24hr Shifts - Do they need to go?

[emt2359]

I have been reading a lot about a push back against 24hr shifts.   I figured I would bring the question here where some real answers can be had instead of the short snippets of dredge that Facebook seems to attract. 

What are your thoughts?

[Just Plain Ruff]

I think a lot depends upon the system you work in.  

if your ambulances are running non-stop all day and all night like many urban systems are - then yes I think they need to go for that system.  You cannot have your medics/emt's fresh and alert running 16 calls a day.  You just can't.  If they cannot get at least a couple hours of good sleep at a time then you are doing your crews a grave disservice by making them work 24 hour shifts.  

if you have your crews running 8 calls in a 24 hour shift then theres room for discussion.  

 

It also depends on how many units you have on the street at one time.  If you have enough crews running so they only will run 8 calls in 24 hours then don't get rid of the 24s but if all your crews are running 16 calls in a 24 hour period, then it's time to add more crews.  

 

The dynamics are fluid in any staffing situation.  there is no guarantee that your crews will only ever run 8 calls in 24 and there is no guarantee that they will run only 16 calls in 24.  But the risk of sleep related crashes or drug errors or just plain human related issues that can be directly related back to 24 hour shifts I believe are too great to keep 24 hour shifts unless you have other safeguards in place.  

Some of those safeguards could be

1.  a number of swing shift crews/trucks that are put on the road on the heavy hours of the day (6a-6p, 3p-3a, 11a-11p those types of hours)

2.  When you see that your 24 hour trucks have met in their first 12 hours a certain number of calls let's say 6 calls or so, they get a mandatory down time of 3-4 hours and are only pulled out for calls such as major trauma, cardiac arrests and major life threats and only if they are the closest unit.  There should be a swing crew covering their area for their downtime.  Depending on the type of area they cover this might not be feasible.  

3.  24 hour trucks should not be used as transfer trucks if there are swing shift trucks available.  And better yet,  staff some BLS transfer crews to take grandma and grandpa jake and jane home from the ER.  An ALS unit should not be utilized for a BLS transfer, this is a waste of resources.  No offense to the EMT's on this forum but that's what they staff BLS transfer units with EMT's for.  Again, no offense.  

4.  NO MORE SSM and sitting at the corner QuikTrip.  I worked under SSM for a large portion of my career and I can say 24 hours in the cab of an ambulance SUCKED BIG DONKEY BALLS.  I'll never do it again and I hope that no one here ever does it again either.  I blame my permanent sciatica partially on sitting in the VAN ambulance at 23rd and Noland Road in Independence MO.  

 

I have more to say but if my bosses see me on this website, I'll get my ass handed to me and then I won't have to worry about sciatica anymore.