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Maloney LM, Hoffman J, Peralta E, Princi R, Thode HC, DiDonato C, LaBarbera A, Williams S. Informal Peer Support and Intentional Acts of Kindness May Attenuate the Impact of Work-Related Stressors on Compassion Satisfaction, Secondary Traumatic Stress, and Burnout of Emergency Medical Services Clinicians. Air Med J 2024; 43:333-339. [PMID: 38897697 DOI: 10.1016/j.amj.2024.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 03/07/2024] [Accepted: 03/08/2024] [Indexed: 06/21/2024]
Abstract
OBJECTIVE Emergency medical services (EMS) Code Lavender was developed to support EMS clinicians after stressful events via consistent recognition of events, informal peer support, and intentional acts of kindness. This study evaluated changes in burnout screening tool responses of EMS clinicians in response to program implementation and the coincidental start of coronavirus disease 2019. METHODS Anonymous surveys with demographic questions and 2 burnout screening tools were distributed before program implementation (spring 2020) and 20 months later (fall 2021). Analysis included t-tests, Fisher exact tests, and multivariable linear regression. RESULTS Seventy-seven preprogram (59% response rate) and 108 intraprogram (88% response rate) survey responses were included. No changes existed between preprogram and intraprogram responses across all subscale scores. Sex was associated with depersonalization subscale scores, with men having scores 1.53 (95% confidence interval [CI] 0.11-2.95) higher than women. Compared with emergency medical technicians, paramedics had higher compassion satisfaction (OR 3.50; 95% CI 1.79-5.70) and personal accomplishment scores (OR 2.40; 95% CI 1.08-3.71). Transport nurses had higher personal accomplishment (OR 3.29; 95% CI 1.18-5.40), depersonalization (OR 3.73; 95% CI 1.19-6.26), and rates of burnout symptoms (OR 0.54; 95% CI 0.09-0.98) than emergency medical technicians. CONCLUSION The organizational commitment, peer support, and authentic leadership of EMS Code Lavender may attenuate work-related stressors among EMS clinicians.
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Affiliation(s)
- Lauren M Maloney
- Department of Emergency Medicine, Stony Brook University Hospital, Stony Brook, NY.
| | - Jason Hoffman
- Department of Emergency Medicine, Stony Brook University Hospital, Stony Brook, NY
| | - Edder Peralta
- Department of Emergency Medicine, Stony Brook University Hospital, Stony Brook, NY
| | - Rudolph Princi
- Department of Emergency Medicine, Stony Brook University Hospital, Stony Brook, NY
| | - Henry C Thode
- Department of Emergency Medicine, Stony Brook University Hospital, Stony Brook, NY
| | - Christopher DiDonato
- Department of Emergency Medicine, Stony Brook University Hospital, Stony Brook, NY
| | - Anthony LaBarbera
- Department of Emergency Medicine, Stony Brook University Hospital, Stony Brook, NY
| | - Sarah Williams
- Department of Emergency Medicine, Stony Brook University Hospital, Stony Brook, NY
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Suokonautio B, Kouvonen A, Nordquist H. Role identities of emergency medical services personnel and their associations with intention to leave the profession. BMC Emerg Med 2024; 24:96. [PMID: 38840088 PMCID: PMC11155154 DOI: 10.1186/s12873-024-01008-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 05/21/2024] [Indexed: 06/07/2024] Open
Abstract
BACKGROUND The scope of emergency medical services (EMS) has expanded from the urgent care of emergency patients to on-call healthcare services provided in the field with a holistic view of the patient's wellbeing. This challenges EMS to find solutions to cover all demands, while simultaneously setting high skill requirements for EMS personnel. Understanding personnel is a critical element in developing functional and resistant EMS. The aim of this study was to investigate how Finnish EMS personnel emphasize the Emergency Medical Services Role Identity Scale aspects of caregiving, thrill-seeking, duty, and capacity; and if these role identities are associated with intention to leave the profession. METHODS We conducted a cross-sectional survey (N = 616, 52% women, mean age 32.9 years). Data were collected through social media platforms and analyzed with means, standard deviations, Mann-Whitney U-tests, Kruskal-Wallis H-tests, and binary logistic regression analyses. RESULTS Our results indicate that capacity is the most emphasized aspect among EMS personnel, and at the same time, it increases intention to leave EMS. Capacity was followed by caregiving, with no association with intention to leave. Duty and thrill-seeking were the least emphasized and were negatively associated with intention to leave. Additionally, there were also other factors that were associated with emphasizing EMS-RIS aspect and intention to leave. CONCLUSION Capacity stands out most strongly in analysis being at the core of the role identity of EMS personnel and was associated with a higher likelihood of leaving intentions. Several other factors were also associated with the intention to leave. Future studies should examine the exact dimensions of capacity that are considered important among EMS personnel and why factors such as work experience are associated with intentions to leave.
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Affiliation(s)
- Beeda Suokonautio
- Faculty of Social Sciences, University of Helsinki, Helsinki, 00014, Finland.
| | - Anne Kouvonen
- Faculty of Social Sciences, University of Helsinki, Helsinki, 00014, Finland
- Centre for Public Health, Queen's University Belfast, Belfast, BT12 6BA, Northern Ireland
| | - Hilla Nordquist
- Faculty of Social Sciences, University of Helsinki, Helsinki, 00014, Finland
- South-Eastern Finland University of Applied Sciences, Kotka, 48220, Finland
- Faculty of Medicine, University of Helsinki, Helsinki, 00014, Finland
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Paramalingam A, Ziesmann A, Pirrie M, Marzanek F, Angeles R, Agarwal G. Paramedic attitudes and experiences working as a community paramedic: a qualitative survey. BMC Emerg Med 2024; 24:50. [PMID: 38561672 PMCID: PMC10983637 DOI: 10.1186/s12873-024-00972-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 03/21/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Community paramedicine (CP) is an extension of the traditional paramedic role, where paramedics provide non-acute care to patients in non-emergent conditions. Due to its success in reducing burden on hospital systems and improving patient outcomes, this type of paramedic role is being increasingly implemented within communities and health systems across Ontario. Previous literature has focused on the patient experience with CP programs, but there is lack of research on the paramedic perspective in this role. This paper aims to understand the perspectives and experiences, both positive and negative, of paramedics working in a CP program towards the community paramedic role. METHODS An online survey was distributed through multiple communication channels (e.g. professional organizations, paramedic services, social media) and convenience sampling was used. Five open-ended questions asked paramedics about their perceptions and experiences with the CP role; the survey also collected demographic data. While the full survey was open to all paramedics, only those who had experience in a CP role were included in the current study. The data was qualitatively analyzed using a comparative thematic analysis. RESULTS Data was collected from 79 respondents who had worked in a CP program. Three overarching themes, with multiple sub-themes, were identified. The first theme was that CP programs fill important gaps in the healthcare system. The second was that they provide paramedics with an opportunity for lateral career movement in a role where they can have deeper patient connections. The third was that CP has created a paradigm shift within paramedicine, extending the traditional scope of the practice. While paramedics largely reported positive experiences, there were some negative perceptions regarding the slower pace of work and the "soft skills" required in the role that vary from the traditional paramedic identity. CONCLUSIONS CP programs utilize paramedic skills to fill a gap in the healthcare system, can improve paramedic mental health, and also provide a new pathway for paramedic careers. As a new role, there are some challenges that CP program planners should take into consideration, such as additional training needs and the varying perceptions of CP.
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Affiliation(s)
- Aarani Paramalingam
- Department of Family Medicine, McMaster University, 100 Main St W, Hamilton, ON, L8P 1H6, Canada
| | - Andrea Ziesmann
- Department of Family Medicine, McMaster University, 100 Main St W, Hamilton, ON, L8P 1H6, Canada
| | - Melissa Pirrie
- Department of Family Medicine, McMaster University, 100 Main St W, Hamilton, ON, L8P 1H6, Canada
| | - Francine Marzanek
- Department of Family Medicine, McMaster University, 100 Main St W, Hamilton, ON, L8P 1H6, Canada
| | - Ricardo Angeles
- Department of Family Medicine, McMaster University, 100 Main St W, Hamilton, ON, L8P 1H6, Canada
| | - Gina Agarwal
- Department of Family Medicine, McMaster University, 100 Main St W, Hamilton, ON, L8P 1H6, Canada.
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton, Ontario, L8S 4L8, Canada.
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Hulkkonen E, Kouvonen A, Nordquist H. Associations between paramedics' salutogenic health experience and the intention to stay in the profession: A cross-sectional survey. Nurs Open 2024; 11:e2133. [PMID: 38500397 PMCID: PMC10948950 DOI: 10.1002/nop2.2133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 02/06/2024] [Accepted: 02/21/2024] [Indexed: 03/20/2024] Open
Abstract
AIM To investigate the association between paramedics' salutogenic health and their intentions to stay in their profession. DESIGN A cross-sectional survey. METHODS Paramedics from eight purposively selected organizations participated in this study (n = 433). The data were collected in 2022 with the Salutogenic Health Indicator Scale and validated single questions that assessed work ability, recovery and self-rated stress. Intention to stay was measured using two questions about the intention to leave prehospital emergency medical service work and leave the nursing sector completely during the next 2 years. Data were analysed using logistic regression and statistical significance tests. RESULTS Men had higher mean salutogenic health scores than women. No significant differences in salutogenic health were observed across work experience or occupational groups. Paramedics intending to stay in their profession exhibited higher salutogenic health scores than those intending to leave. In the logistic regression models, increasing levels of salutogenic health and work ability were associated with intention to stay in the profession.
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Affiliation(s)
- Eve Hulkkonen
- Emergency Medical ServicesThe Wellbeing Services County of Southern SavoniaSavonlinnaFinland
| | - Anne Kouvonen
- Faculty of Social SciencesUniversity of HelsinkiHelsinkiFinland
- Centre for Public HealthQueen's University BelfastBelfastNorthern Ireland
| | - Hilla Nordquist
- South‐Eastern Finland University of Applied SciencesKotkaFinland
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Hill L, Eaton G. Exploring paramedic professional identity. Br Paramed J 2023; 8:42-51. [PMID: 38046791 PMCID: PMC10690486 DOI: 10.29045/14784726.2023.12.8.3.42] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2023] Open
Abstract
The notion of a paramedic (as a title protected in law) has recently entered its third decade, but the history of the paramedic is considerably older than that. Who are we as a profession? What does it mean to be a paramedic? What makes us who we are? These intriguing and yet seldom asked philosophical questions are at the heart of this article, which is intended to provoke discussion and serve as a foundation for further inquiry into questions of identity and philosophy in paramedicine. Literature pertaining to paramedic professional identity was explored and contextualised within current paramedic practice. Although the overall picture is complex, four key areas for discussion emerged: the history of the paramedic profession; role diversity; the influence of ambulance work; and the education and training of paramedics. The influence of ambulance work permeates all areas, suggesting that it is central to the development of paramedic professional identity. This discussion article is an exploration of the unique contexts and experiences that are associated with the process of being and becoming for paramedics.
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Affiliation(s)
- Lawrence Hill
- University of East Anglia ORCID iD https://orcid.org/0000-0002-9147-0934
| | - Georgette Eaton
- University of Oxford; London Ambulance Service NHS Trust ORCID iD: http://orcid.org/0000-0001-9421-2845
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Herttuainen A, Nordquist H. Recent Paramedic Graduates' Chronic Stress Adds Intentions to Leave the Profession: A Pilot Study Utilizing a Web-Based Survey. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2023; 60:469580231210706. [PMID: 38014634 PMCID: PMC10685760 DOI: 10.1177/00469580231210706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 08/23/2023] [Accepted: 10/10/2023] [Indexed: 11/29/2023]
Abstract
Paramedics have mentally and physically demanding jobs, and chronic stress is not uncommon. Recently graduated paramedics, in particular, have been identified as needing support in their early careers. This pilot study examined chronic stress experienced by recent graduate paramedics and their intentions to leave the paramedic profession. Finnish paramedics encompass qualifications to work in various nursing sectors. This pilot study was a cross-sectional survey study among Finnish paramedics who graduated less than 3 years ago and who were currently working in prehospital EMS (n = 152). They evaluated chronic organizational and operational stressors on the Emergency Medical Services Chronic Stress Questionnaire with 20 statements. Two structured questions related to the intention to leave the paramedic profession. Three summary scales were formed. The differences in stress by the intention to leave were reported descriptively and the differences were tested with Mann-Whitney U test. The influence of potential predictors of the intention to leave prehospital EMS work or the nursing sector completely were explored with a forward stepwise logistic regression model. Those who intended to leave prehospital EMS work (25%, n = 35/152) or to leave the nursing sector completely (33%, n = 50/152) experienced higher levels of stress than those without such intentions. Stress related to organizational inequity and leadership challenges was the strongest and stress related to social, health, and personal impacts was the second strongest predictor of the intention to leave. Reducing chronic stress might be important in terms of paramedic retention. Several further study needs are addressed.
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Affiliation(s)
| | - Hilla Nordquist
- South-Eastern Finland University of Applied Sciences, Kotka, Finland
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Role Identity, Dissonance, and Distress among Paramedics. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042115. [PMID: 35206301 PMCID: PMC8871672 DOI: 10.3390/ijerph19042115] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 02/07/2022] [Accepted: 02/11/2022] [Indexed: 02/01/2023]
Abstract
Role identity theory describes the purpose and meaning in life that comes, in part, from occupying social roles. While robustly linked to health and wellbeing, this may become unideal when an individual is unable to fulfill the perceived requirements of an especially salient role in the manner that they believe they should. Amid high rates of mental illness among public safety personnel, we interviewed a purposely selected sample of 21 paramedics from a single service in Ontario, Canada, to explore incongruence between an espoused and able-to-enact paramedic role identity. Situated in an interpretivist epistemology and using successive rounds of thematic analysis, we developed a framework for role identity dissonance wherein chronic, identity-relevant disruptive events cause emotional and psychological distress. While some participants were able to recalibrate their sense of self and understanding of the role, for others, this dissonance was irreconcilable, contributing to disability and lost time from work. In addition to contributing a novel perspective on paramedic mental health and wellbeing, our work also offers a modest contribution to the theory in using the paramedic context as an example to consider identity disruption through chronic workplace stress.
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OUP accepted manuscript. Ann Work Expo Health 2022; 66:946-959. [DOI: 10.1093/annweh/wxac013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 01/25/2022] [Accepted: 02/09/2022] [Indexed: 11/13/2022] Open
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Mausz J, Donnelly EA, Moll S, Harms S, Tavares W, McConnell M. The relationship between role identity and mental health among paramedics. JOURNAL OF WORKPLACE BEHAVIORAL HEALTH 2021. [DOI: 10.1080/15555240.2021.1981763] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Justin Mausz
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Brampton, Canada
- Peel Regional Paramedic Services, Brampton, Canada
| | | | - Sandra Moll
- School of Rehabilitation Sciences, McMaster University, Hamilton, Canada
| | - Sheila Harms
- Department of Psychiatry and Behavioral Neurosciences, Hamilton Health Sciences Centre, Hamilton, Canada
| | - Walter Tavares
- Institute of Health Policy, Management, and Evaluation, The University of Toronto, Toronto, Canada
| | - Meghan McConnell
- Department of Innovation in Medical Education, The University of Ottawa, Ottawa, Canada
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van Huizen P, Mason R, Williams B. Exploring paramedicine student preferences using Holland's vocational theory: A cross-sectional study. Nurs Health Sci 2021; 23:818-824. [PMID: 34310001 DOI: 10.1111/nhs.12870] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 07/01/2021] [Accepted: 07/01/2021] [Indexed: 11/30/2022]
Abstract
Holland's RIASEC typology is a classification of vocational personality types and work environments. Having a predisposition for their vocation, in terms of a personality that is congruent to their work environment, may be protective for paramedics with regards to both their mental and physical health. The purpose of this study was to identify paramedicine students' vocational preference according to Holland's RIASEC model. Bachelor of Paramedicine degree students in the three different year levels completed the 48-item Brief RIASEC Marker Scales to determine their order of the six RIASEC personality types. In this study, the paramedicine students' three most dominant personality types were Social-Investigative-Artistic, differing from the defined Holland Occupational Code for paramedics of Realistic-Social-Investigative. Male students scored significantly higher on the Reality personality type, whereas female students scored significantly higher on the Social personality type. Overall, this study found many students to possess two of the three dominant personality traits that form the desired Holland code for paramedics. This suggests that many students may be better able to cope with the demands of the paramedicine profession upon employment.
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Affiliation(s)
- Pheona van Huizen
- Department of Paramedicine, Monash University, Frankston, Victoria, Australia
| | - Rod Mason
- Department of Paramedicine, Monash University, Frankston, Victoria, Australia
| | - Brett Williams
- Department of Paramedicine, Monash University, Frankston, Victoria, Australia
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Munro GG, O'Meara P, Mathisen B. Paramedic academics in Australia and New Zealand: The 'no man's land' of professional identity. Nurse Educ Pract 2018; 33:33-36. [PMID: 30223111 DOI: 10.1016/j.nepr.2018.08.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Revised: 05/10/2018] [Accepted: 08/18/2018] [Indexed: 10/28/2022]
Abstract
Those transitioning from practice to academia can struggle with the perception that they might lose their hard-won and deeply-held professional identity, while grappling with the difficulty of creating an academic identity. This is a common experience for those entering universities with strong clinical identities. Paramedics, as members of an emerging health profession, share these challenges with nursing and allied health professionals. In this study of paramedic academics in Australia and New Zealand, a majority did not consider themselves to still be paramedics on the basis that they were no longer clinically active. Nor did they consider themselves to be academics as most lacked doctoral qualifications and associated scholarly achievements that made them feel worthy of a place in the 'academy'. This lack of a professional identity as either a paramedic or an academic places them in a 'no man's land' of professional identity. Many are unable to effectively fuse their paramedic and academic identities to become comfortable as 'paramedic academics'. For this to change, there needs to be a partnership between the paramedicine discipline and universities to ensure that paramedics entering academia have a recognised and valued career pathway and are better prepared to make the transition to academia.
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Affiliation(s)
- Graham G Munro
- Australian Catholic University, School of Nursing, Midwifery and Paramedicine NSW/ACT, Faculty of Health Sciences Level 7, 33 Berry Street, Room 533.7.05, North Sydney, NSW, 2060, Australia.
| | - Peter O'Meara
- Rural & Regional Paramedicine School Graduate Research Coordinator, Latrobe Rural Health School, Latrobe University, PO Box 199, Bendigo, Victoria, 3550, Australia.
| | - Bernice Mathisen
- Speech Pathology, Department of Community and Allied Health, Latrobe Rural Health School, Latrobe University, 109 Arnold St., Bendigo, Victoria, 3550, Australia.
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