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EMS, EMS 2.0

That is not a late run

A trend has spread through EMS that is causing a bit of a ruffling of panties in my neck of the woods. If the term ruffling of panties is upsetting to you relax, it’s accurate.

I hear a lot of “We got a late call” both in the yard and online as a reason folks dislike their shifts. Every shift seems to claim they are always held over because of a late call, that the next shift never has to hold over, it’s not fair, IT’S NOT FAIR! Then they jump up and down from foot to foot in a tantrum which causes the bunching panties mentioned earlier.

Complaining in EMS is remarkably easy. We apply anecdotal observations skewed by our own bias and apply it to everyday. Suddenly getting a call 35 minutes before the end of your shift is a late call and being sent to it is an affront to all things holy.

In response to just such a statement recently I was sucked into a common EMS Manager response that had me actually catching my words just before they left my mouth.

“Back in my day…” was how the sentence was going to start, but I was just able to catch it before I lost all credibility.

But then I stopped. It likely looked like a stroke, but the phrase was easy to say, yet lacked the true meaning I wanted to get across.

“You were closest, you got the job. You are assigned to the ambulance until 0300, not until 0230.” I went on to describe methods they could use to check the ambulance and plan their off duty chores in the 106 minutes they were on post prior to the “late call.”

I then told a war story about the call at 825, 25 minutes AFTER my sift was over and when I had been ordered by the Battalion Chief that I was not to leave my post until relieved. That the call ended up being a transport to Saint Farthest and that I didn’t return to the firehouse until close to 10 AM. They were unimpressed and still held on to the belief that they should get some wiggle room at the end of the shift to “wind down and restock.”

The film version of me delivers the speech far better than I do but the point gets across that we are on duty to answer calls for service and make bad days better. Sometimes that means we’re a little late getting home.

Sometimes we have to spend a few extra minutes doing this work that we have chosen, taking the time to do it right instead of half assing it just to race back and disappear, upset that we asked you for a little something extra. Especially when we’re paying you extra to do it.

A late call is a call that comes in AFTER your shift has ended folks, plain and simple. if you are due off duty at 0300 and dispatch gives you a code 3 call guess what? You have another chance to do something for someone who might need it. Be thankful it’s not the other way around.

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8 Comments

  1. Dave October 20, 2012 4:28 pm

    I find this interesting for a few reasons.

    First, this was a constant issue for me when I was on the road. Everyone pretty much understood that your “9-5” shift was really a “9-Whenever you weren’t needed anymore” shift. When I changed services, even though they had rules regarding being mandated for a late call (no more than 30 minutes past your off time) they still happened and happened frequently.

    Secondly, when I first went into management I had the very same reaction you did initially. This happened because that was the way it was, and that was that. After about a year, an EMT came to me with the same issue regarding being held over. His issue wasn’t the fact so much that he constantly was held over, it was the fact that this was a problem we knew happened and had done nothing to fix it. The truth is, he was right. Although there had been a number of issues we had fixed, they ultimately were the low hanging fruit and that had satisfued the management team.

    The fact is, as a manager, you should NEVER be satisfied if there is a perception of a problem, because ultimately perception is someone else’s reality.

    It took a lot of time, the application of some in depth System Status Management Principles to a slew of data (no, dynamic deployments was left out on purpose) along with some geo-spatial plotting and regressive mathematics, but we came up with a solution.

    I won’t lie and tell you everyone loved the solution, because they didn’t. It changed their lives DRAMATICALLY. Shift times, length, type, and placement all changed. There was a lot of pushback initially, but once it was implemented we saw three distinct benefits : 1) OT was significantly reduced 2) UHU was increased and most importantly 3) Hold Overs dropped 92%. Was the problem solved? Only for 92% of the time, which while not perfect, greatly improved the conditions in the field.

    The point I want to make is that, sometimes, while the gripes may just seem to be gripes and very well may just be gripes, sometimes there is merit in looking to solve the problem instead of just going along with it because that was the way it always was. Even if we had looked at the issue, and found nothing that could have been improved upon, at least we would have had better explanations when asked about it.

    • Justin October 21, 2012 7:18 am

      Excellent points Dave, thanks for contributing. Our big issue right now seems to be a reluctance to accept that running a .56 actual (excluding logistics and post changes) and getting a late call rather than the .55 actual and ducking the late call.
      Left out in the discussion above but was at my desk was the fact that because the call came in closest to the yard and dispatchers often rotate crews about to go off duty to that post. Skipping them on the run means not only a longer response for the next car, risking missing our response targets, but that someone else will miss their off duty time instead.

      Kelly makes some great points about CCT cars I can’t comment too much on, but sending a 4 hour round trip that could wait 20 minutes at the onset is a caller / call taker issue in my mind.

      Thanks Dave!

  2. BH October 20, 2012 4:28 pm

    You guys have anything along the lines of a “swing shift” like many PDs do, or is everyone that’s on the road on the same schedule?

  3. Ambulance Driver October 20, 2012 5:12 pm

    If the IRS knew how much EMT’s like to bitch, they’d declare it a taxable job benefit.

    My complaint is the “STAT transfer” that The Borg dispatches like an emergency. Problem is, the hospitals know that a “regular transfer” may hold two hours depending on system demands, so they call everything in as a STAT transfer.

    The result is that, once a week on average, I get a “late call” that goes out of town three hours before my shift ends, which causes me to get off work 4 and sometimes 5 hours late… when holding the call another 20 minutes would have had a brand-new, fresh CCT crew available to take it.

    • Justin October 21, 2012 7:29 am

      Not holding a CCT that can wait sounds like a GIGO problem. We have similar issues when hospitals call the local private contractor for a transfer, get an ETA of more than 10 seconds, then call us for a 911 transfer.
      Our crews race over expecting the worst only to find the patient isn’t even ready to go and they want us to wait.

      It’s happening less often since some guy started reporting them. 🙂

  4. Danny October 20, 2012 5:27 pm

    I’ve never minded late calls, but then again, I work in a system that has a pretty low call volume and doesn’t run transfers. What I hate are calls that happen right before I get on shift, since we do a rolling shift change (i.e, the outgoing crew picks people up and then the oncoming crew drops off the outgoing), and there’s nothing worse than seeing the crew roll down your street, then flip on their lights and just keep going, leaving you stuck there waiting for as long as the call takes.

  5. Jason N October 28, 2012 5:39 am

    I think that when you look at “late calls” you need to break it down, is it an emergency call or a transfer. No true professional would do more then some mild griping for a 911 call that will get you off an hour or so after your scheduled time. But, when you’re assinged a non emergent transfer <30 minutes before then end of your shift, that will sometimes hold you 1.5+ Hours over…..Well, that's just poor dispatching and even worse mangment for allowing it to happen.

    Late calls happen. Incompetent managment, is another.

  6. steve November 4, 2012 5:56 am

    The company I work for does transfers, discharges and nursing home emergencies. I recently started working ALS tours with a medic. We would often get posted at a STEMI post in between to hospitals to transport to a cardiac center. If there were no STEMIs all day you would get stuck on a late emergency that was probably a BLS run and we may not have been the closest truck to just so we didnt cost them as much money that day. Often these runs would result in nearly an hour of OT and the next medic crew getting out late

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