The Slow Death of the 24-Hour Tour
Many U.S. fire and EMS organizations use some form of the 24-hour shift for around-the-clock staffing, but that may soon be changing for both employers and employees. Changes may stem from decreased employee safety and decision-making capabilities while working 24-hour shifts, increased organizational liability for actions by employees working 24-hour shifts, and shifts in worker attitudes about work schedules in general.
In its study entitled Sleep-Wake Cycle: Its Physiology and Impact on Health, the National Sleep Foundation found that sleep deprivation has an adverse affect on:
- Physical health and well-being. In the past few years, investigators have found that sleep loss may have harmful consequences for immune and endocrine systems and can contribute to serious illnesses such as obesity, diabetes and hypertension.
- Cognitive performance and mood. One study showed that people who were awake for up to 19 hours scored substantially worse on performance and alertness tests than those who were legally intoxicated.
Other studies have found that after one night of total sleep deprivation, subjects scored significantly lower on tests of judgment, simple reaction time, explicit recall and inverse word reading. Also daytime alertness and memory are impaired by the loss of eight hours of sleep, especially when sleep loss is sustained over a few nights.
Think about this in terms of rising EMS calls. How functional is an EMT or paramedic in an ambulance at 2 a.m. when he or she has been awake and on duty since 8 a.m.? One of the attractive features of the 24-hour shift is the firefighter’s ability to live a significant distance from the assigned duty station yet still have time for the commute. If that same medic awoke at 5:30 a.m. to arrive in time for ta tour of duty, he or she really has been awake for 20.5 hours when faced with a critical patient-care decision at 2 a.m.
In a Merginet survey of EMS providers, respondents were split almost in half regarding their preference for 24-hour shifts in both the hospital and pre-hospital community, even in light of the research that sleep deprivation has an adverse impact on decision-making.
In light of that same research, can fire and EMS managers continue to support shift schedules that, though desirable to the employee, aren’t in the safety interests of the employee or the public? When more than half of all EMS accidents involve operation the ambulance, can a department afford to have an employee behind the wheel whose cognitive abilities may be akin to those of the motorist taking a field sobriety test at the scene the motor-vehicle crash? We need to be asking ourselves that question and before a plaintiff‘s attorney does it for us.
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Related Topics: Robert Avsec, Management & Administration, EMS, Health & Safety, Leadership
August 17th, 2007 at 11:16 am
Very interesting topic and probably right on target. However, I’m curious as to how a plaintiff’s attorney might view the volunteer firefighter in this context.
August 17th, 2007 at 11:50 am
I believe that there needs to be more supportive evidence that the is an underlying problem. Problem identification and pattern identification Such as, EMS and Fire apparatus crashes time of day, CPR/ALS intervention results by time of day, etc would be a good start prior to jumping in too deep. As with most issues in todays fire service, people get on a band wagon and jump to conclusions prior to all information being evaluated.
August 17th, 2007 at 1:09 pm
HYPOCRISY … It is not the 24-hour shift that is the problem. It is the two 24-hour shifts or in some cases the three 24-hour shifts in a row that is hurting the firefighter. Some firefighters are working full-time for two different departments.Paramedics are doing the same thing. Fire chiefs write SOPs regarding rehab procedures, and some of their firefighters need rehab when they report for duty. We require preventive maintenance on our apparatus but not on our firefighters. If we care about our people we must address the real problem regarding the longevity of their call to duty.
August 17th, 2007 at 3:08 pm
I have to agree with Mr Mattison. I have firefighters working 48, 72, even 96 hours straight — not in our department, but they pull their 24 then it’s off to EMS for 24 then a 24 overtime shift at EMS and back to our station.
Even had one firefighter try to hold a job with us 24/48, one with EMS 24/48 and another department 24/48 — burned himself out so bad he left emergency services altogether. Interesting — each organization considered itself his primary employer, but none of us took any action to limit his activities.
August 17th, 2007 at 9:36 pm
Every supervisor has the same primary goal, to get their people home, and is as good or better shape then when they reported for duty! With that said I feel thin is an area worth looking intobut as said earlier, review all the stats, not just the ones that will support your particular stance.
I work a 24/48 schedule and support this type of rotation, but, I also feel anything we can do to reduce the number of firefighter deaths we see each year should be evaluated. We haven’t found new ways to kill our firefighters each year, we just keep ignoring the repetitious facts staring us right in the face!
August 18th, 2007 at 6:14 pm
Thank you, Chief Avsec, for addressing this issue. We clearly need more research and more scientific data on the of the 24 hour shift and its impact on firefighter health and safety. Your article suggests a movement away from the traditional 24 hour shift, but a different trend seems to be occurring in the west. We have many departments evaluating, or shifting to, a 48-96 schedule. You can find advocates on both sides of the issue of the efficacy of this rotation, but much of the “data” used is anecdotal. I’m glad you brought this issue up and I hope to see more articles and opinion pieces in future editions of Fire Chief. What would be better, however, is a dedicated research project that could give chief officers and union presidents alike an empirical resource to deal with staffing and duty shift issues from a factual position. To me, this is a significant firefighter safety issue that we have given little attention to. Once more, thanks for your article.
August 19th, 2007 at 3:15 pm
Sounds like all the experts forgot the most important cure for the 24 hour shift.I know that staticis can show what ever an agenda feels is necessary to promote thier specific needs. As a firefighter for 30+ years I have seen my share of self promoting agendas pushed down the throat of our great profession.Once again here goes another attempt to put a feather in a cap of whoever supports the great change to more normal shifts.Fact is ,where are the studies shown how a 30 miniute,1 hour,even two or three hour naps supplies suffcient rest and recouperation that is needed to respond appropiately to the next call? Give me a break. There are many houses where the firemen are taxed at best going from call to call. Add stations where there needed not where the politicians want them to go.Yep,I’ll say that comfort and morale is the most important factor to get the best and most professional service delivery from our personnel. Safety naps are allowed to my crews whenever an individual needs them. There has been maybe 4 times this year that my guys requested this tool. They hiave not abused this tool. But they know that if they need to rest they can.
August 24th, 2007 at 8:20 am
I have worked 24/24 and 24/48 shifts all my career time, which is 21 years. Yes, in the middle of the night calls you can have decreased abilities to function and that would be a problem. If the crew is not dogged with petty details to do all day long they can be fresh for the later calls. The study about napping I have read and it does work, my department allows it without an official policy. I like the 24 hr shifts as it is less driving to work and reduced cost for vehicle usage. I believe starting the shifts at 20:00 hrs and doing the 24 hrs might be better as towards the end of your shift it is daylight and that helps in being alert. Yes the extra employment is tiring out our personnel before they arrive at next job, but if the personnel need the money to pay bills it would be hard for an employer to ban extra jobs until the salary is high enough to survive. Finally I have worked 72 hrs straight and it is a long time in a station even if you are not always on calls. There are depts in my area that work the 48/96 and some even do 5 days in a row to cover shifts that are short.
August 27th, 2007 at 6:58 pm
Don’t forget one of the most important things to city councils regarding 24-hour shifts. You can rotate three shifts evenly, 10 days a month each shift at 56 hours. If you go to shorter shifts you need another shift resulting in hiring 25% more people with benefits. Not probable, not where I work.
August 30th, 2007 at 7:20 am
I work 24/48 on a combination department, and the on-call guys who show up on the 0300 alarms aren’t as fresh either. On-call firefighters work their normal 9-5 jobs (example only; not everyone has bankers hours) spend time with their family, and go to bed. They do not get mid-day naps to refresh themselves, there fore, they wouldn’t be any more alert than the duty firefighter. They may actually be worse off if woken up at 0300 hours, because they are in a deep sleep at home, than a lite sleep at the station. Before resorting to cutting out the 24 Hr .shift, the whole picture needs to be addressed, at all angles. Mid-day naps (for those working doubles), starting shifts at 2000 Hrs, and how about putting the responsibility of being rested on the firefighter coming on shift! This looks like another ploy to do away with the career firefighter all together, and rely on on-call personal, which I can tell you from experience, it’s a crap shoot every alarm for personal
October 9th, 2007 at 11:39 pm
I am currently compiling large amounts of data on the 48/96 hour schedule, as many in our west coast department are interested in trying it. I have been working it by shift trades for the last year and have found it superior to the 24/48 in almost every respect. We have a very busy dept. with 40,000+ calls per year for 23 stations. As a company officer I am more efficient at work due to having two operational periods, back to back, to plan work and training with. Additionally I feel better rested when I return after 4 days. I believe that the studies are showing a difference between acute and chronic fatigue with chronic being the more insidious of the two. The addition of naps is clinically being supported by the medical community and seems to be an easy solution. It might just be the administrators inability or unwillingness to accept that full time fire crews are not a resouce to accomplish fire prevention/education/maintenance with, and that a mid day (or anytime) nap does not equate to laziness or inefficiency but good management and well being for the employee, which in the long run reduces cost and difficulties.
November 26th, 2007 at 12:58 pm
There are many ways to adjust the 24 /48,schedue,we can begin at 1800 hours or 2000hoursor 0800hours,but it stll equalsthe same amount of hours.LONG WWITH THE SAME concernsI have worked all three in my 31year career. Each has its ups and downs,its support and antagonists. Most elected governement decision makers have not experienced the delimma of scheduling services twenty-fourhours a day seven days a week plus all holidays.SOmewhere out there is a mind thst can accomplish the staffing task ALONG WITH ADDRESSING THE SERVICE DELIVERY, BUILDING INTO THE EQUATION THE EXPENDITURESS ASSOCIATED WITH BOTH.we need to spend some time researchingt hese issues,with a goal to reach a decision based on fatual data and analytical detail.
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