This study was prompted by the reflective essays submitted by paramedics in which they recounted traumatic experiences from work which seemed unprocessed. I subsequently became interested in how paramedics maintained their resilience and ‘survived’ their work as measured by for example, job satisfaction, morale, attrition and mental and physical well-being.
A qualitative research design was adopted which used a psycho-social interview technique called ‘free association narrative interviewing’ (FANI) as the means of data collection. Data collection included a one hour biographical interview initially and a second follow up 45 minute semi structured interview with seven participants recruited from a trust in England. In all instances data was collected at the university or participant’s home and interviews were digitally recorded. The interviews were transcribed and analysed thematically. The study was approved by UWE and NHS ethics committees.
The analysis explored the key findings within the context of contemporary resilience theory drawing on psychological, sociological and psycho-social literature. However the main focus of the work was from a psycho-social perspective which is psycho-dynamically informed and uses psychoanalytic concepts and principles to explore core issues. The themes captured respondents’ motivations to become a paramedic, which embraced notions of gender differences and the ‘wounded healer’. The hidden toll of the work in relation to health, and the impact of recent performance targets and changes to skill mix which appeared to threaten traditional protective methods of support, emerged as other themes. Support from within the organisation was explored, focusing on the role of management, debriefing, peer support, humour, time out and the culture of shame and denial within the organisation. Outside support explored the role of friends, family and referral to outside agencies. In dealing with unprocessed encounters, paramedics appeared to use other strategies including emotional detachment, dissociation, displays of anger and inappropriate professional behaviour. Despite limitations to the study, the findings unveil a unique account of how paramedics survive and become resilient.