James Geering: A Case for the 24/72 Shift Schedule (11/15/24)

All right, welcome everybody. It is Friday, 11:15. It is 11:00 Eastern Time. Another Florida EMS webinar, myself, Peter Antevi, and my co host, both Tanner Smeda and Dr. Paul Pepe today. It's a very exciting topic. I've been trying to get James on the webinar for quite a while. He's a busy guy. He is a firefighter, paramedic, he is an author. He just published his second book. But he's on a mission for helping the emotional well being for everyone who is on the front lines in the fire and EMS profession. And one of the big things he's tackling is whether or not we have the wrong shift schedule. And he's a big proponent for moving to the 2472. So obviously there's an agency in Broward county who just went to it. Palm beach county agencies are already there and more are moving to it. So without any further ado, James Gearing, Take it away, my friend. Thank you for joining us.

Yeah, thank you. Yeah. I'm not too good at presenting, so I kind of brought some notes from one episode that I did at behind the Shield, which I did answer, like, do a Q and A because I was getting the same questions over and over again. And the beautiful thing about this conversation is there is genuinely an answer for every question. So I think we'll start at the beginning. Like, why are we even having this conversation? As I've said to a lot of people, if the way that we were doing things up to this point worked, there would be no behind the Shield podcast. There would be no discussion on the 2472 because people will be thriving on a 56 hour sleepless work week. But that's not the case. We sadly are seeing issues in all of the areas. So, for example, if you look at cancer, we don't die of a specific cancer over and over again. We die of all the cancers. If you look at the impact on our relationships, it's. It's so sad. It should not be the case that just because you donned a certain uniform that the potential of your marriage breaking down, the potential either of sickness getting to your children, of genetic abnormalities being passed to your children, that should not be part and parcel of every career. The mental health side, you know, I would argue that a lot of our first responders are some of the most mentally and physically resilient members of a community. Yet we're taking our own lives in droves. We're dying. It's not been reported, but we all know that Kind of observational, five years after retirement. So we have a problem. And then to underline that, if you look at it recruitment wise, when I began being a firefighter, my very first department was Hialeah. And it was extremely competitive. And I think the reason why a lot of us got in higher Lear was just that the pay was. It wasn't even listed at the time. And then when we discovered what it was, it wasn't very high. Miami, I think, made almost double what we did. But the point is it was extremely competitive. And here we are now in 2024. And unless you're an anomaly in the fire service, I think Miami Dade, you know, because of the sheer magnitude, because of all the special.

Areas that they, that you can promote in and, you know, go on boats and helicopters and all kinds of things, there's some of those departments are still able to get a decent amount. But I would argue that the rest of the country is struggling, truly struggling. Police, fire, ems. And that is a beautiful opportunity for us to finally change what is broken. When you hear this kind of rhetoric. Well, it's what you signed up for. I disagree. When you're in the fire academy or if you're in paramedic school, you're not talking about mandatory overtime or, you know, that phone call you have to make to your kids because you've been held over or cancers or divorces, you're talking about extrication and make an entry in primary searches and intubation and all the things that we do, which is the job, that is what we signed up for. So what has devolved really is the environment in which we work, the workweek itself. I think one of the problems that we've had. Someone asked me on an interview yesterday and they always say, well, who do we blame for this? Who do we point to? And it's all of us. So I'm going to kind of unpack every level, because the reason that it hasn't been fixed up till this point is I think we've all told ourselves fairy tales about what we do. And when I came on, it was post 9 11, literally like a year after 9 11. And it was all mustaches, sooty faces and saving babies. That was the only conversation, you know, so the work week and the marriages and all that stuff wasn't even on anyone's lips at the time. So Fast forward to 2024. What I argue has really happened is we have this Internet age now, and 20 years ago you could Google, you know, what's it like to be a Firefighter and you would have cats and trees and rescues and, you know, firehouse antics. But now when you Google it, you will also have divorces, cancers, testosterone levels in the toilets, you know, like I said, down syndrome and autism in our children, all of the things. So now what's happening is these young candidates are looking at all of these things side by side. And one of my guests from Gainesville, Don Campbell, was talking about this. He had a recruit and he had a kind of breakdown of like six departments and what the pros and cons were. Because these young people, it's not, they don't want to work. Yes, there's a larger deconditioned amount and that's something we got to address nationally. But they truly value their physical health, their mental health and their emotional health. So their relationships. So when they see, for example, you know, a department with no Kelly, a 56 hour workweek, then an 80 hour workweek, if there's a mandatory that week of which, you know, a lot of the departments I've worked for and the one locally here, that's sometimes four times every week, some of these people are getting hit with a mandatory. So it's an 88, zero hour week, double what a civilian works. So these young people look at that and going, I don't want to do this job. And that is an absolute tragedy. But the beautiful thing is that we also have an opportunity to finally turn the corner now to make a difference. Because back in the day when we were literally just responding to fires and sitting around and smoking cigars and petting the Dalmatian, one on, two off as we call it, even though that's a mislabel, it wasn't that bad, I'm sure. But as we got into EMS, which is 50 plus years we've been doing that now, we just haven't evolved with the work week. And before I dive in, just to put the other side of the coin, you hear the rhetoric in the fire service. Oh, it's like a business. And I personally disagree. I think it's a service. You know, you can't look at it like a business. But if we were, if you look at the corporate world, the progressive corporate world, they are actually pushing towards a four day workweek. Now. Iceland just had a study that came out that was a big success over there. The UK have done it a load. So if you look at Google, you look at Virgin, you look at some of these progressive and extremely successful businesses, they're investing in their people, gyms, in their headquarters, you know, restaurants, that are free, that serve healthy food. They understand that a healthy workforce then, you know, results in a healthy customer. So we have fallen behind even on the corporate world because, you know, the gap between what we work and what they potentially will be working has just got even bigger now. So this is a beautiful opportunity to finally change it. I'm going to kind of head down my. My little list that I use.

James. Yeah. I would love you for you to do that before you do that, just because I want people to know more about your experience in this. I know that you. You've done over a thousand. You probably like, what, 1500 podcast episodes and behind the shield, all specifically related to this concept. So can you. Can you just give people a little bit of a. A bird's eye view of, you know, why you know so much about this topic and then maybe also why you are invested so much in this topic? If you can start with that, that'd be great.

Yeah, sorry. Absolutely. I didn't know where we were going to go. All right. Yeah, so it's been. Just put out a thousand and five episodes now. So, yeah, a lot of. A lot of people. And the origin story of the podcast, I'll give you that. I worked. I ended up having a very gypsy career following my. My son's mother around the state, so she pursued entertainment. And so it gave me a very unique perspective in the fire service as a whole. We're very, very siloed. So if we stay in one department, we really don't know kind of what's beyond the walls. You might go to some conferences, but we really don't see it. And what I was seeing is the same thing in all these places. And what really spurred me was There was about 10 years ago, 10 years into my career, I just kept going to funerals over and over and over again. Now, me, myself, I'm not an expert in anything, but I'm an exercise physiology graduate or major, I'm a coach, I'm an athlete. So I knew enough of the wellness world, what we should be seeing, and it wasn't in our parameters. So after hearing a Navy SEAL that became a physician and then went with the SEALs again, talking about sleep deprivation on another podcast, that really spurred me to start mine. So as I started interviewing all these people, sleep experts, neuroscientists, strength and conditioning coaches, back injury specialists, psychologists, psychiatrists, the one elephant in the room, whether it was cancer, whether it was autoimmune disease, whether it was this crazy testosterone issues that we've got now, was always the same thing. It was sleep deprivation. So that's what really turned my eye to this one unicorn that we had in Florida called Boca Raton, that for the longest time. And it's funny if you hear the backstory of how that came around, that was actually supposed to be a punishment from the city back then because they were on, I believe, 12s or 10s and 14s. And so they put them on a 24, and it ended up being, I would argue, the gold standard shift of the fire service now. So then for me, it was then unpacking. Why are we not doing this? Why. Why is the person who makes your coffee in Starbucks stopping at 40 hours, if that. But the person who's asleep in a bunk room that gets woken up by the tones has to jump on a rig, drive lights and sirens to a fire, you know, then doff gear, throw ladders, make entry, do a search, and then maybe, sorry, dong gear, there may be doff gear, and then do a pediatric cardiac algorithm at three in the morning that we're okay with that person working two full days more than the barista. So that was the. The real thing is when all these scientists in a thousand interviews and not a single person said anything other than, you are insane. The way you work your firefighters, you are killing them mentally, physically, emotionally. That was the real. Aha. Is like, okay, this is a truth. This is not something that James Gearing woke up and said, oh, I think this is the answer. It's. It's something that I've put to literally hundreds and hundreds of guests that work with the, you know, highest performers on the planet and of all different countries. And this is it, you know, 24, I believe, for a firefighter, if you have a place to sleep is a. Is a, you know, a doable thing. Anything more than that. For example, the 4896, that was a single study that the fire service ran with. And the origin story of that, the guy, Joel Billings, super nice guy, was a volunteer firefighter, had never worked overnight as a volunteer. And then he decided to get into the research world. So he studied a department that, in his words, ran less than one call a night. That study was published. They said, oh, it's a healthier one. And then you had Seattle and whoever running with it, who runs a lot more than one call a night. You know, so little knowledge is a dangerous thing. So this was the big thing. It's like trying to really almost think of it like a court case, layer all these. These experts until people finally go, I Understand now I see, you know, why it's not just someone's opinion. This is, you know, a universal thing from astronauts to, you know, Navy SEALs and everything in between. So, okay, so having.

So having said that, And I see Dr. Kramer, he says, I know this is considered heresy, but why not go to 8 or 12 hour shifts? And someone on Twitter said the same thing. He said, find me one doctor who does 24. Now, there are, there are, there are doctors who do that. That's not healthy. But what's your answer to that question?

So the answer, I mean, that's a great question. But firstly, I would put to you, okay, let's pull some professions that work 12s, nurses, corrections officers, police officers, not known for their incredible health and fitness overall. So if, again, it was a great schedule, then absolutely, we would have no argument to say we need to do 12s. If you speak to the sleep experts like Professor Russell Foster, he was the one that discovered the chronoreceptor in the eye. And he was laughed at by his community and I can relate to that by the ophthalmologists, they said there's just rods and there's cones. Well, now, as you hear, everyone says, when you wake up, go look at the sun for, you know, 15 minutes, set your circadian rhythm. Russell was the one that discovered that even though I don't hear him credited very much, but, you know, so over and over again you talk to him.

The.

When you do twelves, you actually have now changed the circadian rhythm. You've told them, this is day and this is night. You know, vice versa. With a firefighter in a 24 that has the ability to lie down for part of the shift, albeit not good quality sleep.

You are still, it's still that circadian rhythm. You haven't reset it. Day is still day and night is still night. So I think that's why it works for us. The other thing as well, with the firefighter, paramedic, or EMT being the Swiss army knife of any profession, like, we are responsible for more skills, I would argue, than any other profession on the planet. I don't think that you can truly prepare and train and run calls in eight or 12 hours. I'm still getting through my to do list. You know, 10, 12 hours into my shift, if you're, if you're working out, if you're pulling hose, if you're doing all the things you should be doing. So I think that's the other argument against. So I. My whole thing is. And even with our 12 hours. If it's killing them, we need to give them more rest and recovery in between as well. If we're asking a police officer to sit in a cruiser for eight, 10 hours, should he be held to, you know, four or she to 40 hours a week or should they be working a little bit less so they can recover more? So that would, that's kind of a universally accepted thing. Is the 12s alternating or, you know, telling, telling a human being that's a mammal that needs to sleep at night. No, no, no, you're going to sleep in the day is very, very detrimental to the circadian rhythm and therefore your.

Health and you know what I mean. All of us who are on this call have experienced that. If you're an ED doc, that's your whole life, right? I just had dinner yesterday with someone who said, I'm having, I'm having dinner with you today. I'm working all day tomorrow at the fire department. I'll sleep for three hours and then all night in the, in the ED. And that's, that's been our lives for 20 plus years. So go ahead and continue. We have 10 minutes left. And I was hoping. I know there's a lot of people on this call who, who have opinions and who want to, want to have. I want to have their opinions heard and maybe have you answer them. So are there some. And again, I know 30 minutes is not enough here and we started a little late, but if you can just give us some high level points that you had kind of, I know you had some things that you wanted to give us and then maybe we'll leave a few minutes at the end for people to bring in their opinion as well.

Yeah, absolutely. I mean the resources would take a lot longer to unpack. So this is actually good. Kind of just set in the scene. Yeah. So the biggest thing for. Because I'll give you, I'll give you the actual bullet points in two seconds. The biggest thing for the firefighter level to understand is you don't work one day on two days off. A24 is three civilian hours crammed together. So it's three days on, one day off or 30 days a month. So debunking our myths. You know, the, the chiefs that, you know, haven't been the station for a while that go home at 40 hours. It's about reconnecting and seeing the absolute meat grinder that your people in the city and county managers is understanding and that the chiefs, the immense waste of money. So I'll just. Because this is the Big thing, how do we get more people? We get more people by, attract, by changing the work environment. So the 2472 in departments that have gone to it, their recruitment has gone through the roof and their retention has gone through the roof. So you've hit it from both sides. But the biggest thing, and this is department to department, if anyone out there is not fully staffed with people lining up outside the door and the right people, because if you're choosing from the top 10% of a list, you're golden. If you're choosing the 90% of the list, you're bringing in some people that maybe you never would have hired when the recruitment was where it was. But if you look at overtime, I'll give you just an example because I have their numbers, Marion County, I was involved with the kind of thinks tank with them. They had almost 200,000 hours of overtime. This would be two years ago. So that's basically $6 million filling these holes. Then you look at the recruits. For every crew, I'm kind of up, rounding up. But for every crew that you hire, that then leaves two, three, five years later. That's $20,000 per human being out the door. So let's say you use 100, that's another 2 million. Now you think about women's comp claims, you think about medical retirement, you think about lawsuits from these sleep deprived firefighters that are hitting vehicles, that are pushing the wrong med, that are being too rough with the patient. Millions and millions. So I will provide a link to the Q and A episode that I did. And it has all the resources from the several people on departments that have already made the move that will explain all of this. But you fill the holes by attracting people and the money is already there. And then obviously you're going to save your city and county money hand over fist. So that's the really big thing. I will provide a resource because it obviously needs to go a lot deeper than this, but it's understanding the problem and understanding, I promise you there is an answer for every single one of the naysayer questions because we're completely programmed to believe that we'll just do it anyway. So I'll leave it there.

I'm fascinated by. So I want you, I wanted you to clarify the three days on one off thing because that didn't register for me. So if you can do the math again. But I also wanted to say if I had a dollar for every firefighter that was on testosterone, then I'd have a lot of money. Like it just seems like Everybody's on testosterone. So if you can first do that math again on that it's not one day on, two days off thing, you say that a little slower.

Sorry, I was trying to speed it up because of the time limit. So yes, if you think about a civilian workday, it's a nine hour day with a one hour lunch. So an eight hour workday, a 24 hour shift is three times eight. So it's three days brand together.

Oh, I got you.

Because we're not on a military base, we're not on an airfield that starts at nine and closes at five. And then we're just off. You know, we are 24 hours on, on, on, on. You know, sometimes we're working through the night over and over again. Now what that does to kind of bridge to the testosterone thing, when you don't sleep, there is massive endocrine disruption. So everything from your pancreas. So that's why you see a lot of diabetics in the fire service, because if you don't sleep, it affects you and you become pre diabetic. But also the testosterone, you know, the mental health side is when your brain processes memories. From a training point of view, it's when your brain processes what you've learned, you know, which is why a lot of us tired firefighters can't get those knots the next day again. Or the drug calcs. But if you look at what happened back in the day with the testosterone, a firefighter would go to a doctor and they'd have A T of 256 and they'd be like, well, you're fine, you're within the range. Well, this is a 28 year old, extremely fit firefighter that should be probably in the eight hundreds at least. So before we did nothing, then there was this massive swing where these men's clinics started opening up. Now that same firefighter goes, oh my God, you're so low. We need to get you exogenous testosterone. Not telling them about infertility and hair loss and you know, the term they use for lady breasts on a man. And then the fact that you are, your testes will literally atrophy and you will have to take that the rest of your life. And I've got friends that took it and now they're, they're, you know, they're stuck on it and they're a ghost of their former selves. So by putting an extra hour or extra day of rest and recovery, we'd see a massive increase in natural testosterone again. And then there's also things called peptides, which can help your own body make a little bit more if you need a boost because you're still going to be working 24 hours. So. So yeah, that's a massive thing and it's not cheap and it's costing these firefighters their health and a huge amount of money.

Yeah. It's also more self insured. A lot of the cities are. So let me bring in Dr. Pepe and then I'll bring in Tanner. Paul, you've been around a lot of departments, you've been around a long time. What's your take on this topic?

This is one of the things we studied early on in the 70s and 80s and I'm just glad he finally got into the issue about the hormones because it's not just testosterone. There are. So the, one of the biggest players is cortisol, of course, and everybody has their cortisol. You know, that comes out at, you know, 4 o' clock in the morning, 5 o' clock in the morning on a, a typical day. And what happens is people will start getting, you know, screw ups there. You think because they're working overnight, their metabolism is up and they do. But they, the irony is it goes the other direction is that you end up being stressed more and so then you'll see people getting more of a, almost like a pre cushion cushing cushioning kind of appearance and all that. And it contributes to the diabetic, you know, or the other things, all the other coronary things. But you know that's, you know, so that's part of it as well. So I just, yeah, I think looking at, there is. And it's not just cortisol, it's not just testosterone. There are various other chemicals that are hormones that get involved and it does, does affect your health. There is something about sleep that's really important, that paradoxically that makes you healthier. So yeah, I don't know.

That does, that does. Thank you so much for that comment. Let me bring in Tanner. Tanner Smita, go ahead and make a comment. I know you had some work with some folks in Pittsburgh, so go ahead and make a comment, Tanner.

Sorry, muted.

So I just wanted to highlight the work of Dr. Dan Patterson who's at the University of Pittsburgh now. He's a paramedic. He has a PhD. I think he's currently the deputy editor at Pre Hospital Emergency Care and he's done a ton of work on the relationship between shift duration and fatigue and measures of cardiovascular health in EMS providers as well as provider safety. Looking at things like injuries, errors in addition, him and a team of others have published a series of systematic reviews that have been compiled in prehospital emergency care as an evidence based guideline. It was one of the first evidence based guidelines published in that journal. So I just wanted to put a couple links to those. In the chat, he talks about things like allowing paramedics and firefighters to sleep on shift, the availability of caffeine during a workday as kind of an adjunct to fight fatigue and fight against some of these.

Negative consequences. But yeah, James, thank you very much for the pleasure.

And Tanner, you actually bring up a great point and I would love to hear James's comment on the caffeine, the Celsius. And you know, we had a firefighter, I won't name the department, but went into cardiac arrest because of all these caffeinated drinks. Is that, how did that all play into this? Sleep deprivation we're fueling up with this external chemicals, etc.

Yeah, it's, it's literally, you know, it's the vicious circle by that point. I, I was the, the coffee monster in the firehouse. You know, I'd have it day and night. I never had the energy drinks. But you know, you, when, when we listen to Andrew Huberman, they're like, don't have any caffeine after 11 o'.

Clock.

Well, that's all well and good because you go to your bed every night, your police officer, your firefighter, your doctor, your nurse, they know they've got to get through the night. So I have seen, you know, an absolute, I mean, I hardly ever see a firefighter without one of those things in their hand these days. And not only are you stopping asleep, but if you think about the downregulation of the nervous system, by adding all those, those compounds into your body, you're upregulating, you're adding stress to stress. So that's a really important point. The other thing I didn't touch on as well, the seat deprivation. We see as the doctor was talking about the, the weight gain. So that hormonal disruption literally causes weight gain, which is why you have these fit, fit. First responders at 10 Years later are asking for larger uniforms. It's partly ownership, but it's the environment as well. But the biggest thing that people don't talk about as well is the cancers. If you look at the World Health Organization, they list shift work as a probable carcinogen. And that's shift work that's not 24 hours, 48 hours with mandatory three or four times a week. So I would argue that our population is even worse when you look at an average shift worker. So when we're not talking about that in the carcinogen side, we should be because, you know, it's, it's heart disease, it's strokes, it's cancers, it's suicide. All of those are related to sleep deprivation as well.

Yeah. I want to bring in Dr. Terry Cohen. You mentioned Boca Raton. He had been the medical director with for Boca Raton fire for a long time. Terry, would you mind unmuting yourself and maybe show us on yourself on camera if you're there. What is your take on what James is saying as someone who's been at a department who's been doing that for so long?

Yeah, when I, I actually started with the department back in the early 80s and even back then we were on 2472. And you know, one of the things that always was grossly obvious is that our medics were happier than most back in those days. You know, it wasn't so much all day, all night. It was a sleepier town back then. But their job satisfaction was high. And actually most of them had a second career because they were able to get sleep at night. Nowadays, you know, if you're at one of the busy stations, you know you're going to go 24. But you know, our retention is very high. And if I just reflect back, you know, on my own experience as a physician when I trained back in the 70s, you know, was sort of like a badge of honor, how many hours you could work non stop. And I think about just how incredibly tired I was all the time, how I probably made so many bad judgments because of that. And you know, finally the Libby Zion case caused us to look at that and say this is, this is, this is lunacy. We're making life and death decisions and, and we're driving ourselves into the ground, you know, that you, you look, you look at who don't sleep for days on end and they're, they function at very low levels. I'm glad to see everybody's catching up with Boca and, and making the switch. I think it's going to be.

A tremendous boon in all the ways that, that were discussed in terms of.

And saving money.

Oh, Terry, thank you for your input. I want to bring in. I'm sorry, I'm just calling on people here because I want to get their take. Chief Tom D. Bernardo, former fire chief of Sunrise Fire Rescue now is crushing it at the state level for us. The time you, you have, have seen both sides of it and now you're at the state level. I'm not sure if you're there listening. I would love your take on it. I'm not asking you to give a state opinion. I'm asking you to give the Tom DiBernardo opinion. What's your thoughts?

I.

Well, it was a fascinating conversation today. I thank you for that. But traveling around the state, we do see all of the different schedules and. But they all go back to the home. You know, everybody's staying on the, the longer duration ones. I think these peak units, maybe we could do a small study on these units that are now appearing around the state, like 12 hour peak units and seeing if we're gonna see if the physiological changes are occurring with those folks. I think that would be a good place to start. There's a lot of day trucks, you know, or temporary trucks, they're calling them as a permanent schedule. So that would be something I think we should focus on looking at and see if they're seeing the same physiological changes.

And so I want to pose that to James. You know, you really kind of enlightened us here today on the fact that there's, there's science behind all of this. Where are those studies? How come that data is not being splashed over the front pages and saying the testosterone and the hormone imbalances and the sleep and the chrono receptors, where is all of that? Are we just missing it? Is it right there?

Not in the fire service, it's not. And I had the same question. Why not?

If an idiot from England can come across the pond, become a firefighter and then find these people, why have we not found this information before? So again with, with my whole thing with the studies, now is a good time. So Gainesville, I think it's USF or one of the maybe Florida State. They're actually embedding with them now. I'm hoping they've got data right before they made the switch. And then they're following through the Joel Billings. Now I believe him and Sarah Jenky are going to start looking at this 2472 as well. But what I would say to counter it is, you know, there's a beautiful phrase, don't wait for science to prove what you already know is true. And if you look at what has happened to our firefighters, you can also equally and opposite hypothesize. If the way we do it breaks them down, if we give them more rest and recovery, it's going to build them back up again. So I think we have to be careful not to be paralyzed by analysis and wait for studies, because as we know, that's going to be years and years and years. So to me, the real data is in the funerals. The real data is in the divorces. You know, we know that this is not working. And now really dive into the Bocas and Boyntons and Gainesville's and Pascos and all these other departments that have had the courage to kind of leave from the front because it goes back down to that same question. Why is a person in an office that works 40 hours telling a firefighter that works 56, sometimes 80 hours, you can't work less?

You know, so, so I think, sadly.

Speaking of that, but go ahead, go ahead.

No, no, please, I was done.

No, I was going to say, because I wanted to jump on to that comment, which is, and Larry McCarter says, he says maybe it's isolated to Pennsylvania, but he's seeing what we see here, that they all have two or three jobs, right? I mean, I got a roofer, I get you a tree cutter. I got you whatever you want is in the fire department. They're amazing. What do you say about that? That you're going to give another day and they're still going to be working their tails off because they got to, we got to bring in the income. And so what is the balance there? And you know, you cannot mandate that they don't work on their days off. Right? What's your thoughts on that?

Yeah, well, firstly, that's exactly the point. That's their days off. That's not, you know, but there's a, there's a, there's a double conversation. There's the sleep hygiene, understanding your responsibility on your days off conversation. But if you look at what most of our people do, just as you said, tree trimmers don't work at 2 in the morning. You know, drywallers don't work at 2 in the morning. So I have no issue at all if someone goes on lifeguards or personal trains or landscapes from nine to five, because they're going to be home for dinner with their family, they're going to be tired, they're going to sleep well in their own bed. What we don't want, and this is what's happening by force at the moment, is telling a firefighter, you got to be sleepless another night. So of course, don't go work an overnight in the er. Don't go work for a private ambulance company on your days off. But the other thing is transition. I say encourage firefighters to be Entrepreneurs not use all your time and, you know, to just work, work, work. But if you have something that you also love, if you're a cabinet maker, if you're, you know, a personal trainer, if you're a masseuse, whatever, the thing is, that's beautiful because one day, if you get hurt, if you get fired, if you get, you know, if you simply retire now you have something, another tribe to transition into, another purpose to transition into. So I keep getting this conversation almost that's a negative. I disagree. As long as it's done during daylight hours or, you know, normal hours and you're spending quality time with your family and you're in your own bed every night, you know, why not, you know, fill those days with something that you love to do. So just understand the rest and recovery piece when you're at home as well. So, you know, if we can really, at the front door, educate on sleep hygiene, you know, blue blocking glasses and no devices before bed in the cool room, and all these things that we know that work and the value of sleep, which I think these young people are already starting to get, then that frees up those extra days to do the entrepreneur thing. And then also that way you're not doing your real estate when you're at the station trying to finish a phone call before a call, you know, so there's that, too.

So I have a comment and then I'm going to ask you to make a prediction and then that's how we'll finish it. Okay? So my comment is, I just read fantastic book. Malcolm Gladwell came out with the second version of the Tipping Point, what makes people change from what they do today. And this book is called the Revenge of the Tipping Point, which I recommend everyone on this call read great book. And I would get the audio version of the book. He says basically that when change happens, it's regional, right? So Boca Raton has been doing 2472s for a long time, but they were like the single thing all of a sudden. Now you got Boynton, you got Miramar and Palm Beach. It's happening. And if you listen to Malcolm Gladwell, he says that's going to tip everybody. So I wonder, do you agree with that? Is that change regional? And what is your prediction for the 2472? How fast do you think it's going to make its way through, let's say, a state like Florida?

I think it's going to go like wildfire. Because the beautiful thing about this now, and just as a side note, I heard someone on a video once recently, and they said, it's not the leader that makes the biggest change, it's the first follower. And I love that. If someone leads and no one else follows them, then you're just standing there on an island on yourself. But this is what happened. Obviously, Boca was there for a long time, but because of how long ago it was, there wasn't this, we need to make this change because it's healthier and all that stuff. It was what they always did, which another undiscussed element is a lot of The Northeast works 2472. We all copy their hose lays and ladder throws, but we don't talk about their shifts. But what I'm seeing now, and this is, this is, again, you can look at this pessimistically or you can look at this optimistically, like there is no better way to change, the better time to change, because we are at a critical mass. There are places that maybe won't have a fire department if we don't figure this out based on the retention and the recruitment. So if you have, in South Florida, for example, departments going around, you know, around going to 2472 and you're already struggling to hire, now, I argue it's forcing you to start changing because you have to be relevant. You have to be, as Hugh talks in Boynton, you have to be a destination department. And if a young person sees that you care about their health and well being, which then results in performance and money saved. As a leader, you know, you're progressive. But I can tell you from my bizarre lens, I've had cities from all over the country reaching out, asking about this, from the west coast to Vegas to everywhere. So the progressive leaders of the American Fire Service are already starting to look at this and go, this is the answer. And there will be people that will dig their heels in. And sadly, I see it even locally here with the department that protects my own family. But, you know, you reap what you sow. If you're not prepared to invest in your people. You know, there will come a time where you'll be removed from that position because everyone around has gone to it, and the only candidates you can get are the ones that are left over.

Excellent. This has been amazing, James.

Where.

Where can people learn more about you? Tell us about, you know, how they can reach out to you if they want to. Also tell us about, just real quickly about the books, because I know that's related to this topic and your podcast. If you can just kind of give us a brief view of that, and then we'll end it. We'll go to Dr. Pepe's webinar.

Yeah, absolutely. So all the stuff is on jamesgeering.com J A M E S G E E R I N G the podcast is called behind the Shield. If you Google either of those, James Gearing, it should all pop up. The books I've got, my first one's called One More Light. People have said this should be a must read in all fire academies, but you know, that's. That's for the person to read it to figure out. But it's a collection of short stories. But it's not supposed to be a biography. They're just kind of introductions into a concept. But then there's a takeaway, and it alludes to the experts that I had on the show. So sleep deprivation, you know, mental health, injury, all the things. And then my most recent one is called kinder, which is actually, it's a. I guess you could almost say historical fiction. It's fictional. But anyone that's in the fire service, you'll recognize these calls. I mean, they're, you know, very, very closely related, hipper, aside from ones that I've had myself. But there's also a multi generational trauma story. So I'm trying to put that empathy and compassion back into everything from what we do through to what we see. You know, homelessness, you know, addiction, sex, work, all the things. So it's a very kind of nuanced human story. And then I will send you a link in a minute. I don't know if you're able to attach this after, but I did an episode. It was a Q and A on 2472. I can't remember which number it was, but that. The webpage to that which I'll send you also has links to Hugh Bruder's episode, Dixon Phillips from Pasco, the Gainesville guys, a Q and A I did with to researchers on the impact of this on our health. So that would really be the one to kind of dive into. Listen to that Q and A. And then if you want to keep layering on, you can listen to all the other ones. So I'll get that to you.

Send that to me. Yeah, yeah, send it to me. And I'll.

I'll.

I'll. I'll send it off in the back channel to everybody. Tanner, any final comments before we head over to Dr. Pepe's webinar?

I just want to say I think you're a. You're a gifted presenter. You. You've convinced me. And moving forward at this time, I don't have any involvement with any. Any fire. I only work for, you know, ems, only agencies. I'll certainly be keeping shift schedule in mind. So thanks.

Thank you, James. Thank you so much. I'm going to put this on YouTube. It'll be on the Florida EMS channel. I'm also going to recommend to the First Air First Care Conference. I don't know if you do speeches like, but we have a conference down here in Florida in July in Hollywood at the Hard Rock. Would you be interested in being considered as a speaker?

Yeah, I. The one dynamic I love to do is more like the Q A. So presenting. But, you know, even. Even with a panel of one or two other people. But, yeah, I mean, yeah, I think people are engaged in a conversation.

Yeah, I think the panel pros, cons, because I think people want to hear both sides of the equation and, you know, that people are making decision based on finances and budget, etc. But I think your argument is very, very strong. So let me see. I think someone else is putting a comment. Oh, Chief Shaw is here. All right. So Chief Shaw is the person in charge of getting great speakers. So, Chief, maybe we'll think about bringing James in. We'll create a panel around this topic. Perfect time. All right, everybody. James, thank you so much, my friend. Great to see you again. And thanks for everything you're doing to protect our folks on the front lines. God bless you and your family. And we're going to move over to Dr. Pepe's webinar now. So the link is in the chat if you're interested in going over to Dr. Pepe's webinar. James, thank you, my friend. You're the best.

Thank you.

Thanks for all you're doing.

Thank you.

Have a good one.

You, too.

Thank you, guys. And thanks everyone for joining. Sorry that I went over a little bit, but I couldn't. This is too important to stop at the bottom of the hour. So, Tanner, great job. Thank you so much.