Emergency Medical Systemic frustration of Aggression and Violence in Conflict Encounters: An Evolved Grounded Theory

Abstract

BackgroundEmergency Medical Services (EMS) staff worldwide have long been at risk of encountering violence and aggression (V&A) at work, including threats, verbal, physical, and sexual assault, and on rare occasions, fatalities occur. Exposure to V&A can result in stress, fear, and burnout. This is an international problem and EMS employers, trade unions and others are working towards tackling it. This paper reports the results of a qualitative study that aimed to explore protecting EMS Staff from aggression and violence in conflict encountersMethodsThis study took place in 2022 in one UK ambulance service covering a population of three million people. Individual, one-to-one semi-structured interviews were conducted with EMS staff via a Voice over Internet Protocol VoIP (VoIP). Data were analysed through Evolved Grounded theory methodology.ResultsTen EMS staff were interviewed, and the following categories emerged:Rusted, busted and inevitability of Violence & Aggression in EMS Environment, Tolerable or intolerable Violence & aggression in EMS, Gendered violence & aggression and Genderization in EMS, modifiable factors and harm reduction of Violence & aggression in EMS, Professional, ethical & clinical judgments of Violence & aggression in EMS, and Socio-cultural and system frustrations of Violence & aggression in EMS.The Basic Socal Process (BSP) that emerged was one ofEmergency Medical Systemic frustration of Aggression and Violence in Conflict Encounters.ConclusionV&A directed toward EMS staff is complex and our participants revealed how it has long been accepted and may be influenced by systemic frustration in EMS. Staff reported frustrations due to tiredness and in patients from delays in EMS response. Female EMS staff experienced sexual V&A by co-workers and patients, and these voices reverberate with female EMS staff internationally. Our study revealed how EMS has not effectively tackled V&A and many sociocultural constructs accepted within EMS. We call for the voices of our participants to be amplified internationally and for purposeful efforts to continue to be made in tackling this issue.