EMS system needs vs human biological needs

[DrParasite]

spinning out of the directionless thread: https://emtlife.com/threads/the-100-directionless-thread.9773/post-710827

Misses my #1 requirement to work that hard. Feed and water me. That's a fight I've picked many times before and don't back down from. As long as I don't get any push back for taking a few minutes to take care of basic needs when needed, I'll keep moving on along.

Always killed me when I made fast turns three times in a row for calls holding and then when I finally need the bathroom and a bottle of water the supe is immediately on my phone. If someone is habitually slow, pay attention and address it.

Don’t miss that.

And I saw this on facebook, where a 911 dispatcher fell asleep on a call: https://www.facebook.com/groups/705886106135524/posts/5463252990398788/

Where does that line get drawn? Back when I was on the truck, as long as I got my essentials completed (typically a bagel sandwich in the morning, and some type of lunch in the afternoon, I was good, but I was well aware that sometimes that didn't happen on my pre-planned times), I was pretty much content, so if we ran 10 calls in 12 hours, so be it. bathroom breaks were taken whenever I could, typically in the hospital, and the moment we arrived at the hospital, agency policy was you could be dispatched for the next assignment.

When I moved to a full-time communication spot, at a much busier system, it was not uncommon for our crews to handle 18 calls during a 12 hour summer time shift. Crews got 10 minutes from the time they arrived at the ER until they could be dispatched for the calls that were holding, and if you needed a 10 or 20 minute break (typically a bathroom break), you needed to ask for it when you were not on a call, or more accurately not when you were just assigned a call. If you needed a few to leave your assigned coverage area to grab food, you could call dispatch, be moved to "last out" and get food, assuming you didn't get a call next to where you were getting food, or all units ended up getting calls and you were up.

During my brief stint as an IFT dispatcher, I dispatched my crew to a pickup at 12pm, after they haven't had anything for the previous 90 minutes. their response was "but we need to get lunch first!" While I understand people need food, if the system needs them to do their job, does that trump their desire to get food, if they had 90 minutes to get it beforehand?

What if you are tired? should a crew be able to go OOS due to fatigue, before their 12-hour shift is over, which causes the EMS system to be even shorter, with no consequences? 24s are a different discussion altogether, esp stand-up 24s....

 

[mgr22]

I never worked for an agency where bathroom breaks or meals were closely monitored. A rule of reason encouraged opportunity over need and treated "out of service" as a flexible state.

I'm pretty sure any crew going OOS for fatigue would have been invited to stay OOS indefinitely.

 

[FiremanMike]

I never worked for an agency where bathroom breaks or meals were closely monitored. A rule of reason encouraged opportunity over need and treated "out of service" as a flexible state.

I'm pretty sure any crew going OOS for fatigue would have been invited to stay OOS indefinitely.

When I worked MICU/HEMS we could call crew rest if needed, which was an automatic 4 hour break. Those obviously aren't entry level jobs, and the folks who work there are generally highly motivated, so crew rest was not abused and it was respected when called.

 

[MMiz]

I worked for a 911/IFT private service running BLS calls and first response to emergencies.

While we rarely ran from call to call, there were times we notified dispatch that we'd be on "pager and prep for a detail."

It wasn't an ask, it was a declaration.

There was a shift where I was working a double (24 hour) in a BLS van with SSM. Called my supervisor 20 hours in and said that I couldn't finish the last four hours. I was allowed to go home without consequences.

I hear it's the norm in delivery jobs like UPS and Fedex to organize packages during lunch and urinate in a bottle in the back of a truck to meet time requirements.

It would be a deal breaker for me.

 

[StCEMT]

spinning out of the directionless thread: https://emtlife.com/threads/the-100-directionless-thread.9773/post-710827



And I saw this on facebook, where a 911 dispatcher fell asleep on a call: https://www.facebook.com/groups/705886106135524/posts/5463252990398788/

Where does that line get drawn? Back when I was on the truck, as long as I got my essentials completed (typically a bagel sandwich in the morning, and some type of lunch in the afternoon, I was good, but I was well aware that sometimes that didn't happen on my pre-planned times), I was pretty much content, so if we ran 10 calls in 12 hours, so be it. bathroom breaks were taken whenever I could, typically in the hospital, and the moment we arrived at the hospital, agency policy was you could be dispatched for the next assignment.

When I moved to a full-time communication spot, at a much busier system, it was not uncommon for our crews to handle 18 calls during a 12 hour summer time shift. Crews got 10 minutes from the time they arrived at the ER until they could be dispatched for the calls that were holding, and if you needed a 10 or 20 minute break (typically a bathroom break), you needed to ask for it when you were not on a call, or more accurately not when you were just assigned a call. If you needed a few to leave your assigned coverage area to grab food, you could call dispatch, be moved to "last out" and get food, assuming you didn't get a call next to where you were getting food, or all units ended up getting calls and you were up.

During my brief stint as an IFT dispatcher, I dispatched my crew to a pickup at 12pm, after they haven't had anything for the previous 90 minutes. their response was "but we need to get lunch first!" While I understand people need food, if the system needs them to do their job, does that trump their desire to get food, if they had 90 minutes to get it beforehand?

What if you are tired? should a crew be able to go OOS due to fatigue, before their 12-hour shift is over, which causes the EMS system to be even shorter, with no consequences? 24s are a different discussion altogether, esp stand-up 24s....

As far as I see it, automatically dispatch me before I clear and you can automatically mark me not responding. 10 minutes is nothing. As soon as you arrive like that previous policy you had is an even dumber idea.

I'm all for creating opportunity at hospital, especially with packing food (for a number of reasons). But people need enough time to utilize the opportunities.Those kinds of policies are a big driver of turnover. Nobody needs to ask permission for a bathroom break and any policy stating such clearly shows the organization doesn't value the well-being of it's people or treat them like adults. Depends. Are you sending them on a 4+ hour transfer and they hadn't planned their meal times for that? If so, let them eat. If not, give them time at destination instead.

Generally I'd say no for 12's, but life does happen. But any place that has forced turnaround times like what you mentioned has a staffing problem, not a staff problem. If that extra 10 minutes is supposedly that crucial, it isn't the crews fault or problem. That's on management to staff accordingly.

 

[DrParasite]

As far as I see it, automatically dispatch me before I clear and you can automatically mark me not responding. 10 minutes is nothing. As soon as you arrive like that previous policy you had is an even dumber idea.

Please don't kill the messenger, I didn't create the policy, I am just relaying what management has the supervisors enforce.

Nobody needs to ask permission for a bathroom break and any policy stating such clearly shows the organization doesn't value the well-being of it's people or treat them like adults. Depends. Are you sending them on a 4+ hour transfer and they hadn't planned their meal times for that? If so, let them eat. If not, give them time at destination instead.

I should have clarified this... The 10 minute turnaround time was for 911 units only, which could run back to back runs for 8 hours straight. all BLS calls were in the city limits, but ALS calls could creep outside into the county. So the bathroom break was to make sure you could poop uninterrupted. It's not like you needed to ask permission, but if you wanted to make sure you didn't get a call during that time...

Generally I'd say no for 12's, but life does happen. But any place that has forced turnaround times like what you mentioned has a staffing problem, not a staff problem. If that extra 10 minutes is supposedly that crucial, it isn't the crews fault or problem. That's on management to staff accordingly.

No disagreements that the agency has staffing issues (or more accurately, the AHJ didn't fund nearly enough units to cover the call volume for the city), so even at full staffing, we still could have used more trucks to handle the call volume. But again, that's often the nature of the 911 system

 

[HardKnocks]

Some Public Service Agencies that denied their employees PAID on-duty breaks and meal periods were sometimes sued and forced to pay O/T, pursuant to the Fair Labor and Standards Act, (i.e. FLSA Pay).

FLSA Pay is not all encompassing in every jurisdiction. State Law and Collective Bargaining Agreements sometimes negate and/or address FLSA pay entitlements.

Here's a primer;
FLSA Case Law Cite

The Fair Labor Standards Act (FLSA) is a federal law that requires employers to pay minimum wage and overtime compensation (under specific circumstances) to their employees. Since the FLSA became applicable to state and local government employers in 1986 following a ruling by the U.S. Supreme Court, many public employers have attempted various ways to avoid paying overtime compensation (i.e., time and one-half pay) to fire fighters, rescue service, and emergency medical service employees. If an employer's overtime pay practices are in violation of the FLSA, employees may file a lawsuit against the employer and obtain back pay (which may be doubled to include what is known as "liquidated damages"), reimbursement for attorneys' fees, and litigation expenses.

 

[Phillyrube]

Working both the law enforcement and EMS fields, I always packed a small cooler with snacks, mosy fruit, veggies, and a Kit Kat bar in case I got into a foot chase. Its nice to sit down for a meal but no guarantees. Potty break every time I hit the ED.
Healthy? Not especially but the realities of life. As an EMS Chief I would monitor call volumes and occasionally put a unit out for a breather. But then I would also call the patient who called for the 3 day old sore knee and apologize but we vant get to him for another hour due to more serious calls.
They always find a ride.

 

[Aprz]

https://m.facebook.com/story.php/?story_fbid=pfbid07DivhYTjmeU5cbpdpWMRcP6X4m951rTPx5ddJ1XD8Hr5QbAi6eSbk8z9izP5xqoal&id=100063526764598

This reminded me of this post.

 

[IsraelEMS]

We mostly do 8-10 hours shifts, but in my region it is the norm to be getting calls back to back the whole time. The hospitals all have EMS rooms where they put out fruit, yoghurt, sandwiches, coffee, tea for us for free. After about 10 minutes in the hospital if there is a real need, dispatch will call us and ask if we can go back out right away (sometimes we are stuck waiting for a bed not just taking a break), otherwise they usually wait until we signal that we are available for the next call. We speak up about our needs and most dispatchers (who also work in the field) are pretty good about helping us meet them. That respect also means that when they tell us they can't give us a break and really need us right now, we know that it means they are slammed and the calls are serious. Our dispatch is also good about giving us an emotional break after a serious call if need be.

 

[CCCSD]

Always carry a pee bottle.

 

[johnrsemt]

8-10 hour shifts are funny: try an 8 hour run: 2 hours to the scene 2 hours back to town with the patient, fuel the ambulance, then 135 miles to the Level 1 or 2 hospital. Then you get a small break then 135 miles back to town.
Worse during a blizzard a few years ago: 5.5 hour transport with a critical Acute MI on board. nothing could fly

 

[IsraelEMS]

8-10 hour shifts are funny: try an 8 hour run: 2 hours to the scene 2 hours back to town with the patient, fuel the ambulance, then 135 miles to the Level 1 or 2 hospital. Then you get a small break then 135 miles back to town.
Worse during a blizzard a few years ago: 5.5 hour transport with a critical Acute MI on board. nothing could fly

Sounds like a nightmare. We are a small country with a lot of level 1 hopsitals, thank G-d. A long transport for me is a half hour to 40 minutes. A really long one is an hour. More than that (in an urgent case) is unheard of. Even when we have a pt at the dead sea (about 2 hours drive to the closest hospital), if he is really urgent we call a helicopter.

 

[johnrsemt]

We try to call birds when we can; and have quite a few available, but they can't always fly. Sometimes the 70+mph winds keep them on the ground or the pads: what is bad is when Dispatch says the weather is too bad and we all look up and go what weather. But 135 miles away the weather sucks.