With the health system in crisis, St John Ambulance is one of many providers called in to pick up the pieces - and trainee paramedics worry that's leaving them vulnerable.
One experienced paramedic said it's the worst it's been in 25 years, and lecturers of paramedicine who're on St John's casual payroll are getting daily call-ups to help.
That is not uncommon in winter, but Newshub understands some are still getting up to 10 requests a day.
Ambulances are also being moved around between regions on any given day to accommodate staff shortages.
"In terms of full time ambulance personnel, right now we are 182 short of where we would like to be, and that's a big challenge for us," said St John deputy chief executive of ambulance operations Dan Ohs.
Trained paramedics are leaving for other parts of the health sector, which means half of all St John staff aboard ambulances are now emergency medical technicians (EMTs).
St John Ambulance said that can mean often it's just two EMTs on board, sometimes with a ride-along student.
"We want to get to a point where we have a paramedic on every ambulance. That, in reality, is going to take two to three years," Ohs said.
He said EMTs are more than competent and can offer almost every level of care except IV fluids. They have 1500 hours under their belt.
Having two EMTs working together on an ambulance, rather than one EMT with a paramedic, is still "very safe", St John said.
"It does make some of the processes a bit slower than what we would like and it does mean they are calling for help more than we would like," they added.
On Monday night, when Newshub's camera was escorted out with a crew, it was "gold standard" with a fully trained paramedic on board and an EMT.
"It's critical at the moment. It's certainly the worst I've seen in my 25 years as paramedic," NZ Ambulance Association union delegate Mark Quinn said.
But St John is assuring the public it's still safe and backup for those EMTs is just a phone call away.
"They have access to senior paramedics from the comms centre they can video in, they have access to GPs, specialists who can help," Ohs said.
But paramedicine students doing on-the-job training as part of their three-year degree have told Newshub if a paramedic is needed on the ground, it can take 40 minutes in wider Auckland and an hour-and-a-half in the South Island.
"There's a degree of concern we are having an ambulance service dominated by EMTs. We need the skills out in the community that a paramedic offers," Quinn said.
St John is now 90 percent government funded, which means it's "in a good position, we just need to attract the people".
It's just embarked on a major international recruitment campaign.
"In the last two weeks, we've been advertising in Australia and the UK. Just on 200 people have registered interest and 60 applications from UK and Australia. These are Kiwi paramedics wanting to come home, which is fantastic," Ohs said.
St John expects it'll be six months before they arrive and supervision training is complete.
In the meantime 115 new EMTs have just graduated from an intensive 28-week live-in course "similar to Police College".
Over 100 more are entering the programme now with capacity for up to 150.
Being paid to train is just one incentive St John hopes will lure more people into learning how to save lives.
