Why working long shifts puts all EMS providers at risk

We laugh about our own fatigue-related episodes, but such gallows humor belittles the real issue that lies beneath


Alright folks, here’s a quick survey: How many of you have fallen asleep while on the job?

I’ll bet more than a few of you answered yes.

Maybe it happened while you were stopped at a traffic light at 0400 or you were with a patient in the back.

Have you responded to a call and began treating a patient, only to realize that when it came to transporting the patient you couldn’t recall exactly where you were?

We laugh about our own fatigue-related episodes and news of an ambulance crew being held well past their scheduled shift end time. But such gallows humor belittles the real issue that lies beneath: As an industry we continue to work excessively long hours, often for little pay. Medics working 56, 72 and even 96 hours per week are not unusual. Many systems have mandatory overtime, late call holdovers, callbacks and forced staffing conditions to deal with chronic budgetary conditions and scarce resources.

It’s easy enough to state the obvious — these practices should stop. In situations where the bottom line is plentiful, that would be true — pay EMS providers a fair wage so they don’t have to work excessive hours.

The trouble is — most EMS organizations are anything but financially stable. Shrinking reimbursements and high overhead costs are more of the norm, be it private or public-based providers. Increasing wages or hiring more staff put an agency in real danger of closing its doors for good.

On the other hand, there are systems, both here in the United States and abroad, where EMS providers are paid a living wage and work fewer than 50 hours per week. Unsurprisingly, the length of employment for such systems is longer. I suspect the average age of its employees is older as well.

What makes these systems succeed? What lessons can be learned and applied to remedy dangerous working conditions elsewhere?

Such successes serve as reminders that it’s possible to thrive in our industry. Getting everyone on board with that concept is a critical first step.

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