Protocol for a constructivist metasynthesis of qualitative research of heroism and paramedic practice

Abstract

Background: Exceptional demands have been placed on paramedics and other healthcare workers (HCWs) during the COVID-19 pandemic. An overwhelming outpouring of public support has unfolded, bringing into focus the relationship between paramedics, other HCWs and society, where they are portrayed as heroes. Scholars have studied the notion of heroism to society, and characteristics of such heroic status include: the voluntary nature of a heroic act, risk of physical or social harm, willingness to accept the consequences of action, acting for the benefit of others and without the expectation of gain. While some HCWs and paramedics may reflect these characteristics, many may not. Such heroic narratives can be damaging, stifling meaningful discussion around limits to duties, failing to acknowledge the importance of reciprocity and potentially imposing demands on paramedics and HCWs to be heroic.Aim: This article prospectively presents the protocol for a metasynthesis which aims to identify, appraise and synthesise the qualitative literature in order to develop theory on heroism and paramedic practice.Methods: Evolved grounded theory methodology is followed along with the procedural guidelines of Noblit and Hare (1988) to guide the analysis. The Preferred Reporting Items for Systematic Reviews and Meta-analysis Protocols (PRISMA-P) have also been adopted when preparing this protocol and will be followed in the study proper. The protocol has been registered with the International Prospective Register of Systematic Reviews PROSPERO 2021, registration number CRD42021234851.Results: We do not currently have results, but PRISMA guidelines will be followed when reporting our findings.Conclusion: Current narratives on heroism and paramedic practice are important in terms of the relationship between paramedics and society. The metasynthesis prospectively reported in this article serves as the first point in our journey of making sense of and developing theory on heroism and paramedic practice.

Heroism and paramedic practice: A constructivist metasynthesis of qualitative research

“…Fluctuating social value and ambivalence from paramedics was recently reflected in Rees et al (2021) when the pandemic was over, they would be forgotten about by the public and return to long hospital delays, inappropriate use of ambulances and violence and aggression directed towards them.…”

“…We adhered to our published plan of investigation as outlined in the study protocol and in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analysis Protocols (PRISMA-P) guidelines ( Rees et al, 2021 ).…”

“…Chandler-Jeanville et al ( 2021) found that nurses' relatives did however consider them to be heroes, which also reflected views of paramedics in Rees et al (2021) (Rees et al, 2021).…”

“…Many definitions and differing views of heroism exist within the literature; however, key factors include the risk of potential physical or social harm, willingness to accept the consequences of action, and acting without the expectation of gain, and for benefit of others ( Rankin and Eagly, 2008 ; Franco et al, 2011 ; Kohen, 2013 ). The notion of heroism and paramedic practice recently emerged in a study conducted by members of our team exploring paramedic experiences of providing care in Wales (United Kingdom) during the 2020 COVID-19 pandemic ( Rees et al, 2021 ). The outpouring of public support and heroization of paramedics revealed complex discourses surrounding their relationship with society and tragic personal and professional choices being made.…”

“…Our previous study resulted in an Evolved Grounded Theory of the tragic choices paramedics experienced in providing care during the COVID-19 pandemic and found that whilst the public held them up as heroes, paramedics did not consider themselves within this characterization, but rather felt they were just doing their job ( Rees et al, 2021 ). Tangherlini (2000) found similar, but far more cynical and self-deprecatory accounts from paramedics of such heroic status, which countermands the public, and media representations of them as silent heroes just doing their job.…”