Paramedics are not receiving enough help to overcome psychological injuries caused by accumulated traumas they confront in their work – with Flinders University researchers identifying them as the forgotten profession within the healthcare system.
A review commissioned by the Ambulance Employees Association (AEA) wanted to assess how the impact of emergency medical service work affects paramedics’ psychological, physical and social well-being – and the results don’t paint a pleasant picture.
According to researchers from the College of Medicine and Public Health at Flinders University, rates of PTSD among paramedics are estimated to be twice as high as other health professionals, with little consideration from organisations about adequately providing for retired paramedics, ambulance officers, call-takers, or those forced to retire due to illness.
“Work-related stress goes far beyond coping with critical incidents,” says Flinders University’s Professor Sharon Lawn, lead author of the report. “It also includes the impact of repeated stresses present in the nature of the work itself, including operational and work-culture factors producing an interactive effect with critical incidents.
“Paramedics report that their access to appropriate care is made difficult through obstacles including a failure in the workplace to acknowledge stress, a lack of confidentiality, use of inappropriate therapies, poor return-to-work mechanisms, isolation, and stigmatisation – and compounded by concerted efforts to obstruct access to Worker’s Compensation provisions, and a lack of post-retirement support.”
The findings in this report has important ramifications for how the industry moves forward to improve the safety and wellbeing of paramedics says Phil Palmer, General Secretary of the Ambulance Employees Association.
“Governments need to reconsider the workforce planning model for ambulance, to ensure the needs of the responders are taken into account rather than the simplistic supply/demand equation,” says Mr Palmer.
The report notes that “Organisational support requires addressing the fall-out from the range of New Public Management strategies imposed on many government agencies that require high levels of productivity and efficiency but, as a consequence, provide inadequate time for recovery, result in long hours of over-time or missed meals, and fail to address the stigma associated with help-seeking. Essential to support was the provision of quality supervision, positive working relationships with supervisors, and implementing education and training for managers and on-road staff in dealing with, and recognising, stress management on an ongoing basis.”
Mr Palmer says “staff resilience is significantly dependant on organisational resilience and support, and current funding and staffing models do not consider these factors. Governments pay more heed to the bottom line than to staff wellbeing.
“This report provides sound evidence for the AEA to use in prosecuting a case for the additional resources needed to create the kind of supportive organisational model that is essential to build resilience and help keep our members safe.”
The researchers found that traumatic incidents that occurred during paramedics’ routine call-outs had a negative impact on staff and were often cumulative in nature, particularly the impact on their family life and relationships. The nature of their shifts, including pressure to go from one job to the next without sufficient time for rest, were also identified as contributors.
One of the main recommendations in the report is that ambulance services should be funded to provide members and their families (employed and retired) with financial support to seek their own confidential psychological well-being counselling outside of the organisation, with no financial cap put on resource use.
The Workers Compensation claims process should be streamlined and accepted for conditions that are often chronic in nature and which require long-term support.
The report notes that WorkCover (called Return to Work in South Australia) claims are prolonged, stressful and often difficult, as burden of proof is hard to establish and the onus is on an individual to provide evidence of psychological injury while they are unwell. Claims are generally not accepted if there is any potential or link to a “reasonable action taken by employer”. However, the report also shows that many of the existing supports and programs available to Ambulance personnel to support their psychological wellbeing fall short on meeting their needs. It also recommends that cover and support should be extended to volunteers who make up a large component of the emergency response.
The researchers also recommended funding for return-to-work programs for paramedics, and better training and understanding of the nature of the work for counsellors working in this space.
The report – titled “Ambulance Employees Association: Scoping Literature Reviews drawing on qualitative literature to address the physical, psychological, psychobiological, and psychosocial health of operational ambulance staff and interventions to address the impact of workplace stressors” – was compiled by the research team of Professor Sharon Lawn, Emeritus Professor Eileen Willis, Dr Louise Roberts, Dr Leah Couzner, Leila Mohammadi and Elizabeth Goble: