Paramedics’ shifts restructured while they are most in demand 

As San Franciscans swelter in a heat wave that threatens triple digits, The City’s paramedics are gearing up for a busy Pride weekend — even as they undergo a reconfiguration meant to reduce the length of shifts.

Hot weather and big events usually keep paramedics and firefighters busy because weather-related problems, such as dehydration and heat stroke, are multiplied by the extra visitors to The City, Emergency Medical Services Division Chief Pete Howes said. This weekend promises to be no exception, but the extra workload comes at a time when the department is changing the way it operates its ambulances.

In 1997, The City’s paramedics, who had been part of the Department of Public Health, merged into the Fire Department. They had been working 10- to 12-hour shifts, but schedules changed to 24-hour shifts because that is the standard Fire Department schedule.

Over the last nine years, Howes said, the department realized that longer shifts were creating a fatigue issue. A 2004 city controller’s report on the Fire Department found that 90 percent of the department’s calls for service are of a medical nature.

"Not only do the paramedics have to respond, but they have to work the patients up and bring them into the hospital. The fatigue was untenable," Howes said.

To solve the problem, the department has begun hiring more licensed paramedics, while simultaneously changing the way ambulances are dispatched.

Until the first class of new recruits went to work May 5, the department employed 250 paramedics. Over the course of the reconfiguration, set to be completed in spring of 2007, an additional 96 will be hired, Howes said.

In order to maximize the efficiency of the shorter-shift paramedics, the department is moving to a system that will rely heavily on "dynamic response units" — ambulances based out of a central location that move continuously through the 10-hour shift, responding to calls citywide. They will operate in concert with the station-based, or "static," paramedic units on 24-hour shifts, and are meant to reduce down-time while increasing response time.

During Thursday’s peak evening hours, the department had 16 static units and 8 dynamic units working, but Howes said the goal is to eventually have more dynamic units than static.

San Francisco Firefighters Association President John Hanley said the union is urging the department to grant overtime to the short-shift, or dynamic, paramedics.

"Those individuals should be given the opportunity to work overtime, thus lessening the workload on those 24-hour guys, who are getting hammered," he said.

amartin@examiner.com

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