Also perhaps a risk to the patients. Or, if you need to operate that rig on the public roads, everybody.

Clearly if you screw up it’s because you weren’t good enough/not trying hard enough. (/s, but I wish mgmt was sarcastic when they said shit like that).

Adrenaline helps ... for a while. But it can't substitute for rest, or clinical judgment. More than one ambulance has crashed because a driver fell asleep.

It's not healthy for patients, and there's a few reasons why it's "tolerated" (not agreeing with these) - "We always have done it this way", and around here, being a unionized city/county fire-paramedic is the top tier for income, and around here, there's few enough paramedic schools that several of them have minimum EMT field experience in time or patient contact numbers, so it's considered a grind until you can get through. And EMS companies know that because of that, there's a steady pipeline of young people willing to "go through the wringer".

I've always assumed that long shifts for interns are to exhaust them in order get them accustomed to making life-and-death decisions without having to experience persistent regret.

But that mechanism would make absolutely no sense for people working out in the field.