Safety Naps?

[UMSTUDENT]

I recently started a new career with a fairly large municipal service as a paramedic. It's not my first job as an ALS provider, but my first "structured" career-oriented job. Not exactly certain how long I plan on staying with this department, but the following is worth asking:

In our service we run a intercept car/chase car system. This is a large metro department and the paramedics function similarly to police officers in that we have a cruiser/SUV that we and only we are responsible for during the day. The SUV is set-up to provide full ALS upgrade to career and volunteer BLS ambulances throughout the county. We are assigned to stations, either fire or EMS only, but essentially operate under our own guise...in most places even independent of career firefighters that are within the station (even though it is an integrated department). We're really just asked to be paramedics, which is extremely nice.

My problem is this: My current station is extremely slow during much of the day and picks up tremendously at night as satellite commuters return home from work, get liquored up, and crash crap or realize they're suddenly sick. We work 24 hour shifts. The upper echelons pretty much mandate that we remain conscious, alert, and in full Class-B uniform during most of the entire work day (0600-2200 hours). Uniform code is extremely rigid as are pretty much all SOPs. We're only allowed out of uniform and into PT clothes during physical training. The issue is that we spend much of the day doing nothing, finding busy work, or just staring at a TV waiting for stuff to happen and then at night, when we're exhausted, sh*t hits the fan.

I know some buddies who work for several large metro fire departments and/or flight services where they are allowed, usually under union contract, to engage in "safety naps" during the day. Some of these services even allow their crews to put the unit entirely out-of-service should they feel "tired" or "unsafe" without repercussion. My issue is that as of lately I've felt like I've been on the verge of "unsafe" in regards to sleep. Not there yet, but given the wrong day or a bad nights sleep before, I could be. I've been getting calls almost every night as we go to wind down and then in the early morning right as I'm approaching a deep sleep. I wake up disoriented and exhausted. I've even noticed what I believe to be a declining IV success rate during these hours.

My question is this: Does your service have these "safety naps" or does it have a liberal policy regarding sleeping during the day? Is this unreasonable? Keep in mind that we often respond miles out of our immediate area, alone, and without significant cover units (back-up or supervision). At night, especially, we work almost entirely with volunteer ambulances that often get out late or fail entirely. Sometimes you can seriously be on scene for quite sometime without any additional personnel. Typical call turn around, including reporting, can be as long as three hours.

[Kaisu]

My large private will begin running 48 hour shifts in January. While currently we are doing 24 on - 24 off for 3 and then 3 off, manpower shortages often have us picking lots of extra shifts. Full timers (like me) are supposed to be taking 10 shifts a month but we are now mandated to take a minimum of 13. Many times we do a 72. The shift runs 0800 to 0800. The rules say morning duties MUST be done and NO sleeping until after 1200. My supervisor waved the no sleeping before 1200 rule for me on my last 72 provided my am duties were complete. It works out.

[akflightmedic]

Never had this problem.

Every service I have worked for has allowed us 1 hour to do with as we please from 1200-1300, provided we are not on a call. After 1700, you can dress down and do whatever you please as long as evening chores are completed as well.

If on a 48, and the night before was unkind, you could request eprmission to bed down early if needed.

[akroeze]

The service I worked at was 12 hours on pager (paid calls) and 12 hours paid per shift. During our 12 hours paid as long as the truck was ready to go we could sleep or do pretty much whatever we wanted.

The service where I do my ALS preceptorship is 12hr shifts and the same applies, as long as the truck is good to go you can sleep.

[hammerpcp]

I had to have a safety nap to make it safely through this post.

[firedoc5]

My first full time job was 24 hr. a day, six days a week. Full timers (Usually between 3-5 of us) live at the ambulance building. We were very busy for a town of a little less than 20,000. When we were busy we'd get "twenty-minute power" naps. Between calls. But if we were real busy we prayed for a coal mine call. At least one of us could lay down on the cot for the 12-15 min ETA to the mine.

Most of us was young, 19-25, and were pretty much lived off adrenaline. What helped me the most is that I've had insomnia my whole life. I actually had two different partners the same way. We could go 32 hrs. without even seeing a bed for us to use, nap for 1-3 hrs. and do another 24 and not even think about it. Even if it was real slow, especially after midnight, we rarely slept. We stayed up, playing a lot of Pinochle and Ping-Pong. We said it was easier to respond to a call if we were already up and not waken from a deep sleep. Stupid...I know.

NOW you know why I've got so much gray hair and my body is shot.

So from my experience to you, get what sleep you can, when you can. Policy may dictate specific times, but don't pass up the times you can.

[Arizonaffcep]

The local private ambulance company (whom I started my EMS career with), and the company I work P/T for in Phx (not the same company), really don't care if you sleep on duty. As long as when you are out in public you are in uniform (polo shirt with EMS/Station pants and black polished boots), and do your daily duties (usually fairly simple) and don't miss a call. Other than that, they don't care. The FD I worked for, as long as our daily duties (including required daily training) was done, the Chief didn't care what we did, as long as when in public we were professional looking and responded in a timely manner to calls.

[Mateo_1387]

My service is mixed on this issue from shift to shift from station to station. Two of our city stations are at FD's, and they sometimes sleep depending on which crew is working at the FD and which crew is working EMS. The rules technically say we are not allowed to sleep, but it is not enforced. The supervisors realize that (especially in the City) things get busy all the time, and a nap may be necessary. They expect chores and building duties to be done before napping. If the supervisor does walk in on you napping, just play it off, and they are usually good. Same rule for the tv, if they walk in, just turn it off, and they let it slip, providing daily chores/duties are complete.

For busy companies that require their employees to work long shifts (ex. 12 hours or more) I think sleeping should be fine. It really is not fair to have persons work long hours in "fight or flight" without allowing for sleep. It is not fair to the employee, or the patient to have a tired paramedic working on them.

I normally do not take naps, cuz I be at the slowest station :twisted:

[reaper]

That's why I won't work somewhere where they try to tell you when you can or can't sleep or watch TV!

I am not in the military or the FD! Our crews can sleep when they want. That way they are rested.

[Arizonaffcep]

It really is not fair to have persons work long hours in "fight or flight" without allowing for sleep. It is not fair to the employee, or the patient to have a tired paramedic working on them.

Actually, from what I have been told (haven't done any research on the issue, minor issue and I'm just too damned busy these days) there are several studies that have been done in the last decade or so that shows that constant "fight/flight" type "lifestyle," along with the "startle" that comes with obnoxious "tones" for dispatch can actually damage the heart over time. Potentially one of the reasons why MI's might be so common in FD. This was one of the reasons that Phoenix Fire (and those they dispatch for) have the "Heart Saver" Tones. The ones that go from soft to loud.