An Exploration of the Effects that Frequent Exposure to Life-threatening Events may have on a Critical Care Paramedic’s Psychological Wellbeing

Abstract

Aim UK Critical Care Paramedic (CCPs) are a specialty of experienced paramedics who have received higher education to deliver extended clinical care. Due to their specialist skills they are dispatched to the most critically ill and injured patients to deliver advanced care. Internationally, CCPs are recognised within the USA and Canada as Advanced Care Paramedics and as Mobile Intensive Care Ambulance Paramedic (MICA) in Australia. Method The CCPs studied within this UK Ambulance Trust have all received post graduate training achieving a certificate, diploma or MSc in Advanced Paramedic Practice or Critical Care. Eight qualified CCPs with at least one years' experience as a CCP, were recruited from one UK Ambulance Service. Face to face, semi structured interviews were conducted. Descriptive phenomenology and Colaizzi's framework for data analysis was used to discover the personal perspectives and experiences of CCPs. Results CCPs see a range of highly emotive incidents on a daily basis, specifically cardiac arrests and traumatically injured patients. They identified with symptoms suggestive of a heightened emotional response. The negativity of trauma identified within the studies literature review was not comparable with the responses from the majority of CCPs. The CCPs demonstrate resilience and adopt a diverse range of conscious coping strategies. The following factors were appraised by the CCPs to enhance their coping strategies: their ability to perform advanced clinical interventions and perceived survival of patients. Organised debriefs and improved clinical reflection. Enhanced inter-professional relationships and a regular crewmate for support. Conclusion CCPs felt the role caused slight disruption to their health and wellbeing. They implied improvements to the ambulance services' counselling. Further research focussing on larger populations adopting CCP and advanced paramedic groups would be recommended.