The paramedic experience of return to clinical practice: A reflexive thematic analysis

Abstract

Background: The Australian paramedic workforce has significantly expanded and evolved in the past few decades. Professionalisation, increasing demand and evolving clinical practice have contributed to pressure on paramedics to meet community expectations of service delivery. Returning to clinical practice after an absence presents a substantial challenge for paramedics who will need to navigate this transitional phase while readjusting to the fast-paced environment of pre-hospital care. This study aims to explore and understand the experience of paramedics returning to clinical practice. Methods: Paramedics were invited to discuss their experiences returning to clinical practice in ambulance services within Australia. A qualitative reflexive thematic analysis was conducted utilising an inductive approach, underpinned by the theoretical framework of the organisational support theory. An experiential orientation was supported by a critical realist ontology, which intersected and overlapped with epistemological contextualism. Results: Three major themes were identified: (1) perceived organisational support, (2) the reality of flexible work, and (3) clinician identity. Theme one was further broken down into three sub-themes relating to structure, work engagement, and clinical support. Conclusions: Our findings provide insight into the lived experiences of paramedics returning to clinical practice. These experiences and challenges should inform the application of organisational policy and resource allocation to better support returning paramedics in the future. Strategies should include enhanced leadership capability, flexible work, robust clinical education, and structured programmes with in-built flexibility to reintegrate staff with an emphasis on communication and support.