The Impact of Working Overtime or Multiple Jobs in Emergency Medical Services

Background: EMS professionals frequently work more than a standard 40-hour work week. For some EMS professionals, working overtime or multiple jobs may be necessary to make ends meet. Our objective was to evaluate the association between job satisfaction, intention to leave EMS, and financial dependence on overtime or working multiple jobs. Methods: We conducted a cross-sectional analysis of nationally-certified EMS professionals who completed an online questionnaire after submitting their recertification application (22,626/101,363, response rate = 22%) between October 2017 - May 2018. Items included dependence on additional work, satisfaction with job, and intentions of leaving the profession. Multivariable logistic regression models were used to describe the association between dependence on additional work, and job satisfaction and intention to leave EMS within 1 year and 5 years, controlling for age, sex, minority status, agency type, employment status, and urbanicity. Results: A total of 18,285 respondents were included in the analysis. The majority of EMS professionals (75%) worked over 40 hours per week. Most respondents (71%) were dependent on overtime or multiple jobs to make ends meet. Those who were dependent on extra work had higher odds of being dissatisfied with their job (aOR 1.92, 95% CI:1.64-2.44, and higher odds of intentions to leave EMS within 1 year and 5 years respectively (aOR 1.32, 95%CI:1.14-1.54; aOR 1.16, 95%CI:1.07-1.25). Conclusion: Many EMS professionals depend on additional work to make a living. Financial dependence was associated with increased odds of workforce-reducing factors, including job satisfaction and intention of leaving. This can lead to poor individual outcomes such as stress and burnout, as well as to turnover within the workforce, thus reducing the number of individuals available to provide high quality emergency care.