What paramedics think about when they think about fatigue : contributing factors

Objective: Paramedic fatigue is associated with burnout, attrition, sickleave, work disability, physical and mental health complaints and impaired performance. However, no studies have addressed how fatigue is understood by paramedics. The present study addresses this shortcoming by exploring factors paramedics recognise as contributors to fatigue. Methods: Forty-nine (12F; 38 years ± 9.7 years) Australian paramedics completed a survey on perceived causes of performance impairing fatigue. A total of 107 responses were systematically coded following principles common to qualitative data analysis: data immersion, coding, categorisation and theme generation. Results: Six themes emerged: working time, sleep, workload, health and wellbeing, work–life balance and environment. Consistent with a scientific understanding of fatigue, prior sleep and wake, time of day and task-related factors were often identified as contributing to fatigue. In other cases, paramedics’ attributions deviated from a scientific understanding of direct causes of fatigue. Conclusions: These findings demonstrate that paramedics have a broad understanding of fatigue. It is critical to take this into account when discussing fatigue with paramedics, particularly in the case of fatigue education or wellness programmes. These data highlight areas for intervention and education to minimise the experience of paramedic fatigue and the negative health and safety outcomes for paramedics and patients as a result

Attitudes and perceptions of paramedics about end-of-life care: a literature review

Background: Paramedics must be prepared to respond to crises in which a threat to a patient's health may result in death. They are therefore highly involved with end-of-life care. Aims: Involvement with end-of-life care is the context in which this paper examines how paramedics perceive and respond to this part of their role. Methods: This is a systematic literature review that examines current evidence. Findings: Five themes emerged, which suggest that paramedics are not prepared to work with crisis situations involving the end of patients' lives: emotional resilience; decision making; communicating death; recognising dying patients; and death education. Conclusion: The current review concludes that the dearth of data is not preventing improvements in services, nor education and training, in this field