Yes, I shamelessly lured you into the this article using the Obamacare promise……
I’m going to preface this post by saying that I currently work 24 hour shifts, and I enjoy them. Throughout my career I have been assigned to 10’s, 12’s, 24’s, 48’s and even 72’s. I even pushed the envelope a few times and did a couple 7-day stretches (Disclaimer: It’s a bad idea. Don’t do it). For the most part, long-hour shifts are all I’ve known for the majority of my adult life. I don’t want to see them go away, but realistically I know they will.
Every time I bring this topic up, it is usually hit with some pretty fierce opposition. 24 hour shifts have been a staple in our industry since it’s creation and like many other things we enjoy, we hold on for dear life. Working 10 days a month on the right shift rotation allows us to do a lot of things that most people on traditional 8-5 schedules couldn’t dream of.
Here’s the problem….
Too many employers (and employees) don’t take the issue of fatigue and safety seriously. Virtually every branch of commercial or public transportation has very strict rules on hours that their employees can operate, except EMS. I can literally be on the tail end of a 48 hour shift with absolutely no sleep and legally operate an ambulance or fire engine. I’m fortunate enough to work for a service that takes work hours and safety seriously, but I wasn’t always so lucky. Many services subscribe to the “suck it up” mentality and actually punish employees for “tapping out” or blowing the whistle when they’re too tired to take a long distance transfer or run a call.
The “on your feet from 8-5” policies are also killing the 24 hour shifts. I completely support station duty and equipment maintenance requirements. However, once the requirements are met, I feel that it’s very foolish not to allow your employees to lay down and get some rest during the day to reduce fatigue in the night hours. Setting “break hours” only works when the pieces fall into place and no calls go out during that time. If you’re dead set on “not paying your employees to sleep”, then switch to 12-hour shifts. Quit putting your employees and your patients at risk.
I have never understood the practice of discouraging employees from requesting down time to rest. Yes, I understand that needs of the service and community have to be met, but at what cost? We don’t encourage our employees to enter unsafe scenes – regardless of how critical the patient is – so why aren’t we doing the same when it comes to fatigue? If a loved one called me and told me that they were exhausted while making a long drive, I would tell them to immediately pull over and sleep. If it isn’t good enough for ourselves or our loved ones, then why is it good enough for our employees? Nothing is worth a human life…not even staffing requirements.
My wake up call happened several years back when I was working as an EMT-Basic. I was working a 48 hour shift in a rural community and we were up running back-to-back calls for the majority of this particular rotation. I was driving to a hospital in a town that was an hour away from the scene location. Shortly after hitting the interstate, I started feeling the affects of fatigue and I started fighting to stay awake. I wanted to say something, but I was afraid that I would be sent home without pay if I tapped out. I tried rolling down the window, cranking on the air conditioner, listening to the radio, and even attempting to engage my partner in conversation. I had a brief period where I blacked out and the next thing I remember was waking up 3 lanes over from where I remembered and nearly striking a guard rail. I played it off like I was moving out of the way of an animal that ran out on the road. Thankfully, nothing else happened and we made to our destination safely. Yes, I showed up to work with plenty of rest that shift, but that didn’t do me a lot of good at hour 37 with no sleep.
Yes, I still work 24 hour shifts and I enjoy them. The difference is, I work for an employer that is serious about how many hours we work consecutively and encourages us to rest whenever we can. If I’m working a 48-hour shift, I’m not required to be awake at a specific time to perform a pointless “log-on”. I’m typically able to catch a decent nap during the day, and I know that if the time came where I couldn’t safely operate the ambulance, I could notify my supervisor without fear of punishment. In other words, they’re doing it right.
As far the title goes, yes we can keep the 24-hour shifts, but we are going to have to be serious about the risks from fatigue. If employers continue dangerous practices then it will just be a matter of time before we start to see legislation that restricts our work hours. I don’t want to see that, but my confidence in the industry to do the right thing is nearly non-existent when it comes to this issue.
I would love to hear what you have to say on the subject. Comment below to let us know your thoughts on 24 hour shifts.