Fatigue has always been a major challenge for emergency medical services (EMS) workers, making it a concern for those they serve in emergencies and everyone sharing the road with EMS drivers. The fatigue issues have presumably deepened in recent months, particularly since one symptom of fatigue is a reduced ability to withstand other stressors.

Authorities on EMS worked with the National Highway Traffic Safety Administration to issue recommendations that, if followed, might lessen the hazards of EMS fatigue. The EMS workers and the public had little power to heed these suggestions aimed at organizations and their managers. Hopefully, they have implemented the suggestions in the two years since receiving them.

Coffee, tea or bad outcomes

Almost everybody says they cannot function without coffee, and if they do not say it, their coffee mug often does. Data may back them up. Caffeine’s ability to improve the performance of emergency workers has been studied and quantified well enough that the NHTSA panel urged EMS managers to do something about it. The NHTSA panel said managers should take positive steps to be sure caffeine is, and stays, easily available to EMS.

Management and workers both need sleep education

The work culture of EMS and other first responders may not be always tolerant of workers who need cat naps. But experts recommend that organizations and their managers get up to speed on the latest information and then bring EMS workers along for the education. Sleep, mental and physical health, work performance and public safety intertwine in the life of EMS workers. The panel suggests programs to become sleep-savvy.

Encourage falling asleep on the job

Experts say that there are times when a nap on company time needs tolerance and even encouragement. Napping is a tool for managing fatigue, maximizing performance, improving outcomes and preventing disasters. Do not, the panel recommends, deny permission, opportunities or means to cat nap.

A hard upper limit on shift duration

EMS commonly work shifts lasting 24 hours or more. Even where rules prohibit shifts longer than 12 hours, management has sometimes required workers to work two 12-hour shifts back to back. The panel pointed to the evidence and recommended no shifts longer than a maximum of 24 hours. The alternative may be greater danger for the public, people needing services and EMS workers themselves.

Seek out and listen to experiences of EMS workers

All organizations need good information to make good decisions. Without systematically finding out how the organization’s polices affect the real-world experiences of EMS workers, organizations should not assume their decisions are effective. The panel especially pointed out that surveying people to get information is as specialized a field as EMS itself. It said organizations should work with experts to develop an effective information-gathering strategy.