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When asked about the impact of longer
shifts on health and safety in EMS, Scott,
a supervisor, says, “I would advocate mov-
ing away from 24-hour shifts. It throws off
your internal clock and really impacts your
eating habits. Your mental sharpness defi-
nitely fades after so many hours on the truck.
Even if you do get sleep during shifts, it’s not
battery-charging sleep. If you’re working a
24-hour shift, it’s like working a 32 because
you have to recover the next day. These lon-
ger-duration shifts and working too much has
a tremendous impact on your life.”
Despite the concerns, Scott believes that
24-hour and longer-duration shifts can be ben-
eficial. “It does provide a better living for folks.”
Scott advocates for a potential threshold on
shift duration. “My push would be to move
away from 24s, and go with 16s as the longest
shift that people would work. Many people
don’t want to work five days a week. The happy
medium would be 10-, 12- and 16-hour shifts.”
Others interviewed for this article share
Scott’s view that longer-duration shifts are
dangerous, yet offer a better lifestyle. Bob,
a paramedic from the Midwest, works 24
hours on, followed by 48 hours off. “Your
time at home feels vastly more improved [with
24-hour shifts]. Your interaction with family is
WORKING MULTIPLE JOBS
a lot better. It’s much more enjoyable.”
The details of shift schedules and patterns
of those involved in the events described earlier
aren’t clear. It’s possible that some may have
been working on longer-duration shifts, on
back-to-back shifts, or some other pattern of
shiftwork. It’s possible that shift scheduling
contributed to their reported feelings of fatigue
or sleepiness, and preceded the poor outcomes.
The U.S. Bureau of Labor Statistics defines fulltime workers as “persons who work 35 hours
or more per week.”
32 Large numbers of EMS
personnel work more than 35 hours per week,
and many work 45 hours or more each week.31
Working multiple jobs is common in EMS.
The 2016 JEMS salary survey reported that
more than half of EMS personnel have a sec-
ond job to supplement income.
33 One study
of 119 EMS clinicians in Western Pennsyl-
vania reported that 34% work more than one
10 A separate study of 511 clinicians from
across the U.S. also showed that 34% work
11 Another study of 450 clini-
cians from across the U.S. showed that 46%
work more than one job.
34 And yet another
study shows that more than 80% of air-med-
ical clinicians have outside employment, and
that many start a shift within eight hours of
leaving their other job.
Some in EMS may not work multiple jobs, yet
they work multiple shifts back-to-back with limited time off or take advantage of overtime.
“There’s an addictive, compulsive behavior
about overtime,” says George, a paramedic in the
Northeast with six years’ experience as a clinician.
As a supervisor in a busy urban system, Scott
believes that when his crews work too much,
it’s detrimental to their physical and mental
health. “You don’t get downtime to recover
and decompress. This is where burnout origi-
nates in EMS. For those who work more than
80 hours a week, it’s almost guaranteed they’ll
have a safety event or get sick. I get worried
about my crews when they work long-duration
shifts; but unfortunately, with the turnover rate
and call-offs, it’s a necessary evil.”
Nancy from the Northeast recalls, “I tried to
work multiple jobs for a few years, but it didn’t
work for me. I just wasn’t able to meet the
needs and demands of my different employers.”
It’s plausible that those involved in the
tragic events described in the introduction to
this article worked multiple jobs. It’s plausible