You Can Nap if You Want To! Or You can Leave Your Calls Behind!

What a week! You’ve been pulling at least a double shift a week at your full-time ambulance job and have been hitting it pretty hard at your part-time job as well. Both services can’t seem to keep their schedules filled and everyone’s been working lots of hours in order to keep the doors going up and the trucks going out. To top it all off, the citizens just can’t seem to be good lately and both services’ call volumes have been high.

You were tired when you got up this morning and were seriously considering a nap after your morning shower, but after a gallon or two of coffee you were bright and shiny in your uniform at your station, ready for another day of EMS greatness.

That was five hours ago though, and the early barrage of calls fired at you this morning has turned into an afternoon lull. Now you’re sitting at your main station, close to the brass, with the words in the educational article you’re reading fading in and out of your bleary, cross-eyed vision. Since the activity level has decreased, you’ve gotten yourself a case of the sleepies that you just can’t shake. Since you’ve been consuming the steaming bean juice religiously lately, your stomach just won’t let you think of having another cup of the acrid station coffee and there’s no shift chores left to do, since you did them an hour ago fighting the same lethargy.

Unfortunately, in three hours you can see a long distance transfer scheduled that you’re probably going to have to do. Four hours of monotonous highway driving and the radio in the truck doesn’t have that great of reception. You don’t have any idea how you’re going to stay awake enough to drive the truck and that’s not even considering the fact that if the tones went off right now for an emergency you probably wouldn’t remember how to put on a band-aid, let alone remember a drug calculation.

You’re tired, you’re fatigued, and your body’s telling you that you’ve been pushing it too hard. It wants to shut down for a while. Your brain won’t think. You’re mouth won’t talk. You can’t keep your eyes open and wake up with a startle when you’ve realized you’ve dozed off for a bit. This is torture.

Sleep deprivation is no stranger to EMS people. We’ve all fought the lethargy caused by long 24, 48, and more-hour shifts. A great number of us work more than one job to make ends meet and pack as much family time and recreation into our off time as we can. A lot of us are going for more education and all of us get woken up from our sleep a lot more often than is healthy to run on calls. I regularly miss full nights of sleep and rarely have a night when I can say I got a full night’s sleep. We get use to it some of the way, but our bodies just aren’t meant for chronic sleep deprivation. We need to reset and reorder our brains and let our bodies recharge once in a while.

Unfortunately, our communities need us and we have to be there for them. EMS is important and it’s easy to get sucked in.

That’s why in this situation, I have very little dispute with taking a “Safety Nap”.

"SSSS-AAAA-FFFF-EEEE...."

The “Safety Nap” is a quick power nap. A shut-down and reset period where a person who never knows when they may be called to be up all night without sleep can rest and relax for a while and ensure that they’ll be wide awake and alert for whatever they may be called to do. I took an hour last shift around 3pm as a matter of fact. I didn’t get to sleep until 1am afterwards and I was up at 5am for a call. EMS is like that, shift work is like that. We have to ensure that we’re well-rested enough to make quality decisions of the type we have to when they need to be made… and we can’t do them well when we’re drooling on ourselves from exhaustion. One of Murphy’s laws for EMS states that “You know you’re in EMS when your favorite hallucinogen is sheer exhaustion” and I have to tell you, I’ve done that while on duty before. It’s just not safe.

There are problems with this, I know. Some will say that we shouldn’t allow ourselves to be scheduled this many hours and that it’s irresponsible to do so. Well, then they can come talk to my bosses and pay my mortgage. Some people will sleep all day if they let them, and won’t put any effort into their shifts unless they have to. That has to be monitored. With that said, a balance has to be sought. I see nothing wrong with the occasional safety nap and I believe that EMS managers should allow it. They also should be unafraid to throw a cup of cold water on the Rip Van Winkles among us to ensure that they pull their weight with the non-call-response aspects of an EMS job.

What do you think? Does your employer allow “Safety Naps”? Do you take them?

I’d write more but Zzzzzzzzzzzzzzzzzz

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  • Ambulance_Driver

    What is this, EMTs Without Hats?

    The Borg allows its 24-hour crews to call for “down time,” no questions asked. When you request it, dispatch routes you to the nearest station and takes you out of the call rotation for 4 hours. You're expected to spend that time in a horizontal position, snoring gently, not catching up on paperwork or watching television.

    The practice is subject to retrospective review by your supervisors, and you can be disciplined if you use it inappropriately, but they don't question the request until after your nap.

    Our 12-hour crews are expected to be well-rested before they come to work, and aren't afforded such privileges. If one of the crew is pulling a 2nd shift of overtime, and thus working a 24 or 36, dispatch may take pity on you and route long-distance transfers to other trucks, but there are no guarantees.

  • http://thehappymedic.com the Happy Medic

    “Members are not to be in a position condusive to sleep between the hours of 8AM and 10PM.”

    We can get rest if we need it, but like AD says, if you abuse is you're in trouble.
    10s, 24s, 48s, whatever shifts we work we need to put our safety and the safety of our patients first. If that means sneaking away for a bit of shut eye without effecting company effectiveness, then so be it.

  • http://twitter.com/SamBradley11 Sam Bradley

    I worked 24 hour shifts for my entire field career. As an EMT at a small Southern California ambulance company there was no union to mandate a “fatigue policy”. We could run 17 911 transport calls a day and had the requisite 5150 transports to the county hospital. There was no pity. No one else would take a call for you in the middle of the night because “it was your area”. I can't tell you how close I came to putting the rig in a ditch numerous times. I got real good at “power naps” standing against the wall of the ER. Fortunately, relocating to Northern California meant a union and a fatigue policy that was meant to assure the safety of the crew (and, ultimately the patients). Much like AD described, as a supervisor I got the job of justifying the use of said policy. Unlike Chris's situation, 24 hour crews were supposed to grab rest when they could during the day. I agree with Justin in that naps are not only appropriate, but necessary for safety. Consider what these shifts do to normal sleep cycles over time. Even though I've been out of the field for a while, when I try to sleep anywhere but home my body is in a “work mode” and sleep is just a noise away from wakefulness. Naps, yes. Studies have shown that downtime provides for a more productive workday even in an 8 hour shift. Good luck with that, Chris!

  • http://portraitofalady-lizzie.blogspot.com/ LadyLizzie

    Well, I don't work EMS, but my patient transfer job is run like an EMS station. We love naps. If we're waiting to pick someone up, if we're at the station waiting for a call to come in – you can usually find us on a couch somewhere. Granted, we don't have station chores to do, reports to write in our downtime and our calls can usually wait 5 minutes, so when we have some time we take it to sleep. In fact, I'm waking up at 0400 to head into work tomorrow and I fully expect that I'll be napping at least once during the day.

  • http://twitter.com/phxgonline PhxG Online

    When I was with fire we did 24's with a strong policy of resting as long as all other station tasks were complete. Currently, I'm with a private ambo company and we have scheduled 12's with a max work day of 16 hours except in emergency situations. While we corner post we are allowed to sleep (if we can) in the rig as long as one of us is listening for the radio.

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  • thaddeussetla

    Sleep depravation was one of the main causes for me to back off of my regular 80 hours a week schedule. I knew that I could not sustain that and my body made me realize it quicker than my pocket book did. I agree on the power naps, but ultimately you are right, it is just not safe… period. We are entering into a new paradigm of education and awareness and this is a prime chance to help decision makers understand the importance of fair wages, quality education and career paths…

  • 40lizard

    I agree that power napping should be allowed as long as its not abused- there are some days that just run you ragged and others that don't and sometimes that 5 minute power nap is what makes the difference between surviving and not surviving the shift- our company has a mandatory 8 hour rest period between shifts and that includes if you're moonlighting somewhere else- how they enforce it I am not sure- oh well!

  • Totwtytr

    We don't have an official policy on napping, just that one that says that we have to answer the radio when called. Power naps work fine, and they don't have to be more than 20 minutes or so. At least for me. I believe the USAF did a study on this some years back and found that short naps have a positive effect on alertness.

    The guys that come in to work and expect several hours of uninterrupted sleep are a different story.

  • http://grumpydispatcher.blogspot.com/ The Grumpy Dispatcher

    FD 24s? Not yet busy enough to require permission, as even with drill and house duties in there you still get enough down time without having to sneak it. I'm not a full-timer on my FD, so only rarely work the 24s when filling in.

    Power company 12s? Not allowed. We do it anyway. Ya gotta do what gotta do. One dispatcher will nod off and the others just watch his alarms for him until his phone rings or he wakes up. No discussion.

    I hate the hallucinations when driving home. Freaked me right the hell out first time it happened.

  • Mmorsepfd

    I'm doing a thirty-eight right now. Coffee has replaced bthe blood in my veins. Hour sixteen now, fifteen calls so far. Two stabbings, sexual assault, MI, MVA's, drunks and people vomiting. Our union doesn't care, our administration would have a cow if we didn't answer the bell because of a nap, sleeping while shitting is a luxury.

    I've yet to compromise patient care. I had nineteen years yesterday. (Happy anniversary to me!) It's a race to the finish at this point. My naps consist of sitting at my desk, holding a pencil and dozing. When the pencil falls, it wakes me up and I'm good to go. A hot five minute shower equals 4 hours sleep as well.

    EMS is a catastrophe in Providence. The entire department is on run number 25,345 as i write this. Rescue 1 is pushing 3000 calls so far. That's more than 10% of the entire department's call volume. Yet we are still considered unworthy to fill the fire gods boots.

    Thanks for posting this, I needed to vent, can't sleep, call coming in.

  • http://www.lifeunderthelights.com Ckemtp

    Howdy Lt.

    Wow. I had to put that out on Twitter. Here's pullin for ya buddy. I'd tell ya, I'd come work with ya if I could. We're only on call 1400… And I still sometimes complain. If I got paid better and could make progress on 2 or 3 things, I'd love my job.

    I should come ride with you some day.

  • Mmorsepfd

    The rescue gods must have been listening…just took an hour snooze! Weekends are rough, during weeknights things aren't too bad. Weekdays are ridiculously busy though.

  • http://twitter.com/AmbulanceJunkie Ambulance Junkie

    For years my agency held a no sleeping stance and Bout a yr ago my agency took part in a sleep deprivation study. Was suggested by our insurance provider and done by all providers online. Results showed the expected, we were deprived. The insurance actually helped change our private agencies stance. 8hr between shifts and naps allowed if needed. Though its expected to have all OSHA chores and peer Qa/Qi done. While returning from long transfers it common to advice dispatch of a power nap at a rest stop for 30-45min. It's unfortunate that the change took the insurance's promise of saving money for the agency but at least it occurred.

  • http://twitter.com/MedicDan Dan Pelzel

    I volunteer for a agency and they don’t mind us sleeping as long as the truck is clean and we respond when the tones go off. And as loud as those tones are, that’s not an issue. I work for a for-profit ambulance company that does transfers, dialysis, doc visits, discharges and so on. Well this company does not allow naps for day time crews. Infact one of the new supervisors will on his days off, drive around in his pov to catch crews sleeping and threatens to fire if your caught sleeping. Night crews can sleep, but day crews are not sleep for any reason. This is also the supervisor who has been quoted saying, “EMT-B stands for empty my trash bitch.”

  • Scott

    Morons….sleep dep KILLS PEOPLE, both those not getting the sleep and the patients they kill doing dumb things. You sleep whenever you get the chance…any “management” telling you otherwise needs to be gotten rid of, quickly. Dinosaurs have to be culled from the ranks…they are stupid and dangerous and if you are one of those, spend less time replying to this post and more time looking for a new job. Its not tough, its not cool, its not “the way we’ve always done it”, its moronic, period, end of story. If you are working sleep deprived you are irresponsible, bills to be paid not withstanding…your bills are more important than somebody else’s life? Why the hell did you get in EMS to begin with?

    Take naps….they save lives. 24s and 48s work fine once people realize that your body needs a little sleep to function.

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Chris Kaiser aka "Ckemtp"

I am a paramedic trying to advance the idea that the Emergency Medical Services can be made into the profession that we all want it, need it, and know it deserves to be.

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  • Comments
    mr618
    Welcome to the Club
    Well said, Chris. We can't save everybody, but the ones we don't save tend to stick around a lot longer than the ones we do save.
    2014-10-18 14:40:00
    Steel City Medic
    Welcome to the Club
    Particularly appropriate for me this week. Thanks.
    2014-09-23 21:46:00
    DiverMedic
    Welcome to the Club
    Very well done, Chris.
    2014-09-17 22:15:00
    DiverMedic
    My Blogroll
    One of these days you'll figure out where my blog is... :)
    2014-09-17 22:11:00
    emtterri123
    Six Tricks You Can Use Today to Improve Your EMS Narrative Report
    The first and best way to get people reading you to think that you are an idiot is to pepper your writing with spelling and grammatical errors. It makes you look dumb. - Me thinks this should have been restructured as it does not flow and caused me to reread it several times. lol :)
    2014-09-17 08:27:00

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