When Rob Bear became a paramedic three decades ago, it was a completely different ballgame.
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Although he was switching out of a nursing career, his new colleagues had little to no medical backgrounds.
Training was on the job and jobs were plentiful enough.
Mr Bear said the changes were immense in the 31 years he'd been involved in the paramedic industry.
He said the scope of work had widened, now requiring a university degree.
"The changes in technology are incredible and hard to believe," he said.
"The equipment, uniforms and the vehicles themselves have all changed but the scope of practice and the nature of the workload are the biggest changes."
Now the Charles Sturt University paramedicine head of discipline, Mr Bear said the ambulance sector worldwide was today struggling with staff shortages in a post-global pandemic world.
He said pre-COVID there were not enough jobs in paramedicine, forcing Australian graduates overseas.
"Post-COVID, the ambulance sector worldwide can't keep up with attrition," Mr Bear said.
"The paramedic career life average is now seven years whereas 12 years ago it used to be 15 or 16 years on average.
"People are working a lot harder to get into the profession and they're not staying as long."
The 2022-2023 NSW Budget invested a staggering $1.8 billion to enable NSW Ambulance to recruit 2128 staff and open 30 new ambulance stations.
A Port Macquarie-based lecturer, Mr Bear said that sort of investment would help address some of the challenges facing the industry.
He said training paramedic graduates on their own health and wellbeing would also benefit the broader sector.
"I'm talking with my third year students now about their own health and wellbeing and strategies to develop resilience," he said.
"They will encounter traumatic jobs and the frequency of those jobs is still the same now as ever.
"But ambulance organisations have come a long way in the past 15 years to manage those experiences.
"After the Newcastle bus crash the level of counselling was unprecedented."
Mr Bear was part of a panel interviewed for the new Charles Sturt University Podcast Series: Global Pressures.
Paramedicine: A New Age of Emergencies explores the mental health challenges for paramedics particularly in light of recent high-profile tragedies.
The Charles Sturt University Podcast Series: Global Pressures explores how our essential industries are being impacted by a world under growing pressures, and the career paths that are helping these industries to overcome, adapt and survive.
Each episode features experts across a range of fields who are navigating and developing solutions to critical challenges in IT and artificial intelligence, agriculture, social work, law and justice and paramedicine.
The podcast can be found by searching Charles Sturt Podcast Series on Soundcloud.