legal ramifications

[crotchitymedic1986]

You can live off of one EMS salary (as long as you arent EMTB), you choose not to live within your budget.

[VentMedic]

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

A few states have extended their immunity clause to non governmental EMS agencies and a couple are written under their Good Sam laws. There have been a few changes in some EMS laws since 9/11.

However, the immunity statutes that exist for FDs in just about every area are probably very attractive to some Paramedics and a good reason to go with Fire and not a private EMS. Some states also extend their workmen's comp to off duty FF/EMS if injured performing in a similar capacity as their job description.

Some health professionals prefer not to or are discouraged from volunteering on ambulances on their off duty hours unless they have 8 hours between shifts either volunteer or paid. While the Good Sam law will cover them for healthcare in good faith at the volunteer job, it will not protect them and and be used against them at their paid healthcare profession. We are required to disclose any and all sources of other employment to the hospital. While they may not always restrict your employment elsewhere, they can restrict you from OT and monitor special requests or sick time more closely.

The other thing to consider is liability after you finish your shift and cause an MVC on your way home from work. There are several case precedents concerning that situation.

There were also at least two deaths last year caused by the EMS provider falling asleep while driving the ambulance. One was a volunteer.

So, it really doesn't matter if you are a volunteer or paid when it comes to the legalities that can stem from your actions or the very real consequences. The only difference will be if the patient or bystander or other motor vehicle operators/passengers can receive monetary compensation from you or your company.

Night shift workers at the hospitals have their own jokes about EMS providers that do 24 hours shifts. Often the expectation of quality is not there.

"Not alive after 5 (AM)" usually refers to both the providers and the patient.

It doesn't take a rocket scientist to figure out more IVs are missed or not even attempted after 16 hours on duty. The same goes for ETIs.

It is often as sad as it is funny to see the shape some providers are in when they bring patients to the ED after 23 hours on or after crawling out of bed from a dead sleep. Not the example of professional providers one would want to portray in broad daylight either from crews that work too many hours.

[cynical_as_hell]

My company doesn't care if you are tired or not. Currently we are doing 24hr shifts, getting ready to go to 48's beginning of the year. A typical day for us is 30-35 calls with only 3 crews. We stay pretty busy. And then all the late night transfers come in and everyone is too tired to take them because we haven't had any rest. When we say something to our supervisors, they come back with " So are you telling me that you are not going to take this transfer?" So we always end up taking it because if we don't then we will get fired for what they say is refusing to do our job. Most of our transfers are to Las Vegas, so it isn't so bad. But the ones that are the hardest are the midnight transfers to Phoenix. Our company doesn't care that we are tired. All they want are the dollars, regardless of risks.

[Arizonaffcep]

My company doesn't care if you are tired or not. Currently we are doing 24hr shifts, getting ready to go to 48's beginning of the year. A typical day for us is 30-35 calls with only 3 crews. We stay pretty busy. And then all the late night transfers come in and everyone is too tired to take them because we haven't had any rest. When we say something to our supervisors, they come back with " So are you telling me that you are not going to take this transfer?" So we always end up taking it because if we don't then we will get fired for what they say is refusing to do our job. Most of our transfers are to Las Vegas, so it isn't so bad. But the ones that are the hardest are the midnight transfers to Phoenix. Our company doesn't care that we are tired. All they want are the dollars, regardless of risks.

Seems to be a fairly common thought in Private EMS in AZ.

[crotchitymedic1986]

You only have to go to 48s if you chose too. You guys can stick together, resign all on the same day and get it reversed if management will not listen to you. You should bust up one of your 24 hours into two 12 hour shifts (can use the 6 that are on it now, and add 2 part-timers or people on OT to cover the extra shifts) . Then the night 12hour shift can run those long ones.

[VentMedic]

Many in EMS only prefer the 24 or 48 hour shifts and EMS may not be that attractive to some if the shifts were 8 or 12 hours. Although, many of those are very young and/or work in slow stations. The companies that are busier may still try to accomondate those preferences to keep attracting people even though the turnover might be higher. The companies are essentially caught in the middle and will get whiners either way. Even those that complain of how tired they are may be reluctant to go to 12 hour shifts if given the option tomorrow.

[reaper]

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."

I would hope that you would realize this, before going on a call.

The biggest difference is how you let your service treat you! If I am to exhausted or too sick to work, then I will pull myself off the street. Supervisors do not have a say in it. I have no problem walking out the door, I can find another job! The only time I wait is if I am in the middle of a call. As soon as it is over, I go out of service.

There is a demand out there for personnel. I can go any where and get a job. I do not let a service dictate my Pt's or my own safety.

You screw up on a call because you are tired, it is your arse on the line. You will lose your license and a lot more. I take my safety and my certs, seriously. I would hope others do to! :wink:

[Just Plain Ruff]

I would hope that you would realize this, before going on a call.

The biggest difference is how you let your service treat you! If I am to exhausted or too sick to work, then I will pull myself off the street. Supervisors do not have a say in it. I have no problem walking out the door, I can find another job! The only time I wait is if I am in the middle of a call. As soon as it is over, I go out of service.

There is a demand out there for personnel. I can go any where and get a job. I do not let a service dictate my Pt's or my own safety.

You screw up on a call because you are tired, it is your arse on the line. You will lose your license and a lot more. I take my safety and my certs, seriously. I would hope others do to! :wink:

I'm going to agree right there. If you are too tired to take a call then don't take it. IF a mistake is made and it's a sentinal event (in the hosp) or a injury or illness (fatal) to the patient then you must take the blame. No matter what blame you can lay on the company. I have taken myself off only 3 times in my career and all three were justified and no questions asked because I worked for a good company but those who work for these other companies listed that don't seem to care about their people being tired, I feel for you.

I spent too many hours and days and too much blood sweat and tears to get it yanked because I was too tired to pull myself off shift and a patient died or suffered, it is my fault.

I work night shift, 7p-7a and I routinely work with people who spent all day up the day before, they worked the night shift, then spent the day awake because they had stuff to do and now they are taking patients with 36 hours of no-sleep. This is a disaster waiting to happen. Case in point

About 16 years ago I had a medic co-worker. He had worked a night shift, then got called in the next day to run a transfer. He then worked that night. At around 4:30 am he had to start an IV. He did. He was told to infuse a liter of saline with 40Meq's of KCL(potassium chloride). He put the liter to run and then drew up 40meq's of KCL. He was going over to inject the KCL in the iV Line via IV Push. I saw him going over and asked him to come help me NOW. He did. I asked him what he was doing with the syringe and he said he was going to give it IV. I pointed out that it needed to go in the bag and not the IV for PUsh. He then sat down and nearly cried. Had he have given the med the way he planned we'd have had a death in the ER.

He told me he was so tired that he wasn't thnking straight. He took himself off shift and went to one of the empty ER rooms and fell asleep.

This is just one example of sleep induced errors that I know of.

[Richard B the EMT]

Going back to the Good Sam laws: If memory serves me correctly, Good Sam only happens when the person rendering aid, to the level of training, performs the aid with no expectation of financial or other type of payback.

[cynical_as_hell]

You only have to go to 48s if you chose too. You guys can stick together, resign all on the same day and get it reversed if management will not listen to you. You should bust up one of your 24 hours into two 12 hour shifts (can use the 6 that are on it now, and add 2 part-timers or people on OT to cover the extra shifts) . Then the night 12hour shift can run those long ones.

Upper management put it to a vote stating that "majority rules" so we were told that we had a say in it. I beg to differ though. I think that regardless of what people voted, they were going to change to 48s because it will once again cut down on all the overtime they pay. In AZ its a right to work state, so if we were to all resign then they would just replace us and show us to the door. It sucks being owned by cooperate now because they will just replace you as soon as you leave. Now the challenge that myself and my coworkers are facing is the reality that to the company, we are just another warm body to run the calls and bring in the money. My thought has always been that AMR is the WalMart of EMS.