In the first news item this week, I pulled an article from EMSWorld.com on dealing with fatigue in EMTs and paramedics. I know that EMS fatigue issues is not a new issue. Because we are available around the clock, we often work night shifts and then struggle to sleep during the day.
Working Overnight Difficult at Best
I like this article because it looks at the problem from an overall industry safety angle. EMS is not the only career and industry that deals with fatigue from working overnight hours. Trucking, hospital based health care, and many manufacturing jobs all deal with shift work and fatigue.
The article points out that the problem is more complex than just getting enough sleep. There are problems associated with not working regular shifts to allow the body to change sleep and awake rhythms. When the schedule changes and you end up starting your “day” at a different time, you end up being more fatigued than when you just work the same shift all of the time.
One Size Fits All Shifts Don’t Work
There is also the problem of trying a “one size fits all” approach to the issue. Some places work 24 hours shifts and overtax their providers because call volume in these systems mean that EMTs and paramedics get little or no sleep in that shift. The same 24 hour shift in a system with lower call volume, like a rural area, may make a lot more sense. In these slower zones, a provider will likely get opportunities to get sleep during the shift.
Generally, though, the experts recommend no shifts longer than 12 hours so that the provider can go home and get uninterrupted rest. They point out that when a person has been awake for 24 hours, they have the reaction time and decision making capabilities of a person who is legally drunk from alcohol. I don’t think we want people who are legally drunk providing us health care.
Other Industries Have Sleep Safety Standards
In the hospital setting, physicians are setting standards for patient safety and physicians being on call for too many hours without rest. The same types of standards should be put in place for emergency medical services., too. What kind of shifts are you working in your system? I’d love to hear from you about your close calls and safety concerns. Shoot me an email to firstname.lastname@example.org and let me know what you think.
Follow-up on the information in this article in the news links and other resources found in the show notes page from this episode of the MedicCast — Transdermal Patch Overdose and Episode 323.