Working the overnight shift in EMS, paramedics and EMTs face the extremes of the job.

“We get some weird stuff,” said Michael Artman, a paramedic who works the weekend overnight shift for Saxonburg Volunteer Fire Company EMS. “A lot of it’s drugs and alcohol-induced.”

The 16-year paramedic recalled an incident years ago where he responded around 2 a.m. for an unresponsive man lying in the street. When EMS and state police arrived, Artman said he could tell the man was highly intoxicated.

State police hauled the man off, and that was the end of the evening for Artman — until right before shift change.

Artman was dispatched for a vehicle that drove into a pond at a wedding venue — where a state trooper was getting married that day. Some of the groomsmen, who were also state troopers, heard the report over the radio and went to help.

Artman and the troopers found a man, who appeared to be intoxicated, lying on the pond bank.

While he and state police were assessing the man on the pond bank, the man from the earlier incident pulled up on a motorcycle with no license plate, Artman said.

“So, it ended up with police taking both of them into custody and charging them with DUI,” Artman said.

Police determined the crash into the pond had occurred earlier in the night, Artman said. He said the two men were joyriding through nearby fields in a Jeep, which was now in the pond. After the crash, one man had crawled to the bank and fell asleep, and the other was walking home when he passed out in the road where Artman found him.

“Unfortunately for those two, it was the worst-case scenario, but in the long run, if he wouldn’t have been out of the vehicle, at least it was somebody with some training, a police officer, that was the one that discovered it,” Artman said.

Not every nighttime 911 call is as comical, but if it’s not something basic such as a lift assist, it’s usually serious. Artman said patients calling 911 at night tend to be worse off. Patients seen during the day usually say the problem started several hours ago, whereas those seen at night usually say it started the previous day.

“All day, they’ve been dealing with it and kind of putting it off … and now, it’s the middle of the night, and that shortness of breath is so severe they can’t even sleep,” Artman said.

Artman has built his life around working the overnight shift since before he became a paramedic in 2010. He earned his EMS certification in 2003, and began working for Saxonburg Volunteer Fire Company EMS in 2008.

He was already working the overnight shift as an EMT, so his bosses asked him to stay on the shift when he became a paramedic. It ended up changing his life even more when a former partner became his wife. The two met on the job in 2013 and have been married for eight years.

“I could’ve changed (my shift) at any point, but it’s allowed me to build out,” Artman said. “I like it.”

Artman’s overnight shift runs from midnight to 8 a.m. on Fridays and 4 p.m. Saturday to 8 a.m. Sunday, he said. He also works seasonally in heavy highway construction from around April 1 to Dec. 1. His shifts there typically run from 6 a.m. to 6 p.m. Monday to Friday. He tries to leave about four hours between shifts on Fridays to go home, shower, eat and see his family.

“There’s times where the job runs over,” he said.

Call volumes can vary widely between shifts, but Artman said he typically receives about four calls on a busy night. Pediatric call volumes are also lower at night since children should be asleep.

“There’s times where we don’t get any calls, and there’s times where we don’t get to see the station,” Artman said. “Whether we’re running calls or not, we have somebody here ready to go.”

EMS leaders call it the “cost of readiness,” the need to be ready to respond to an emergency at any time. EMS is legally required to respond in an emergency.

“We don’t have to worry about fuel or maintenance necessarily when (ambulances) are sitting in the station, but we have insurance costs, the cost of the ambulance itself, we have to keep the lights on …

“There’s overhead every business deals with, and (here) it might be more than the typical 9-5 business,” Artman said.

The EMS service conducts some nonemergency transports overnight, but it's usually when the hospital needs a patient taken back to a nearby nursing home.

In his time between calls, Artman is usually completing paperwork from previous calls, watching TV or sleeping.

“Yeah, we get sleep, but it’s not good quality sleep,” he said. “You’re always in that state of awareness and listening for that pager to go off or the radio to talk.”

Responding to calls overnight and trying to fit in naps alters his sleep pattern, Artman said. There are times he wakes up full of adrenaline thinking he heard the pager, but nothing went off. Then, as he’s about to fall asleep again, the pager goes off.

“It’s like an aura beforehand,” he said. “It wakes me up.”

Quick responses are important at night to avoid using mutual aid. Saxonburg EMS, like most services in the area, only staff one ambulance overnight. Artman explained that the services don’t want to get into a cycle of leaving their primary coverage areas unattended if there are multiple calls at night, but they do end up responding within each other’s primary areas more often.

For Saxonburg EMS, that’s Freeport EMS and Middlesex Township Volunteer Fire Company’s EMS unit to the south and Butler Ambulance Service to the north.

“We do our best to cover as many calls as we can, but to cover 100% of them is unrealistic,” Artman said.

Artman had always thought of himself as a career firefighter and got his EMT certification to stand out. When he saw how competitive the job market was for paid positions, he took the extra step and got his paramedic certification. He said it was a tough first four years applying for jobs outside Pennsylvania as a paramedic.

“You can go in and be one of 1,000 people and they’re hiring one,” he said.

He said paid positions have since become more common, so it’s not as competitive.

“I like helping people. I like interacting with people. I like the job, and that’s why even though I have another job and could leave this field, I still choose to stay here and work the night shift,” Artman said.