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Effect of shift length on paramedic anxiety

02 May 2023
Volume 15 · Issue 5



Paramedics frequently experience extremely stressful situations. A combination of the unknown, long shifts and witnessing human distress and tragedy can have lasting effects on the psyche of these individuals. The purpose of this study was to determine if there was a difference between anxiety levels experienced by paramedics who work 12-hour shifts and those working 24-hour shifts. It was hypothesised that those required to work longer shifts would experience higher levels of anxiety.


This survey research study measured anxiety experienced by paramedic practitioners (n=78) at three local emergency medical services using the Beck Anxiety Inventory. A binary logistical regression analysis was used to determine whether any results met criteria for significance and to determine the odds ratio for categories that did reach significance.


Paramedics who worked 24-hour shifts were significantly more likely to experience moderate-to-severe anxiety than those working 12-hour shifts (P=0.042; OR 0.002). Age affects the likelihood that participants experienced moderate-to-severe anxiety (P=0.028; OR=0.594); as age increases, the likelihood of experiencing moderate-to-severe anxiety decreases significantly.


Paramedics who worked 24-hour shifts were significantly more likely to experience moderate-to-severe anxiety than those working 12-hour shifts. Age also affects whether paramedics experience moderate-to-severe anxiety; the older the individual, the better able they are at moderating their anxiety. Emergency medical service administrators are encouraged to reconsider the use of 24-hour shifts. If not already in place, strategies should be developed to assist paramedics and other prehospital care practitioners to recognise and address anxiety and other mental health disorders.

When an individual contacts 911 because of a medical emergency, he or she expects to receive an ambulance staffed with highly trained, professional prehospital practitioners. These health professionals should arrive quickly then rapidly, safely and efficiently transport the patient to the emergency department and/or provide treatment and care on the scene.

As prehospital providers, paramedics continually face unexpected situations and are exposed to some of the worst situations imaginable. They also work long shifts, often ranging from 12–24 hours at a time in parts of the United States and potentially even longer shifts internationally (Pacheco, 2023).

A combination of encountering unexpected situations, long shifts and witnessing human distress and tragedy can have lasting effects on the psyche of these health professionals.

Numerous studies have addressed the physical effects of 24-hour shifts in emergency medical services (EMS) on paramedics; however, there is limited research focused on their mental health regarding anxiety. The purpose of this study was to examine and compare anxiety levels in paramedics who work 12-hour shifts with those working 24-hour shifts.

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