What is busy?

[mmorsepfd]

Hello, I'm new here, been working EMS in Providence on what I think is a busy truck. We do about 5000 calls a year, als and bls, mostly bs to be quite honest. I know we do a lot of calls compared to the other cities around here. We have six rescues for a city of about 180,000, can never keep up.

Typical week is a thirty-four hour shift followed by 24 off then thirty-eight then three days off then do it all over.

Is this normal? I honestly don't know and can't find and information from google searches etc.

Thanks for any input, much appreciated.

 

[Shishkabob]

It's objective, really.



How many calls a shift do you get?


The trucks I rode, 14+ calls in a 12hr shift is busy.

 

[mmorsepfd]

Our shifts are long ones, two ten hour days followed by two fourteen hour nights. Due to shortages in the division we normally work the in betweens making for a thirty-four, twenty-four off then a thirty-eight. Normal call volume in that period is twenty-five to thirty five calls. I divided our yearly runs, about 5000 per truck by days in a year and it came out to I think seventeen calls every twenty-four hours.

I'm not complaining, just looking for some data so I can figure out if I'm overworked, I'm too tired to think about it rationally.

I think the volume of calls would be more manageable if we went to eight hour shifts, but the city of Providence refuses to hire more people, it's pretty much business as usual, suck it up and if you don't like it, quit.

 

[TransportJockey]

On my internships, a normal 13 hr shift is busy if you run more than 10 calls. I've been on busy shifts the entire time

 

[FF-EMT Diver]

Here I think we're kinda slow, we work 24 on 48 off, we have 2 units per shift and run between 12-20 calls per shift but a lot of times we take transfers that range from 3 hr round trip to 8 hr, so you never know where you'll be.

 

[Epi-do]

I think it all depends upon what you are used to. Where I currently work, anything over 6-8 calls per 24 hours, and most of the guys say we are busy. However, in the past I have worked on trucks where that is a normal run load and "busy" would be considered anything over 10 runs/12 hour shift. It's all about perspective.

 

[46Young]

Our shifts are long ones, two ten hour days followed by two fourteen hour nights. Due to shortages in the division we normally work the in betweens making for a thirty-four, twenty-four off then a thirty-eight. Normal call volume in that period is twenty-five to thirty five calls. I divided our yearly runs, about 5000 per truck by days in a year and it came out to I think seventeen calls every twenty-four hours.

I'm not complaining, just looking for some data so I can figure out if I'm overworked, I'm too tired to think about it rationally.

I think the volume of calls would be more manageable if we went to eight hour shifts, but the city of Providence refuses to hire more people, it's pretty much business as usual, suck it up and if you don't like it, quit.

Another third service winner. Do you have a union to address your issues and working conditions? I'm guessing not by the "if you don't like it, quit" attitude.

You said that you're supposed to work two 10's and two 14's for a 48 hour/wk schedule. Are you working the in betweens voluntarily for extra money, or are you being forced?

You said that your six rescues can never keep up. You also said "I'm too tired to think about it rationally". So yes, you're overworked. 24 let alone 38 hours of running around 100 mph with your hair on fire is dangerous for the crew, the pt, and other motorists.

I hope that your yearly salary is based on a 24 hour workweek, and the additional 24 hours are time and a half. Check with your state to see if 38 hour EMS shifts are even legal. Management will be forced to hire if your crews aren't being forced into dangerously long shifts. I know what it's like firsthand. Read about CCEMS on the quality EMS agencies thread.

17 calls in 24 hours is A LOT. There are those that are proud of their non stop call volume, and wear it like a badge of honor. I come to work to run calls, but being run constantly for 50-70 hours/week will burn you out, and is unhealthy as you're up the entire night for several nights per week. Why would you want to do that to yourself for 20+ years?

 

[46Young]

17 calls in 24 hours, ON AVERAGE(some buses run less, but some run more), probably takes you through the entire shift without a break. If you're urban, you can turn around a medicaid abuse sick call from start to finish in about 20 mins, tops. If you have longer txp times, you're SOL. If you're rural, 9-10 calls per day will take up all of you're time. ALS takes more time as well.

 

[NomadicMedic]

24 hour shifts for us, all 911/BLS. We work a Modified Detroit schedule and run between 12 to 15 calls per shift. I like it steady, but I'm on what's considered a busy truck.

 

[46Young]

What's a (modified) Detroit schedule?

 

[boingo]

Another third service winner. Do you have a union to address your issues and working conditions? I'm guessing not by the "if you don't like it, quit" attitude.
QUOTE]


Third service? Not even close. Providence is run by the Fire department, although I'll agree there working conditions seem sub-par.

 

[Ridryder911]

You show me 14 calls in < 12 hours and I will show you poor care. Sorry, it takes at the least of 30 minutes on a call, 15 minutes for charting and cleaning and preparing again and all the necessary stuff. Then boom go again ... no breaks, no lunch?

The same as in 24 hours shifts. Years ago there was detailed psychological study on those in EMS (wish I could recall the study name) that described after about the 7'th or 8'th call the Paramedic lost quite a bit of their drive and attention span. I first thought this was non-sense but I have ever since closely watched medics and found this to be true.

My crews work 24 hour and run from 6-12 calls per unit. We have those that come from large Metro areas and assume they can handle it being less a number they soon find out differently. They are busy. We cover a lot of square miles and it is not unusual to be on a single call for over an hour and transport more than one patient at a time. Enough, we are placing additonal units to help solve the fatigue and burn out.

I worry about any EMS unit that is making more than one true patient contact, assessment and treatment and getting the unit bake in service in less than 45 minutes to an hour. How much assessment was really performed, how well was the treatment done and then whow well and in-depth was the documentation?

Not saying it can't be done... just worry about the quality of care and as well as the crew maintaining the pace.

I also ask, does those that work 24 hour shifts log how much sleep time they recieve? That is something I am closely monitoring on my staff as well. I am concerned to see medics enter their vehicle droggy and attempt to drive. I would not allow drunk drivers, I am sure not going to allow one of our employees get slaughtered either..

R/r 911

 

[marineman]

Our company in general is real similar to rid's. 6-10 is about average for us depending on the area. All of our ambulances stay busy enough but the actual work can vary from one to another. For the most part 3 of the 5 are strictly covering city area so they get a couple more calls but have shorter transport times. Also our policy is the ambulance stationed at the originating hospital takes any transfers. The other 2 stations are at the edges of the city so they only cover a portion of the city but also a larger area of country and small outlying towns. Those 2 also are the ones that post in between their area and another if any other rig goes out and they are the first 2 that get long distance transfers (at least once a day we send a truck to madison or milwaukee both of which are about 1:30 one way).

So generally only 6-10 actual calls but you are out and about doing enough to stay busy for a 24 hour shift.

 

[NomadicMedic]

What's a (modified) Detroit schedule?

A Modified Detroit is 24 on, 24 off, 24 on, 24 off, 24 on, 4 days off.
http://www.bennadel.com/resources/demo/modified_detroit/
You can click the link the see it. (I currently work 'B" shift.)

 

[mmorsepfd]

Thanks for the input. Our fire department operates the rescue division. Right now the city operates 14 engines, eight ladders and heavy rescue and 6 als units. The fire suppression side is understaffed, most trucks run with 3 firefighters, some with 4. The city wants the union to give the 4th firefighter to the rescue division so two more rescues can be added. The union won't do it. Their argument is manning the fire apparatus is equally important as running adequet rescues. I agree, it is not the unions fault that EMS calls have increased 40% in the last fifteen years while our department has stayed stagnant.

As for the thirty-four and thirty-eight hour shifts-The overtime is mostly voluntary, occassionally we will be ordered to stay on duty but never over 38 hours. A lot of our calls are taxi rides, done in half an hour, but as you know some days every call is als. It does get difficult.

I've been trying to compile data to substantiate my claims that the ems division needs more resourses.

 

[boingo]

This is one of my biggest gripes with fire based EMS. They will sacrifice EMS to staff supression, when the vast majority of your responses are EMS. I don't think 3 man engines and ladders are a good idea, but something has to give.

 

[46Young]

A Modified Detroit is 24 on, 24 off, 24 on, 24 off, 24 on, 4 days off.
http://www.bennadel.com/resources/demo/modified_detroit/
You can click the link the see it. (I currently work 'B" shift.)

I'm embarrased. The modified Detroit is what we have here. XOXOXOOOO. It's great, because we can't be forced to work more than 36 consecutive hours, and get 4 day breaks three times per month. This is a variant of 24/48. That sucks because you spend your first day recovering (if you're not forced to stay), and the second day you know you have to go back to work. You also need to take several days off to have a good block of vacation time.

 

[marineman]

I'm embarrased. The modified Detroit is what we have here. XOXOXOOOO. It's great, because we can't be forced to work more than 36 consecutive hours, and get 4 day breaks three times per month. This is a variant of 24/48. That sucks because you spend your first day recovering (if you're not forced to stay), and the second day you know you have to go back to work. You also need to take several days off to have a good block of vacation time.

We work the same schedule and call it a california shift. I think everyone just names them whatever they want so don't feel bad, I never heard of the modified detroit either.

 

[NomadicMedic]

I'm embarrased. The modified Detroit is what we have here. XOXOXOOOO. It's great, because we can't be forced to work more than 36 consecutive hours, and get 4 day breaks three times per month. This is a variant of 24/48. That sucks because you spend your first day recovering (if you're not forced to stay), and the second day you know you have to go back to work. You also need to take several days off to have a good block of vacation time.

Agreed. I just worked my second day, and go back tomorrow morning for the third day in the set. I like the 4 days off, you can trade a shift at the beginning or end of your set to get a 6 day vacation. We do shift trades pretty often. (Also, I had never heard the name 'Modified Detroit' either.)

Sorry to hijack... back to your regularly scheduled thread.

 

[FF-EMT Diver]

I also ask, does those that work 24 hour shifts log how much sleep time they recieve? That is something I am closely monitoring on my staff as well. I am concerned to see medics enter their vehicle droggy and attempt to drive. I would not allow drunk drivers, I am sure not going to allow one of our employees get slaughtered either..

R/r 911[/QUOTE]

R/R we get to sleep fairly well I director does not allow for sleepy sub par medics, so she will allow us to sleep during the day if need be. on average though as long as someone doesn't abuse themselves by staying up watching TV or on-line there is oppurtunity for 6-7 hr's per shift.