Rest Breaks

A couple of people asked me in the comments about having only one cup of tea during the shift. This desire for tea is not limited to the ambulance service (See the recent post from the excellent Inspector Gadget).

Here is how it works…

Due to the European Working Time Directive us ambulance people have, under law, the entitlement for a marked out 'rest break'.

Except that sometimes we don't.

Sticking to twelve hour shifts, because otherwise it gets complicated, we should have one forty-five minute rest break. Thirty minutes of this break is unpaid and is uninterruptible. The final fifteen minutes can be interrupted, and if it is interrupted then we get £10 compensation.

We should only get interrupted for 'life-threatening' calls.

We must be given our rest break in a 'window' stretching from four hours into our shift and the break must be completed two hours before the end of the shift.

Now the interesting thing about all this, and the bit that I don't understand, is that all this is kind of optional.

On many shifts we don't get a break, and so are allowed to go home half an hour early (and claim £10). This means that we are working for eleven and a half hours without a break. On a busy day this means that the opportunities for a cup of tea are limited. It might also mean that the LAS is breaking the law – but this is just my layman view.

Why don't we get a break? Because it's too busy, because people want ambulances for the tiniest little thing and because there just aren't enough ambulances on the road to cope.

This is further complicated in that many ambulance people don't want to have a break – an extra £10 a shift makes a fair bit of difference to our pay packet and you can come out an extra £150-200 better off at the end of a month because of it. So you will find some crews trying to avoid being put on a break.

Things are made even more complicated when the Press suddenly realised that us ambulance people require the odd cup of tea and so the newspapers were rife with 'My Mum Died While Paramedics Drank Tea' type stories. One is even mentioned in the recent Trust Report where the reporter seemed to think that a broken down ambulance is 'on a break'. I went into this aspect of having a rest break in more detail previously.

But all this wouldn't matter except that technology has stuffed up your ambulance crew on the street.

It used to be said that if you couldn't find a cup of tea or a bite to eat then you weren't much of an ambulance crew. Hospitals have kettles, there are lots of chips shops in London and if you are desperate then you could even risk the hospital canteen.

However, with satellite tracking and an increasing number of calls (without an increasing number of ambulances), there is more pressure to make ready at hospital after dropping off a patient. Where we may have had time for a quick brew from the nurse's staffroom we are now receiving terse messages from Control asking what the delay is.

Not that I think these messages come from our Dispatchers – I always imagine some officer with epaulettes wide enough to hold all that 'scrambled egg' wandering around with a cup of tea, looking over the Dispatcher's shoulders pointedly asking why a crew is spending longer than half an hour at hospital…

Likewise, the location tracking on our vehicles means that we can no longer sneak down to 'George's chip shop' for saveloy and chips without being asked to 'update your status and location'.

(And people wonder why ambulance staff are often fat and die young…)

So we end up without breaks, or risk being disciplined for sneaking off for a drink and a bite to eat. This is why we like the dirty or bleeding patient, it means we have to return to station to clean out the ambulance and this gives us a chance for a cup of tea. It's why an incompetent assault that requires paperwork to be filled in is almost something to look forward to.

It's also why, when someone misses the vomit bowl and pukes all over the floor of the ambulance, I can honestly tell them not to worry about it with a big smile on my face.

16 thoughts on “Rest Breaks”

  1. Is it ever tempting to make a deal with a 'frequent flyer' that you won't tell them off for calling an ambulance they don't need as long as they've put the kettle on before phoning?Or perhaps on a more serious level, get a proper teapot and a tea cosy for it to have at the station. Stays within the drinkable-temperature-range for ages, that does, and everyone can pour a cup, swig it, and top up the tealeaves/water as needed within a two-minute window.

  2. So you have not had the joy yet of your 'individual performance' letter?Our complex has….. Its a load of collated times from the past 8months like Time at hospital, job cycle, how quick going amber to scene, on scene duration yada yada…. Im not sure if the times have been collected from EOC or PRFs.

    Anyway i've been told now this is 'live' we can potentially be run for our times at hospital- how crap is that?! And it will be included in our PDRs so if you have a bad average and dont improve it will be picked up on! Grrr to Big Brother syndrome.

  3. That's assuming you haven't had a memo (generally ignored coff coff) saying that you must not be seen eating or drinking on the ambulance or indeed carry any food or drink on the ambulance! We have no scheduled half hour break in a twelve hour shift and if you have had half an hour on station after 11.30 you are deemed to have had your meal break. That said comms are pretty good about trying to make sure we have what they discreetly call a 10:80, even if it isn't till 4.30pm after a 7.00am start.

    I'd better not say what service this is for (in case THEY are watching) but I live in New Zealand where there are only two main ambulance service providers….

  4. THIS is why God invented the humble Thermos (R) flask. Not quite as good as a freshly brewed cuppa, but something warm and wet can often be just the ticket.Now, of course you'll need a cup with a lid so you don't spill it all as your crewmate careens around London with the blues on…..

  5. My fiance is TS'ing at the moment, and in the last 3 weeks he has yet to have a rest break or go home early.. actually he has yet to go home on time!… and his shifts have been anywhere from 8-12 hours long. Sounds like he should get used to it and I should get used to lot of grumpy, tired grumblings!

  6. I work for a different trust. Just to further illustrate this point, here was my day today:5:45 am Woke, shower, dress. Slice of toast.

    6:30 am Arrive on station for 7am shift. Cup of tea

    6:45 am Book on for 7am shift. Inform control we are commencing our vehicle check

    6:47 am Job comes in, for 67yof with breathing difficulties. We leave immediately informing control we have not completed our vehicle check.

    After this we bounced from job to job. At the end of each one we informed control we had not yet fully checked our vehicle and each time they confirmed they had noted it but there was no one else available.

    Our meal break window was from 11:30 to 15:30 and we were informed on 3 occasions after greening up from jobs at the hospital to return to base for our meal break (and our vehicle check), but never actually got there. Control were very apologetic, but these were red calls and needed a crew. “No” is not an option in our trust, whether you've had your break or not.

    At 16:15 we arrived at hospital with a patient having had neither food or drunk for 10 hours and had been on shift, without a break for over 9. Having handed over the patient, settled the relatives and completed my paperwork I sprinted to the hospital shop to get a nutrigrain bar whilst my crewmate returned the trolley to the vehicle and tidied up. We greened up just within the 20 minute slot we are permitted to be at hospital for and were immediately dispatched to our next job.

    We remained busy and off station until 18:30 when we finally landed back on station for what was now a protected meal break. There was another crew on station so we were really in with a chance of pulling it off …………..until of course at 18:34 an RTC interrupted our reverie and sent both crews off station. A 'protected' meal break is not protected from a red call.

    We arrived on scene at 18:50 and left with our patient long boarded at 19:08.

    Here's the best bit. Now they've downgraded the hospital which is just 7 minutes from the scene of this particular accident, we have a 35 minute drive to the receiving hospital……..in the wrong direction. We arrived at the hospital at 19:40 (a good run) and had to remain to assist A&E staff whilst the patient was assessed because they were spinal, and finally cleared the hospital at 20:15.

    We got back on station at 21:00hrs, cleaned and restocked the vehicle, locked away the drugs and left.

    I am now home, having completed a 14 hour shift, lifting, carrying, supporting, reassuring and treating patients on 1 nutrigrain bar and a cup of tea, hungry, but far far too tired to eat. I'm due on again for a 12 hour shift in 8 and a half hours.

    Granted this isn't a typical day, but it's by no means a rarity either. Oh, and in case you're wondering, we never got to complete our vehicle check. As luck would have it we had everything we needed.

    G'night!

  7. I have the same problem. I remember sometimes doing on calls where I'd not eaten or drunk for 14-15 hours, or more… regularly I don't eat or drink for 8 or 9 hours. I have got very good at eating in traffic jams, and trying to remember to take a bottle of water with me (and hoping someone offers me a cup of tea along the way).

  8. Yep, they're breaking the law. Under the Road Traffic regulations recently put in place, you're required to take an UNINTERRUPTED 30 minute break before or at the 6 hour point in your shift, and if your shift goes on over 12 hours, again at that point. I drive trucks for a living, and these rules are a pain in the neck.And by that law, you can refuse to answer the radio for that 30 minutes, since you're not supposed to undertake work related activities during your break, and are also legally required to be able to “freely dispose of your time”.

    I had a transport manager whine at me for being 45 mins late at a drop. He said I should have taken my break at the previous drop. I told him that being forced to sit in a cold, drafty waiting room on an uncomfortable chair was no break in my book. Stupid H&S rules…

  9. Mental note: If the ambulance people are round our block of flats for the drunken couple on the bottom floor, offer them some tea and toast.

  10. I'd kill to be a paramedic, but this is why I'm currently not going after it. I don't think I could handle a 14 hour shift, sleep and then another shift.How many 12 hours shifts do you work in a week?

    Just wondering as well – with the story in the papers a couple weeks ago about an ambulance transporting a heart for transplant that broke down. The crew flagged down a car and took the heart in that way with a police escort. Would the paramedic/technician driving the ambulance drive the car? I presume they couldn't drive above the speed limit until the escort arrived. Just an odd question I had…

  11. We work four 12 hour shifts in a row before we have a rest day, these may be days or nights, and as you have seen, these are usually closer to 13 or 14 hours shifts. When you are on a run of shifts like this you don't plan anything at all in your life, or agree to anything as we inevitably end up letting people down. We have absolutely no control over what time we get off; it is entirely out of our control.This is why the divorce rate amongst ambulance staff is so high. It's hard to have a life.

    If you would really kill to be a paramedic, then do it. It's the best and worst job in the world but I'd not do anything else…….knackered knees, battered back, scrapped social life, screwed up sleep pattern and all!!

  12. I need to wait a year or so to do my C + D driving license (ruddy scottish ambulance service!) so I have plenty of time to ponder. Still got a uni degree to finish so I'll bide my time and think it over.So have I got it right thinking its 4 days on, rest day, 4 days on and so on?

  13. If it's an Agenda for Change contract then it's a 37.5 hour week, on average. I work an 11-week pattern: most of it is two 12-hour days, two 12-hour nights then five days off. Two of the weeks that don't conform are 48-hour “relief” duties (can be any combination of shifts at a number of stations, filling in for annual leave, etc.) and one of the other weeks includes an 8-hour relief day. The days and nights are long, but the days off more than compensate, IMHO.

  14. Well I never thought I'd see the day that our trust was better in any respect than any other..!We have a thirty minute break which you have between the third and fifth hour of your 12 hour shift.. you have the choice to be available during the break for which if you say “yes” you get 5.. Control can only disturb the break for Catagory A calls.. for which you get an extra 20..! If you have your break disturbed before 20 minutes you get to go back and have a 30 minutes UNDISTURBED break… after 20 minutes you lose the rest.. IF you haven't had a break by the 5th hour, you get to go back to station UNAVAILABLE for any call whatsoever.. then have 30 undisturbed minutes. Our station being rural in nature we get dragged into the city where usually we get used and abused for 5 hours.. but then we drive back to station at the speed limits through the lunchtime traffic which can take an hour, so one and a half hours away from the dross.. most of the time it's straight back out.

    The second ” rest period” however is 20 minutes between the 7th and 9th hours for which you don't get stood down for, you don't have to go back to station for and can be disturbed for any emergency call and you don't get any time owing.. invariably we don't get the second break.. and sometimes if we're still on station at 10am they'll put us on break and half hour later we'll be out for the rest of the shift, without stopping.

    All credit to the rest of you.. especially Tom and AmbuSam, there would be a revolt down here if your break policies were in action here..! They must be breaking Employment Law and I'd recommend you speak to the Unions..

    One last thing.. Ambusam.. why did you go out 15 minutes before the start of your shift..? Were you covering the night crew or can they make you go out early..? If covering others then ok, otherwise screw that..!

  15. Hi Sleepyhollow.Yes, we were covering the night crew, and no, they can't make us go out early, although control regularly try!!

    Madmeg. I am speechless by your comments. No breaks and no food. Does your employer not get tired of having to inform their staff's relatives that ANOTHER of their crews has collapsed with either low blood sugar or dehydration. No food or drink on the vehicle…..that was a decision CLEARLY made by a management team who's spent years at the sharp end wasn't it??

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