What's the best shift?

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Permalink Reply by Skip Kirkwood on June 21, 2012 at 8:52am

What a great topic for some valid, legitimate research!!!!

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Permalink Reply by Bob Sullivan on June 21, 2012 at 3:21pm

Until that happens, I'll settle for everyone's expert opinions.

Skip Kirkwood said:

What a great topic for some valid, legitimate research!!!!

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Permalink Reply by Neil White on June 21, 2012 at 5:12pm

Interesting...

For all three I guess you'd look at some form of 10 day shift 8am till 6pm

- Awake enough to be functioning 

- Achieving the average working week in 4 day rota allowing 3 days off, for family life

- No night shift and no rotating pattern to improve provider health. 

I guess a fixed shift pattern of 1 type of shift that accommodates for circadian rhythms and allows for the provider to achieve a 3 day maximum of 4 day working week. 

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Permalink Reply by Bob Sullivan on June 21, 2012 at 7:00pm

Thanks Neil!

I was wondring more about agency-wide shift schedules.  Someone has to work at night, so what's th best way to do it?  Should it be straight days/afternoons/nights or a mix? Should it go by days of the week or a rotation?  How long should they be?  I'd be interested in learning what you do in the UK. 

Neil White said:

Interesting...

For all three I guess you'd look at some form of 10 day shift 8am till 6pm

- Awake enough to be functioning 

- Achieving the average working week in 4 day rota allowing 3 days off, for family life

- No night shift and no rotating pattern to improve provider health. 

I guess a fixed shift pattern of 1 type of shift that accommodates for circadian rhythms and allows for the provider to achieve a 3 day maximum of 4 day working week. 

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Permalink Reply by Neil White on June 23, 2012 at 10:01am

OK, well in the UK there are two schools of thought...Annualised and Non Annualised. 

Annualised used by many companies now, takes your average yearly working hours in our case 37.5 times 52 weeks and then minus the annual leave requirement which in the UK on average is 5.6 weeks....

You are left with an Annualised total to achieve throughout the year. It works for the employee and against in some cases...Downside for providers with paramedics is that longer periods of time off are fixed by the rota and may not combine with school holidays. 

In one case in was 3 shifts on 3 off for 5 weeks and then 9 days off and back to 3 on and 3 off...the 3 was a mixture of days and nights on a varying pattern. Trouble was if your last shift was a night you only really had 2 days off which made for a tiring set of 5 weeks, get to the 9 days and you spend most of it catching up. 

This system allowed for shift swaps and dropped shifts, which created havoc...within 2 weeks notice you could drop a shift without giving a reason but you needed to pay it back at some point. 

With this system there is no overtime only shifts can be banked so if you wanted to turn your 9 in to 14 days off you would need to work 5 extra shifts somewhere. That said with dropping shifts, if there was then no shifts for you to repay, your salary is docked the according amount. 

The other way tends to be a fixed pattern of 4 on 5 off with a couple of weeks relief in the mix covering annual leave ect, time off was requested to the manager and only to were allowed off at any time. Overtime at time and a half with this system and the shift pattern tended to be 2 days and 2 nights followed by the 5 days off. 

Really agencies use system analysis models so any combination of shifts if allowed by the european working time directive is allowed. There is some thought to trialing split shifts.... a crew does a busy 7am  - 11am and then returns at 4pm and works till 8pm.... 

We don't do 24 hour shifts, remote locations such as the scottish highlands, work on an on call basis, they live in a house with the ambulance car parked in the drive way, essentially they respond 24/7 but may do 1 job followed by 10 days without one. 

We mainly work 12hour shifts, some agencies work 8...and in fairness many staff prefer the 8 hour shifts, with increased demand finishing with a late job on a 12 can turn it into 15+ hours... 

I guess there couldn't be a perfect pattern because each area is unique in its response requirements. 

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Permalink Reply by 808 Medic on June 25, 2012 at 7:54pm

The best shift for each department will depend on call volume, staffing requirements, and personnel. Neil was correct by stating that "there couldn't be a perfect pattern because each area is unique in its response requirements. 

1. Being alert while caring for patients. 

-Depends on call volume, shift length, and time off between shifts. 

3. For quality time away from work. 

-More time away from work means that you have to work longer shifts. Longer shifts may have an effect on #1. 

Shorter shifts don't always guarantee alertness while caring for patients. Department that i currently work for operates on 8 hour shifts. Shorter shifts require more shift changes during 24 hour period. More shift changes require more personnel. We have a problem with chronic staffing shortages causing forced overtime. It's not uncommon for personnel to do multiple 16 hour shifts in a row, this leaves very little down time between shifts. Working an 8 hour schedule 5 days a week and then being forced to do mandatory overtime leaves very little quality time away from work. 

Our department is in the process of trying to implement an alternative staffing pilot program (process has already been drawn out for over two years). 

One of the schedules i personally worked on involves 16 hour fixed shifts with fixed days. Shift one is from 11pm to 3pm, shift two is from 7am to 11pm. Heres an Example of how one employees schedule would work. First week 3 days on tu/thurs/sun, second week 2 days on th/thurs, third week 3 days on th/thurs/sun, fourth week 2 days on thurs/sun. Four week cycle repeats itself after that. Schedule equals 80 hours per 2 week pay cycle. Never work two shifts in a row. Anyways the schedule has a lot of other details that i can provide if anyone is interested. 

Another important factor to consider are any preexisting union contracts, and your human resources department. Any built in overtime may not be an option for some departments. 

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