The duty operations manager for the western sector NSW Ambulance was presented with a guard of honour by paramedics and executives from Narromine and surrounding areas at the Narromine Ambulance Station on Thursday before his final sign-off to the western control centre.

Inspector Silver joined NSW Ambulance service in 1975 after he was inspired by a careers magazine brought home by his brother.

"My young brother bought home a school careers magazine and in it was a piece about the ambulance service I read that and decided I wanted to try and join the ambulance service," he said.

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"My mother told me I was mad and wouldn't last 10 minutes. She said I'm leaving a perfectly good government job on the railway to go and do that 'you won't last'.

"I've lasted longer in the job than the railway's lasted in the area."

Initially Inspector Silver was based at Ryde station where he was involved in the Granville train derailment on January 18, 1977, which claimed 83 lives and injured 213 others. The incident is one that's "always" on the Inspector's mind.

"Peer support started up in the service and I'm a member of the peer support team," he said.

"Peer support started up as a result of Granville.

"[Before] it was a case of everyone did their debrief and their distress by going to the pub and getting drunk, so things have improved from there."

Over the next three decades the Inspector moved between Armidale, Barraba and Baradine before moving to Narromine in 2004 where he became station officer and later took on the role as duty operations manager.

In 44 years, Inspector Silver has witnessed many changes to the NSW Ambulance service including to the treatments given and the skills and equipment used.

"When I first joined you worked by yourself and yes it's a bit hard to carry both ends of the stretcher because they didn't have wheels on them," he said.

"These days there's two-officer crewing policy so there's two people to push the stretcher, that actually has hydraulics in it and lifts itself up and down.

"There's so much that can be done for people now. It's not a case where we're a transport organisation, we're an organisation that goes out and gives people their initial treatment so they're arriving at hospital in a far, far better condition."

The Inspector said one of the most "incredible" things about the career was meeting so many people and hearing their stories from a cabin boy on the Titanic to a man in charge of rounding up Japanese prisoners of war who escaped in Cowra.

"You hear about these things in history, but to have these people actually relay their experiences that's a good thing," Inspector Silver said.

While Mr Silver rarely discusses his work, he said the most humbling experience was receiving flowers off a patient's daughter.

"There's the time I got a bunch of flowers off a young girl in Armidale, her father actually arrested, so we arrived, did straight CPR, transported him to hospital and the father actually survived.

"That was before defibrillators, so that was a very memorable moment her coming in and doing that.

"She said 'you shouldn't give a bloke flowers,' but that time really stands out in my mind."

For upcoming NSW Ambulance paramedics Mr Silver's advice was to remember where they started.

"Remember what it was like when you started as you get promoted make sure you treat people as you want to be treated when you first started," he said.

"Often people get promoted and they forget what it's like to be the person on the bottom who wants info, wants to be spoken to but gets ignored.

"So when you get promoted through the service remember what you wanted when you first started."