48/96 Schedule

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After reading a few posts where the topic of schedules or hours worked came up I thought I would try and get some thoughts on the 48/96 schedule. There are many fire departments either using the schedule,in trials or in discussions to open it up for a vote. I think there are some definite advantages for those that commute a long distance, also when you take your kelly day you would end up with a 9 day stretch off once a month. You would have less hand off time and more time to attend to projects. On the negative side a busy house or car could mean a real lack of rest if you run hard. I know that departments that use this schedule allocate drills and other more strenuous duties to the first 24 allow more downtime during your second 24. I think the fatigue factor might be more of a problem for the EMS side than the fire side. I think the input from departments now using this schedule has been overwhelmingly positive. I came back and added a link to the 48/96 website. Any thoughts?

www.48-96.com
 
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It has been shown that if you are extremely busy and have no downtime, by the end of 24 hours you will be fatigued to the point where you will have all of the cognitive abilities of somebody who is legally drunk. You really think doubling that is a good idea? Maybe for the fire side, where you might get two calls in 48 hours, but definitely not on the EMS side, where in the same 48 hours you might run 30+ calls.
 
If it is a county operation that isn't busy, it might work.

Try doing that in Dallas where a single station averages 30 calls in 24 hours, and you'd be hated.
 
There are plenty of agencies where medics, private service or fire based are picking up trades or forced on to an extra 24 hour shift. I know the studies show a great deal of fatigue but studies are not much use in today's world of shrinking budgets and where agencies must stretch their overtime to the max. At least with the 48/96 you get the benefit of the four days off after your 24.

The 48-96 website has not been updated but I know there are departments that have houses that run 40 calls in a 24 shift so it can be done. I know many of the department personnel are skeptical at first but after trials they see it can work and really enjoy the off time offered.
 
In a slow service where the odds are you will get 8 hours sleep every 24 it is a nice system. Slow equals in 120 24 hour shifts having fewer than 5 times w/o getting 8 hours sleep in a 24 shift. In a busy system 12 hours is to long. Patient care and Paramedics health should come before the budget otherwise at some point the lawsuits from injury and malpractice will cost far more than the service saves.
 
Its fine for slower services, maybe no more than 5 or 6 calls in a day, but for services that run 10 or more calls a day, that'll tire you out before you get through the second 24.

St. Louis city got rid of 24s for their EMS vehicles and went to 12s. The city is more busy than the county departments, so some of the county departments still keep their 24s even for EMS.
 
I'd love it, gets me out of the house. But if I were a patient, I'd feel weary of a guy performing medical interventions on me after 24 hours of calls, let alone 48. I'll keep my 24-48
 
For those of you judging based on call volume you should be looking at it as how many hours of downtime in a 24 hour period is there. Medic417 for example is way out in the sticks where calls will take several hours, in that system 10 calls a day is almost no downtime. In an area where you're never more than 10 minutes from a hospital and an average call is 30 minutes from dispatch to clearing the hospital then 10 calls a day is not bad at all.

With that in mind I will agree with medic417, if an average workload allows 8 hours of sleep then yes a 48/96 would be fine but anything less is asking for trouble. My company for that reason allows a max of a 48 hour shift, then you must have 12 hours off duty. They used to allow up to a 72 hour shift but at that point they found a decrease in the quality of patient care so that got the axe.
 
72? My oh my! Even surgical residents don't go that long!

And marineman, you're right. I forgot that we are 10 minutes from the closest hospital and even with a major trauma only about 20-30 minutes from the trauma center downtown.
 
I still trade days and will do 120 hour shifts at a station that averages 1 call per 24 hours. If anything we get to much sleep.

But I am against more than 12 unless in a slow place with at least 8 hours sleep almost 100% assured.
 
120!!!!!!!!

!@@@#$%^&*#@*($%#$%^&*()!!!!!!!!!!!!!!!!!!

and only one call /24 hours?

I think i'd go INSANE!
 
WuLabsWuTecH said:
120!!!!!!!!

!@@@#$%^&*#@*($%#$%^&*()!!!!!!!!!!!!!!!!!!

and only one call /24 hours?

I think i'd go INSANE!
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Allows time to catch up on study, movies, etc. But when we get calls they are almost all very serious and you work your butt off.
 
Wow, you work in a district with very few BS calls? You don't happen to live in the 80s do you and just time travel to post on our board? :)
 
WuLabsWuTecH said:
Wow, you work in a district with very few BS calls? You don't happen to live in the 80s do you and just time travel to post on our board? :)
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I don't think the people are used to a full time staffed ambulance yet as they still almost always drive even serious injury or illness to the ER. Once they get used to us being there we will probably start being used like all other ambulances that is a horizontal taxi.

Right now we mainly get wrecks, oil field accidents, very little medical which sucks as that is where the challenge in medicine is, anyone can bandage and backboard. Until we opened this station I would have called anyone that said the majority of their calls serious a liar, and they still probably are.

But the last few shifts we did get a couple of people that could have walked across the street to the hospital quicker than we could get there and they had nothing wrong that a good nights rest wouldn't fix as confirmed by the doctor when we drove them across the street. So looks like the honeymoon is about over.
 
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We have quite a variety of shifts here. I currently work the peak shift which consists of Mon-Thurs from 0700 to 1730. Meanwhile, the other crew works 12 hours straight time, and 12 hours on call. During the Fri-Sun that I don't work, the crew that is on does 12 hours straight, and 12 hours on-call. Technically, they do 72 hours, but they don't get paid 72 hours straight time. But, our call volume allows them to get plenty of sleep. Due to the high population of over 65 here, the majority of our calls are medical in nature. I can't remember how long since my last serious MVC.

Some of the other stations run either 12 hour or 24 hour shifts. depending on staff and vehicles available. Manning, AB does 24 hour shifts. and occasionally, get stacked emerg calls.
 
A 48/96 can be rough in a high call volume system. Productivity will drop after 16 consecutive work hours, and dangerous as well. NYC has a 16 hour consecutive work hour rule in regards.

What's even more rough is working a 24/48, but in reality working a 48/24 a la Charleston County EMS. This place regularly forces you out of the ED repeatedly without even having written a word on your PCR. Your "downtime" is spent playing catch up. I recently spoke to my friend that still works there, and he told me that they're forcing medic crew chiefs for additional 24's 4-8 times per month. That's spending half of your life at work!

Some DoD FD's use a 48/72, but their call volume is low. I suppose a 48/96 would be preferable to a 24/48, as it's half the travel time, and prevents forced OT.

Unless your call volume is low, I feel that anything over a 16 hour shift is inappropriate for EMS. It's not sustainable long term. It promotes burnout and attrition. 3 12's with a swing shift, or a 16/16/8 would be excellent options for a busy system.

I know someone who did this: If you're being forced to work in excess of 24 hours frequently, inform them that you're too fatigued to either drive or make pt care decisions. Do it on a taped line. When they order you to continue work, crash the ambulance on the way to the first call. When they fire you, take them to court for a mid six figure settlement. I'm not suggesting anyone do this, for the record.
 
medic417 said:
I don't think the people are used to a full time staffed ambulance yet as they still almost always drive even serious injury or illness to the ER. Once they get used to us being there we will probably start being used like all other ambulances that is a horizontal taxi.

Right now we mainly get wrecks, oil field accidents, very little medical which sucks as that is where the challenge in medicine is, anyone can bandage and backboard. Until we opened this station I would have called anyone that said the majority of their calls serious a liar, and they still probably are.

But the last few shifts we did get a couple of people that could have walked across the street to the hospital quicker than we could get there and they had nothing wrong that a good nights rest wouldn't fix as confirmed by the doctor when we drove them across the street. So looks like the honeymoon is about over.
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I had the opposite issue. A LOT of medical and very little trauma up until recent!
 
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