The union representing the province's full-time paramedics says a growing number are taking higher-paying jobs in Alberta, sparking worries a retreat could affect patient care in Nova Scotia.
Terry Chapman, a paramedic and business manager with the union, said he used to hear about two or three people a year leaving for work out west.
Now he said they're leaving by the month.
"In the inception of this company there weren't very many who would leave. In the past years there's been up to a couple a month who come and go," he said.
"Recently there's quite a few, possibly up to 30 or so going. I personally know half a dozen of those, two of whom left last month."
Money is one appeal; some paramedics can make twice as much in Alberta as they do in the Maritimes.
It also comes down to workload. Chapman said besides working in ambulances Nova Scotia paramedics are continually asked to work in hospitals and clinics without extra pay.
With some of the most highly trained medics leaving, Chapman said he's worried about public safety.
"As the 911 calls come in, there will be fewer and fewer people capable, legally and technically, of caring for extreme emergencies," he said.
Emergency Health Services runs paramedic services in Nova Scotia.
Spokeswoman Stacey Brown said the allure of Alberta can be a challenge, but maintains the company's retention rate is stable.
"We do plan for that and our paramedic turnover rate has actually remained stable, so it's not an issue we're seeing right now," she said.
Paramedics have been without a contract for nearly two years.
Chapman said they'll soon vote on the company's final offer.