At the front of the front-line: Ontario paramedics' experiences of occupational safety, risk and communication during the 2020 COVID-19 pandemic
Notice bibliographique
Résumé
Purpose The study aimed to (1) determine on what bases paramedics in this context have defined themselves as feeling safe or at risk while serving on the front lines and (2) develop recommendations to support paramedics in their critical public health emergency response role. Design/methodology/approach This qualitative study consisted of 21 semi-structured interviews with primary care paramedics (PCPs), advanced care paramedics (ACPs) and critical care paramedics (CCPs) with first-hand experience responding to the COVID-19 pandemic in Ontario. Qualitative research is best suited to the research objectives of gaining detailed and nuanced understandings of paramedics' experiences during this public health emergency, and identifying in paramedics' accounts what changes to policy and practice might strengthen their sense of safety in future infectious disease outbreaks (Bowling, 2002; Chafe, 2017). Data collection occurred over the course of 3.5 months, from June 2020 until September 2020. Findings Participants described several factors that heightened their feeling exposed to risk particular to working on the front lines of the COVID-19 public health response. These factors include stress connected to personal protective equipment (PPE) and equipment access, risks of infection to self and family, communications and feelings of being systematically under-considered. Recommendations from this research include, but are not limited to, ensuring a more equitable distribution of protective equipment to paramedics across unevenly funded services, and recognizing paramedics face unique and additional stressors in public health emergencies. Research limitations/implications A key limitation of this study was the relatively small sample, with 50% of potential participants deciding not to engage in an interview. The authors suspect this is likely a result of timing, as this was conducting during significant periods of the COVID-19 pandemic in Ontario. The study identifies and begins to shed light on the way in which feelings of compromised safety and specific stressors in a public health emergency context connect to one another and potentially increase risks of burnout for this healthcare provider group. This study's documentation of paramedics feeling uncertainty about their own and their family's safety, combined with feeling occupational pressure, decisional pressure within constrained frameworks of care delivery, a lack of autonomy and a lack of consideration within their healthcare system in general and within its pandemic response in particular, is important in and of itself. These stressors can have serious implications for the ability of paramedics to sustain their integral role in public health emergency response. Practical implications A series of pandemic-specific and generalizable recommendations emerged from this research and in collaboration with community-based medical leadership. (1) Consult paramedics on effectiveness of screening questions and equipment. Be sure to illicit and respond to paramedic feedback in a timely manner. (2) Implement operational changes during pandemics in the form of donning and doffing stations, disposable gowns, decontamination teams at hospitals, infectious disease paramedic (IDP) truck, anti-fog sprays for goggles, and safe and controlled areas for eating and taking breaks. (3) Develop an emergency pandemic plan that is resourced and maintained as part of EMS strategic planning. Involve EMS in decisions related to health system emergency planning and sustainability of EMS practice. (4) Establish equitable distribution of resources, such as ensuring PPE is distributed equitably and applying pandemic pay equally to all essential workers. (5) Validate and respect EMS, as they are essential workers. Recognize the expertise of paramedics and community healthcare providers. Finally, an overarching recommendation at the core of this research is the consideration for paramedic knowledge as expertise given their role as critical front line healthcare specialists and the protection of this crucial human resource as it relates to their resilience and mental wellbeing. Social implications Evidence-based awareness and improved understanding of paramedic stress during the pandemic is a first step to developing strategies to reduce that stress. This is essential in ensuring access to this essential service during emergencies and the safety of the communities they serve. Originality/value Findings from this study can inform development of supports to sustain paramedic wellbeing during public health emergencies, during the ongoing pandemic, in Ontario and beyond.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,007 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».