Our department and the FD we run with are doing a study on the 48/96 schedules. Our system has 7 als transport/primary units units, with 2 ALS supervisor trucks. The debate is to 48/96 or stay on our 3/4 kelly shift. A 3/4 kelly looks like this : XOXOXOOOO..then repeats itself. We cover 700 square miles in Arizona. We do EMS and transfers. Most shifts are stand up 24s for all the units..Most of our employees live within 1 hour or less to work. I am in favor of keeping it the way it is. I am looking for mainly CONS on this subject. There is not enough info for EMS 48/96.

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The most important factor in this equation is missing - how BUSY are your units? If your units average 2 or 3 calls per 24 hour period, it probably doesn't matter (you can get plenty of sleep on either schedule). If your units run 8+ calls per 24 hour period, and they are distributed throughout the shift, you shouldn't be doing 24 hour shifts on ANY schedule - your crews are too busy. (Some service that do a good chunk of inter-facility work will do 8 calls, but they will all be before 1600, so 24 hour crews CAN be assured of sleep at night.)

There is lots of research out there, but the bottom line is this - if your personnel aren't assured 5 consecutive hours of sleep in a 24-hour period, at the 19th hour their ability to function will be impaired as though their blood alcohol concentration was 0.08 or greater - legally drunk in most states.

Besides the risk to the patients, there is a great risk to the crews themselves. A study done of physician interns/residents showed a huge risk of MVC injuries or deaths on the way home from work after a 24 or 36 hour shift.
If you do EMS, you shouldn't be doing shifts longer than 24 hours even if it's on the slow end of the range Skip discusses. The "sleep" you get on duty isn't like getting a really restful sleep at home.

The 48-96 is great for the off-duty time, but it isn't great for your safety while at work.
Can I ask purely out of curiosity does 48/96 mean 48 hours at work start 7am monday and finish 7am wednesday and have 96 hours or 5 days off?

Or is it as we do here 4 12 hour shifts (2 day shift, 2 night) and have 5 days off...

Ben Waller said:
If you do EMS, you shouldn't be doing shifts longer than 24 hours even if it's on the slow end of the range Skip discusses. The "sleep" you get on duty isn't like getting a really restful sleep at home. The 48-96 is great for the off-duty time, but it isn't great for your safety while at work.
Neil,

The short answer to your question is "yes".

In U.S. terms, a 24/48 shift means that the agency has three shifts, each of whom works for 24 consecutive hours then takes 48 hours off.

Some agencies that have low call volumes have changed the 24/48 rotation to 48/96 which gives them four days off in a row after two work days. Those agencies tend to train and do public education during the daytime and then get to relax, sleep, or work on personal/career development for the rest of the shift.
There are some agencies that have gone to 48/96 that are not in any way shape or form "low call volume." IMHO they have made a conscious decision to put the public and their employees at risk, in order that their employees can enjoy multiple consecutive days off.

They will get away with it, of course, until they don't get away with it. And the result will be tragic.
Neil, I've also worked the 3/4 Kelly shifts on a high-volume ALS unit, and it is almost as dangerous as the 48 consecutive hours for busy units.

The additional downside is that on the second and third days of a work rotation, you often come in to work still tired from the previous shift.

I also worked a four-platoon 24-72 system and it was better than the other two options being discussed here, but it still was too many consecutive hour for the busy units that usually ran 20 or more calls in a 24-hour shift.

One other thing about 24-hour shifts is that for places that run low-to-medium call volumes in the daytime and that don't run much at night, they work just fine. Those are mostly suburban places.

In urban systems, 12 hours is the most I want to work - or to have my people work - consecutively.
24/48's are bad enough if you are in even a remotely busy system. Where I work, we have 8's, 10's, 12's, 16's and 24/48's. The 24/48's have Kelly shifts. Currently I am on a 24/48... and I hate it. I don't agree with 24 hour shifts. I don't agree with most company's policies of allowing personnel to run up to 36-48 hour continuous. It is completely and totally unsafe for the crews, the patients and for the citizens we have to drive past while we can barely hold our eyes open. Not to mention the brutal beating it is on one's body.

But with that being said, the time offered by a 24/48 (especially with a Kelly) is outstanding. And as a single parent, when I combine that with the fact that I can work for 2 days and have more total hours then the guys on the other shifts (those shifts are scheduled to be low OT), I feel it's a beating I have no choice but to take. If I worked a 12 hour shift on my companies schedule I'd end up with 84 total hours (3 days one week, 4 the next). On my shift, each pay period is 96 hours (before extra ot). So, just to make the same money I'd have pick up an 8th shift. And that's if they even had any spots open.

Where I'm going with this, is that if 24/48's can be that bad, then a 48 hour shift has the potential for disaster. And the fact of the matter is the only reason places push so hard for 24 or 48 hour shifts if monetary. You can do the same work with less people. Not as many shift changes also means less missed work hours (the time the truck is down for change over). For me personally, I'd prefer to come in, do my job and then go sleep in my own bed. I also prefer to be off shift before my skills and critical judgement is so diminished from lack of sleep that I almost put unleaded in the diesel engine.
I'm just struggling to comprehend working 48 hours straight but I guess in systems where call volumes are very low then I can see how services would opt for this to reduce staffing costs.

In our service busy metro system we're hitting 14 jobs per crew in a 12 hour period. It is physically draining and unless you are of the mindset to go straight to bed when you get home, you don't have enough sleep and are less than productive the next day. So doing 4 12 hour shifts and then the last shift being a night finishing and spending the first day off in bed, the next block of shifts roll around so quickly. This coupled with an annualised hours system that means annual leave is incorporated into the rota pattern you physically collapse at the end of the rota cycle and send the leave period catching up with yourself.

After a vehicle incident here, patterns and break policies are being reviewed here but as has been mentioned staff prefer lots of days off. The unleaded in a diesel vehicle is the most common sleep deprived error that occurs here.

The department of health (aka the government) and the european union in brussels would prefer us to work an 8 hour shift so do 5 a week averaged across a 13 week pattern. Then again we look at our police forces who are on an 8 hour pattern and then the size of the end of shift forced overtime expenditure and the idea of it happening in EMS disappears.
Neil, it is a fact that there are only two god ways to really keep end-of-shift forced overtime for "late calls" to a minimum is to minimize the number of shift changes per 24-hours, or to have staggered shift changes with the end-of-shift units allowed to go out of service to return to the station or deployment base for the crew change.

That's one of the attractive things for 24-hour shifts for agencies that are slow enough to allow a few hours of on-duty sleep.

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