The Hours

How many shifts are we really working?


Jon Studnek, MS, NREMT-PAntonio R. Fernandez, BS, NREMT-P | | Friday, November 14, 2008

We're happy to be back after a few months off to collect new data and brainstorm new myths. So let's start this series off with a bang. (OK, maybe more like one hand clapping.) During our brief time off, we noticed a common topic coming up in workforce discussions.EMS as a profession seems to have many individuals working many hours. Whether they're career providers working overtime or volunteers helping cover shifts, there's a feeling that we may be overworking.

Myth: The majority of us are working too many hours a week.

What We Know

We looked to an old friend of ours, the LEADS project. LEADS is a yearly survey of nationally registered EMT-Bs and paramedics. As luck would have it, questions were included on the 2006 LEADS survey asking participants to report their average shift length and the number of shifts they had worked in the past four weeks.

There were 1,642EMS professionals who returned a LEADS survey in 2006, and of those, 1,290 were nice enough to answer all of the questions we needed for this analysis. LEADS participants were presented with six shift-length options (8 hours, 10 hours, 12 hours, 24 hours, ˙Other,Ó and ˙I don't work shiftsÓ) and were asked to choose the one that most closely resembled their shift length.

Table 1shows that the 24-hour shift at 44.7% was the most common shift length reported. Participants were asked to choose from nine options regarding the number of shifts worked in the past four weeks. This data is presented inTable 2, and as you can see, about one-third ofEMS professionals work nine to 12 shifts per month. However, we also see that about one-third ofEMS professionals are working 13 or more shifts per month.

So what do these figures tell us? They give us an idea of how oftenEMS providers are working, but it doesn't directly answer our question. Perhaps we can combine these two survey questions together and get something more useful. Let's do some math. (Hold back the excited cheers.)

By using shift length and the number of shifts worked, we can calculate the average number of hours an individual worked in the past four weeks. To do this, you have to assume that each individual worked the median number of shifts; for example, an individual who said they worked nine to 12 shifts was assigned the median of 10.5 shifts every four weeks. If we divide the number we just calculated by four, you have the average number of hours worked per week per person. Granted this is a crude estimation, but it's better than nothing.

We found that on average LEADS participants reported working 49.9 hours per week, with 66.4% of participants working more than 40 hours per week. These estimates appear to be a little more informative than the figures shown above. However, we should still be careful not to jump to any conclusions before we dig a little deeper into the data.

Among this group of EMT-Bs and paramedics, 40.6% reported working for fire departments. We thought it would be interesting to look at shift length and shifts worked by the type of service an individual works for. This data is displayed inFigures1and2.

For simplicity's sake, we compared fire departments with all other service types. A clear majority of EMS providers in fire departments work 24-hour shifts, while those in other services are split between 12- and 24-hour shifts. Accordingly, more than half of those in fire departments work nine to 12 shifts per month, whereas for other services the number of shifts is more widely distributed. Interestingly, when we calculate out the number of hours worked, on average those in fire departments worked 58.1 hours per week compared with 46.3 hours per week for all other service types.

What We Still Don't Know

As always, we must be up front about the limitations. This is survey data from nationally registered EMT-Bs and paramedics; results from your localEMS agencies may vary. Also, we took two survey questions, mashed them together and came up with the average number of hours an individual works per week. Wouldn't it have been better to just ask how many hours people work per week? Maybe. Unfortunately, this survey wasn't designed to answer our particular question, so we had to be creative.

Did we answer the question of whether or notEMS providers are working too many hours a week? Probably not. Whether someone is working a lot is subjective; a lot of hours for one person may not be for another. However, we tried to set up this month's myth to help us explore various ways of analyzing data. Sometimes, it's not enough to just look at the answers to individual survey questions. If done appropriately, combining answers may help form a better picture and answer more complex questions.

Verdict: Plausible.Fifty-eight hours a week sure sounds like a lot, but heck, we could always use the time and a half.

Jon Studnek, MS, NREMT-P,is a research fellow for the National Registry of EMTs. He has been an EMT/paramedic for six years.

Antonio R. Fernandez, BS, NREMT-P,is a research fellow for the National Registry of EMTs. He's currently pursuing a master's degree in public health. Fernandez also has experience as a clinical assistant in a Level 1 trauma center as an EMT-B and a paramedic.

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