The planes that I flew on the serious ambulance callouts were pretty well set up with GPS, radar, radalt, HSI/RMI, deicing that works, decent autopilot etc etc. All right we also had a battered old Seneca that we used to use for training and fair-weather, low priority hospital transfers, and in dire emergencies when another plane was tech, but on the whole the aircraft had a lot better gear in them than the commuter-airliner I fly now.
Yes veenee you do get time off but a lot of your work is done out of hours. You typically carry a pager 3 or 4 24-hour-periods a week but you do work all those hours, and it's just nature that the pager goes off when you're just busy cooking dinner, or putting the kids to bed, or catching up with your long lost mate who's dropped by, or proposing to your girlfriend or whatever. You obviously can't have a beer with your dinner or anything like that, you have to live within 5-10 mins of the airport (or sleep in the crew room on your on-call nights), and no matter how much you can't be arsed to, you can't EVER make up some excuse not to go.
I can't cover all the variables here because all organizations are different, but the only point i was trying to make is that it is definitely a lot harder on relationships / normal family life than, say, instructing or air taxi or whatever.
FTL schemes don't really apply I'm afraid, it's considered to be aerial work rather than air transport. If you've come on duty in the morning, done 5 consecutive hospital callouts and didn't get home til 2am and you are absolutely shattered, yeah you might for example leave a message on the office answerphone that you won't be reporting to the office until 2 pm the next afternoon, but you are still on call for the rest of that 24 hour period (and if you're on call for the next day as well, well tough s h i t).
You can still be on call for multiple consecutive 24-hour periods and you basically have to fly everything that comes up in that period. Yes of course the ops manual will state somewhere in it that you have the on-paper right to refuse to fly if you consider yourself to be so knackered as to be dangerous, in which case you call in the standby guy.
In practice the standby guy is normally the boss, and then he gives you a big talking to over the phone about how he's busy, and how he did twice as many hours as you when he was a young fella, and if you stand your ground he chucks a big wobbly and threatens you with the sack if you don't harden up and go flying
