Fatigue Questions

[MMohler]

Where abouts are you working? We have a 24 similar to that where its a mix of ift/911 and its a 24, that shift was horrendous. We count it as a fire car but by no means is dedicated. They are around most of the days during the week because of day cars running ift only. On the weekends they are gone all the time. The universal unit that is running whatever is busier.

 

[DrParasite]

And as the FD’s need for coverage increases, so does the company’s need to run IFTs, because the fire contract is a financial sinkhole that does not generate enough revenue.

Just for clarification: in many places, 911 is a money loser, especially if you deal with a population that is not insured. Very few industries are you required to provide top notch services when the recipient is under no obligation to pay for said services.

IFTs are defiantly more profitable, and are often used to offset the losses from 911. Or the AHJ needs to provide money to the agency to offset the losses.

And for the record: I bet if everyone refused to work back to back 24s, wages would increase.

 

[Qulevrius]

Where abouts are you working? We have a 24 similar to that where its a mix of ift/911 and its a 24, that shift was horrendous. We count it as a fire car but by no means is dedicated. They are around most of the days during the week because of day cars running ift only. On the weekends they are gone all the time. The universal unit that is running whatever is busier.

That’s an accurate description of my shift. We’re staged out of Westminster, covering for fire as far as Anaheim Hills and getting f***ed with IFTs as far as San Bernardino/Riverside.

 

[Qulevrius]

Just for clarification: in many places, 911 is a money loser, especially if you deal with a population that is not insured. Very few industries are you required to provide top notch services when the recipient is under no obligation to pay for said services.

IFTs are defiantly more profitable, and are often used to offset the losses from 911. Or the AHJ needs to provide money to the agency to offset the losses.

And for the record: I bet if everyone refused to work back to back 24s, wages would increase.

Both the transient and a the illegal populations in SoCal are well educated on how to play the system, and these are 60% of the calls. Add the BLS Express fire crews to the equation, and it becomes a never ending nightmare.

That will never happen as long as there’s a steady stream of young, starry eyed fire hopefuls who’d bend backwards for a chance to work in a 911 system.

 

[MMohler]

And this is with care I presume? To go off what parasite was saying we have a population that for the most part is insured. So I presume that is where they get this idea that fire brings in more.

Anyways we don't do much IFT in riverside we stick to OC/LA I swear it was almost guaranteed that we would get a 2 or 3AM call out of Arcadia Methodist. I think in 4-5 months on that shift I slept through the night 2? maybe 3 nights? It was no bueno...

 

[Qulevrius]

And this is with care I presume? To go off what parasite was saying we have a population that for the most part is insured. So I presume that is where they get this idea that fire brings in more.

Anyways we don't do much IFT in riverside we stick to OC/LA I swear it was almost guaranteed that we would get a 2 or 3AM call out of Arcadia Methodist. I think in 4-5 months on that shift I slept through the night 2? maybe 3 nights? It was no bueno...

The idea of fire calls bringing in more $ is based off of a perfect world scenario, in which a patient has his ID + med insurance ready for you and fire not pushing you in the back to load & go. In this ideal scenario, the company gets their crumbs from the city for transport and can bill the patient for service. Realistically, that happens on maybe 40% of calls.

There are only 3 companies with fire contracts in OC/LA, and 2 of them are minding their small AOs. Not very difficult to guess who I’m working for.

 

[MMohler]

Well how long have you been there? why are you working a shift like that if you have been there for awhile? go in house? go to south county?

 

[Qulevrius]

Well how long have you been there? why are you working a shift like that if you have been there for awhile? go in house? go to south county?

I have my reasons. Not sure what you’ve heard about in house shifts, but it’s no different. Any in house covers for x2 firehouses at any given time, it’s back to back for the entire shift. Anyway, it has nothing to do with the subject at hand.

 

[MMohler]

Agreed just wondered why you wouldnt attempt for a more lax shift in terms of call volume is all.

 

[Qulevrius]

In the big picture, it makes no difference. If it isn’t me who’s getting destroyed on that shift, then it’s someone else. The problem still persists and will keep persisting, for the reasons already mentioned. It’s a systemic flaw, not an isolated incident.

 

[VinceVega91]

What are your thoughts?[/QUOTE]

So I've been extended an opportunity to participate in a working group looking at the problem of fatigue, resource management and unit-hour utilization. I'm wanting to compile a good set of ideas to take into this group, and want to bounce ideas and solutions off of y'all, and draw on your opinions and experience.

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. We've got 15 24-hour trucks, one consistently-operational 12-hour peak truck, and a second occasionally-up peak truck. When levels in one portion of our district are low, or when we are at low levels within our system, we post 24-hour station trucks (this is unpopular). There is no existing fatigue-management policy.

The prevalent EMS culture of Houston is 24-hour shift work, and to my knowledge, no local 911 agency is based in 12-hour shifts. Anecdotally, most of our workforce supports 24-hour shifts because they "get all their hours out of the way at once", have three days off in a row (leaving time for family and supplemental work) and only work 8ish days a month to be full-time. It seems that the 24 is more popular than the 12 in this area, and several local agencies actually work 48/96 shifts.

What are your thoughts?

That's very interesting and I wished our city let us do 24's. As far as there being no fatigue management policy for your department, what type of arrangements are set up currently for your workers when you are on shift for a 24?

As for where I work, we only do 12 hour shifts, the only breaks we get are in between calls and the amount of time can vary depending on how busy it is on a given day. When we do overtime such as picking up an 18 hour shift, we are still not given any type of official break or sleeping arrangements, and if we happen to pick up a 24 hour shift, there is a statement in our contract that says we have to have some sort of break during those 24 hours, but since we "voluntarily" picked up the shift, the city and our division technically relinquishes any responsibility in case something were to happen to us while working a 24 hour shift.