Ambulance Workers Research Articles

Participant Observation, Observant Participation, and Hybrid Ethnography

How much should ethnographers involve themselves with the people, places, and processes they study? One answer has become increasingly popular: invert the standard method of participant observation into observant participation. This article draws on an ethnography of ambulance work to consider the trade-offs between these approaches. My fieldwork included “ride-alongs” with labor and management at a private ambulance firm in California (participant observation) and short-term employment as a novice emergency medical technician at the same company (observant participation). Beyond a simplistic distinction in “empirical depth,” I identify three issues at stake between participant observation and observant participation: field positioning, analytic gaze, and data assembly. Where participant observation presents more opportunities for mobile positioning, outward gazing, and inscription, observant participation presents more opportunities for fixed positioning, inward gazing, and incarnation. In addition to justifying such contrasts, I consider the advantages of mixing these styles into a hybrid approach when feasible.

Pacifist utopias: humanitarianism, tragedy and complicity in the Second World War

Pacifist utopias: humanitarianism, tragedy and complicity in the Second World War

EXPERIENCING STRESS DURING A CORONAVIRUS COVID-19 PANDEMIC: THE PERSPECTIVE OF AN AMBULANCE WORKER

Relevance of the topic.  A person’s daily life is full of stress and tension, often the current age is called the era of stress. The impact of stress in professional activities is becoming one of the most relevant topics. One of these professional activities includes ambulance physicians [1], [2]. Recent stress during a coronavirus pandemic is one of the most sensitive and pressing issues. Ambulances are currently working in particularly difficult conditions, facing non-standard situations on a daily basis, receiving a wide range of new information, changing working conditions and increased workloads. Therefore, the aim of this work is to assess the stress experienced during a coronavirus COVID-19 pandemic from the perspective of ambulance personnel. The aim of the study - to evaluate the stress experienced during a pandemic from the point of view of ambulance staff. The problem of the research - what is the stress experienced during a coronavirus COVID-19 pandemic from the perspective of ambulance personnel? The objectives of the study are: to define the concept of stress and its factors in a theoretical aspect. To assess the stress experienced by ambulance workers during the coronavirus COVID-19 pandemic. To compare the stress experienced of small-town X and city Y during a coronavirus pandemic from the point of view of ambulance personnel. The subjects of research was conducted at ambulance stations in town  X and city Y. During the quantitative research, employees of town X and city Y ambulance stations were interviewed using an anonymous questionnaire.  The used methodology is justified - scientific literature analysis. Questionnaire survey. Descriptive statistical analysis. The study involved 60 respondents. Research selection - target: respondents - ambulance staff working in X town and Y city ambulance stations. The study interviewed 30 ambulance workers from two different cities and institutions (X town and city Y). A comparative analysis was performed between these two institutions

Information technology improving the efficiency of emergency doctors

At the present stage of development of society, one of the most important areas is information technology. Every year the amount of information is constantly increasing, forcing you to spend more and more time and labor on your processing. In this regard, modern automated information systems are becoming more and more necessary, able to process input information in a short time and provide it in a convenient form that allow rational and accessible storage of used information. The introduction of information technology has also begun to be used in medical institutions. To do this, you need to move to a more modern level of computer technology. It is computer technology that helps to increase the speed of personnel management and the preparation of paper documentation. Establishment of an expert-diagnostic system, the main task of which is to obtain information based on the list of symptoms of the patient, and to establish the most probable disease that corresponds to the patient's state of health. The objectives of the development are: to remove the factor of human error in diagnosis, increase the percentage of correctly diagnosed, facilitate the process of diagnosis by symptoms, increase patients' trust in doctors, increase the speed of diagnosing patients. The created system has all the capabilities necessary for efficient and fast management of ambulance workers. It contains all the basic tools you may need to function properly, generate reports for the required period, register new employees (users), set up an individual work schedule and receive patients, manage received calls, administer and control vehicles. The WEB interface of the «Reception Manager» was created for the application software interface to be able to coordinate and direct free machines to the specified calls. During the theoretical analysis, the general structure of the system was presented, which includes an application programming interface (API) with web-interfaces, which is divided into several main roles: the role of «Reception Manager», the role of «Direction Manager», the role of «Patient». The system will significantly speed up the work of ambulances by taking over almost all the work on communication between employees and document management, as well as patient management. Collectively, the developed systems will be able to significantly increase the speed and efficiency of doctors.

A Questionnaire Study Effect of COVID-19 Pandemic on Anxiety and Burnout Levels in Emergency Healthcare Workers

Objectives
 During the COVID19 pandemic, an increase in anxiety and burnout levels may occur unwittingly due to the increased workload and intense stress experienced by emergency healthcare workers (HCWs) dealing with potential or suspected COVID-19 and other emergency patients. In our study, it is aimed to investigate whether there is an increase of anxiety and burnout levels of the HCWs working in ES and pandemic fields fighting against the outbreak of COVID-19 in Turkey.
 Methods
 The study was carried out between April 1 to May 15, 2020, with the online questionnaire method with the participation of 920 HCWs that are working actively in pandemic areas across the country. In the questionnaire, the sociodemographic characteristics of the participants were questioned, and Beck anxiety scale (BAI) and Maslach Burnout Inventory (MBI) were applied.
 Results
 The pandemic area and the intensive care workers' BAI score are similar to those in the emergency service and ambulance (p = 0.05). The MBI-desensitization score of those working in the field of ED, ICUs and pandemics was higher than other places (p <0.05). The MBI-emotional score of the emergency and ambulance workers was higher (p = 0.001), and the MBI-personal accomplishment score was lower than radiology, laboratory and office personnel (p=0.049).
 Conclusions
 The COVID-19 outbreak may create stress in HCWs, leading to various psychiatric disorders such as anxiety, depression, and burnout syndrome. Early recognition, prevention and coping methods of burnout and anxiety in HCWs play a key role in during the pandemic period.
 Keywords: COVID-19, Emergency Service, Healthcare Worker, Beck Anxiety Inventory, Maslach Burnout Inventory

Health behaviours in ambulance workers

Introduction: Awareness is increasing that health behaviours, which are a part of a person's lifestyle, have significant effects on emotional and physical wellbeing. Ambulance workers are at a higher risk of poorer psychological health outcomes than the general population. This begs the question whether lifestyle could play a role in emotional and physical health outcomes, which is an understudied area in this population. This paper reviews health behaviours in paramedics and assesses the impact they may have on their emotional and physical wellbeing. Methodology: PRISMA guidelines were adhered to and seven online bibliographic databases (MEDLINE, CINAHL, PsychArticles, PsychINFO, Web of Science, PubMed and Google Scholar) and reference lists of eligible articles were searched. Papers were systematically extracted and selected by title, then by abstract using inclusion and exclusion criteria. Findings: The papers included in this review (n=6) cover a range lifestyle factors (physical activity, smoking, alcohol use and sleep) that potentially affect wellbeing outcomes (weight/body mass index and post-traumatic stress symptoms) of ambulance workers across the Western world. They have various limitations. Conclusion: Ambulance workers engage in negative health behaviours that have some bearing on their emotional and physical wellbeing. Further research could explore the role of health behaviours and lifestyle in ambulance workers using validated measures. The findings could support the development of an evidence-based, occupation-specific intervention.

Ergonomic risk factors and physical fatigue among ambulance workers in Bulgaria

Abstract Background Ambulance workers' job is characterized by extended shifts, inconsistent shift patterns, poor sleep, non-ergonomic work places and work postures, high levels of physical and mental strain. Fatigue in the Emergency Medical Services (EMS) workplace may be related to high patient care loads, demanding work schedules, physical overload and associated stress. The impaired health of those workers can result in pressure on health and insurance systems for treating them as well as bad health care services for emergency patients. Methods The study was conducted among 468 workers in emergency healthcare centers in Bulgaria in the period from December 2017 to April 2018. A sociological method was used - a questionniare. The results of the study are presented using descriptive statistics and Chi-square test. Results The biggest part of participants complained from ergonomic hazards such as lifting, carrying weights have negative impact on their health: 71.1% of the ambulance drivers, 61.4% of the doctors, 53% of paramedics, followed by nurses with 52.4% and sanitarians with 51.9%. The distribution by positions show that high levels of physical fatigue are among paramedics 59.1%, followed by doctors - 58.3%, nurses 47.6%, medical orderly 33.3% and ambulance drivers 31.9%. The highest levels of the physical fatigue are among respondents at age up to 35 years. Risk reduction measures were developed and distributed among ambulance workers and their employers. Special stress coping strategies were implemented. Conclusions Work among ambulance workers is associated with a number of risks as among the main once are ergonomics and related high levels of physical fatigue at the end of the working day. Key messages The levels of ergonomic hazards are high among ambulance workers. Ergonomic hazards have negative impact on ambulance workers’ health and the prevalence of musculoskeletal disorders is very high.

The Effectiveness of Interventions Aimed at Improving Well-Being and Resilience to Stress in First Responders

Abstract. First responders are routinely exposed to traumatic critical incidents, placing them at higher risk for developing stress-related psychopathology and associated health problems than the general population. Interventions which could improve resilience to stress may help to protect the health of this high risk population. We systematically reviewed such interventions for first responders to determine which ones work and why. We searched the Cochrane and Campbell Collaboration Library, EMBASE, IBSS, Medline, PILOTS, PubMed, PsycINFO, and SCOPUS from January 1, 1980 to June 28, 2018 for randomized and quasi-randomized controlled studies aiming to improve well-being, resilience, or stress management for police, ambulance, fire, or search and rescue workers using non-pharmacological interventions. Data were extracted from published reports and obtained from authors. Within- and between-group effect sizes were calculated for mental and physical health outcomes. Risk of bias was assessed using the Cochrane Collaboration’s Risk of Bias Tool. The initial search identified 3,816 studies, 13 of which were eligible for analysis ( n = 634 cases, n = 628 controls). Six studies demonstrated intervention-related improvements. However, risk of bias was mostly unclear or high. Within-group intervention effect sizes ranged from −0.82 (95% CI [−1.48, −0.17]) to 2.71 [1.99, 3.42] and between-group intervention effect sizes ranged from −0.73 [−1.25, −0.21] to 1.47 [0.94, 2.01], depending on the outcome. Largest effects were seen for interventions that targeted modifiable risk factors for trauma-related psychiatric disorders. Targeting modifiable predictors of trauma-related psychiatric disorders through training may protect the health of first responders who routinely face trauma in their line of work.

The effects of emergency medical service work on the psychological, physical, and social well-being of ambulance personnel: a systematic review of qualitative research

BackgroundHigh rates of mental distress, mental illness, and the associated physical effects of psychological injury experienced by ambulance personnel has been widely reported in quantitative research. However, there is limited understanding of how the nature of ambulance work contributes to this problem, the significant large toll that emergency medical response takes on the individual, and particularly about late and cumulative development of work-related distress among this first responder workforce.MethodsThis study examined peer-reviewed qualitative research published from 2000 to 2018 to outline the effect of emergency medical response work on the psychological, psychosocial, and physical health of paramedics, ambulance officers, ambulance volunteers, and call-takers. Databases searched included: Ovid Medline, CINAHL, Ovid EMcare, PsychInfo and Scopus. The systematic review was organised around five key areas: impact of the work on psychological wellbeing; impact of psychological stress on physical wellbeing; how work-related well-being needs were articulated; effects of workflow and the nature of the work on well-being; and, effects of organisational structures on psychological and physical well-being.ResultsThirty-nine articles met the eligibility criteria. Several factors present in the day-to-day work of ambulance personnel, and in how organisational management acknowledge and respond, were identified as being significant and contributing to mental health and well-being, or increasing the risk for developing conditions such as PTSD, depression, and anxiety. Ambulance personnel articulated their well-being needs across four key areas: organisational support; informal support; use of humour; and individual mechanisms to cope such as detachment and external supports.ConclusionsInteractions between critical incidents and workplace culture and demands have an overwhelming impact on the psychological, physical and social well-being of ambulance personnel. These include day-to-day managerial actions and responses, the impact of shift work, poorly-managed rosters, and long hours of work with little time between for recovery. Mental health issues result from exposure to traumatic events, and the way managers and peers respond to worker distress. Ambulance personnel suffering from work-related stress feel abandoned by peers, management, and the service, during illness, in return-to-work, and post-retirement. Policy, programmes and interventions, and education need to occur at an individual, peer, organisational, and government level.

Public knowledge and attitudes towards bystander cardiopulmonary resuscitation (CPR) in Ghana, West Africa

Background and objectivesEarly bystander cardiopulmonary resuscitation (CPR) is one of the most important predictors of out-of-hospital cardiac arrests (OHCA) survival. There is a dearth of literature on CPR engagement in countries such as Ghana, where cardiovascular events are increasingly prevalent. In this study, we sought to evaluate Ghanaians’ knowledge of and attitudes towards bystander CPR, in the context of the country’s nascent emergency medicine network.MethodsCapitalizing on the growing ubiquity and use of social media across the country, we used a novel social media sampling strategy for this study. We created, pre-tested, and distributed an online survey, using the two most utilized social media platforms in Ghana: WhatsApp and Facebook. An airtime data incentive of 5 US dollars, worth between 5 and 10 GB of cellular data based on mobile phone carrier, was provided as incentive. Inclusion criteria were (1) ≥ 18 years of age, (2) living in Ghana. Survey participants were encouraged to distribute the survey within their own networks to expand its reach. We stratified participants’ responses by healthcare affiliation, and further grouped healthcare workers into ambulance and non-ambulance personnel. We used chi-square (χ2)/Fisher’s Exact tests to compare differences in responses between the groups. Based on the question “have you ever heard of CPR?”, an alpha of 0.05 and a 95% confidence interval, we expected to have 80% power to detect a 15% difference in responses between lay and healthcare providers with an estimated sample size of 246 study participants.ResultsThe survey was launched on 8 July 2019 and closed approximately 51 h post-launch. With a 64% completion rate and 479 unique survey completions, the study was overpowered at 96% power, to detect differences in responses between the groups. There was geographic representation across all 10 historic regions of Ghana. Over half (57.8%, n = 277) of the respondents were non-medically affiliated, and 71.9% were women. Healthcare workers were more aware of CPR than lay respondents (96.5% vs 68.1%; p < 0.001). Eighty-five percent of respondents were aware that CPR involves chest compressions, and almost 70% indicated that “mouth to mouth” is a necessary component of CPR. Fewer than 10% were unwilling to administer CPR. Lack of skills (44.9%) and fear of causing harm (25.5%) were barriers noted by respondents for not administering CPR. Notably, a quarter of ambulance workers reported never having received CPR training. If they were to witness a collapse, 62.0% would call an ambulance, and 32.6% would hail a taxi.ConclusionThe majority of participants are willing to perform CPR. Contextualized training that emphasizes hands-only CPR and builds participants’ confidence may increase bystander willingness and engagement.

Outsourcing of transport services at emergency medical stations in the regions of the Russian Federation: negative consequences of the introduction

The article is devoted to the consideration and analysis of such a phenomenon as outsourcing at ambulance stations in the Russian Federation. Experiments on the introduction of ambulance outsourcing in different regions of Russia have been conducted for almost 10 years. The analysis of social and labor conflicts shows that the cases when these attempts were made without conflicts are isolated exceptions. This threatens the reliability of the organization of emergency medical care to the population and worsens the situation of ambulance workers.

Early diagnosis and rapid isolation: response to COVID-19 outbreak in Korea

Early diagnosis and rapid isolation: response to COVID-19 outbreak in Korea

Differences of Emotional Intelligence, Self-Effectiveness and Job Stress Levels by ambulance worker Personal Characteristics

Background/Objectives: As the field activity of the fire fighter is increased increasing the exposure to the traumatic event, the development of effective program to reduce the job stress is needed.Methods/Statistical analysis: The present study investigated levels of emotional intelligence, self-efficacy, and job stress by personal characteristics, working environment of ambulance workers, and grasped their correlations. A survey of ambulance workers in service at fire stations in the northern Gyeonggi province was conducted from Feb. 22 to Mar. 31, 2019 and 160 questionnaires were analyzed. Collected data were subjected to frequency analysis, t-test, and ANOVA using SPSS software 12.0 program.Findings: Emotional intelligence showed a score of 63 out of 80 points. Emotional intelligence of females was higher than that of males. That of workers not younger than 35 years was higher than that of workers younger than 30 years. That of fire engineers or fire lieutenants was shown to be higher than that of firefighters. Job stress of females was higher than that of males. That of EMT level 2 qualification holders or workers who took the training course was shown to be higher than that of EMT level 1 qualification holders. That when less than three workers were mobilized was shown to be higher than that when three workers and more were mobilized. Self-efficacy showed a positive correlation with emotional intelligence but a negative correlation with job stress. Emotional intelligence showed a negative correlation with job stress. The higher the emotional intelligence, the higher the self-efficacy. The higher the emotional intelligence and self-efficacy, the lower the job stress.Improvements/Applications: To reduce the job stress, the health should be improved and the field response capability should be enhanced by establishing the strategy to enhance the emotional intelligence.

The magnitude and determinants of violence against healthcare workers in Pakistan

ObjectivesTo determine the magnitude and determinants of violence against healthcare workers (HCWs) and to identify the predominant types and causes of violence experienced by them.MethodologyA cross-sectional survey based on structured...

First hospitalized case of laboratory-confirmed coronavirus infectious disease 2019 (COVID-19) in Alberta, Canada

As the pandemic of coronavirus disease 2019 (COVID-19) continues to evolve globally and within our Canadian borders, hospitals will begin to see an increasing number of confirmed or suspected cases at their doors. Although many patients can be managed at home, a reasonable proportion will experience progression of disease requiring hospitalization and potentially mechanical ventilation and intensive care. Herein, we report the presentation of the first case of COVID-19 admitted to hospital in Alberta. While The patient's course was mild, this case highlights a number of key points—namely the importance of widespread testing in the community to help inform emergency services (ambulance) workers and receiving front-line health care staff. Other important points include in-hospital monitoring and pharmacologic treatment.

Emergency workers' experiences of the use of section 136 of the Mental Health Act 1983: interpretative phenomenological investigation.

To explore the experiences of emergency workers dealing with incidents in which section 136 of the Mental Health Act 1983 is invoked by the police. Data from interviews with police officers and ambulance workers in a London locality were subject to interpretative phenomenological analysis. Participants felt they were the first port of call and that training should be improved to help them deal with those experiencing mental health crises in the community. Police participants noted time pressures trying to gain individuals' trust and described section 136 detention as sometimes feeling like a betrayal of the individual. Most participants had negative experiences of admissions to the 136 suite; several suggested ways of improving the admissions system. Several went beyond their expected duties to ensure that distressed individuals were supported before accessing mental healthcare services. Improving training of emergency workers in dealing with mental health crises would also help with aftercare decision-making. Learning identified from the participants' experiences lends support to collaboration between emergency and mental health services, an important step towards improving the section 136 process so that detainees can access help without unnecessary delay.

Working in prehospital emergency contexts

Purpose Ambulance personnel face a diversity of stressful events that could be potentially traumatic, putting their health and well-being at risk. The purpose of this paper is to explore, from this group perspective, sources of stress, coping strategies and support measures. Design/methodology/approach The authors interviewed 14 ambulance workers of Portuguese Red Cross local structures from the north of Portugal. Data were analyzed according to thematic analysis procedures. Findings The authors identified three themes: operational and organizational factors, control and predictability; anticipating scenarios, focusing on procedures and dealing with reactions; and from undervalued support to support as routine. Dealing with human lives, the unpredictability of calls and working under pressure are the main sources of stress, causing, in some of them, insomnia, fatigue, anxiety and intrusive thoughts. Road accidents, situations involving children and cardiac arrest are the most distressing events. During events, they cope focusing on technical procedures, but after them they prefer to talk with colleagues and seek support from family and friends. All participants emphasize the inexistence of structured support measures. Practical implications It is important to develop support measures tailored to ambulance personnel’s needs, leading to enhancements of theirs work performance, health and well-being. Originality/value Contrarily to most of the studies that explore mostly PTSD and/or burnout, the authors explored, from the perspective of professionals, other dimensions such as sources of stress, coping strategies and support measures, adopting a qualitative approach, which has been rarely used.

Doing care work on the fly - exploring the unnoticed socio-emotional skills of male ambulance staff.

Prehospital ambulance work is a healthcare arena hitherto neglected by sociologists of health and illness. This is unfortunate because it is an interesting and dynamic area, and in contrast to most healthcare sectors, it is male dominated. Via ethnographic fieldwork, this article examines the particular caring practices and socio-emotional skills that ambulance staff use in practising prehospital care work. The empirical analysis outlines six recurring prehospital practices: medicine work, machine work, scene management, becalming work, communication work and bodywork. Each practice represents a different element of prehospital care practice and is best understood as a repertoire, as many different assemblages of these care practices can work effectively in prehospital situations. The article concludes that despite institutionalised blue-collar masculinity, numeric dominance and scarce formal education in ambulance psychology, male ambulance staff are generally proud and reflexive care practitioners.

Moscow ambulance station. From origin to modern times

This article is dedicated to the 100th anniversary of the establishment of the Ambulance and Medical Emergency Care Station n. a. A. S. Puchkov in Moscow. Alexander Sergeyevich Puchkov, Doctor of Medical Sciences, Honored Doctor of the RSFSR, steadily led her from 1923 to 1952. The data presented in the articles of Mr. Puchkov served as the basis for comparing indicators about the station’s activities during its formation and the modern ambulance and emergency medical services in Moscow. Some features, characteristics and conditions for the provision of emergency and emergency medical care in Moscow in the year 1926 are shown. So, for example, the number of brigades increased by 68.7 times (from 15 in 1926 to 1,031 in 2018). The average time of arrival of the brigade for an accident both in 1926 and in 2018 is 10–12 minutes long. The share of calls by ambulance teams to children under 15 years of age has also increased significantly. The analysis of performance over the years has made it possible to trace the development of the ambulance station from the time of its creation to the present day. The fundamental principles laid down by Alexander S. Puchkov remain in the ambulance work at the present time. Doctors and paramedics of ambulance and emergency medical care teams continue to promptly provide medical care to all those in need, guided by many provisions that were developed and implemented over 90 years ago.

Delegation-based and directive mentoring relationships in high reliability organizations: Negotiating the reliability-resilience tension in ambulance work

ABSTRACTThis study focuses on the thorny problematic of how mentors and mentees negotiate on-the-job learning in emergency ambulance work. Based on fieldnotes and interviews with 54 volunteer and paid ambulance crew from Aotearoa New Zealand's largest emergency ambulance service, the analysis identifies six ways of organizing the mentoring relationship and describes how each navigates the reliability–resilience tension. Coaching, hands-off mentoring, and coaxing are delegation-based relationships, whereas bossing, controlling, and criticizing are directive. The findings extend research on mentoring in high reliability organizations by showing that resilience and reliability depend on how mentors delegate authority, enable participation, or exclude mentees from the decision-making process.