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Kamrujjaman MD, Demetriou C, Cuartas Álvarez T, Castro Delgado R. The Role of Social Work for Emergency Medical Services (EMS): A Systematic Review. Prehosp Disaster Med 2023; 38:628-635. [PMID: 37525489 PMCID: PMC10548022 DOI: 10.1017/s1049023x23006143] [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: 04/28/2023] [Revised: 06/05/2023] [Accepted: 06/15/2023] [Indexed: 08/02/2023]
Abstract
INTRODUCTION Emergency Medical Services (EMS) are integrated services involving doctors, paramedics, nurses, and social workers. This research was carried out to synthesize the evidence concerning social work roles for EMS. The aim of this study was to synthesize literature on the social worker's role in EMS settings. METHODS The study was a systematic review. Data were collected through selected databases. The researcher used Scopus, Sociology Database, Social Science Database, and Public Health Database related to EMS and social work settings. English papers were selected, without restrictions on publication time, place, and year. The searched keywords were: "Social Work AND Emergency Medical Services AND Ambulance Services," "Social Worker AND Emergency Medical Systems AND Ambulance Services," "Social Work AND EMS," "Social Worker AND EMS," "Social Work OR Social Worker," "Social Work Role AND EMS," Social Worker AND EMS," "Emergency Medical Services OR/AND Emergency Medical Systems." RESULTS The study synthesized the literature about the social work role in pre-EMS, during emergency, and post-EMS. The following themes were highlighted: social workers act as cultural liaisons, effective communicators, emergency workers, and mental health practitioners, collaborating with other disciplines and researchers, for this study. In pre-emergency stages, social workers have roles as educators, communicators, advocates, and awareness builders. During an emergency, social workers act as search and rescue workers, advocates, facilitators, networkers, psychosocial assessors, consultants, counselors, and liaisons for referral activities. And in the post-emergency period, social workers have roles as planners, liaisons, interdisciplinary collaborators, researchers, evaluators, and individuals responsible for follow up. CONCLUSION This study synthesizes the roles of social workers in EMS settings. It is the first study on this topic, aiming to produce new knowledge, evidence, and an EMS practice framework for the social worker.
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Affiliation(s)
- MD Kamrujjaman
- Department of Medicine, University of Oviedo, 33006Oviedo, Spain
- Department of Primary Care and Population Health, University of Nicosia Medical School, 2414 Engomi, Nicosia, Cyprus
| | - Christiana Demetriou
- Department of Primary Care and Population Health, University of Nicosia Medical School, 2414 Engomi, Nicosia, Cyprus
| | - Tatiana Cuartas Álvarez
- Health Service of the Principality of Asturias (SAMU-Asturias), Health Research Institute of the Principality of Asturias (Research Group on Prehospital Care and Disasters, GIAPREDE), Oviedo, Spain
- RINVEMER-SEMES (Research Network on Prehospital Care-Spanish Society of Emergency Medicine), Madrid, Spain
| | - Rafael Castro Delgado
- Department of Medicine, University of Oviedo, 33006Oviedo, Spain
- Health Service of the Principality of Asturias (SAMU-Asturias), Health Research Institute of the Principality of Asturias (Research Group on Prehospital Care and Disasters, GIAPREDE), Oviedo, Spain
- RINVEMER-SEMES (Research Network on Prehospital Care-Spanish Society of Emergency Medicine), Madrid, Spain
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Spelten E, van Vuuren J, O'Meara P, Thomas B, Grenier M, Ferron R, Helmer J, Agarwal G. Workplace violence against emergency health care workers: What Strategies do Workers use? BMC Emerg Med 2022; 22:78. [PMID: 35524175 PMCID: PMC9074314 DOI: 10.1186/s12873-022-00621-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 03/28/2022] [Indexed: 12/01/2022] Open
Abstract
Background Workplace violence by patients and bystanders against health care workers, is a major problem, for workers, organizations, patients, and society. It is estimated to affect up to 95% of health care workers. Emergency health care workers experience very high levels of workplace violence, with one study finding that paramedics had nearly triple the odds of experiencing physical and verbal violence. Many interventions have been developed, ranging from zero-tolerance approaches to engaging with the violent perpetrator. Unfortunately, as a recent Cochrane review showed, there is no evidence that any of these interventions work in reducing or minimizing violence. To design better interventions to prevent and minimize workplace violence, more information is needed on those strategies emergency health care workers currently use to prevent or minimize violence. The objective of the study was to identify and discuss strategies used by prehospital emergency health care workers, in response to violence and aggression from patients and bystanders. Mapping the strategies used and their perceived usefulness will inform the development of tailored interventions to reduce the risk of serious harm to health care workers. In this study the following research questions were addressed: (1) What strategies do prehospital emergency health care workers utilize against workplace violence from patients or bystanders? (2) What is their experience with these strategies? Methods Five focus groups with paramedics and dispatchers were held at different urban and rural locations in Canada. The focus group responses were transcribed verbatim and analyzed using thematic analysis. Results It became apparent that emergency healthcare workers use a variety of strategies when dealing with violent patients or bystanders. Most strategies, other than generic de-escalation techniques, reflect a reliance on the systems the workers work with and within. Conclusion The study results support the move away from focusing on the individual worker, who is the victim, to a systems-based approach to help reduce and minimize violence against health care workers. For this to be effective, system-based strategies need to be implemented and supported in healthcare organizations and legitimized through professional bodies, unions, public policies, and regulations.
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Affiliation(s)
- Evelien Spelten
- Violet Vines Marshman Research Centre, Rural Health School, La Trobe University, Melbourne, Australia.
| | - Julia van Vuuren
- Violet Vines Marshman Research Centre, Rural Health School, La Trobe University, Melbourne, Australia
| | - Peter O'Meara
- Department of Paramedicine, Monash University, Melbourne, Australia
| | - Brodie Thomas
- Violet Vines Marshman Research Centre, Rural Health School, La Trobe University, Melbourne, Australia
| | | | - Richard Ferron
- Niagara Emergency Medical Services, Niagara Region, Niagara, Canada
| | - Jennie Helmer
- School of Population and Public Health, University of British Columbia, Vancouver, Canada.,British Columbia Emergency Health Services, Vancouver, Canada
| | - Gina Agarwal
- Department of Family Medicine, McMaster University, Hamilton, Canada.,Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
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Community nurse-paramedics' sphere of practice in primary care; an ethnographic study. BMC Health Serv Res 2021; 21:710. [PMID: 34275436 PMCID: PMC8286441 DOI: 10.1186/s12913-021-06691-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Accepted: 06/23/2021] [Indexed: 11/15/2022] Open
Abstract
Background Primary care, the principal function of the health care system, requires effort from all local primary health care teams. Community Paramedicine (CP) has managed to reduce the use of Emergency Medical Services (EMS) for non-emergency calls, but for the paramedic to move from traditional emergency calls to non-emergency care will mean new demands. There is a paucity of research exploring nurse-paramedics’ experiences and perceptions of their novel roles as community paramedics in Finland. This study aims to explore the community nurse-paramedics’ (CNP) experiences in their new sphere of practice. Methods A descriptive ethnographic study was conducted, to collect data through participant observation (317 h total) and semi-structured interviews (N = 22) in three hospital districts (HD) where the CNPs have worked for at least 1 year. Both data sets were combined, organised, and analysed using inductive content analysis. Results Five main categories were developed by applying inductive content analysis: the new way of thinking, the broad group of patients, the way to provide care, the diversity of multidisciplinary collaboration, and tailored support from the organisation. The CNP was identified as needing an appropriate attitude towards care and a broader way of thinking compared to the traditional practice of taking care of the patient and the family members. The diversity of multidisciplinary collaboration teams can be a sensitive but worthwhile topic for offering new possibilities. Tailored support from the organisation includes tools for future CP models. Conclusions Our results indicate the CNPs’ deep involvement in patients’ and families’ care needs and challenges with their skills and competencies. Their professional attitudes and eagerness to develop and maintain multidisciplinary collaboration can offer preventive and long-term caring solutions from which citizens, allied health, safety, and social care providers benefit locally and globally.
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Godfrey R, Brewis J. ‘Nowhere else sells bliss like this’: Exploring the emotional labour of soldiers at war. GENDER WORK AND ORGANIZATION 2018. [DOI: 10.1111/gwao.12229] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Richard Godfrey
- School of Business; University of Leicester; University Road Leicester LE1 7RH UK
| | - Joanna Brewis
- School of Business; University of Leicester; University Road Leicester LE1 7RH UK
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Ford-Jones PC, Chaufan C. A Critical Analysis of Debates Around Mental Health Calls in the Prehospital Setting. INQUIRY: The Journal of Health Care Organization, Provision, and Financing 2017; 54:46958017704608. [PMID: 28466658 PMCID: PMC5798668 DOI: 10.1177/0046958017704608] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Paramedics, health care workers who assess and manage health concerns in the prehospital setting, are increasingly providing psychosocial care in response to a rise in mental health call volume. Observers have construed this fact as “misuse” of paramedic services, and proposed as solutions better triaging of patients, better mental health training of paramedics, and a greater number of community mental health services. In this commentary, we argue that despite the ostensibly well-intentioned nature of these solutions, they shift attention and accountability away from relevant public policies, as well as from broader economic, social, and political determinants of mental health, while placing responsibility on those requiring services or, at best, on the health care system. We also argue that the perspective of paramedics, who are exposed to, and interact with, individuals in their everyday environments, has the potential to inform a better, structural and critical, understanding of the factors driving the rise in psychosocial crises in the first place. Finally, we suggest that a greater engagement with the political and social determinants of mental health would lead to preventing, rather than primarily reacting to, these crises after the fact.
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Affiliation(s)
- Polly Christine Ford-Jones
- York University, Toronto, Ontario, Canada
- Polly Christine Ford-Jones, York University, 4700 Keele St, Toronto, Ontario, Canada M3J 1P3.
| | - Claudia Chaufan
- York University, Toronto, Ontario, Canada
- University of California, San Francisco, USA
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Tavares W, Bowles R, Donelon B. Informing a Canadian paramedic profile: framing concepts, roles and crosscutting themes. BMC Health Serv Res 2016; 16:477. [PMID: 27605119 PMCID: PMC5015210 DOI: 10.1186/s12913-016-1739-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Accepted: 09/01/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Paramedicine is a rapidly evolving health profession with increasing responsibilities and contributions to healthcare. This rapid growth has left the profession with unclear professional and clinical boundaries. Existing defining frameworks may no longer align with the practice of paramedicine or expectations of the public. The purpose of this study was to explore the roles paramedics in Canada are to embody and that align with or support the rapid and ongoing evolution of the profession. METHODS We used a concurrent mixed methods study design involving a focused discourse analysis (i.e., analysis of language used to describe paramedics and paramedicine) of peer reviewed and grey literature (Phase 1) and in-depth one-on-one semi-structured interviews with key informants in Canadian paramedicine (Phase 2). Data from both methods were analyzed simultaneously throughout and after being merged using inductive thematic analysis. RESULTS Saturation was reached after 99 national and international grey and peer reviewed publications and 20 in depth interviews with stakeholders representing six provinces, seven different service/agency types, 11 operational roles and seven provider roles. After merging both data sets three framing concepts, six roles and four crosscutting themes emerged that may be significant to both present-day practice and aspirational. Framing concepts, which provide context, include variable contexts or practice, embedded relationships and a health and social continuum. Roles include clinician, health and social advocate, team member, educator, professional and reflective practitioner. Crosscutting themes including patient safety, adaptability, compassion and communication appear to exist in all roles. CONCLUSIONS The paramedic profession is experiencing a shift that appears to deviate or at least place a tension on traditional views or models of practice. Underlying and evolving notions of practice are resulting in intended or actual clinical and professional boundaries that may require the profession to re-think how it is defined and/or shaped. Until these framing concepts, roles and crosscutting themes are fully understood, tested and operationalized, tensions between guiding frameworks and actual or intended practice may persist.
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Affiliation(s)
- Walter Tavares
- Centennial College, School of Community and Health Studies, 941 Progress Ave. Station A, P.O. Box 631, M1K 5E9 Toronto, ON Canada
- York Region Paramedic Services, 80 Bales Dr. E. R.R.#1, L0G 1V0 East Sharon, ON Canada
- Ornge Transport Medicine, 5310, Mississauga, L4W 5H8 ON Canada
- Paramedic Association of Canada, 201-4 Florence St., K2P 0W7 Ottawa, ON Canada
- McMaster University, 1200 Main St., L8N 3Z5 Hamilton, ON Canada
| | - Ron Bowles
- Justice Institute of British Columbia, 715 McBride Blvd, V3L 5T4 New Westminster, BC Canada
- Society for Prehospital Educators of Canada, 101-265 Carleton Dr., T8N 4J9 St. Albert, AB Canada
| | - Becky Donelon
- Alberta College of Paramedics, 2755 Broadmoor Blvd., T8H 2W7 Sherwood Park, AB Canada
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O'Meara P, Stirling C, Ruest M, Martin A. Community paramedicine model of care: an observational, ethnographic case study. BMC Health Serv Res 2016; 16:39. [PMID: 26842850 PMCID: PMC4739332 DOI: 10.1186/s12913-016-1282-0] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Accepted: 01/22/2016] [Indexed: 11/18/2022] Open
Abstract
Background Community paramedicine programs have emerged throughout North America and beyond in response to demographic changes and health system reform. Our aim was to identify and analyse how community paramedics create and maintain new role boundaries and identities in terms of flexibility and permeability and through this develop and frame a coherent community paramedicine model of care that distinguish the model from other innovations in paramedic service delivery. Methods Using an observational ethnographic case study approach, we collected data through interviews, focus groups and field observations. We then applied a combination of thematic analysis techniques and boundary theory to develop a community paramedicine model of care. Results A model of care that distinguishes community paramedicine from other paramedic service innovations emerged that follows the mnemonic RESPIGHT: Response to emergencies; Engaging with communities; Situated practice; Primary health care; Integration with health, aged care and social services; Governance and leadership; Higher education; Treatment and transport options. Conclusions Community engagement and situated practice distinguish community paramedicine models of care from other paramedicine and out-of-hospital health care models. Successful community paramedicine programs are integrated with health, aged care and social services and benefit from strong governance and paramedic leadership.
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Affiliation(s)
- Peter O'Meara
- La Trobe University, PO Box 199, Flora Hill, Victoria, 3552, Australia. .,La Trobe Rural Health School, PO Box 199, Flora Hill, Victoria, 3552, Australia.
| | - Christine Stirling
- University of Tasmania, Private Bag 135, Hobart, Tasmania, 7001, Australia
| | - Michel Ruest
- County of Renfrew Paramedic Services, 9 International Drive, Pembroke, Ontario, K8A 6W5, Canada
| | - Angela Martin
- La Trobe University, PO Box 199, Flora Hill, Victoria, 3550, Australia
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