Workplace Incivility Among Nationally Certified EMS Professionals and Associations with Workforce-Reducing Factors and Organizational Culture

Cash, Rebecca E.; White-Mills, Kim; Crowe, Remle P.; Rivard, Madison K.; Panchal, Ashish R.

doi:10.1080/10903127.2018.1502383

Cited by 32 publications

(28 citation statements)

References 37 publications

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“…While surveys of EMS personnel from local agencies or single states often achieve higher response rates (5,56), the response rates for electronic surveys of nationally-certified EMS personnel typically range from 10 to 12% (2,8,57), so the 19% response rate achieved in the current study was better than expected. Nevertheless, to help overcome this limitation, weighting was used to increase the representativeness of respondents to the overall target population of nationally-certified EMS personnel.…”

Section: Limitationsmentioning

confidence: 68%

“…Typical response rates to electronic surveys among nationally-certified EMS professionals have been between 10-12% (2,7,8). To adjust for nonresponse and differential response rates, survey weights were created based on variables that are related to response rates in this population, specifically certification level, sex, and minority status (28).…”

Section: Missing Data and Survey Weightingmentioning

confidence: 99%

“…In many EMS agencies, personnel are on-duty for 24 or more hours at a time, often without the opportunity for uninterrupted periods of rest. Emergency medical services personnel are also subjected to frequent psychological stressors such as critically ill patients, time pressure to complete tasks, and the potential for being a victim of violence (2,3). These occupational factors may contribute to the negative health outcomes frequently reported by EMS personnel.…”

Section: Introductionmentioning

confidence: 99%

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Comparing the Prevalence of Poor Sleep and Stress Metrics in Basic versus Advanced Life Support Emergency Medical Services Personnel

Cash

Anderson

Lancaster

et al. 2020

Prehospital Emergency Care

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Background: Emergency medical services (EMS) personnel frequently encounter occupational factors that increase the risk of poor sleep and stress. The national prevalence of poor sleep and stress in EMS personnel is unclear, especially differences between personnel at the basic (BLS) versus advanced (ALS) life support levels. The objectives of this study were to: (1) estimate the prevalence of sleep and stress metrics in EMS personnel; and (2) compare these metrics between BLS and ALS-certified personnel. Methods: This study was a survey of recertifying nationally-certified EMS personnel working in civilian settings. Respondents completed an electronic questionnaire assessing their sleep quality; workday, non-workday, and average sleep duration; sleep debt; perceived stress; and chronic stress. Survey-weighted Poisson regression models were used to estimate adjusted prevalence ratios (PR) comparing BLS (emergency medical technician) to ALS (advanced emergency medical technician and paramedic) for each metric. Models were adjusted for age, sex, minority status, education level, EMS agency type, service type, EMS role, and significant interactions. Results: A total of 17,913 (response rate ¼ 19%) responses were received with 17,522 included in the analysis. Adjusted PRs were significantly higher for ALS-certified personnel compared to BLS-certified for poor sleep quality (PR: 1.23, 95% CI: 1.20-1.27) and short (<7 hours) or long (!9 hours) workday sleep duration (PR: 1.17, 95% CI: 1.15-1.19). Significant interactions were found between certification level and sex (average sleep duration) or age category (sleep debt, perceived stress, and chronic stress). The highest prevalence of short or long average sleep duration was among ALS men. Sleep debt, perceived stress, and chronic stress differed by age group between certification levels with higher PRs for ALS regardless of age group. Conclusions: There is a high prevalence of poor sleep and stress in EMS personnel, with evidence of the highest prevalence among ALS-certified personnel. Evidence of effect modification by age category and among BLS and ALS personnel suggests that interventions could target certain subgroups, such as older ALS personnel, to be most effective. Continued focus on sleep health and stress reduction is needed to improve the health and well-being of the EMS workforce.

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Section: Limitationsmentioning

confidence: 68%

Section: Missing Data and Survey Weightingmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Comparing the Prevalence of Poor Sleep and Stress Metrics in Basic versus Advanced Life Support Emergency Medical Services Personnel

Cash

Anderson

Lancaster

et al. 2020

Prehospital Emergency Care

Self Cite

View full text Add to dashboard Cite

show abstract

“…EMS providers are in the frontline of care provision to patients, where patients' family members may not be in good and stable mental conditions. Therefore, they are at great risk for threat and violence [13]. Another potential source of physical injury to EMS providers is related to ambulance crashes [38][39][40].…”

Section: Critical Conditions Of Ems Provisionmentioning

confidence: 99%

“…Consequently, they experience high levels of stress and suffer from chronic stress. Studies showed that 22% of EMS providers deal with stress-related complications [3,4] such as anxiety, irritability, social isolation, sleep disorder [5][6][7][8], job dissatisfaction, burnout [9][10][11], workplace incivility, leaving the profession, suicide [12][13][14] post-traumatic stress disorder, risk behaviors, psychological problems, and depression, and are more likely to commit medical errors [15][16][17].…”

Section: Introductionmentioning

confidence: 99%

Perceived occupational stressors among emergency medical service providers: a qualitative study

et al. 2021

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Introduction Emergency medical services (EMS) providers are at continuous exposure to occupational stressors which negatively affect their health and professional practice. This study explored perceived occupational stressors among EMS providers. Methods This qualitative study was conducted from December 2019 to April 2020 using conventional content analysis. Sixteen EMS providers were purposively selected from EMS stations in Hamadan, Iran. Semi-structured interviews (with length of 45–60 min) were held for data collection. Data were analyzed through Graneheim and Lundman’s conventional content analysis approach. Findings Data analysis resulted in the development of two themes, namely critical conditions of EMS provision, and personal and professional conflicts. The six categories of these two themes were complexity of patients’ clinical conditions, interruption of EMS provision, health hazards, interpersonal problems, interprofessional interactions, and legal conflicts. Conclusion Besides the stress associated with emergency patient care, EMS providers face many different occupational stressors. EMS managers can use the findings of the present study to develop strategies for reducing occupational stress among EMS providers and thereby, improve their health and care quality.

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COVID‐19 and coworker conflict among emergency medical service clinicians

Di Tosto,

Melnyk,

Powell

et al. 2024

JACEP Open

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ObjectivesSafety policies enacted in response to the emergence of coronavirus disease 2019 (COVID‐19) have greatly affected the working environments of emergency medical service (EMS) clinicians. Our objective was to evaluate whether changes in the EMS environment during the COVID‐19 pandemic were associated with increased workplace conflict.MethodsThis evaluation was a cross‐sectional analysis of a random sample of 19,497 national certified EMS clinicians who were selected to receive an electronic survey in April 2022. The survey included an assessment of their level of stress using the Perceived Stress Scale instrument and examined changes in their working environment they perceived had occurred due to the emergence of COVID‐19. Logistic regression modeling was used to evaluate the associations between workforce demographics, infrastructure, scheduling, and policies to and COVID‐19‐induced coworker conflict.ResultsA total of 1686 responses were evaluated (response rate 10%). We found that COVID‐19 was reported to have exacerbated conflict between coworkers in 51% of responses. Respondents who perceived an increase in coworker conflict due to COVID‐19 self‐reported higher levels of stress than the rest of the respondents. Perceptions of the impact of COVID‐19 on conflict had also an association with the level of certification, indicating that national registered paramedics were more likely than emergency medical technicians to report coworker conflict due to COVID‐19 (adjusted odds ratio [AOR] 1.30, 95% confidence interval [CI] 1.05–1.61). Multivariable analysis highlighted the impact of mandatory overtime policies, reported by 27% of the respondents and associated with higher odds of exacerbated coworker conflict in our model (AOR 2.05, 95% CI 1.62–2.60).ConclusionsThese findings indicate that conflict can be considered a potential indicator of high levels of stress in the EMS workforce and may be a reliable signal to monitor when implementing mandates that affect EMS clinicians and their workloads.

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Workplace Incivility Among Nationally Certified EMS Professionals and Associations with Workforce-Reducing Factors and Organizational Culture

Abstract: Nearly half of respondents experienced incivility once a week or more, and incivility was associated with potential workforce-reducing factors. Further research is needed to understand how organizational climate and interpersonal behaviors in the workplace affect the EMS workforce.

Cited by 32 publications

References 37 publications

Comparing the Prevalence of Poor Sleep and Stress Metrics in Basic versus Advanced Life Support Emergency Medical Services Personnel

Comparing the Prevalence of Poor Sleep and Stress Metrics in Basic versus Advanced Life Support Emergency Medical Services Personnel

Perceived occupational stressors among emergency medical service providers: a qualitative study

COVID‐19 and coworker conflict among emergency medical service clinicians

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