"the number one problem facing EMS"

typical JEMS article, at least 16 years behind the times, with a study that is supposed to be credible because it is focused on EMS.

How many hours a day are commercial truck drivers permitted to drive?

When did those laws go into effect?

How many hours can an airline pilot fly? How much consecutive rest is required?

How far back do studies showing physician work hours factor into medical errors?

(How much money to hospitals lobby not to reduce resident work hours in the US, compared to their European counterparts? Why do you think that is?)

Speaking of residents, why are there seemingly continual efforts to reduce hours along with mandatory periods of rest?

Why do high volume systems shorten their shifts from 24h to 16, 12, or 8?

How far back in history do militaries consider soldier fatigue as a critical factor for military operations and readiness?

Were all these things somehow different than EMS workers that required a study of EMS workers?

That is why EMS are tradesmen.
 
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Actually, I am glad to see that it is finally being addressed on a national level. Yes, we all know common sense SHOULD play into safety, schedules, patient care and outcomes and yes... personal safety. Again unfortunately, too many of those within EMS fail and worse refuse to participate to cause change!

Yes, alike all of those agencies and professions that allowed dangerous behaviors for decades and centuries that caused unknown amount of needless deaths. I remember while in Paramedic school, physician residents working 40-50 hours straight and being sleep deprived and needless errors and problems that followed.. all in the name of "this is how we always done it and the right of passage"... Thank goodness, that has changed but it took numerous litigation to do so. Hopefully, we can and learn off other professions and use common sense to realize our industry errors.

During my professional career medic for 34 + years, there are very few services I did not work at least 24 hour shifts. The number of responses have increased for EMS, the nature and intensity of the types of calls has drastically changed. So why not the change in working conditions?...

Simply put...$$ Financial. With the increase of responses and such, one would also expect the revenue to also rise... right? No. More denials from third party insurance, medicaid and medicare reimbursements drastically reduced; how are companies to create change?

Does this give the industry a legitimate excuse? No. but.. what is the answer?

Can local EMS providers afford to double their annual salaries, to create more salaries or worse can we not afford to?

I do not envy EMS administrators at this time... I see both sides and alike many other EMS dilemmas there is not a clear answer.. Alike the article pointed out, better scheduling opportunities, if possible allow more "down time" to get rest and sleep, ensure your crew does not have to vacate stations until it is safe for them to.

Maybe.. if those in EMS would review how the other industries changed theirs( per legislation and peer requirements) and changed the industry standards, then reimbursement ratio would have to follow to continue services.. not until then will we really see a change

R/r 911
 
Oh... My... God... It's RID!!!!!
 
Ridryder911 said:
Actually, I am glad to see that it is finally being addressed on a national level. Yes, we all know common sense SHOULD play into safety, schedules, patient care and outcomes and yes... personal safety. Again unfortunately, too many of those within EMS fail and worse refuse to participate to cause change!

Yes, alike all of those agencies and professions that allowed dangerous behaviors for decades and centuries that caused unknown amount of needless deaths. I remember while in Paramedic school, physician residents working 40-50 hours straight and being sleep deprived and needless errors and problems that followed.. all in the name of "this is how we always done it and the right of passage"... Thank goodness, that has changed but it took numerous litigation to do so. Hopefully, we can and learn off other professions and use common sense to realize our industry errors.

During my professional career medic for 34 + years, there are very few services I did not work at least 24 hour shifts. The number of responses have increased for EMS, the nature and intensity of the types of calls has drastically changed. So why not the change in working conditions?...

Simply put...$$ Financial. With the increase of responses and such, one would also expect the revenue to also rise... right? No. More denials from third party insurance, medicaid and medicare reimbursements drastically reduced; how are companies to create change?

Does this give the industry a legitimate excuse? No. but.. what is the answer?

Can local EMS providers afford to double their annual salaries, to create more salaries or worse can we not afford to?

I do not envy EMS administrators at this time... I see both sides and alike many other EMS dilemmas there is not a clear answer.. Alike the article pointed out, better scheduling opportunities, if possible allow more "down time" to get rest and sleep, ensure your crew does not have to vacate stations until it is safe for them to.

Maybe.. if those in EMS would review how the other industries changed theirs( per legislation and peer requirements) and changed the industry standards, then reimbursement ratio would have to follow to continue services.. not until then will we really see a change

R/r 911
Click to expand...

Welcome back Rid!
 
medichopeful said:
Welcome back Rid!
Click to expand...

tumblr_lir6yr3LH51qcshcjo1_500.gif
 
Around here they are.implementing a law/policy/protocol banning 24hr shifts.

At my work we do 12s we do posting so there isn't a station to sit.at.

We can work 2 12s back to back then have to have 8hrs off.

Unless you are on the inner.city cars. Then you can only work twelve.

I really don't doubt the whole being tired= intoxication.

After being up for 32hrs I was barely functioning.
 
The number 1 problem in EMS is lack of pay. Without incentive, there is no attraction for one to better themselves. Hence why most find other opportunities.
 
Dr. Bledsoe once wrote an article that EMS is losing their best and their brightest.

These people usually understand they must first work to better themselves, often incurring costs for things like education, lost wages, etc.

After they have put in considerable effort and various levels of sacrifice, they are rewarded with better pay, job satisfaction.

So they put in the effort before they get a reward?

What an alien concept...

Anyway, I also notice that most of the people who try to drag EMS forward have already moved on to another type of career.

Which begs the question, if the best and the brightest move on, what's left?
 
There ought to be a formula that requires a 24 hour unit to be cut down to a 16 or 12 if their net utilization averages above a certain number. This should be put into law, but I don't know how that can be realistically achieved.

For 24's, I feel a 24/72 isn't bad, and a 24/48 with Kelly days are decent as well. It's when you get to a 56 hour workweek - 24/48, or the 24/24 for three work days the 96 off that chronic fatigue can really settle in. The Federal schedules, such as the 24/24's or the 48/72 are horrible unless you're sleeping most nights.

The problem is, even in areas that have 8's and 12's, the sleep deprivation can still be an issue. Many of us work extra hours, so we can end up doig some days and some nights. Some places do two 10 hour days, and two 14 hour nights every week.

At least with 24's, your hours are condensed, so even if you do OT, you still have more time away from work. 24's can also be attactive for an employer, since the employee can live much further away from work and only make 8-10 round trips a month.

I do a 24/24/24/24/24/96 off, a variation of a 24/48 w/o Kellys, a 56 hour workweek. My medic is busy. Each call takes 1-1.5 hours out the door to back in quarters. We sleep the whole night maybe every 7-8 shifts. We typically run 2-3 on the majority of nights after 2200 hrs. Our mandatory holdover cannot exceed 36 consecutive hours worked. I work 24-36 hours of OT/per diem a pay period, and it can be a drain. However, when I worked in NYC, I did two 8's and two 12's, so if I worked OT, it was for less hours, typically 12-24 a pay period, and I was at work more days, typically consecutive. The FDNY EMS people have it worse - they work 8 hour shifts. They can double up for OT. But, some T3's can end at midnight or 0100 plus a late job, so an afternoon start time can still wreck your sleep 4-5 nights a week.
 
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