Stress Levels in EMS Personnel: A Longitudinal Study with Work‐schedule Modification

Abstract

Objective:To determine if stress levels of emergency medical services (EMS) personnel can be reduced by adjusting work schedules to personnel preferences. Methods:A prospective, longitudinal, cohort study with a work‐schedule modification intervention was performed. All EMS personnel employed by the City of Cleveland EMS were eligible for participation. EMS employees voluntarily completed an abbreviated medical personnel stress survey (MPSS‐R), a 20‐question validated stress‐assessment tool, in September 1989, February 1991, and September 1991. A new scheduling pattern was introduced March 1991. At that time, 27 EMS employees volunteered to work the new schedule (12 hours/shift: 3 days on/2 days off/2 days on/3 days off). The remaining 109 EMS employees remained on the old schedule (8 hours/shift: 6 days on/2 days off). Results:Mean MPSS‐R stress scores increased significantly from September 1990 (61.9 ± 7.87) to September 1991 (65.08± 7.23) (p < 0.05). In September 1991, mean stress scores of EMS personnel working the new schedule (64.39± 7.82) were not significantly lower than stress scores of EMS personnel working the old schedule (65.25 ± 7.10). Conclusion:Stress in EMS personnel increased despite a new schedule pattern designed to accommodate the preferences of EMS personnel.

Why do Emergency Medical Services (EMS) Professionals Leave EMS?

“…Cydulka et al 17 found that 89% of EMT-Paramedics reported that their job was stressful and were psychologically worn out, or exhausted. Research indicates that the emotional labor (surface acting and deep acting) involved in being an EMS professional can play a role in such exhaustion.…”

"A hard day's night?" The effects of Compressed Working Week interventions on the health and work-life balance of shift workers: a systematic review

“…The majority of health outcomes, and all WLB ones, were self-reported. In a sizeable number of the CWW studies, the intervention was either at the behest of the work force,34 – 36 41 47 49 60 69 70 83 or from the management (with a stated desire to improve health or WLB) 37 50 62 – 64 66 71 74 79 80 82. However, in other studies, the motivation was more obviously efficiency or productivity 46 48 51 53 54 59 61 67 77 78 81.…”

“…The effects of the CWW interventions on health outcomes were not conclusive: a number of studies reported some improvements in workforce health,34 – 38 42 – 45 47 – 50 52 54 56 – 60 62 – 65 67 68 72 – 74 78 – 83 whilst others found no change,39 40 46 53 55 66 69 – 71 75 76 77 and two found only negative effects 41 51…”

“…A number of smaller studies of varying methodological quality and sample size reported no changes in any of the health indicators 40 46 53 55 66. Other studies were more conclusive, finding significant improvements in sleep duration,42 absence,47 physiological distress, fatigue and stress,48 sleep between shifts, sleep difficulties, and health disorders 60.…”

“…Generally, the studies suggested that the organisational effects of the CWW were small or absent with most studies finding no evidence of either benefit or detriment 34 – 37 42 47 49 52 54 65 66 68 78…”