It is never an ideal time to insist on ideal conditions for emergency medical services workers. The reason is in their job title, and every day can bring multiple life-or-death emergencies. But with every emergency and every long shift, the problem of fatigue has the chance to bring tragic, preventable outcomes.
EMS operations have had two years to absorb, implement and potentially lose focus on the core recommendations of a panel of experts organized between the National Highway Traffic Safety Administration and EMS experts. Their top five recommendations, discussed below, are now more important than ever before.
Asking workers to find out what works
EMS organizations need to know about fatigue in their personnel. The panel recommends surveying EMS workers to check how the organization’s decisions are affecting fatigue and whether changes have their desired results. Organizations also need to carefully choose their survey questions and methods to tease out a desired kind of information.
Shift duration as part of the conversation
While shift duration can be a heated issue, the study found that work shifts shorter than 24 hours yielded better results in terms of fatigue as well as in the negative outcomes that fatigue brings. So, the recommendation is for no shifts longer than 24 hours, including back-to-back 12-hour shifts.
Taking caffeine seriously
While some workers cannot be separated from their coffee mugs by any means, others may have trouble finding access or motivation. The panel recommends managers look at the data, see that caffeine makes an objectively measurable improvement in performance, and think through the problem of making caffeine available, always and for everyone.
Normalizing napping on the job
The panel found that naps help keep fatigue under control and lead to more positive outcomes. Breaks alone are not enough. The panel is talking specifically about sleep-induced loss of consciousness. The panel recommends actively providing “the access, opportunity and permission to nap while on duty.”
Management and workers both need sleep education
EMS workers need high-quality information to do their work effectively, and that includes a good working understanding of the role of sleep. The panel calls for “education and training in sleep health and the dangers of fatigue to mitigate fatigue and fatigue-related risks.” It says training for new employees as part of orientation and a refresher every two years would have a positive impact on outcomes.