Guest guest Posted December 28, 2008 Report Share Posted December 28, 2008 , I appreciate the response and apology. Please understand that I was not doubting your assumption that this employee may have been up for hours. I think you are probably right. I was only asking if the article indicated how long he had been on duty since I was unable to open it with my BB. I agree that in many situations 24 hour shifts are too long. However as Dudley points out, this is going to be difficult to change. A/TCEMS proved that it CAN be done. Dave Sent via BlackBerry by AT & T Houston I didn't mean to sound like a smart-ass. You are right in that I am not sure of the actual cause. Sorry. BEB E. Bledsoe, DO, FACEP Clinical Professor of Emergency Medicine University of Nevada School of Medicine Department of Emergency Medicine University Medical Center of Southern Nevada Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 28, 2008 Report Share Posted December 28, 2008 If I am not mistaken...A/TC EMS is still doing a whole bunch of 24's.....with some 12's.... Dudley Houston I didn't mean to sound like a smart-ass. You are right in that I am not sure of the actual cause. Sorry. BEB E. Bledsoe, DO, FACEP Clinical Professor of Emergency Medicine University of Nevada School of Medicine Department of Emergency Medicine University Medical Center of Southern Nevada Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 29, 2008 Report Share Posted December 29, 2008 On Sunday, December 28, 2008 22:14, spiband@... said: > I agree that in many situations 24 hour shifts are too long. However as Dudley > points out, this is going to be difficult to change. I theorise that tradition is the number one killer of EMS and fire personnel. Probably of our patients too. There are just too many things that we do simply because that's the way we've always done it. 24 hour shifts is one of those pointless carry-over traditions that many EMS agencies have taken from the fire service for no good reason. And heck, the agency involved in this incident wasn't even EMS, it was just an ambulance service. While I agree that there are many agencies -- especially rural agencies -- where 24 hour shifts are the best option, I cannot imagine that an urban non-emergency transfer ambulance service is one of them. And of course, the problem is compounded by another pointless tradition, being the prohibition of sleeping before a certain hour of the evening. Why? Because that's the way we've always done it. It's almost criminal. Rob Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 29, 2008 Report Share Posted December 29, 2008 Rob, I agree 24 hour shifts are dangerous in areas where sleep is not likely to happen. It is a shame that services do not allow sleep before X time as there is no way to be sure even in a slow rural service that sleep will happen later. But in slow rural services the 24 or longer shifts are the only way to get staffing as many have to travel in to work and a 12 hour shift would not cover that expense. So my opinion is 24 or more is great in services where you should on 90%+ of shifts expect to get at least 8 hours uninterupted sleep. For busy services where sleep is not likly a 12 hour shift could be to long. Fatigue is bad as or worse than being drunk. Lets be safe out there. Renny > > On Sunday, December 28, 2008 22:14, spiband@... said: > > > I agree that in many situations 24 hour shifts are too long. However as Dudley > > points out, this is going to be difficult to change. > > I theorise that tradition is the number one killer of EMS and fire personnel. Probably of our patients too. There are just too many things that we do simply because that's the way we've always done it. 24 hour shifts is one of those pointless carry-over traditions that many EMS agencies have taken from the fire service for no good reason. And heck, the agency involved in this incident wasn't even EMS, it was just an ambulance service. While I agree that there are many agencies -- especially rural agencies -- where 24 hour shifts are the best option, I cannot imagine that an urban non-emergency transfer ambulance service is one of them. > > And of course, the problem is compounded by another pointless tradition, being the prohibition of sleeping before a certain hour of the evening. Why? Because that's the way we've always done it. It's almost criminal. > > Rob > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 29, 2008 Report Share Posted December 29, 2008 Several years ago I suggested that 24-hour shifts were not good for EMS due to fatigue, burn-out, wear and tear on the body, etc., which I observed in several friends and colleagues who had been doing them for 10 to 15 years or more. (Particularly when you factor in additional overtime hours.) When I suggested going to 8's or 12's, you would have thought I had suggested doing away with football in Texas. The arguments primarily centered on the impact that would have on take-home pay. While not minimizing that concern, in reflection it seemed that the argument were very focused on the immediate and short-term needs related to getting paid for a job, not how can we make our bodies last over the long-term in order to have a career. Barry Barry Sharp, MSHP, CHES Program Coordinator Tobacco Prevention & Control Texas Dept. of State Health Services Barry.Sharp@... PLEASE NOTE NEW MAILING ADDRESS: P.O. Box 149347 Mail Code 2018 Austin, Texas 78714-9347 ________________________________ From: texasems-l [mailto:texasems-l ] On Behalf Of rob.davis@... Sent: Monday, December 29, 2008 6:49 AM To: texasems-l Subject: RE: Re: Houston On Sunday, December 28, 2008 22:14, spiband@... <mailto:spiband%40yahoo.com> said: > I agree that in many situations 24 hour shifts are too long. However as Dudley > points out, this is going to be difficult to change. I theorise that tradition is the number one killer of EMS and fire personnel. Probably of our patients too. There are just too many things that we do simply because that's the way we've always done it. 24 hour shifts is one of those pointless carry-over traditions that many EMS agencies have taken from the fire service for no good reason. And heck, the agency involved in this incident wasn't even EMS, it was just an ambulance service. While I agree that there are many agencies -- especially rural agencies -- where 24 hour shifts are the best option, I cannot imagine that an urban non-emergency transfer ambulance service is one of them. And of course, the problem is compounded by another pointless tradition, being the prohibition of sleeping before a certain hour of the evening. Why? Because that's the way we've always done it. It's almost criminal. Rob Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 29, 2008 Report Share Posted December 29, 2008 We staff like fire and work like police. There needs to be a big picture look into EMS human resource development and organizational development that includes pay, training, recruitment, staffing patterns as a profession rather than as a single system or provider. The micro examination might fix it for " X " agency and their employees but it does little for the profession unless others learn and adopt better practices. Renny is exactly right, when there is no expectation of sleep and rest then things should be changed. Set the staffing based on the needs and then do what it takes to get the right people in there - by using pay and other incentives to make it worth while. It may even mean doing some home-growing of staff or looking way outside of the box to find solutions. Barry Barry Sharp, MSHP, CHES Program Coordinator Tobacco Prevention & Control Texas Dept. of State Health Services Barry.Sharp@... PLEASE NOTE NEW MAILING ADDRESS: P.O. Box 149347 Mail Code 2018 Austin, Texas 78714-9347 ________________________________ From: texasems-l [mailto:texasems-l ] On Behalf Of spenair Sent: Monday, December 29, 2008 10:34 AM To: texasems-l Subject: Re: Houston Rob, I agree 24 hour shifts are dangerous in areas where sleep is not likely to happen. It is a shame that services do not allow sleep before X time as there is no way to be sure even in a slow rural service that sleep will happen later. But in slow rural services the 24 or longer shifts are the only way to get staffing as many have to travel in to work and a 12 hour shift would not cover that expense. So my opinion is 24 or more is great in services where you should on 90%+ of shifts expect to get at least 8 hours uninterupted sleep. For busy services where sleep is not likly a 12 hour shift could be to long. Fatigue is bad as or worse than being drunk. Lets be safe out there. Renny > > On Sunday, December 28, 2008 22:14, spiband@... said: > > > I agree that in many situations 24 hour shifts are too long. However as Dudley > > points out, this is going to be difficult to change. > > I theorise that tradition is the number one killer of EMS and fire personnel. Probably of our patients too. There are just too many things that we do simply because that's the way we've always done it. 24 hour shifts is one of those pointless carry-over traditions that many EMS agencies have taken from the fire service for no good reason. And heck, the agency involved in this incident wasn't even EMS, it was just an ambulance service. While I agree that there are many agencies -- especially rural agencies -- where 24 hour shifts are the best option, I cannot imagine that an urban non-emergency transfer ambulance service is one of them. > > And of course, the problem is compounded by another pointless tradition, being the prohibition of sleeping before a certain hour of the evening. Why? Because that's the way we've always done it. It's almost criminal. > > Rob > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 29, 2008 Report Share Posted December 29, 2008 Absolutely Barry....it is often VERY difficult to see the forest for the trees. The short and medium term issues are real issues....which leads to the complexity of this.? If you want to keep the same money for the medics (which should be our goal) then to simply go to 12's instead of 24's, you need 33% more money to pay the extra people....33% is HUGE in an industry that has single digit profit (or reserve for your government guys like me) margins.....when the 33% increase is in the single budget line that comprises 65-70% of your overall budget....OUCH!!!!? I do agree however, that the 24/48 is something every service should evaluate for its true merits vs. its true issues. Dudley RE: Re: Houston On Sunday, December 28, 2008 22:14, spiband@... <mailto:spiband%40yahoo.com> said: > I agree that in many situations 24 hour shifts are too long. However as Dudley > points out, this is going to be difficult to change. I theorise that tradition is the number one killer of EMS and fire personnel. Probably of our patients too. There are just too many things that we do simply because that's the way we've always done it. 24 hour shifts is one of those pointless carry-over traditions that many EMS agencies have taken from the fire service for no good reason. And heck, the agency involved in this incident wasn't even EMS, it was just an ambulance service. While I agree that there are many agencies -- especially rural agencies -- where 24 hour shifts are the best option, I cannot imagine that an urban non-emergency transfer ambulance service is one of them. And of course, the problem is compounded by another pointless tradition, being the prohibition of sleeping before a certain hour of the evening. Why? Because that's the way we've always done it. It's almost criminal. Rob Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 29, 2008 Report Share Posted December 29, 2008 Careful there Barry....I hear Jack Stout starting to stir in the back closet?....ooooohhhhhhhh.......... Dudley Re: Houston Rob, I agree 24 hour shifts are dangerous in areas where sleep is not likely to happen. It is a shame that services do not allow sleep before X time as there is no way to be sure even in a slow rural service that sleep will happen later. But in slow rural services the 24 or longer shifts are the only way to get staffing as many have to travel in to work and a 12 hour shift would not cover that expense. So my opinion is 24 or more is great in services where you should on 90%+ of shifts expect to get at least 8 hours uninterupted sleep. For busy services where sleep is not likly a 12 hour shift could be to long. Fatigue is bad as or worse than being drunk. Lets be safe out there. Renny > > On Sunday, December 28, 2008 22:14, spiband@... said: > > > I agree that in many situations 24 hour shifts are too long. However as Dudley > > points out, this is going to be difficult to change. > > I theorise that tradition is the number one killer of EMS and fire personnel. Probably of our patients too. There are just too many things that we do simply because that's the way we've always done it. 24 hour shifts is one of those pointless carry-over traditions that many EMS agencies have taken from the fire service for no good reason. And heck, the agency involved in this incident wasn't even EMS, it was just an ambulance service. While I agree that there are many agencies -- especially rural agencies -- where 24 hour shifts are the best option, I cannot imagine that an urban non-emergency transfer ambulance service is one of them. > > And of course, the problem is compounded by another pointless tradition, being the prohibition of sleeping before a certain hour of the evening. Why? Because that's the way we've always done it. It's almost criminal. > > Rob > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 29, 2008 Report Share Posted December 29, 2008 I suggest that services that do not have a health and wellness program as a part of their organizational setup are (1) doing themselves a great disservice since sick time and worker's comp claims cost them lots of money and (2) their employees a disservice as well. The best corporate employers have such programs and promote them. They are a part of " best employment practices " that one can find if one spends half an hour on Google looking into the subject. Oops. My bad. What EMS service would qualify as being a " best employer " or using " best employment practices? " Few indeed. GG GG > > Don't get me wrong...I fully agree.? I also have to input though, it isn't > just 24/48's that are putting our 40 year old colleagues into 70 yo > bodies...it is also a total lack of education and training into health and wellness, > physical fitness and proper lifting techniques needed to properly care for our > bodies.? Working 2 or 3 24's a week or 5 - 8's or 4-10's or whatever won't > solve the problem of the obese medic who constantly uses improper lifting > techniques from blowing our spinal discs and injuring back muscles...it certainly > could help by providing less lifts per shift...but a huge number of back > injuries are repetitive use injuries...not one or two big lifts.? How many medics > do you know that suffered a long-term back injury by picking up a PCR off > the floor or reaching in to pick up the ALS bag from the side door?? > > Again, it all goes together...but I do agree we should start looking outside > of the FD/EMS box to try and find solutions. > > Dudley > > Re: Houston > > Rob, > > I agree 24 hour shifts are dangerous in areas where sleep is not > likely to happen. It is a shame that services do not allow sleep > before X time as there is no way to be sure even in a slow rural > service that sleep will happen later. > > But in slow rural services the 24 or longer shifts are the only way > to get staffing as many have to travel in to work and a 12 hour shift > would not cover that expense. So my opinion is 24 or more is great > in services where you should on 90%+ of shifts expect to get at least > 8 hours uninterupted sleep. For busy services where sleep is not > likly a 12 hour shift could be to long. Fatigue is bad as or worse > than being drunk. > > Lets be safe out there. > > Renny > > > > > > On Sunday, December 28, 2008 22:14, spiband@... said: > > > > > I agree that in many situations 24 hour shifts are too long. > However as Dudley > > > points out, this is going to be difficult to change. > > > > I theorise that tradition is the number one killer of EMS and fire > personnel. Probably of our patients too. There are just too many > things that we do simply because that's the way we've always done > it. 24 hour shifts is one of those pointless carry-over traditions > that many EMS agencies have taken from the fire service for no good > reason. And heck, the agency involved in this incident wasn't even > EMS, it was just an ambulance service. While I agree that there are > many agencies -- especially rural agencies -- where 24 hour shifts > are the best option, I cannot imagine that an urban non-emergency > transfer ambulance service is one of them. > > > > And of course, the problem is compounded by another pointless > tradition, being the prohibition of sleeping before a certain hour of > the evening. Why? Because that's the way we've always done it. > It's almost criminal. > > > > Rob > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 29, 2008 Report Share Posted December 29, 2008 You are correct sir. We still have 24 hour shifts at our " slow stations " and most of our medics work a hybrid of a 24 and two 12s. The exceptions being our rescue and hazmat units. Sent from my Verizon Wireless BlackBerry Houston I didn't mean to sound like a smart-ass. You are right in that I am not sure of the actual cause. Sorry. BEB E. Bledsoe, DO, FACEP Clinical Professor of Emergency Medicine University of Nevada School of Medicine Department of Emergency Medicine University Medical Center of Southern Nevada Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 29, 2008 Report Share Posted December 29, 2008 Not trying to resurrect Stout, but rather to get us to look at our needs (short and long term) as it relates to staffing and taking care of those in the profession so they can take care of our patients. Which means finding the model that words best and creating the system to support that model, not using someone else's model and making our system fit it. It's a paradigm shift and may mean looking inside and outside of several boxes to find the right one. It just bothers me when I see friends who have been on the streets for 15-20 years who are in their low 40s with the bodies of someone in their 60s or 70s due to the toll of doing what they love. There's got to be a better way. Barry Sharp, MSHP, CHES Program Coordinator Tobacco Prevention & Control Texas Dept. of State Health Services Barry.Sharp@... PLEASE NOTE NEW MAILING ADDRESS: P.O. Box 149347 Mail Code 2018 Austin, Texas 78714-9347 ________________________________ From: texasems-l [mailto:texasems-l ] On Behalf Of THEDUDMAN@... Sent: Monday, December 29, 2008 12:06 PM To: texasems-l Subject: Re: Re: Houston Careful there Barry....I hear Jack Stout starting to stir in the back closet?....ooooohhhhhhhh.......... Dudley Re: Houston Rob, I agree 24 hour shifts are dangerous in areas where sleep is not likely to happen. It is a shame that services do not allow sleep before X time as there is no way to be sure even in a slow rural service that sleep will happen later. But in slow rural services the 24 or longer shifts are the only way to get staffing as many have to travel in to work and a 12 hour shift would not cover that expense. So my opinion is 24 or more is great in services where you should on 90%+ of shifts expect to get at least 8 hours uninterupted sleep. For busy services where sleep is not likly a 12 hour shift could be to long. Fatigue is bad as or worse than being drunk. Lets be safe out there. Renny > > On Sunday, December 28, 2008 22:14, spiband@... said: > > > I agree that in many situations 24 hour shifts are too long. However as Dudley > > points out, this is going to be difficult to change. > > I theorise that tradition is the number one killer of EMS and fire personnel. Probably of our patients too. There are just too many things that we do simply because that's the way we've always done it. 24 hour shifts is one of those pointless carry-over traditions that many EMS agencies have taken from the fire service for no good reason. And heck, the agency involved in this incident wasn't even EMS, it was just an ambulance service. While I agree that there are many agencies -- especially rural agencies -- where 24 hour shifts are the best option, I cannot imagine that an urban non-emergency transfer ambulance service is one of them. > > And of course, the problem is compounded by another pointless tradition, being the prohibition of sleeping before a certain hour of the evening. Why? Because that's the way we've always done it. It's almost criminal. > > Rob > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 29, 2008 Report Share Posted December 29, 2008 Yes, most medics are doing a 24 at a lower call volume station and then (2) 12-hour shifts at a busier station. It varies a little from medic to medic depending on seniority in the department. -Ben THEDUDMAN@... wrote: > > If I am not mistaken...A/TC EMS is still doing a whole bunch of > 24's.....with some 12's.... > > Dudley > > Houston > > I didn't mean to sound like a smart-ass. You are right in that I am not > sure of the actual cause. Sorry. > > BEB > > E. Bledsoe, DO, FACEP > > Clinical Professor of Emergency Medicine > > University of Nevada School of Medicine > > Department of Emergency Medicine > > University Medical Center of Southern Nevada > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 29, 2008 Report Share Posted December 29, 2008 just so everyone can chime in. Andy Foote Re: Houston Rob, I agree 24 hour shifts are dangerous in areas where sleep is not likely to happen. It is a shame that services do not allow sleep before X time as there is no way to be sure even in a slow rural service that sleep will happen later. But in slow rural services the 24 or longer shifts are the only way to get staffing as many have to travel in to work and a 12 hour shift would not cover that expense. So my opinion is 24 or more is great in services where you should on 90%+ of shifts expect to get at least 8 hours uninterupted sleep. For busy services where sleep is not likly a 12 hour shift could be to long. Fatigue is bad as or worse than being drunk. Lets be safe out there. Renny > > On Sunday, December 28, 2008 22:14, spiband@... said: > > > I agree that in many situations 24 hour shifts are too long. However as Dudley > > points out, this is going to be difficult to change. > > I theorise that tradition is the number one killer of EMS and fire personnel. Probably of our patients too. There are just too many things that we do simply because that's the way we've always done it. 24 hour shifts is one of those pointless carry-over traditions that many EMS agencies have taken from the fire service for no good reason. And heck, the agency involved in this incident wasn't even EMS, it was just an ambulance service. While I agree that there are many agencies -- especially rural agencies -- where 24 hour shifts are the best option, I cannot imagine that an urban non-emergency transfer ambulance service is one of them. > > And of course, the problem is compounded by another pointless tradition, being the prohibition of sleeping before a certain hour of the evening. Why? Because that's the way we've always done it. It's almost criminal. > > Rob > ------------------------------------ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 29, 2008 Report Share Posted December 29, 2008 Don't get me wrong...I fully agree.? I also have to input though, it isn't just 24/48's that are putting our 40 year old colleagues into 70 yo bodies...it is also a total lack of education and training into health and wellness, physical fitness and proper lifting techniques needed to properly care for our bodies.? Working 2 or 3 24's a week or 5 - 8's or 4-10's or whatever won't solve the problem of the obese medic who constantly uses improper lifting techniques from blowing our spinal discs and injuring back muscles...it certainly could help by providing less lifts per shift...but a huge number of back injuries are repetitive use injuries...not one or two big lifts.? How many medics do you know that suffered a long-term back injury by picking up a PCR off the floor or reaching in to pick up the ALS bag from the side door?? Again, it all goes together...but I do agree we should start looking outside of the FD/EMS box to try and find solutions. Dudley Re: Houston Rob, I agree 24 hour shifts are dangerous in areas where sleep is not likely to happen. It is a shame that services do not allow sleep before X time as there is no way to be sure even in a slow rural service that sleep will happen later. But in slow rural services the 24 or longer shifts are the only way to get staffing as many have to travel in to work and a 12 hour shift would not cover that expense. So my opinion is 24 or more is great in services where you should on 90%+ of shifts expect to get at least 8 hours uninterupted sleep. For busy services where sleep is not likly a 12 hour shift could be to long. Fatigue is bad as or worse than being drunk. Lets be safe out there. Renny > > On Sunday, December 28, 2008 22:14, spiband@... said: > > > I agree that in many situations 24 hour shifts are too long. However as Dudley > > points out, this is going to be difficult to change. > > I theorise that tradition is the number one killer of EMS and fire personnel. Probably of our patients too. There are just too many things that we do simply because that's the way we've always done it. 24 hour shifts is one of those pointless carry-over traditions that many EMS agencies have taken from the fire service for no good reason. And heck, the agency involved in this incident wasn't even EMS, it was just an ambulance service. While I agree that there are many agencies -- especially rural agencies -- where 24 hour shifts are the best option, I cannot imagine that an urban non-emergency transfer ambulance service is one of them. > > And of course, the problem is compounded by another pointless tradition, being the prohibition of sleeping before a certain hour of the evening. Why? Because that's the way we've always done it. It's almost criminal. > > Rob > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 29, 2008 Report Share Posted December 29, 2008 maybe someone needs to get Jack Black to make a movie about the situation? ck S. Krin, DO FAAFP In a message dated 12/29/2008 12:44:27 Central Standard Time, THEDUDMAN@... writes: Careful there Barry....I hear Jack Stout starting to stir in the back closet?....ooooohhhCareful tCareful the **************One site keeps you connected to all your email: AOL Mail, Gmail, and Yahoo Mail. Try it now. (http://www.aol.com/?optin=new-dp & icid=aolcom40vanity & ncid=emlcntaolcom00000025) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 29, 2008 Report Share Posted December 29, 2008 Andy, you make a few very important points in your message... 1) People don't get into EMS for the money and no amount of money would make someone take a job they perceive as bad. (If they are bent towards emergency services, they may perceive FD or PD as better career options. If they are bent towards medical, then nursing may be perceived as a better option.) 2) There are professionals who work 80-hour weeks. Lawyers, doctors and accountants (in private practice) are considered professionals, which are exempt from FLSA, and are paid from billable hours. So overtime pay isn't an incentive to work those extra hours. Also, there are times when the job demands extra hours and times when the work load is light. They can pretty well determine their work loads. 3) Your last sentence, " ...they would allow people to still work enough overtime hours to keep their trucks full " strikes at my concern. Too many are using overtime as a means of meeting minimal staffing levels. When you pay 2 people 150% of their base salaries you are effectively paying the salaries of 3 people. (Benefit costs not included.) Why not hire 3 people to do the work of three people instead of pushing 2 people? Use OT to cover when someone is sick, on jury duty or on vacation instead of making it part of the normal expectations. Then, when the unexpected happens you have the capacity to handle problems without driving people into the ground. (There is something to be said about having depth, just ask any coach.) On a side note, there was an article in today's Austin paper about the County Sheriff's Department using volunteers as reserve deputy sheriff's to fill in for the regular troops on vacations, special events, sick leave, etc. The volunteer are trained the same as the paid and held to the same disciplinary standards as the paid. While they must put in a minimum of 16 hours per month, several are putting in more than 1,000 hours annually. This may be something to consider as a means to add depth to the rooster. Instead of pitting volunteers against the paid, incorporate them into the system in a real and meaningful way so that the system benefits and the volunteer gets their intrinsic needs met by giving to their community in way that adds value. Just something to consider and think about. Barry Barry Sharp, MSHP, CHES Program Coordinator Tobacco Prevention & Control Texas Dept. of State Health Services Barry.Sharp@... PLEASE NOTE NEW MAILING ADDRESS: P.O. Box 149347 Mail Code 2018 Austin, Texas 78714-9347 ________________________________ From: texasems-l [mailto:texasems-l ] On Behalf Of rachfoote@... Sent: Monday, December 29, 2008 3:09 PM To: texasems-l Subject: Fwd: Re: Re: Houston just so everyone can chime in. Andy Foote Re: Houston Rob, I agree 24 hour shifts are dangerous in areas where sleep is not likely to happen. It is a shame that services do not allow sleep before X time as there is no way to be sure even in a slow rural service that sleep will happen later. But in slow rural services the 24 or longer shifts are the only way to get staffing as many have to travel in to work and a 12 hour shift would not cover that expense. So my opinion is 24 or more is great in services where you should on 90%+ of shifts expect to get at least 8 hours uninterupted sleep. For busy services where sleep is not likly a 12 hour shift could be to long. Fatigue is bad as or worse than being drunk. Lets be safe out there. Renny > > On Sunday, December 28, 2008 22:14, spiband@... said: > > > I agree that in many situations 24 hour shifts are too long. However as Dudley > > points out, this is going to be difficult to change. > > I theorise that tradition is the number one killer of EMS and fire personnel. Probably of our patients too. There are just too many things that we do simply because that's the way we've always done it. 24 hour shifts is one of those pointless carry-over traditions that many EMS agencies have taken from the fire service for no good reason. And heck, the agency involved in this incident wasn't even EMS, it was just an ambulance service. While I agree that there are many agencies -- especially rural agencies -- where 24 hour shifts are the best option, I cannot imagine that an urban non-emergency transfer ambulance service is one of them. > > And of course, the problem is compounded by another pointless tradition, being the prohibition of sleeping before a certain hour of the evening. Why? Because that's the way we've always done it. It's almost criminal. > > Rob > ------------------------------------ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 29, 2008 Report Share Posted December 29, 2008 Most of the professionals who work 80+ hours a week are making anywhere from $50-$300 an hour or more. Certainly that's true of the lawyers, doctors, architects, and stock brokers. At some point there will be an incident causing injury that's attributable to fatigue, and there will be lawsuits. We already know about the " Libby Zion Case " in New York that resulted from a resident physician having been at work for 36 hours when she mistreated Ms. Zion. This ultimately resulted in The Libby Zion Law which, in NY State, limits the number of hours that physicians may work. If I had a client who was injured in an accident where an ambulance driver went to sleep, I would be all over that service with subpoenas for their personnel records, their call logs, and so forth looking for any evidence that fatigue played a part in the incident or evidence that the driver had a preexisting condition that might have contributed, and so forth. I would demand records of other accidents and incidents involving ambulances, and I would be seeking ways to prove gross negligence on the part of the service that would allow awarding of punitive damages. I am sure that the injured patient's lawyers will be doing that, and if I were the injured medic's lawyer, I would be seeking ways to get it out from under Worker's Comp and seeking a whole lot of damages from the service. Now, I'm not interested in filing lawsuits these days, but other lawyers are. The days of operating in the shadows are over for EMS. Lawyers are always looking for ways to make a buck, and when we adopt industry policies and procedures that allow them to argue that our practices cause injury, we have just asked for the legal drubbing that we're eventually going to get. It's time for EMS management to get its head out of the sand and begin to look at these practices such as 24 hour shifts in high volume areas and so forth. If it doesn't there's going to be hell to pay. The air medical industry is now a prime target for lawyers, and every time an incident such as the one we're talking about happens with its ensuing publicity, it just stirs the pot. Worse, there are always folks in Congress who think they know more about how to run a business than we do, and when we fail to make obvious corrections to our practices, we too often end up with unwanted regulations that make it even more difficult for us to operate. The best remedies are those taken in-house before Congress gets involved. GG > > Also, the professionals who work 80 hours?a week are not dying at the rate > of 12.7 fatalities/100,Also, the professionals who work 80 hours?a week are > not dying at the rate of 12.7 fatalities/100,<wbr>000 workers in that professio > > Unfortunately, we are a transportation industry...and currently that is the > only way we get paid.? Until we find a way to resolve that, we have to start > paying attention to what is proven to provide safer transportation such as > improper rest, poor screening, no training, and long hours...not to mention the > degradation of motor skills that starts to occur late in a 24 hour shift.... > > Dudley > > Re: Houston > > Rob, > > I agree 24 hour shifts are dangerous in areas where sleep is not > likely to happen. It is a shame that services do not allow sleep > before X time as there is no way to be sure even in a slow rural > service that sleep will happen later. > > But in slow rural services the 24 or longer shifts are the only way > to get staffing as many have to travel in to work and a 12 hour shift > would not cover that expense. So my opinion is 24 or more is great > in services where you should on 90%+ of shifts expect to get at least > 8 hours uninterupted sleep. For busy services where sleep is not > likly a 12 hour shift could be to long. Fatigue is bad as or worse > than being drunk. > > Lets be safe out there. > > Renny > > > > > > On Sunday, December 28, 2008 22:14, spiband@... said: > > > > > I agree that in many situations 24 hour shifts are too long. > However as Dudley > > > points out, this is going to be difficult to change. > > > > I theorise that tradition is the number one killer of EMS and fire > personnel. Probably of our patients too. There are just too many > things that we do simply because that's the way we've always done > it. 24 hour shifts is one of those pointless carry-over traditions > that many EMS agencies have taken from the fire service for no good > reason. And heck, the agency involved in this incident wasn't even > EMS, it was just an ambulance service. While I agree that there are > many agencies -- especially rural agencies -- where 24 hour shifts > are the best option, I cannot imagine that an urban non-emergency > transfer ambulance service is one of them. > > > > And of course, the problem is compounded by another pointless > tradition, being the prohibition of sleeping before a certain hour of > the evening. Why? Because that's the way we've always done it. > It's almost criminal. > > > > Rob > > > > ------------ -------- -------- ----- > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 29, 2008 Report Share Posted December 29, 2008 My point is, Dudley, we are not going to solve the problem. It did not start this week. It has been and will be going on a lot longer. It is not what we make or what they make as lawyers, etc or truck drivers. It is the fact that if we have 2 hour shifts, the employees will be allowed to work 12's if they want them to keep our trucks filled. Andy **************One site keeps you connected to all your email: AOL Mail, Gmail, and Yahoo Mail. Try it now. (http://www.aol.com/?optin=new-dp & icid=aolcom40vanity & ncid=emlcntaolcom00000025) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 29, 2008 Report Share Posted December 29, 2008 At some point there are always law suits and if successful the company files bankruptcy and opens up tomorrow as Acme Ambulance service. It (lawsuits) have not happened enough to stop the nonsense. I understand what you are trying to say Gene, it just doesn't stop it Andy **************One site keeps you connected to all your email: AOL Mail, Gmail, and Yahoo Mail. Try it now. (http://www.aol.com/?optin=new-dp & icid=aolcom40vanity & ncid=emlcntaolcom00000025) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 29, 2008 Report Share Posted December 29, 2008 Barry, Sorry bout misleading. I would hire everyone that applies to work for me, but they just do not meet the qualifications. Since the pay increase however, I have hired 6 more and will be hiring some more in February. They just are not there. **************One site keeps you connected to all your email: AOL Mail, Gmail, and Yahoo Mail. Try it now. (http://www.aol.com/?optin=new-dp & icid=aolcom40vanity & ncid=emlcntaolcom00000025) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 29, 2008 Report Share Posted December 29, 2008 Amen brother Dudley. We only get one body so we need to take care of it. When we can start working on this? Barry Sharp, MSHP, CHES Program Coordinator Tobacco Prevention & Control Texas Dept. of State Health Services Barry.Sharp@... PLEASE NOTE NEW MAILING ADDRESS: P.O. Box 149347 Mail Code 2018 Austin, Texas 78714-9347 ________________________________ From: texasems-l [mailto:texasems-l ] On Behalf Of THEDUDMAN@... Sent: Monday, December 29, 2008 3:15 PM To: texasems-l Subject: Re: Re: Houston Don't get me wrong...I fully agree.? I also have to input though, it isn't just 24/48's that are putting our 40 year old colleagues into 70 yo bodies...it is also a total lack of education and training into health and wellness, physical fitness and proper lifting techniques needed to properly care for our bodies.? Working 2 or 3 24's a week or 5 - 8's or 4-10's or whatever won't solve the problem of the obese medic who constantly uses improper lifting techniques from blowing our spinal discs and injuring back muscles...it certainly could help by providing less lifts per shift...but a huge number of back injuries are repetitive use injuries...not one or two big lifts.? How many medics do you know that suffered a long-term back injury by picking up a PCR off the floor or reaching in to pick up the ALS bag from the side door?? Again, it all goes together...but I do agree we should start looking outside of the FD/EMS box to try and find solutions. Dudley Re: Houston Rob, I agree 24 hour shifts are dangerous in areas where sleep is not likely to happen. It is a shame that services do not allow sleep before X time as there is no way to be sure even in a slow rural service that sleep will happen later. But in slow rural services the 24 or longer shifts are the only way to get staffing as many have to travel in to work and a 12 hour shift would not cover that expense. So my opinion is 24 or more is great in services where you should on 90%+ of shifts expect to get at least 8 hours uninterupted sleep. For busy services where sleep is not likly a 12 hour shift could be to long. Fatigue is bad as or worse than being drunk. Lets be safe out there. Renny > > On Sunday, December 28, 2008 22:14, spiband@... said: > > > I agree that in many situations 24 hour shifts are too long. However as Dudley > > points out, this is going to be difficult to change. > > I theorise that tradition is the number one killer of EMS and fire personnel. Probably of our patients too. There are just too many things that we do simply because that's the way we've always done it. 24 hour shifts is one of those pointless carry-over traditions that many EMS agencies have taken from the fire service for no good reason. And heck, the agency involved in this incident wasn't even EMS, it was just an ambulance service. While I agree that there are many agencies -- especially rural agencies -- where 24 hour shifts are the best option, I cannot imagine that an urban non-emergency transfer ambulance service is one of them. > > And of course, the problem is compounded by another pointless tradition, being the prohibition of sleeping before a certain hour of the evening. Why? Because that's the way we've always done it. It's almost criminal. > > Rob > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 29, 2008 Report Share Posted December 29, 2008 Oh, I know it doesn't stop it. I only report. You decide. LOL. GG > > At some point there are always law suits and if successful the company files > bankruptcy and opens up tomorrow as Acme Ambulance service. It (lawsuits) > have not happened enough to stop the nonsense. I understand what you are > trying to say Gene, it just doesn't stop it > > Andy > ************ ************<wbr>**One site keeps you connected to all your > Gmail, and Yahoo Mail. Try it now. > (http://www.aol.http://www.http:/ & icid=icid=<wbr>aolc & <wbr>ncid=emlcnt<wbr> > ncid) > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 29, 2008 Report Share Posted December 29, 2008 Also, the professionals who work 80 hours?a week are not dying at the rate of 12.7 fatalities/100,000 workers in that profession, with 74% of those being from transportation related fatalities with 87% of those being UNRESTRAINED! Unfortunately, we are a transportation industry...and currently that is the only way we get paid.? Until we find a way to resolve that, we have to start paying attention to what is proven to provide safer transportation such as improper rest, poor screening, no training, and long hours...not to mention the degradation of motor skills that starts to occur late in a 24 hour shift.... Dudley Re: Houston Rob, I agree 24 hour shifts are dangerous in areas where sleep is not likely to happen. It is a shame that services do not allow sleep before X time as there is no way to be sure even in a slow rural service that sleep will happen later. But in slow rural services the 24 or longer shifts are the only way to get staffing as many have to travel in to work and a 12 hour shift would not cover that expense. So my opinion is 24 or more is great in services where you should on 90%+ of shifts expect to get at least 8 hours uninterupted sleep. For busy services where sleep is not likly a 12 hour shift could be to long. Fatigue is bad as or worse than being drunk. Lets be safe out there. Renny > > On Sunday, December 28, 2008 22:14, spiband@... said: > > > I agree that in many situations 24 hour shifts are too long. However as Dudley > > points out, this is going to be difficult to change. > > I theorise that tradition is the number one killer of EMS and fire personnel. Probably of our patients too. There are just too many things that we do simply because that's the way we've always done it. 24 hour shifts is one of those pointless carry-over traditions that many EMS agencies have taken from the fire service for no good reason. And heck, the agency involved in this incident wasn't even EMS, it was just an ambulance service. While I agree that there are many agencies -- especially rural agencies -- where 24 hour shifts are the best option, I cannot imagine that an urban non-emergency transfer ambulance service is one of them. > > And of course, the problem is compounded by another pointless tradition, being the prohibition of sleeping before a certain hour of the evening. Why? Because that's the way we've always done it. It's almost criminal. > > Rob > ------------------------------------ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 31, 2008 Report Share Posted December 31, 2008 Rob, I would like to take note of what you said about the service “not being E MS, it was just an ambulance serviceâ€! I work for AEMSTAR EMS, a PRIVATE AMBULANCE SERVICE. We run our share of emergency calls and transfer calls. We DESERVE the same respect as that of any other EMS service. By the way, The service that was involved in the accident runs the 911 service for Pasadena, Texas, and runs 911 calls up in the Tyler area. Please get your facts straight!!!!! B. mood Marketing and Business Development Manager AEMSTAR EMS 13003 Road Suite F-1 Stafford, Texas 77477 Office: Cell: Fax: E-mail: mlindamood@... From: texasems-l [mailto:texasems-l ] On Behalf Of rob.davis@... Sent: Monday, December 29, 2008 6:49 AM To: texasems-l Subject: RE: Re: Houston On Sunday, December 28, 2008 22:14, spiband@... <mailto:spiband%40yahoo.com> said: > I agree that in many situations 24 hour shifts are too long. However as Dudley > points out, this is going to be difficult to change. I theorise that tradition is the number one killer of EMS and fire personnel. Probably of our patients too. There are just too many things that we do simply because that's the way we've always done it. 24 hour shifts is one of those pointless carry-over traditions that many EMS agencies have taken from the fire service for no good reason. And heck, the agency involved in this incident wasn't even EMS, it was just an ambulance service. While I agree that there are many agencies -- especially rural agencies -- where 24 hour shifts are the best option, I cannot imagine that an urban non-emergency transfer ambulance service is one of them. And of course, the problem is compounded by another pointless tradition, being the prohibition of sleeping before a certain hour of the evening. Why? Because that's the way we've always done it. It's almost criminal. Rob Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 31, 2008 Report Share Posted December 31, 2008 On Wednesday, December 31, 2008 08:08, " mood " said: > Rob, > > I would like to take note of what you said about the service “not being E > MS, it was just an ambulance serviceâ€! I work for AEMSTAR EMS, a PRIVATE > AMBULANCE SERVICE. We run our share of emergency calls and transfer calls. > > We DESERVE the same respect as that of any other EMS service. By the way, The > service that was involved in the accident runs the 911 service for Pasadena, > Texas, and runs 911 calls up in the Tyler area. I stand corrected on the service involved in this incident. Generally speaking, a private ambulance in the City of Houston equals non-EMS, so it was a logical assumption. The error was on the part of whoever reported this to be a private service in the first place. I don't know anything about your agency. However, I maintain that, if a service is not 911 dispatched, it is not EMS, no matter how many of their transfers happen to turn emergent. Recognising that reality does not in any way disrespect you or the job you do. It simply makes a technical distinction. It is the very same distinction I would make between a police department and a private security agency. Rob Quote Link to comment Share on other sites More sharing options...
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