Paramedics are regularly exposed to traumatic situations in the prehospital environment, which can profoundly affect their emotional resilience. A debrief is a recognised tool that is used to manage the aftermath of such events. Its aims are to unpick the components of the situation, identify any issues or achievements in clinical care, highlight learning points to improve future practice and safeguard the clinician’s emotional wellbeing. This article explores the benefits of and barriers to debriefing in clinical practice as well as the emerging debate around the potential harm or benefit of single-session debriefing.

Most ambulance services experience frequent callers or high-volume user populations. It is not an isolated issue but a worldwide problem. Frequent users are a heterogeneous population, with complex physical, mental and social needs. These patients often have numerous conditions or compounding factors, such as frequent falls, psychiatric illness, substance misuse and long-term conditions. As a result, these patients are often vulnerable to poverty, social isolation, reduced quality of life and higher than expected mortality rates. Attending to these patients requires intense emotional investment from clinicians. Without this, communication can break down and practitioners can rapidly become frustrated. Patients who fail to provide validation of the clinician's role as a provider of care and assistance threaten the clinician's sense of control, create demand and risk moral jeopardy. Moral appraisal is intrinsically bound to human development and difficult to avoid without deliberate moderation. This article seeks to explore literature on the frequent caller population, the development of frustration, the consequences for practice and how empathy can restore the therapeutic relationship.

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