Recovery between Work Shifts among Emergency Medical Services Clinicians

Shift workers regularly report sleep problems, fatigue, and the need for recuperative rest between shifts (intershift recovery). We sought to characterize intershift recovery among emergency medical services (EMS) workers and the role of worker demographics and work-related factors.

We combined cross-sectional survey data from two studies of EMS shift workers who completed standardized instruments, including the Occupational Fatigue Exhaustion Recovery (OFER) scale. A multivariable regression identified demographic and work factors most strongly associated with intershift recovery.

Mean intershift recovery among 450 EMS workers varied by clinical setting, general health status, length of work shift, sleep quality score, fatigue score, and daytime sleepiness. Recovery was better for EMS workers who report greater satisfaction with their schedule, higher for shift schedules >12 hours, and lowest for individuals who usually work 12-hour shifts.

In this sample of EMS workers, greater recovery between shifts is associated with satisfaction with scheduling and longer shift length. There were weaker associations of recovery with health status, sleep quality, and workplace fatigue. Future studies should address the relationship of intershift recovery with time off between shifts, workload, and workplace safety and performance.