Nurse preceptors' experience-based strategies for supporting learning in the ambulance service-A combined focus group and dyadic interview study

'We are expected to be problem solvers'-Paramedics' performance expectations through the lens of organizational socialization: An interview study

AIM

To explore Finnish paramedics' perceptions of work-related performance expectations in relation to work experience, and understand how organizational socialization contributes to understanding paramedics' performance expectations.

DESIGN

A qualitative design with a deductive-inductive approach utilizing a social constructivist framework. The organizational socialization framework by Wanberg was used as the theoretical basis.

METHODS

Data were collected between May and August 2023, using group and individual interviews of newly graduated (n = 9) and experienced paramedics (n = 13). Participants were recruited via social media channels. Data were first analyzed deductively, according to constructs of the organizational socialization framework (role clarity, task mastery, and social acceptance), then inductively, using codes not utilized in the deductive phase.

DATA SOURCES

Interviewed Finnish paramedics (N = 22), both newly graduated paramedics (n = 9) and experienced paramedics (n = 13). The interviews were performed remotely and then transcribed into text.

RESULTS

Our findings showed comparable performance expectations between newly graduated and experienced paramedics, mismatches in role clarity of paramedic work, challenges in both learning and upholding professional competence, and difficulties of social acceptance into the paramedic community. There were variations in how expectations were perceived between groups, indicating that experience might partly affect how paramedics identify and manage performance expectations. The organizational socialization framework enables the contextualization of these performance expectations.

CONCLUSIONS AND IMPLICATIONS

Paramedic work involves challenges to upholding clinical competence, aligning to a professional role, and social integration into the professional community. Our research contributes to understanding how paramedics perceive these challenges as performance expectations in different stages of their careers and how they could be managed utilizing a framework for organizational socialization. The socialization of paramedics into the workforce needs to account for these performance expectations, especially considering the changing paradigm of paramedic work, role, and societal expectations.

PATIENT OR PUBLIC CONTRIBUTION

No Patient or Public Contribution.

Maintenance and Development of Paramedics' Competence on Joint Emergency Medical Service and Helicopter Emergency Medical Service Missions

OBJECTIVE

In health care, learning and collaboration between professions are crucial in providing patient-centered, responsive, and high-quality care. Given that interprofessional learning can occur indirectly while working but is scarcely studied in the context of prehospital emergency care, we examined the maintenance and development of paramedic competence on joint emergency medical service (EMS) and helicopter emergency medical service (HEMS) missions.

METHODS

Qualitative methodology was chosen. Sixty-one Finnish paramedics and EMS field supervisors answered a single open-ended survey question. Inductive content analysis was used to analyze the data.

RESULTS

The maintenance and development of paramedics' competence on joint EMS and HEMS missions formed 2 main categories: the transfer of professional skills and interactive competence development. The transfer of skills was formed by 3 upper categories: practicing working as part of the team, transmission of tacit knowledge, and deepening of clinical knowledge. Interactive competence development was formed by 2 upper categories: ensuring one's own competence and educational working model as built-in. All the upper categories had several subcategories.

CONCLUSION

EMS and HEMS joint missions provide an additional learning opportunity for paramedics. The expertise, examples, and educational attitudes shared by the HEMS are valued. The results reveal the need for further research on this subject.

The ways specialist nursing students understand the work in the ambulance service - a national Swedish phenomenographic study

Objective

Design, sample, and measurements

Findings

Conclusions

Paramedics' perceptions of job demands and resources in Finnish emergency medical services: a qualitative study

BACKGROUND

Paramedics' fatigue is rising. Stress factors show increased risk for burnout, fatigue, leaving the profession, decreased performance and risk for patient safety. Meanwhile, paramedics' strong community of practice, autonomy and a sense of professional respect are important factors in forming psychological resilience. We aimed to explore Finnish paramedics' perceptions of job demands and resources.

METHODS

Our study design was descriptive, inductive with a constructivist approach. Using reflexive thematic analysis, we analyse open-ended questions, from a web-based survey and essays written by Finnish paramedic masters-degree students. The study followed the SRQR checklist.

RESULTS

We identified paramedics' job demands as stress from a high workload, environmental factors and emotional burden. Performance expectations and a sense of inadequacy were further noted, as well as an organizational culture of hardiness, presenting lack of support and sense of inequality. Paramedics' job resources were pressure management strategies, which were expressed as positive coping mechanisms, agency to affect workload and professional self-actualization, expressed as psychologically safe work community, professional pride and internal drive to professional development.

CONCLUSIONS

Finnish paramedics exhibit resources and demands related to uncertainty and emotional burden as well as cultural hardiness and psychological safety in communities.

PATIENT OR PUBLIC CONTRIBUTION

This study was done based on survey data collected and analysed by the authors. No patient or public contribution was utilized for this study.