Care and empathy in ambulance services: paramedics’ experiences of communicative challenges in transports of patients with prolonged cancer

Abstract

Prehospital interaction between health workers and seriously ill patients involves many communicative challenges, but these challenges have not received much attention in the literature on health communication. This article presents an exploratory study of how paramedics working in the national ambulance services in Norway experience communication with cancer patients. The method was qualitative and involved semi-structured, in-depth interviews with 20 paramedics. The main finding was that none of the paramedics thought that the main communicative challenges concerned medical issues. Instead, the challenges they experienced concerned interpersonal relations, ethical issues, and choices of communicative strategy. The paramedics thought that it was difficult to secure communication in the sense that it was personally and professionally difficult to find the ‘right words’. In the discussion of these findings two consequences are highlighted. Firstly, emergency personnel need education and training in preparing for emotional work and challenging patient communication. This is, to a large extent, a management responsibility. Secondly, internal collegial support arrangements in emergency services should not only focus on intense transports involving acute disease or injury but should also help paramedics to cope with more quiet transports that are experienced as difficult.