legal ramifications

[Just Plain Ruff]

I've been doing some thinking and everyone knows where that get's me

What are the legal ramifications of working without sleep for over 24 hours?

What I'm asking is this

If you are working on a 24 hour shift and you have no ability to sleep based on call volume and you make a mistake, costing a patient their life, who is responsible?

Are you the employee wholly responsible?

Is your employer responsible in part?

These are the types of questions I come up with at 3:10 am sitting in my living room watching the Rape of Europa(the looting of Europes great art during WWII)

[AnthonyM83]

I've always thought that work schedule is ridiculous unless you work a slow station.

As far as driving, I believe it's mainly operator's responsibility to say he's too tired and ambulance owner's responsibility to make sure fatigued drivers aren't made to drive. (So driver has to speak up first.)

As far as medical provider error, I can't see it being blamed mostly on the medical provider if it was obviously caused by fatigue (which you'll have to prove in court). If it's an industry standard, I guess it'll go back to..ummm...? the employer? The EMS agency? Or maybe they'll try to say since it's industry standard, it's responsibility of provider to be able to handle such a farked up sleep schedule?

I went to sleep too early and woke up after a few hours...so I'm up too thinking of random stuff and studying.

[reaper]

Try it working 36hrs without sleep! :wink:

I think some can handle it and some can't. I would say it is up to you as a provider to know when you have reached the point of exhaustion and speak up about it.

If you knowingly provide substandard care, when you know that you are beyond a point of being totally exhausted. Then you should take some of the blame for the outcome.

A lot of states that I have worked, put a 36hr cap on continuous hrs worked.

[Arizonaffcep]

Try it working 36hrs without sleep! :wink:

I think some can handle it and some can't. I would say it is up to you as a provider to know when you have reached the point of exhaustion and speak up about it.

If you knowingly provide substandard care, when you know that you are beyond a point of being totally exhausted. Then you should take some of the blame for the outcome.

A lot of states that I have worked, put a 36hr cap on continuous hrs worked.

Thats only erffective when your company will listen to you. Most where I work would say something like..."Too bad. You're on a call."

[AnthonyM83]

We can do 72's here and FD medics can do . . . well most I've heard of is 5 days straight, but they tend to get more sleep than us.

[VentMedic]

When one of our doctors in residency makes a mistake, the first thing risk managers and hospital attorneys now ask is how long they have been on shift. The same goes for any of the other licensed staff. If an RT is involved in a sentinel event even if it is equipment failure, their timesheets are requested. That can also mean any timesheets from other employers.

There are still many that view 12 hour shift as too long for licensed hospital staff and use that to fight for 8 hour shift. There is now even debate in Law Enforcement as to whether 12 hours shift are safe since the LEO in CA ran over 3 bicyclists, killing 2 of them. However, when the San Antonio Fire Medics got heat for making a mistake at scene, they used the excuse that it was their 23 hour of work and that was okay. No further mention has been made again about the number of hours.

Other employers of medical professionals that are wage, and not salaried, are severely scrutinized if the number of hours an employee works is unsafe. And, that is not necessarily a union thing. Unions could care less about the number of hours worked as evidenced by FDs. SFFD got some scrutiny from the public when it became known some of the type FF wage earners were working many days straight but the union justified the hours as not being a public safety issue since they spent most of the time sleeping.

As long as EMS is identified with Fire, there won't be any change in safety for the employee or the public. Many still rely on governmental immunity or protection from the Good Sam portion of the statutes for EMS workers to get them out of many serious blunders.

[Arizonaffcep]

When one of our doctors in residency makes a mistake, the first thing risk managers and hospital attorneys now ask is how long they have been on shift. The same goes for any of the other licensed staff. If an RT is involved in a sentinel event even if it is equipment failure, their timesheets are requested. That can also mean any timesheets from other employers.

There are still many that view 12 hour shift as too long for licensed hospital staff and use that to fight for 8 hour shift. There is now even debate in Law Enforcement as to whether 12 hours shift are safe since the LEO in CA ran over 3 bicyclists, killing 2 of them. However, when the San Antonio Fire Medics got heat for making a mistake at scene, they used the excuse that it was their 23 hour of work and that was okay. No further mention has been made again about the number of hours.

Other employers of medical professionals that are wage, and not salaried, are severely scrutinized if the number of hours an employee works is unsafe. And, that is not necessarily a union thing. Unions could care less about the number of hours worked as evidenced by FDs. SFFD got some scrutiny from the public when it became known some of the type FF wage earners were working many days straight but the union justified the hours as not being a public safety issue since they spent most of the time sleeping.

As long as EMS is identified with Fire, there won't be any change in safety for the employee or the public. Many still rely on governmental immunity or protection from the Good Sam portion of the statutes for EMS workers to get them out of many serious blunders.

I was always under the impression that if you were on the clock, you weren't covered by Good Sam Laws.

[Freaknuggetz_chick]

i'm not certain of the legar stuff exactly here in alberta, but the rural areas i've worked have given me fresh drivers while making me continue work,..... although i'd been up just as long as my partner. i have taken myself off car once (we get 8 hrs) and have swapped drivers a few times, as well as having my partner drive cuz i just couldnt anymore. that is certainly one thing that sucks about rural, when it rains, it pours, and you usually dont get an umbrella.

[crotchitymedic1986]

To answer your question, everyone will be at fault --- we are fortunate that this has not become a bigger problem, probably because lawyers havent thought to look at total hours at work in a week's time (full-time and part-time). As mentioned above, many hospitals have changed their residency hours to something much more reasonable (it was nothing for them to be up 36-72 hours with little sleep).

[Laura Anne]

My full time organization frowns on shifts that are 24hrs. Its a very busy place and sleeping is NOT allowed. I think the NO sleep policy is dangerous, but if you're on the clock for only 12hrs, it shouldn't be a problem. One of my part time jobs allows up to 24hrs per shift, but no more. The part time gig is very slow and pays very well, so I don't have a problem being there for 24hrs...oh and they let you sleep, too! 8)

The REAL problem around my way is that everyone around here knows you can't just work 1 EMS job and live off that salary. I work 3 different places: 1 full time and 2 part time. I know a lot of people who schedule themselves back-to-back, therefore being up for over 18-36hrs straight!!! That would not be the organizations issue if legal ramifications came down due to a medical provider not sleeping enough. The individual did that to themselves.....

**RUFF: There's a book with the same title Rape of Europa, but not the same story line** good book!