Fatigue Questions

Tigger

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If it is that bad we as in me and my partner will switch or vise versa. When I was on a 24 ift/911 car it was mostly one sleep on the way there and other sleep on the way back. An actual emergent call also wakes you up pretty quickly...
No, it doesn't. You are a danger to yourself and others whetheryou believe science applies to you or not.
 

MMohler

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So you’re saying everytime you were tired you complained and said send another unit? Or called fatigue? I’m not saying by any means that you should feel pressure not to but sometimes you get screwed at nights sometimes you don’t. We work in a 911 system there is no time off. Some days you sleep some days you don’t. Splash your face with cold water, slap your self a few times do whatever you have to do. fatigue is inevitable at times could it be reduced? Sure. Will it ever go away? No. We all signed up for this field of work.
 

Qulevrius

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If it is that bad we as in me and my partner will switch or vise versa. When I was on a 24 ift/911 car it was mostly one sleep on the way there and other sleep on the way back. An actual emergent call also wakes you up pretty quickly...

I suggest educating yourself on REMS deprivation. You might feel OK at your tender age, but it'll catch up with you very fast (and very painful).
 

Tigger

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So you’re saying everytime you were tired you complained and said send another unit? Or called fatigue? I’m not saying by any means that you should feel pressure not to but sometimes you get screwed at nights sometimes you don’t. We work in a 911 system there is no time off. Some days you sleep some days you don’t. Splash your face with cold water, slap your self a few times do whatever you have to do. fatigue is inevitable at times could it be reduced? Sure. Will it ever go away? No. We all signed up for this field of work.
No I don't. Sometimes I have to be tired, but I also show up to work well rested. If you showed up to your part time job with seven hours of sleep in the previous 48, you were not well rested.
 
OP
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RocketMedic

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So you’re saying everytime you were tired you complained and said send another unit? Or called fatigue? I’m not saying by any means that you should feel pressure not to but sometimes you get screwed at nights sometimes you don’t. We work in a 911 system there is no time off. Some days you sleep some days you don’t. Splash your face with cold water, slap your self a few times do whatever you have to do. fatigue is inevitable at times could it be reduced? Sure. Will it ever go away? No. We all signed up for this field of work.

The fact that you are placed in that situation is a management failure.
 
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NPO

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At present, we're a busy urban/suburban EMS system that operates on 24-hour shifts, in a four-platoon rotation (24 on/72 off). We run P/B, and answer more than 50,000 911 calls annually. Functionally, our service area is pretty busy, with our "slow" stations averaging 6ish calls a day and our "busy" stations averaging 12-14 calls a day, with UHUs ranging from .25 to .75 on average.

What are "normal" UHUs? I don't know what the UHU was at my previous employer, but as a busy metro/suburban/rural system with 8/10/12/24/48 shifts, I imagine it varried quite a bit, but trended high.

My current employer prefers to keep UHU around .16, and when they go over .20 for more than a few days it's considered "busy". One weekend we sustained .22 for 2 days and everyone lost their minds.
Screenshot_20180328-002941~2.jpg
 

MMohler

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Well my part time job is behind a desk and has 0 liability in peoples health or risking anyones life. Yah, I am young but I don't want to be an EMT forever so I need some sort of extra income to save for medic school or an academy. An EMT in California makes nothing and it isn't enough to save much.

Again I am going to reiterate that I do not approve of fatigue, it truly is a silent killer. But, in this industry it is inevitable. We work 2 24s a week and a rotating Saturday so every third week is a 48. I usually will have almost 4-5 days of recovery after this. The end goal is FF/Paramedic and I have heard horror stories from a captain with an unnamed department that worked 10 days, thats 10 DAYS straight. So no I think 24/48 arent too bad in retrospect. It was just one of those shifts where nothing happens until 5pm and everything comes at night. So be it. I was never at one point too tired to feel that my pt care or me, my partner, and pt safety was compromised. I would say about 85% of the shifts we get 6-7 hours of sleep every night, just not the case for this shift. I am not pouting about it but adding to the fact that sometimes it happens is all. And yes if I felt that me and my partner were a risk to each other or a pt I would say something.

In summary my angle in this topic is that fatigue is bad, avoid it at all costs, but even then it still happens.
 

DrParasite

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My current employer prefers to keep UHU around .16, and when they go over .20 for more than a few days it's considered "busy". One weekend we sustained .22 for 2 days and everyone lost their minds. View attachment 4190
people lost their minds when the UHU was .22?

damn, our UHU fluctuated between 0.9 and 1.2 during the summer days..... if it dropped below .25, I think we would be getting to see if the phones in our comm center were functioning properly.

BTW, here was the breakdown from J.R. Henry Consulting Inc regarding optimal UHU:

.55 - .45 – Optimal Utilization
.45 - .35 – Above Average Utilization
.35 - .25 – Average Utilization
.25 - .15 – Below Average Utilization
.15 - .01 – Poor Utilization

And while my former employer was grossly overworked, if your people are losing their minds at 0.22......
 
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NPO

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people lost their minds when the UHU was .22?

damn, our UHU fluctuated between 0.9 and 1.2 during the summer days..... if it dropped below .25, I think we would be getting to see if the phones in our comm center were functioning properly
A lot of my co-workers have been here doing this job for YEARS, and have grown accustomed to their ways. Change is difficult for them, and for some, calls are a nuisance...
 

Qulevrius

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Well my part time job is behind a desk and has 0 liability in peoples health or risking anyones life. Yah, I am young but I don't want to be an EMT forever so I need some sort of extra income to save for medic school or an academy. An EMT in California makes nothing and it isn't enough to save much.

Again I am going to reiterate that I do not approve of fatigue, it truly is a silent killer. But, in this industry it is inevitable. We work 2 24s a week and a rotating Saturday so every third week is a 48. I usually will have almost 4-5 days of recovery after this. The end goal is FF/Paramedic and I have heard horror stories from a captain with an unnamed department that worked 10 days, thats 10 DAYS straight. So no I think 24/48 arent too bad in retrospect. It was just one of those shifts where nothing happens until 5pm and everything comes at night. So be it. I was never at one point too tired to feel that my pt care or me, my partner, and pt safety was compromised. I would say about 85% of the shifts we get 6-7 hours of sleep every night, just not the case for this shift. I am not pouting about it but adding to the fact that sometimes it happens is all. And yes if I felt that me and my partner were a risk to each other or a pt I would say something.

In summary my angle in this topic is that fatigue is bad, avoid it at all costs, but even then it still happens.

10 days straight isn’t a horror story, unless he hasn’t slept for 240 hrs (which would be a blatant lie, because fire crews rotate and have guaranteed downtime). I myself had 9, 10 and 11 days work stretches and whilst exhausting, it is not the end of the world, as long as the call volume doesn’t put you in a shallow grave.

What’s happening with us right now though, is a complete opposite. With x2 set 24s, we’re getting routinely destroyed with call volumes that keep us up for as long as 22-23 hrs straight. The source of this issue is multifaceted and not something I’m willing to discuss on an open forum, for obvious reasons. I just would like to point out that a total majority of prehospital systems, consider their employees unskilled laborers, and treat them as such. Kudos to you for trying to crawl out of the bog, but the truth is that FDs are exactly the same. The only reason they seem to be different, is because of the post-9/11 glorification, which will not last forever.
 

Tigger

Dodges Pucks
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people lost their minds when the UHU was .22?

damn, our UHU fluctuated between 0.9 and 1.2 during the summer days..... if it dropped below .25, I think we would be getting to see if the phones in our comm center were functioning properly.

BTW, here was the breakdown from J.R. Henry Consulting Inc regarding optimal UHU:

.55 - .45 – Optimal Utilization
.45 - .35 – Above Average Utilization
.35 - .25 – Average Utilization
.25 - .15 – Below Average Utilization
.15 - .01 – Poor Utilization

And while my former employer was grossly overworked, if your people are losing their minds at 0.22......
Was it calculated the same way as above?
 

NPO

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Was it calculated the same way as above?
UHU is calculated by taking transports, and dividing by unit hours. For example, 2 calls in 12 hours equals UHU of 0.16 (my shift yesterday). A pretty easy shift because both of those transports we're short.

One thing that isn't reflected by UHU is long transports. If a call takes more than an hour it's unfairly represented in UHU. Most of our transports are 30-60 minutes, several over an hour, and with some exceeding 4 hours. This isn't factored into UHU.

Also, we are overstaffed for a population our size. We staff 6 ALS units during peak hours and 4 at night (after 2am until 8am) for a county population of about 50,000. The reason is because we have a large tourist city which swells by several million in the summer. We need this many units due to the call volume and longish transports during the summer months.
 

MMohler

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10 days straight isn’t a horror story, unless he hasn’t slept for 240 hrs


Well being that this is at a station thats known to be one of the busiest in the state averaging about ~6000 calls a year I dont think there was much sleep. I do not think I am in any bog here just submitting an angle to an open forum. Whether you agree or not fatigue can and will happen. It is never COMPLETELY avoidable. I have never put my partner or pt safety in jeopardy and will keep it that way. You can produce a perfected system to eliminate fatigue and still have a busy day. EMS at its core is unpredictable, I signed up for this to help people because its what I love to do. I didnt sign up to get a guaranteed 7-9 hours of sleep every night if I wanted that I could go back to sitting behind a desk full time. Not sure where my angle is getting misconstrued with that I like being tired all the time but again would like to clarify that I DO NOT APPROVE OF FATIGUE. They can do any study they want but the point being that fatigue is still around and never 100% eliminated. Every state and EMS system is different. Being that I work private ambulance (and not a big one) I understand that its a business. They still have to produce a profit or I am out of a job. Putting 10 fire cars out for 3 cities is not realistic. Sorry my local system does not agree with yours but I like my job, the company, and the areas that I cover. So no, I do not have an issue with getting woken up at night. Or getting a good nights sleep. Sometimes I sleep through the night sometimes I dont. Life goes on.
 

MMohler

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With x2 set 24s, we’re getting routinely destroyed with call volumes that keep us up for as long as 22-23 hrs straight.

Well this isnt even close to my shifts we average about 6 calls a day and on a busy day we are around 10.
 

Qulevrius

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Well this isnt even close to my shifts we average about 6 calls a day and on a busy day we are around 10.

^ let’s pretend the quote includes your previous posts as well.

This isn’t a pissing contest discussion where we take pride in how much abuse we can tolerate, because “this is what we signed up for”. I also don’t see anyone being impressed with the “I do it because I want to help people“ rah-rah (appreciate you not dropping the So Others May Live/Saving Lives bombs, so I don’t lose my sh*t here). Whether you work for McCormick or Emergency, your job is simple - you’re a gurney pusher, outsourced by a county/city FD because having you is cheaper than having their own ETs. The sooner you realize it, the sooner you’ll get the Kool-Aid out of your system and save yourself the frustration.

Yes, fatigue is unavoidable. But what’s routinely happening in EMS, differs from other jobs in terms of acuity, because for EMS the fatigue is chronic. You might not worked in the field long enough to start feeling the effects, but when you will, it better not be too late.
 

Tigger

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UHU is calculated by taking transports, and dividing by unit hours. For example, 2 calls in 12 hours equals UHU of 0.16 (my shift yesterday). A pretty easy shift because both of those transports we're short.

One thing that isn't reflected by UHU is long transports. If a call takes more than an hour it's unfairly represented in UHU. Most of our transports are 30-60 minutes, several over an hour, and with some exceeding 4 hours. This isn't factored into UHU.

Also, we are overstaffed for a population our size. We staff 6 ALS units during peak hours and 4 at night (after 2am until 8am) for a county population of about 50,000. The reason is because we have a large tourist city which swells by several million in the summer. We need this many units due to the call volume and longish transports during the summer months.
It is sometimes calculated like that. Like all statistics, apples to apples. Your methodology is posted, the other poster did not.
 

Tigger

Dodges Pucks
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Well being that this is at a station thats known to be one of the busiest in the state averaging about ~6000 calls a year I dont think there was much sleep. I do not think I am in any bog here just submitting an angle to an open forum. Whether you agree or not fatigue can and will happen. It is never COMPLETELY avoidable. I have never put my partner or pt safety in jeopardy and will keep it that way. You can produce a perfected system to eliminate fatigue and still have a busy day. EMS at its core is unpredictable, I signed up for this to help people because its what I love to do. I didnt sign up to get a guaranteed 7-9 hours of sleep every night if I wanted that I could go back to sitting behind a desk full time. Not sure where my angle is getting misconstrued with that I like being tired all the time but again would like to clarify that I DO NOT APPROVE OF FATIGUE. They can do any study they want but the point being that fatigue is still around and never 100% eliminated. Every state and EMS system is different. Being that I work private ambulance (and not a big one) I understand that its a business. They still have to produce a profit or I am out of a job. Putting 10 fire cars out for 3 cities is not realistic. Sorry my local system does not agree with yours but I like my job, the company, and the areas that I cover. So no, I do not have an issue with getting woken up at night. Or getting a good nights sleep. Sometimes I sleep through the night sometimes I dont. Life goes on.
Look. There is no way to justify getting seven hours of sleep in 48 hours. Whether or not you think it's acceptable or you are willing to do that makes no difference. You posted dangerous about a dangerous work environment. It is a problem. It doesn't matter if you signed up for that or not. Yes, if you work 24+ hour sleeps, you should expect to get up at night. But seven hours in 48 hours is dangerous. Being ok with that danger is a problem.
 
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RocketMedic

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It is the responsibility of management to devise solutions.
 

MMohler

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It is a problem

Yah, it certainly is but this does not happen frequently. I had one bad shift and now have 4 days off to catch up on sleep and recover. You dont have to bring more "education" on about it only takes one shift to get in an accident, injure a pt, etc. The system is already in shambles as far as private ambulance goes. Itd be all rainbow and butterflies if we were funded by government and state. We could staff as many cars out as we wanted to! it is just not possible in any way. In reference to
you’re a gurney pusher
. Youre right but I understand my position and know it isnt my end all. Might as well keep drinking my kool aid because better to be enthusiastic about carting people around then to pout and start this "burn out" process quicker.
 
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