RE: 24 hours shifts and the hornets nest

["Eric Niegelberg [Emergency Medicine]" <eniegelb@epo.hsc.sunysb.edu>]

I am an administrator and also care provider.  We have both ground 
teams and flight teams.  Our schedule is 8 or 12 hour shifts.  Very 
uncommonly we will approve a 16 hour shift.  Why, for all the 
reasons mentioned.  It is not safe to drive an ambulance or provide 
medical care at the 15th hour of a shift.  This, coupled with the 
potential for that call to last 2-3 hours has the staff attempting 
to "get out of" that call.  Since the hourly pay is the same, 
turnover is low, the jobs are actively desired by other qualified 
personnel, there is no reason to pay people to sleep.

The staff prefer to work as few days as possible and would love a 24 
hour shift with an opportunity to rest as needed.  This is not 
productive for the institution or for the patient.  Our hospital 
based staff  "helps out" in the ED when there are no calls.  They 
don't have a district, they are not allowed to transport patients out 
of the department, and they are ready to leave on 2 minutes notice.


> From:          
Robert Cole <EMCOLERS@adaweb.net>
> To:            "'flightmed@flightweb.com'" <flightmed@flightweb.com>
> Subject:       RE: 24 hours shifts and the hornets nest
> Date:          Thu, 17 Jan 2002 18:32:56 -0700
> Reply-to:      flightmed@flightweb.com

> 
> At my primary job, we are a medium sized (16k/year) all 911 ground service
> we too work 24 hour shifts, two a week similar to stat medevac.  The crews
> generally LOVE it. I would imagine the factors and concerns mentioned here
> in regard to flight services are even more profound when applied to a ground
> service, as the "crew" is also responsible for vehicular operation.  Also I
> would venture that our crew have a generally higher unit hour utilization
> than most (not all) flight services, with an average call volume between 6
> and 10 calls a shift, sometimes as high as 17-20 patient contacts per shift
> (charts)
> we do get buy, in fact most the time its pretty decent.  But the key factor
> is we have sleeping quarters, I have heard some "traditional" hospital
> administrators balking to pay money "for someone to sleep"...they want the
> crew helping out in the ER or CCU most of the time.  Result VERY tired
> people.
> If you provide the "Decompression tank" for the crews, and a back up
> mechanism, I thing 24 hour shifts are very appropriate for most small to
> medium services, especially when you look at the dividends it pays in moral,
> family support, scheduling, etc.
> Otherwise you have problems.
> 
> Robert S. "Steve" Cole
> Paramedic, CCEMTP
> Education Department
> Ada County Paramedics 
> 208-375-7079
> emcolers@adaweb.net
> 
> "...A mind stretched with new ideas never regains its former shape"
> 
> 
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> 
******************************************************
Eric Niegelberg                     Tel: 631-444-2496
EMS Director                        Fax: 631-689-7376
ED Administrator
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