EMS Disordered Sleep And Work Schedule

Issues of Concern

Several issues contribute to disordered sleep and work schedules for EMS providers. Some of these issues are controllable, and some are not. If an EMS provider does not have proper money management skills in their personal life, it burdens work and sleep schedules. The provider feels obligated to work overtime to meet ends. Spending habits play a significant factor in money management. The desire for lavish material items often takes control of better judgment when making budgeting decisions. Impulse buying is also hurtful to budgeting and creates a need for additional overtime hours. This issue can be controlled through better money management techniques. Courses like Dave Ramsey are available to learn more about controlling expenses.

EMS does not always have control over dynamic staffing and scheduling issues, and agencies complain of having only a few qualified applicants to fill the roles. Pay scales are a direct attribute for an EMS provider to sacrifice sleep and work more. Pay plays a large factor when making educational choices for a career field of study. Stagnant wages in the EMS field have caused many "would-be" EMS students to pursue other fields of study. Additionally, several EMS career professionals have left the field recently to pursue a nursing degree. State EMS-controlling agencies have taken notice of staffing issues and are currently conducting surveys regarding pay scale and consequences for EMS professionals.

EMS management style and method of delivery are often anemic in substance. Some great personalities are present, while others lack a basic understanding of being a leader. Scheduling and sleep disorders occur when a manager does not properly delegate the workload to emergency service providers. Proper scheduling techniques are similar to uniforms and oxygen tanks brought into a patient's home. A strong leader understands that their role is to provide their team with the tools needed to complete the job. A leader understands that the measure of success is how well the organization runs when they are not present. Providing the team with needed tools helps to create a successful EMS organization.

Home and life responsibilities play a role in sleep and work disorders. An EMS provider often gets little to no sleep during a 24-hour shift. The provider makes their way home, looking to pay back their sleep deficit by napping. Noise at home or a room not being dark enough can prevent sleep. Marital and financial stresses are 2 major issues experienced by EMS professionals. Personal and financial responsibilities do not end despite a dynamic work schedule. A sleep-deprived EMS provider often has to run errands after being up most of the night before. In most states, educational requirements to maintain licensure status have increased. This additional requirement adds training during off-duty hours. More college-level courses, additional hours, and requirements to participate in EMS-related programs exist. These requirements add to the cycle of extra work and disordered sleeping schedules.

Clinical Significance

Disordered sleep and work schedules greatly impact EMS provider performance. Adrenaline provides a performance benefit for bad calls, but daily fatigue leads to more errors during routine, gray-area calls. Driving safety is an important topic during discussions about EMS provider sleep and schedule disturbances. Ambulance crashes are highly noticeable in the media and are typically the result of fatigued or distracted driving. Sanctioned defensive driving courses promote safety but don't replace a healthy sleep schedule.[5][6][7][8]

Current research suggests that poor sleep habits accelerate the advancement of disease processes, such as diabetes and heart problems. Poor diets are often prevalent in the EMS field. Poor food choices, especially late at night, can contribute to sleep problems and the disease process. Healthcare courses in prevention can often eliminate or reduce risk factors in diet and sleep problems. Enjoying time at home with family and/or friends is a vital component of being happy in life. Companionship in some form is desired on every level of human intelligence. Sleep and work schedule disorders often have a direct impact on time at home. The time off from work is largely used to rest from a taxing work schedule. Holidays and appointments become less important due to sleep and work schedule disorders.

State EMS-controlling agencies are conducting studies in the EMS field to correct the issues discussed in this topic. New pay scales and scheduling techniques are being considered to address and improve these problems. While some emergency management workers perform the traditional 24-hour shifts, some companies have opted to test a 12-hour shift system. The reduced shifts are aimed at reducing emergency management provider fatigue. The ultimate goal of newer scheduling techniques is that the last patient contact of the shift should receive the same quality care as the first shift patient. Emergency management providers are dedicated to their community and patients and continue to do their jobs while they work on issues in their field.