48 on, 96 off

[JakeEMTP]

I don't know if I like this. How safe is it for you, your crew member and your patient? Not to mention the lay public who, unbeknownst to them, I have possibly been up for 48 hours?

http://www.defrance.org/artman/publish/article_2012.shtml

One of the providers mentions in the article that they had 4hrs sleep in 48. What they don't mention is if that was 4hrs straight or 1/2hr here and there. Not that it matters. I think it is a terrible idea. Quite frankly, I think it is down right dangerous.

[firedoc5]

I definitely don't agree with that. 48 is WAY too long, especially if it's one of those shifts that are non-stop. Of course even 24 doesn't always mean 24. Could go 32, 36, etc. Once I wound up doing 56, and the guy with me did 58 because he started two hours before I did. But if they go 48 and it turns into 52, 55, etc. you, your patients, co-workers are all at additional risk.

And for those who think grabbing a few winks here and there, three hours sleep, stay up four hours, then get another three hours sleep, then another hours equals eight hours sleep, it doens't work that way. Check with sleep clinics.

I might be spouting off here for some odd reason, but I've said my peace.

[Just Plain Ruff]

I have a huge issue with 48 hour shifts

There is really only one reason you should be working that many hours in a row. That's if there's a disaster happening.

If any of us agree to work 48 hour shifts then you are just as much to blame if something happens. Your company is to blame but you must take some of the blame because you let yourself get into that situation.

sorry if this makes anyone mad but sleep deprivation on a 48 hour stretch is terrible.

The service you work for may say you have down time but unless there is guaranteed of downtime like 4-6 hours at a time then there is no guarantee that you will get some sleep.

Errors are made by crewmembers on a full nights sleep and are even higher incidents of errors on less sleep.

WE talk so much about professionalism but this is important people, how professional does it look to the public when we tell them we've been working for 48 hours or 56 hours straight.

No court in the land would find you non-negligent if you tell them that when you made the mistake that cost a family their child or caused a very serious reaction med error that you had been working for 36 hours straight. There's no way you will win in any court in the land.

[firedoc5]

On another personal note, I've been hospitalized three times for exhaustion and it's only by the grace of God no one I or my partner were effected by that while treating them.

So to me, 24 on/ 48 off should be the standard.

[JakeEMTP]

Ruff brings up a couple of important points.

There is the obvious one of negligence. Through sleep deprivation, it is inevitable that errors in patient care will be made. The law firm of Dewey, Screwum and Howe will have a field day with you in court.

Secondly, yeah, how professional will your appearance be if you've been working 48hrs straight? If you don't have time to sleep, then you won't have time to shower either.

[Ridryder 911]

This is a common event if not more in some rural places. Most assume since it is rural they will get rest, not considering some calls and transfers are in hours, not minutes. Yes, it could be a dangerous event. I just came off a 36 hour tour with about a total of 6 hrs of sleep. It happens way too often and since there is no regulatory sanction and enforce hours there is not much that will be done.

I even know of a flight service that had a flight nurse that worked 9/24 hr shifts with very little down time and since they were not CAMTS certified, not much could be done. When she rebuked about it, they questioned her dedication.... to say the least she informed them what they could do.

Personally, I like 24hr shifts because the available days off, but like many other services the run volume has increased with down time is a luxury.

IAFC has performed several sleep studies showing the effects.http://www.iafc.org/displaycommon.cfm?an=1&subarticlenbr=559

Ironically, truck drivers that transport cargo only can work so many hours, yet we that transport precious cargo and perform tasks that can be dangerous or life saving have no regulations. Make sense?

R/r 911

[JakeEMTP]

Ironically, truck drivers that transport cargo only can work so many hours, yet we that transport precious cargo and perform tasks that can be dangerous or life saving have no regulations. Make sense?

Not really since we are run by the D.O.T. :shock:

I like the 24hr shifts also. Lately though, I have been working more 12's and quite frankly, I'm learning to like those better.

[firedoc5]

In the fore mentioned 56hrs. I put in the longest down time either myself or my partner had was 15 mins. at a time if we had a coal mine call. One drove while the other laid on the cot. The "boss" was down with an appendectomy, and the only one's that could make it in wound up making all the Interstate transfers since all the helo's were down due to severe winter conditions. Did I mention it was a blizzard warning? Once we did get off, a LPN friend of ours who knew our situation came to our apartment above the ambulance building. Last I remember was seeing her undressing Brad and putting him in bed. She helped me to bed and later woke up beside her. So, if anything happened I apparently missed it.

Like I said before, trash the 48, stay with the 24/48.

[Arkymedic]

I don't know if I like this. How safe is it for you, your crew member and your patient? Not to mention the lay public who, unbeknownst to them, I have possibly been up for 48 hours?

http://www.defrance.org/artman/publish/article_2012.shtml

One of the providers mentions in the article that they had 4hrs sleep in 48. What they don't mention is if that was 4hrs straight or 1/2hr here and there. Not that it matters. I think it is a terrible idea. Quite frankly, I think it is down right dangerous.

I work 24 (where we get paid for 16 hrs only unless you are up for three hours past midnight resulting in less than 5 hrs sleep)/48 at my main service however if someone calls in and the supervisor cannot find coverage, you are stuck and have no choice but to work. Many of us also pull doubles due to trades, conflicts, etc. I have also worked 48/48s, 48/24s, 6 12s, 3/4 4/3 12s and many other combinations. Very common type of system for EMS in AR and OK

[Just Plain Ruff]

In the fore mentioned 56hrs. I put in the longest down time either myself or my partner had was 15 mins. at a time if we had a coal mine call. One drove while the other laid on the cot. The "boss" was down with an appendectomy, and the only one's that could make it in wound up making all the Interstate transfers since all the helo's were down due to severe winter conditions. Did I mention it was a blizzard warning? Once we did get off, a LPN friend of ours who knew our situation came to our apartment above the ambulance building. Last I remember was seeing her undressing Brad and putting him in bed. She helped me to bed and later woke up beside her. So, if anything happened I apparently missed it.

Like I said before, trash the 48, stay with the 24/48.

well, you didn't say it was a disasater or blizzard. There might be allowable circumstances.

What types of patients were you guys transporting in blizzard like conditions that warranted transport?

I know you cannot shut down but you sure can shut down to the calls that don't require to go NOW. But I wasn't there so I'm not sure what you were working against.