Paramedic professional identity: A qualitative case study using a role theory lens

Abstract

Background: Health professional roles, organisations and workplace experiences are often studied in conjunction with professional identity (PI) and role theory. This study focused on paramedic PI and role perceptions within the United States context. Methods: The exploratory qualitative case study data included 15 semi-structured interviews with practising paramedics in EMS contexts. Results: The data is presented in five categories and 23 subthemes. Data categories included exploration of why paramedics were drawn to the profession, envisioning eventual exit from paramedicine, discussion of paramedic PI perceptions in relation to professional insiders, to first responders and to hospital-based healthcare professionals. Findings: The study findings drew upon data categories to theorise four overall findings about participant PI and roles: (1) ‘I know that what I do is important!’ reflecting paramedic expressions of an inner reservoir of strength surrounding the importance of their work, even if the personal motivations for working in EMS are varied, (2) ‘My primary role is care of the patient’ indicating strong identification with a primary role as patient caregiver that serves as both an enduring positive foundation for identity and a constant role dissonance stressor, (3) ‘The respect I receive is variable and conditional’ suggesting a capacity to not only cope with, but to leverage a shared sense of being unevenly respected by other professionals into patient advocacy and a quest for excellence; and (4) ‘In my role, I have to function well with a fluctuating locus of control’ signalling that PI partially rests in an ability to shift identities in a fluid way because the locus of control and roles paramedics occupy throughout their environments vary constantly. Conclusions: The findings contribute valuable information that may be used to address paramedic workplace stressors, enhance professional capacity building and to adapt paramedic environment structures and policies.