Doctorate
Doctorate Title: Morning always comes : Exploring Finnish paramedic professionals’ resilience resources.
Doctorate Description:
Abstract
The varying nature of paramedic practice, including acute trauma and accumulated fatigue, is mirrored in increasing turnover rates among paramedic professionals. Signs indicate that paramedics suffer from increased mental load and professional role dissonance at an early stage. Socialization into the community of Emergency Medical Services (EMS) can act as a social support anchor but also appears as negative cultures of hardiness and blame. Professional value formation among paramedics might thus have an impact on developing their sense of coherence (SOC) and resilience resources at an early stage. Paramedics’ resilience resources are therefore relevant to explore beyond conventional perspectives of trauma-related resilience. Aiming to explore Finnish paramedic professionals’ resilience resources and their formation during professional transition, this thesis has chosen to utilize employee resilience as a theoretical framework, with SOC and organizational socialization (OS) as key concepts.
Based on four sub-studies, this study has a descriptive, retrospective design and includes sub-studies with predominantly qualitative approaches (II–IV), one study having a quantitative approach (I). All data were collected between 2018 and 2023. The first sub-study (I) explored correlations between paramedics’ one-year assignment experiences and defusing use to compassion fatigue (CF), compassion satisfaction (CS), and burnout (BO) scores (ProQOL Scale R-IV). The second sub-study (II) explored paramedics’ job demands and resources, utilizing thematic analysis of web-based surveys and essays written by Finnish paramedic master’s students’ material. The third sub-study (III) explored newly graduated and experienced paramedics’ perceptions of work-related performance expectations in relation to OS using group and individual interviews of both newly graduated and experienced paramedics. The fourth sub-study (IV) investigated newly graduated paramedics’ professional value formations and connections to SOC using story-mediated individual interviews, analyzed using thematic analysis.
In total, potentially 490 paramedic professionals participated in all studies (I–IV). In the first study (I), paramedics’ experiences of social emergencies and traumatic events correlated with secondary traumatic stress (STS) and BO levels, while participants’ need for post-assignment defusing correlated with STS. While subjective perceptions of positive effects from attending defusing was associated with lower BO and higher CS, actual participation in defusing did not show correlations. Exploring paramedics’ job demands and resources (II), the jobs required high workload with emotional burden, culture of hardiness, and performance expectations as a paramedic, while resources were disconnecting and balancing EMS work, being respected and valued within the EMS community, and a sense of professional self-actualization. Newly graduated and experienced paramedics’ perceptions of performance expectations connected to OS constructs of role clarity, task mastery, and social acceptance (III). Graduates described paramedic work as having steep transitional gaps, mismatches in expectations of abilities and learning support, challenges in handling complex work, inclusion as a new paramedic, and the impact of collegial acceptance. Experienced paramedics were challenged by expectations of professional certainty, ambiguity of paramedics’ core purpose, keeping up with new knowledge, stretching the borders of their performance, and a sense of professional belonging but having to carry mental loads alone. Professional value formations among newly graduated paramedics were related to the performance of paramedic work, sense of professional community, and dimensions of professionalism (IV). The SOC construct of manageability was formulated from values related to paramedics’ competencies, adaptation to complexity, trust in team, and responsibility for their work and themselves from the burdens of work. The SOC construct of comprehensibility was formulated from values related to compassionate care, sense of loyalty from EMS communities, and being a respected paramedic professional. The SOC construct of meaningfulness was formulated out of descriptions of being able to perform autonomous, compassionate, and empathetic work; a sense of professional integrity; and having an impact.
Prehospital emergency care work involves many dimensions of demands and multiple resources for developing paramedics’ resilience-enhancing behavior models of learning, adaptability, and network leveraging. While job demands stem from EMS patient encounters with potential consequences for paramedics’ well-being, further demands and resources can stem from the EMS work community and culture, paramedics’ private emotional management, clarity of the professional role, and performance expectations. Concurrently, newly graduated paramedics’ professional value formation aids in shaping their work-related sense of coherence, a resource in developing employee resilience. Strengthening paramedics’ resilience resources should be done on individual, organizational, and educational levels.
Details:
Type: PhD
University: University of Helsinki
Primary Supervisor: Dr Hilla Sumanen, Dr Veronica Lindström, Dr Ann Rudman
Category: Staff Wellbeing
Funding:
Start Date: 2020
End Date: 2025
Status: Complete
Thesis
ThesisResearch Interests
Paramedic Resilience, Burnout, Compassion Fatigue, Psychological Safety, Coping Strategies.
