Posted by: medicblog999 | July 20, 2009

The late Job!!

paramedic saving lives squareOne of the things that is inevitable when you work for an emergency service (certainly in EMS) is the frequency of the late job!

If I am on shift from 0600 to 1800, you can almost guarantee that at least 50% of the time, a job will come in a 1745 or later which will result in me getting the aforementioned late finish.

This is all part of the job though, we all know it, we all accept it, and we all at times have a good moan about it.

The question I posed yesterday quickly got a number of responses, all stating that the standard of care doesn’t change when they get a late job. That was to be expected though.

Some may say that its only because no one would actually own up to dropping their level of care so that they can get a patient to a hospital quicker and get home as soon as possible. My theory on those that commented is that if you are either writing EMS blogs or reading them, you have a certain dedication or commitment to your profession which would suggest that you would be treating all patients the same way regardless of what time of shift it is.

Maybe though that isn’t the same for everyone.

I try to keep the attitude that I will finish when I am done. I tend not to think that I finish at a certain time, that way I wont be disappointed when it doesn’t happen. That doesn’t mean I don’t mutter the occasional swear word when we get caught 10 minutes before the end of shift on the way back to station, after all Im only human right? But by the time I am standing in front of the patient, its all smiles and courtesy again.

Its easy to keep up the professionalism when you are presented with a late job and the patient is acutely unwell and it is a ‘proper job’. The difficulty comes when the caller that makes you miss seeing your kids before they go to bed, is one of your inappropriate users of the emergency services. That is when you try and put the smile back on your face and keep your professionalism.

Its expected that we always treat our patients the same way, regardless of time of day or closeness to shift finishing time, and at the end of the day, is it really worth risking your job to get home 30 mins earlier.

I would find it interesting though if there were ever a study done on patient experience from ambulance services dependant on time of day that the call was made!

What do you think?

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Responses

  1. I have NO doubt that, globally, patient care and their experience is impacted by the “late job”. As EMS professionals this, to me, is the most trying of situations requiring a huge personal effort to overcome. Nobody likes getting off late and many of us have after-shift commitments such as child care, second job (gotta make that mortgage payment!) and sleep for pete’s sake because we’re back in in twelve!
    Personally I feel that dispatch and management do not make nearly the necessary effort to keep these calls to a minimum – it’s way too easy a fix, especially in so called “high-performance” systems, to send an off-going crew to cover what is basically a staffing problem and then relying on the crew’s professionalism to overcome their anger and frustration at a mostly preventable situation.
    “Abuse of crew” (I think I should patent that phrase – what do you think?) is a leading cause of burnout and low morale, causing a downward spiral of short-staffing, extended sick call-outs and has desperate long term effects on any system.
    Everyone expects the occasional late job – it’s where the occasion is the usual that the problems occur.

  2. Some crews feel it is their right and privelege to get out of work on time and do everything in their limited power to make it so. Decon, fuel, equipment failure; all at the end of shift. oddly, it is always the younger, single people who have the most important “plans” that cannot be interfered with.

    Some brilliant strategy goes on in the waning hour. I guess the theory is, no patient, no difference in patient care!

  3. Over in our service, as soon as we hit overtime, our hourly rates double. Sure, if you want to get home you still might ‘hurry up that little bit more’, but generally a lot of crews take it easy. Why not for that kind of money?
    that would be a great addition to that study – see what overtime rates are and how it affects treatment 🙂

  4. The late job is just one more aspect of what we do everyday. I work a lot of my shifts in a small outstation, the run to the nearest hospital is around 30 minutes on lights. Diffrent people you work with deal with this in diffrent ways, some will try and find alternative pathways to treatment, local GP, district nurse or even local cottage hospital where appropriate. Others just ‘load and go’ whatever the situation. Im still fairly new to the job so I still try and approach every job the same way, while others do change their approach. Contrary to the post above it’s usually the older guys who want to get a shift on while the younger ones tend to still have their enthusiasim intact.


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