EMS Fatigue, breaks, etc

[KnightRider]

So, after writing to a State Senator, he has extended an opportunity to meet with me 1 on 1 regarding the issues that plague private EMS in Ohio. On the heels of a bill written to limit the fatigue on nurses in Ohio, I thought this would be a good opportunity to enlighten him in hopes of making a difference. However, when I meet with him, I want to go in there with solid information and stats, and not just a grievance. I did a Google search and came up empty.

Does anyone know any states that do anything that limit EMS fatigue? Such as, mandatory rest periods, etc?
Traffic deaths caused by fatigue, either to crew members or patients?
Treatment accidents caused by fatigue?

This is basically my main topic, EMS fatigue in the private sector. I may touch on other things like low wages and such but I know not much they can do there.

Any help would be appreciated! Thanks!

 

[mgr22]

Have a look at this:

https://www.ems1.com/ems-products/e...-combat-sleep-deprivation-and-fatigue-in-EMS/

The references may be more helpful than the article itself.

 

[KnightRider]

Thanks! Keep all the info coming!

 

[StCEMT]

@RocketMedic

 

[Lo2w]

As another Ohioan I'd be interested to hear what comes of your conversation. My 911 is unionized and they technically have various things in place regarding downtime between shifts, mandated OT etc.

Working private I feel you have a bit more control since you're rarely taking anything critical/emergent (unless you have a contract with a SNF or standalone ED/urgent care) and just have to push back a bit when dispatch runs you hard. I would love to see some protections in place or better guidelines.

 

[KnightRider]

As another Ohioan I'd be interested to hear what comes of your conversation. My 911 is unionized and they technically have various things in place regarding downtime between shifts, mandated OT etc.

Working private I feel you have a bit more control since you're rarely taking anything critical/emergent (unless you have a contract with a SNF or standalone ED/urgent care) and just have to push back a bit when dispatch runs you hard. I would love to see some protections in place or better guidelines.

I have not seen a private service that has "a bit more control." You go to the run or you can, or most likely will be fired. My fellow crew members had to lie to dispatch by saying they were enroute to the run but in reality enroute to a restaurant, just to eat. You have no control.

 

[Lo2w]

I have not seen a private service that has "a bit more control." You go to the run or you can, or most likely will be fired. My fellow crew members had to lie to dispatch by saying they were enroute to the run but in reality enroute to a restaurant, just to eat. You have no control.

I have no problem telling dispatch we need gas, coffee, food etc before taking a run. You also have the time after transferring care before you clear. I'm not saying refuse the run outright.

 

[KnightRider]

I have no problem telling dispatch we need gas, coffee, food etc before taking a run. You also have the time after transferring care before you clear. I'm not saying refuse the run outright.

They will understand if we need fuel for the trucks, so we can take more runs. Ask for a meal break and you can forget it. Heck, they drop runs on you and put you in-service while you are still on a run because they want you to keep moving. Your dispatchers must be lenient. Ours are merciless and the management will back them up over the crew. Anyway, enough off-topic..lol

 

[DrParasite]

You go to the run or you can, or most likely will be fired. My fellow crew members had to lie to dispatch by saying they were enroute to the run but in reality enroute to a restaurant, just to eat. You have no control.

I'd fire them too for lying to dispatch, especially if they said they were enroute to a run but going to a restaurant to eat. As a former dispatcher, I have 0 issues with crews getting food, but when you start lying and falsifying your documentation, and then I, as the dispatcher, need to justify why you are late to the facility, well, covering up certain things are not the way to do it.

Why didn't they bring their food with them (IE, brown bag it)? Are they legit that busy that they had 0 downtime, for the entire duration of their shift? or just not during a convenient time for them?

If you are getting runs dropped on you when you are still on a run, that's an issue, because you can only handle one run at a time. But if you are hanging out at the facility, flirting with a nurse, or taking a break, because you know once you call clear you have another run, that's an issue. Whether you realize it or not (and it seems that many people don't understand this), you are paid an hourly wage to work, to go on runs, and to generate revenue for the company.

That all being said, If you want to push for fatigue limits though legislative action, go for it. I think that running 24 hours straight is dangerously unsafe, and think that any EMS director that allows it to happen on a regular basis should be criminally charged with negligence. And I also think that if enough providers refused to work 24 hour shifts, agencies would change their schedule to 12s or 8s.

However, we all know providers that prefer 24 hour shifts, or will work a double 12 hour shift for OT. Are you speaking for them too? Do you know providers who accepted a job (or applied for the job because they only wanted to work 24s) knowing it was for a 24/48 or 24/72 hour schedule? Or do you know people who will work a 12 hour shift at their FT job, and then go directly to their PT job? Are you going to make that act illegal, and what will the consequences be? For every provider that is fighting for shorter shifts, there are 3 or 4 that are willing to work 24s, willing to pick up OT on a double, or are going from one job to the next.

If you don't feel like you are given the proper amount of breaks, file a complaint with the department of labor and have them investigate and determine if what management is doing is legal; trust me, they love fighting for the little guy when they are taken advantage of.

If yours are that bad, quit and work elsewhere. Or even better, transfer into dispatch (I feel like I've suggested this to you before), so you can show them how it's supposed to be.

I've been in dispatch, on both the 911 and IFT side. on the IFT side, if you call me and ask for a break to get some food, assuming a previous dispatcher didn't screw you with scheduling, I will do what I can to give you 20 minutes to grab a bite, because the schedule can sometimes be massaged a little bit. if you are on a 911 truck, it's luck of the draw, and if you are closer to the job, your getting it (but if you say you need a break, sometimes I can hold you last out).

Dispatchers are often doing what management tells them to do, so instead of blaming the dispatcher, why not address it with management? And if management is that bad, quit and work elsewhere.

 

[Lo2w]

^ pretty much all of that

Especially in Ohio with a plethora of privates, the work is there. Talk to the crews at the ED, get a feel for the good places to work.

 

[KnightRider]

I'd fire them too for lying to dispatch, especially if they said they were enroute to a run but going to a restaurant to eat. As a former dispatcher, I have 0 issues with crews getting food, but when you start lying and falsifying your documentation, and then I, as the dispatcher, need to justify why you are late to the facility, well, covering up certain things are not the way to do it.

Why didn't they bring their food with them (IE, brown bag it)? Are they legit that busy that they had 0 downtime, for the entire duration of their shift? or just not during a convenient time for them?

If you are getting runs dropped on you when you are still on a run, that's an issue, because you can only handle one run at a time. But if you are hanging out at the facility, flirting with a nurse, or taking a break, because you know once you call clear you have another run, that's an issue. Whether you realize it or not (and it seems that many people don't understand this), you are paid an hourly wage to work, to go on runs, and to generate revenue for the company.

That all being said, If you want to push for fatigue limits though legislative action, go for it. I think that running 24 hours straight is dangerously unsafe, and think that any EMS director that allows it to happen on a regular basis should be criminally charged with negligence. And I also think that if enough providers refused to work 24 hour shifts, agencies would change their schedule to 12s or 8s.

However, we all know providers that prefer 24 hour shifts, or will work a double 12 hour shift for OT. Are you speaking for them too? Do you know providers who accepted a job (or applied for the job because they only wanted to work 24s) knowing it was for a 24/48 or 24/72 hour schedule? Or do you know people who will work a 12 hour shift at their FT job, and then go directly to their PT job? Are you going to make that act illegal, and what will the consequences be? For every provider that is fighting for shorter shifts, there are 3 or 4 that are willing to work 24s, willing to pick up OT on a double, or are going from one job to the next.

If you don't feel like you are given the proper amount of breaks, file a complaint with the department of labor and have them investigate and determine if what management is doing is legal; trust me, they love fighting for the little guy when they are taken advantage of.

If yours are that bad, quit and work elsewhere. Or even better, transfer into dispatch (I feel like I've suggested this to you before), so you can show them how it's supposed to be.

I've been in dispatch, on both the 911 and IFT side. on the IFT side, if you call me and ask for a break to get some food, assuming a previous dispatcher didn't screw you with scheduling, I will do what I can to give you 20 minutes to grab a bite, because the schedule can sometimes be massaged a little bit. if you are on a 911 truck, it's luck of the draw, and if you are closer to the job, your getting it (but if you say you need a break, sometimes I can hold you last out).

Dispatchers are often doing what management tells them to do, so instead of blaming the dispatcher, why not address it with management? And if management is that bad, quit and work elsewhere.

The problem is fatigue in EMS in general. It needs to be addressed. You are correct, working 24's is unsafe. I am seeking for mandatory rest periods. Nothing more, nothing less. I know there are people willing to do it, but doesnt mean its safe. Some are left with little choice. Most of us can not afford to drive 50 miles away to make less and work in EMS.

Dispatchers at my company make less, like $9/HR. Wheelchair drivers make around $10-$10.50, EMT-B's at $12, Medics around $16

I could not find any info for a "Dept of Labor" in Ohio.

If you wish to address other issues, PM me. I want to keep this thread on track

 

[DrParasite]

Dispatchers at my company make less, like $9/HR. Wheelchair drivers make around $10-$10.50, EMT-B's at $12, Medics around $16

You do realize that you are complaining about dispatches, who are lowly paid employees (remember you get what you pay for) who are getting paid less than you do and just doing what management is telling them to do in order to keep their jobs right?

I could not find any info for a "Dept of Labor" in Ohio.

hopefully you are more prepared when you speak to the senator.... took me all of 30 seconds to find this: https://www.ohio.gov/working/rights/ and https://www.dol.gov/whd/

oh and this is what you are going up against:

Mo. county considers returning to 24-hour EMS shifts
Cole County officials will discuss switching back to 24-hour shifts in an effort to “stabilize” staffing

 

[Lo2w]

https://www.employmentlawhandbook.com/wage-and-hour-laws/state-wage-and-hour-laws/ohio/

 

[KnightRider]

I found those links too but not a dedicated dept in Ohio.

Man, try to do something positive that seems to be plaguing this industry for safety-sake...geez.

 

[Lo2w]

I found those links too but not a dedicated dept in Ohio.

Man, try to do something positive that seems to be plaguing this industry for safety-sake...geez.

If that's how you respond when others either challenge your thesis or offer up information to better inform you and help you be prepared then you're in for a rough time meeting with the rep.

 

[KnightRider]

Ive met with government and elected officials before with no issues so this isnt my first rodeo. I posted this thread to obtain information about a specific topic, fatigue, and what can be done to mitigate it properly. Many other professions get breaks/rest periods to perform safely. EMS should too.

 

[DrParasite]

There might not be a dedicated department in Ohio, but that doesn't mean there isn't a department responsible for it in Ohio. And if you can't find the state office, call the federal one (believe it or not, the Feds do have jurisdiction in Ohio).

I know this might clash your myopic view of EMS, but there are more stakeholders involved in making this type of decision on a legislative basis than one field provider who doesn't want to have to have to work for all 24 hours that he is being paid to work. There are scheduling supervisors who need to get shifts covered, employees who want or relay on working 24 hour shifts, company owners who need to hire enough staff to serve their area or contracts and don't want to pay staff when said staff aren't making them any money, AHJs who contract a certain level of service, which often isn't met due to staff vacancies, medical facilities that operate 24/7, and that doesn't include any regulators, inspectors or other support personnel.

Your cause might be in the name of safety, and it might be a righteous one, but there are just as many people who would fight any government intervention, as well as those who want the 24s and will fight to keep them or quit their current company if they are forced to switch to 12s.

I think if you fail to consider all the stakeholders' points of view, you will find yourself very disappointed when you speak to the senator (as his job is to consider all the stakeholders before recommending a legislative change), and leave very frustrated when you don't get what you want out of the meeting.

 

[DrParasite]

Many other professions get breaks/rest periods to perform safely. EMS should too.

Maybe you should list them..... and make sure you include if these breaks/rest periods paid or unpaid.

I know airline pilots can only fly for so long before they have mandatory unpaid downtime. Ditto truck drivers. Failure to document this can result in serious fines to both the agency and the individual.

Think of it this way: If you are working a 24 hour shift, are you ok with an unpaid 4 hour rest period during your shift? Are all of your coworkers?

In regards to breaks, the Federal Department of Labor does not mandate them.The same goes for Ohio.