all hours within that range. It really is dependent on how many other staff are working that week, how many are taking time off and whether there are any notable events taking place.

Of course, it’s not likely that an EMT or paramedic will work the same shift length every day throughout the week, with the exception of stations that exclusively offer 12 hour shifts.

A 9 hour shift is the closest to what you’d experience at a normal job. These can take place at any time of day or night and will require EMTs and paramedics to be on-call throughout the whole shift.

This means that breaks can be taken during downtime, in between calls. However, during a particularly busy shift, it is entirely possible that workers will not have a chance to take a break.

12 hour shifts are very common in cities across the US and can also be scheduled for absolutely any time of day. Many workers request to have more regular shift patterns, either working exclusively at night or during the day.

Whatever the case, no station will have the same changeover point for all of their EMTs and paramedics. For example, if one team finishes and hands over to the next team at 7PM, another team will finish and hand over at 8PM.

This way, there will always be EMTs and paramedics working and ready to be called to an emergency without having to worry about changing over.

What’s A Shift As An EMT Or Paramedic Like?

Doctor, Nurse, Paramedics medical emergency

As you can imagine, working any length of shift as an EMT or paramedic can be a very physically and mentally demanding experience. It’s also true that no two shifts will really be the same, as emergency situations always take on different forms and levels of severity.

When starting a shift, an EMT or paramedic might be sitting at their station or in an ambulance with their team, ready to be called out to an emergency at any moment. For that reason, they need to start the shift in their uniform, already prepared to start.

Depending on where they work, an EMT or paramedic could have to deal with extremely hot or cold conditions and will have to have a uniform prepared that is appropriate for the weather.

Upon being called out to an emergency situation, they must ride in or drive an ambulance to the scene and listen carefully to details given by the operator about where they need to go and what kind of equipment they should be prepared to use.

Emergency situations can often involve life or death moments and, as a result, EMTs and paramedics must be prepared for the worst every time they’re called out.

Many EMTs and paramedics note that they need to feel very little emotional connection with the patients they care for because they need to be able to remain calm and professional when called out to their next emergency situation, without letting the previous one affect them.

On particularly long shifts, like the 24/48 hour ones worked in some rural areas, there will often be a lot more downtime between callouts in which EMTs and paramedics can have a chance to eat and sleep.

However, they must always be ready to be interrupted by another member of their team if an emergency arises.

How To Cope With The Demands Of An EMT Or Paramedic Shift Schedule

Everything we’ve looked at so far in this article tells us just how difficult it can be to work as an EMT or paramedic. These workers have to undergo some of the most physically and mentally demanding working conditions of any career and do so for periods of up to 48 hours at a time!

These are some of the tips that experienced EMTs and paramedics have given about dealing with the demands of this working life:

Maintaining A Healthy Diet

The physical demands of working as an EMT or paramedic mean you’ll need your body to be working in a good condition just to be able to carry out the work properly.

However, eating properly can also be beneficial to maintaining good mental health. Everyone can get a bit cranky when they don’t eat enough food and the same can be true when you don’t eat healthy food.

Getting Sufficient Sleep

In terms of sleeping, getting a full 6-9 hours might not always be a possibility during a long shift. That’s why it’s essential to arrive to a shift on as much sleep as possible.

This will allow you to work for longer without getting tired, losing focus or draining yourself so much that you can’t recover in time for your next shift.

Maintain A Positive Mindset

As you might expect, working as an EMT or paramedic can have some very low points. As hard as you may have to work, there are some situations in which people simply can’t be saved.

In these situations, it’s important to have a supportive team around you to help maintain positivity and not let a negative situation affect the way you operate in the next emergency situation.

Final Thoughts

That’s pretty much everything there is to know about the kinds of shifts EMTs and paramedics work on a regular basis.

Maybe you are an EMT or paramedic and wanted to see how your shifts compared with others, or perhaps you’re thinking about going into the EMS industry and want to see what you’d be getting yourself into!

Whatever you take away from this, remember that there will be huge variations between different regions and departments in the types of shifts EMTs and paramedics will be required to work.

However, we’re all very thankful that they do work in these conditions, as lives would literally be lost without their heroic efforts.