Female paramedics' attitudes towards career progression in the ambulance service

Abstract

Background: Women's historic under-representation in paramedic roles in the London Ambulance Service (LAS) has recently improved, and women and men are equally represented in paramedic roles. However, the gender balance of advanced paramedic practitioners in critical care in the LAS remains unequal, with women constituting only 15.1% of this group. Aims: This study aimed to gather the views of female paramedics to gain some insight into potential reasons for this under-representation. Methods: A feminist pragmatic approach was taken. Qualitative, open-ended surveys were distributed via internal social media and bulletins. These surveys underwent primary thematic analysis to generate lines of enquiry that informed semi-structured interview questions. The questions were then posed to a maximum variation, purposeful sample of six women from the LAS. Interviews were audio-recorded, transcribed and thematically analysed. Findings: Ninety-four women responded to the survey; six were sampled for interviews. The women varied by experience, clinical grade, age, work location and societal factors, including whether they were mothers and the number of children they had. A main overarching theme was ‘social construction of women and career progression within the ambulance service’. This was informed by three interrelated subthemes of ‘caregiving lifestyle’, ‘perceptions of self’ and ‘gender stereotypes’. Conclusion: Women in the ambulance service have unique challenges that mirror those in wider society. Social constructs may impose unconscious bias and pressures that prevent women from advancing. Organisational structures and the cultural norms of the LAS may require adapting to improve the gender balance of the workforce and therefore the service it delivers.