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Texas EMS staffing shortage causes shift change, forcing medics to sleep on cots during pilot program

In Fort Worth, rising EMS attrition has prompted the fire department to shift crews to a 24/48 schedule

FORT WORTH, Texas — Fort Worth’s interim fire chief is sounding the alarm over staffing shortages in the department’s ambulance division.

Speaking on March 3 at a City Council Public Safety Committee meeting, Interim Chief Raymond Hill said the department is losing EMS personnel at an accelerated rate, CBS News Texas reported.

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Hill said about seven EMS employees leave the department each month, pushing the attrition rate to 16%, well above the fire department’s historical average of 5%.

The department currently has 360 EMS personnel, short of its target staffing level of 449. Of those, 74 are in training or have recently graduated and are not yet ready to deploy, leaving 89 positions vacant.

Some Fort Worth council members say the city’s EMS staffing shortage is raising concerns about ambulance availability as new systems are rolled out.

Because of the staffing shortages, the department plans to launch a temporary pilot program that will shift EMS crews from 12-hour shifts to 24-hour shifts.

Currently, EMTs and paramedics work seven, 12-hour shifts over two weeks, three shifts one week and four the next, a schedule that requires at least four hours of mandatory overtime per employee. Beginning Saturday, the department will move to a three-month pilot of the 24/48 schedule, with crews working 24 hours on duty followed by 48 hours off.

Hill said the 24/48 schedule can improve work-life balance by giving EMS personnel more days off each month and noted the schedule is widely used across the country.

“The majority of our EMS providers are leaving for dual role positions in other agencies,” Hill said. “Some of the benefits are that you get more days off per month, an improved work-life balance, an easier commute management, and a shift desirability; 87% of the employees want to work that 24/48.”

The 24/48 model also has challenges, including the need for EMS staff to sleep at fire stations. Hill said the department still does not have enough beds in place, so crews will use cots until more beds arrive in about two months.

The department must also install privacy partitions in stations, particularly as a growing share of EMS staff are women who will be sharing facilities with firefighters.

Would switching from 12-hour shifts to a 24/48 schedule improve or worsen EMS retention at your agency?



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Bill Carey is the associate editor for FireRescue1.com and EMS1.com. A former Maryland volunteer firefighter, sergeant, and lieutenant, Bill has written for several fire service publications and platforms. His work on firefighter behavioral health garnered a 2014 Neal Award nomination. His ongoing research and writings about line-of-duty death data is frequently cited in articles, presentations, and trainings. Have a news tip? He can be reached at news@lexipol.com.