Adopting a ‘System of Caring' as a leadership strategy toward professionalisation within South African emergency medical services: A grounded theory

Financial medicine as a source of moral distress: An unrecognised pathway to moral injury in the South African EMS systems

“…Through the data analysis process and coding procedures, analytical labels were developed and grouped to formulate 6 category labels. The 6 category labels were subjected to further analysis and thematic labels were generated, which formed the basis for the theorisation of the ‘System of Caring’ [2] .…”

“…as being “work that is of excellent technical quality, work that is ethically pursued and socially responsible, and work that is engaging, enjoyable and feels good” [ 14 , 15 ]. The substantive findings of this research was the development of a conceptual leadership strategy, called the ‘System of Caring’ which has subsequently been published [2] . During the development of this conceptual theory, the researchers came across an incidental finding that did not directly form part of the conceptual theory, and is now being presented in this article.…”

“…While the impact on the quality of patient care appears to be more obvious, we suggest that this pattern of behaviour, and resulting consequences, could hold some key insights into the ongoing national crisis associated with retaining South African prehospital care providers within the local workforce. The conversion of Moral Distress into Moral Injury is significant as this represents a turning point in an individual's resilience and coping mechanisms such that the deleterious effects of the experience predominate the modulation of the individuals mentality and interior attitude, leading to a conformational change in the individuals moral attitude, which is primarily outwardly manifested in or as a change in their professional identify and subsequent professional practice [ 2 , 12 ]. The phenomenon of the South African healthcare system losing skilled healthcare providers is a widely known issue challenging the prosperity and proper functioning of South African society across many domains, with there being very real implications felt with in the South African prehospital domain, primarily in the ongoing loss of graduate professionals.…”

“…A unique domain of the South African Healthcare system, within which the palpable effects of Financial Medicine Practices are experienced, is the prehospital domain [1] . The prehospital domain continues to struggle with a number of persistent challenges that continue to threaten the ongoing professionalization of the sector [2] . Among these challenges is the ongoing poor retention of qualified prehospital staff, for which a myriad of suggestions have been offered [3] .…”

“…While identifying and exploring the impact of Financial Medicine was not an aim of the initial study in which what was called a ‘System of Caring’ was developed, the researchers soon realised the significance of this specific finding and sought to explore and subsequently report the preliminary observations that were gleaned through the data gathering and analysis process [2] . For this reason the researchers are now presenting the perceptions and experiences of the research participants in the face of Financial Medicine Practices.…”