“While my sleep patterns as a firefighter were pretty awful they got much worse as a chief. I hated the feeling of being abruptly awakened in the middle of the night and suddenly thrust into a situation where I had to make life-and-death decisions in the stressful confines of the fireground. I much preferred to stay awake most of the night to avoid the shock of that experience. Sometimes I would catch up on some administrative work and then spend my nights reading a book, watching television, or just lying down and monitoring the department radio.” FDNY Deputy Chief (ret) Thomas Dunne
This excerpt from “The Day After” in his memoir describes how Chief Dunne became absolutely sleep-deprived as rose through the ranks. Dunne’s did four things when operating under chronic sleep deprivation while on duty:
- Used a routine to complete tasks and respond to emergencies
- Stay caffeinated during the overnight stage
- Maintain awareness of what is happening on the street by monitoring the radio
- Do not deeply sleep while on-duty
EMS Fatigue Guidelines
Chief Dunne’s workload is a lot like an EMS crew working a 24-hour shift. The National Association of State EMS Officials (NASEMSO) partnered with the University of Pittsburgh School of Medicine to develop evidence-based guidelines. This graphic shows where they are in the process:
The evidence-based results included 5 recommendations:
Both fire commanders and ems caregivers have to make critical decisions with limited information and under severe time requirements. Exploring the documents available at NASEMSO’s page http://www.emsfatigue.com may provide some ideas to improve your performance.
When you hit the brick wall
Chief Dunne shared a problem that some of you will recognize:
The only time I would really hit the proverbial brick wall was when I had to produce some detailed administrative report after a particularly rough night. There were times when I actually nodded off at the keyboard of my office computer.
A great book
I have enjoyed reading Chief Dunne’s book. It provides a great panorama of the FDNY as described by someone who spent 33 years on the streets.
There is a lot of content that is valuable for the aspiring or rising company commander.
Like his fire conference presentations, the book is engaging and provides memorable stories and vivid details of big city firefighting.
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Dunne, Thomas (2020) Notes from the Fireground: Memoir of a New York Firefighter. Jefferson, NC: McFarland & Company. ISBN (print) 978-1-4766-7988-4. https://www.amazon.com/Notes-Fireground-Memoir-York-Firefighter/dp/1476679886/
P. Daniel Patterson, J. Stephen Higgins, Hans P. A. Van Dongen, Daniel J. Buysse, Ronald W. Thackery, Douglas F. Kupas, David S. Becker, Bradley E. Dean, George H. Lindbeck, Francis X. Guyette, Josef H. Penner, John M. Violanti, Eddy S. Lang & Christian Martin-Gill (2018) Evidence-Based Guidelines for Fatigue Risk Management in Emergency Medical Services, Prehospital Emergency Care, 22:sup1, 89-101, DOI: 10.1080/10903127.2017.1376137 Accessed March 8, 2020: https://www.tandfonline.com/doi/full/10.1080/10903127.2017.1376137