FORT WORTH, Texas — Fort Worth’s interim fire chief is sounding the alarm over staffing shortages in the department’s ambulance division.
Speaking on March 3 at a City Council Public Safety Committee meeting, Interim Chief Raymond Hill said the department is losing EMS personnel at an accelerated rate, CBS News Texas reported.
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Hill said about seven EMS employees leave the department each month, pushing the attrition rate to 16%, well above the fire department’s historical average of 5%.
The department currently has 360 EMS personnel, short of its target staffing level of 449. Of those, 74 are in training or have recently graduated and are not yet ready to deploy, leaving 89 positions vacant.
Some Fort Worth council members say the city’s EMS staffing shortage is raising concerns about ambulance availability as new systems are rolled out.
Because of the staffing shortages, the department plans to launch a temporary pilot program that will shift EMS crews from 12-hour shifts to 24-hour shifts.
Currently, EMTs and paramedics work seven, 12-hour shifts over two weeks, three shifts one week and four the next, a schedule that requires at least four hours of mandatory overtime per employee. Beginning Saturday, the department will move to a three-month pilot of the 24/48 schedule, with crews working 24 hours on duty followed by 48 hours off.
Hill said the 24/48 schedule can improve work-life balance by giving EMS personnel more days off each month and noted the schedule is widely used across the country.
“The majority of our EMS providers are leaving for dual role positions in other agencies,” Hill said. “Some of the benefits are that you get more days off per month, an improved work-life balance, an easier commute management, and a shift desirability; 87% of the employees want to work that 24/48.”
The 24/48 model also has challenges, including the need for EMS staff to sleep at fire stations. Hill said the department still does not have enough beds in place, so crews will use cots until more beds arrive in about two months.
The department must also install privacy partitions in stations, particularly as a growing share of EMS staff are women who will be sharing facilities with firefighters.
Would switching from 12-hour shifts to a 24/48 schedule improve or worsen EMS retention at your agency?
EMS1 readers respond
“That shift schedule will accelerate the attrition even more. You get banged up on a 24, held for additional 4 hours, and then go home on day #1 off and collapse.”
“My agency is 24/72 with 4 crews. I love my schedule.”
“The article doesn’t address that this translates to a 56 hour average workweek and would likely dictate a mandatory 16 hours of overtime per week based on a 40-hour pay schedule. In regards to EMS retention, it likely depends on the average amount of night runs. If the personnel can get enough sleep to function on the first day off, it would likely be favorable. But of course, they would have to get used to missing entire holidays.”
“I worked at a very busy service with 24/72 hour shifts. I retired last month at 24 years of service at 62 years of age. A nonstop 24-hour shift is extremely hard no matter your age or how many days you have off after.”
“24-hour shifts are fundamentally unsafe in a busy system. There are many studies on the impact of EMS provider fatigue on safety- driving, patient care, etc. Accidents and LODD are far more likely to occur towards the end of a 24 than at the beginning. I understand the staffing challenges, but this is dangerous and probably unsustainable.”
“Our agency works 10 24-hour shifts per month. We have three shifts A, B, & C. We work 24 on, 24 off for five shifts. Then we get a six-day break. Our crews love it and many work other jobs on days off. We are a Parish (County) EMS third service agency that provides 911 only service.”
“24/48 allows agencies to pull in crews from further distance to work. I prefer 48/96 schedule.”
“24-hour shifts are fundamentally unsafe in a busy system. There are many studies on the impact of EMS provider fatigue on safety- driving, patient care, etc. Accidents and LODD are far more likely to occur towards the end of a 24 than at the beginning. I understand the staffing challenges, but this is dangerous and probably unsustainable.”
“This sounds miserable. 24/48 means you’re never off, and overtime coverage means someone is doing a 48/24. In a busy system like Fort Worth, this will absolutely hurt people.”
“The survey asked if switching to 24/48 would be the reason why you would be more likely to leave the department not if you wanted to go to 24/48.”
“I’m retired now, but have worked several different EMS systems. By far, the best for me was as a dual role FF/paramedic on our local fire department. Yes, 24-hour shifts can get really tiring, but the next 2 days off allow for rest, or for you young bucks, a decent 2nd job. Much better benefits on the fire dept. as well!”
“I would quit EMS if it was not for 24/48. That’s the biggest perk of the job.”
