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Conflict in the EMS Workforce: An Analysis of an Open-Ended Survey Question Reveals a Complex Assemblage of Stress, Burnout, and Pandemic-Related Factors Influencing Well-Being

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  • Halia Melnyk

    (Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research (CATALYST), College of Medicine, Ohio State University, Columbus, OH 43202, USA)

  • Gennaro Di Tosto

    (Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research (CATALYST), College of Medicine, Ohio State University, Columbus, OH 43202, USA)

  • Jonathan Powell

    (National Registry of Emergency Medical Technicians, Columbus, OH 43223, USA
    Division of Epidemiology, College of Public Health, Ohio State University, Columbus, OH 43210, USA)

  • Ashish R. Panchal

    (Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research (CATALYST), College of Medicine, Ohio State University, Columbus, OH 43202, USA
    Division of Epidemiology, College of Public Health, Ohio State University, Columbus, OH 43210, USA
    Department of Emergency Medicine, Wexner Medical Center, Ohio State University, Columbus, OH 43210, USA)

  • Ann Scheck McAlearney

    (Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research (CATALYST), College of Medicine, Ohio State University, Columbus, OH 43202, USA
    Department of Family and Community Medicine, College of Medicine, Ohio State University, Columbus, OH 43210, USA)

Abstract

Emergency Medical Services (EMS) clinicians provide patient care within a high-stakes, unpredictable, and complex work environment in which conflict is inevitable. Our objective was to explore the extent to which added stressors of the pandemic exacerbated EMS workplace conflict. We administered our survey to a sample of U.S. nationally certified EMS clinicians during the COVID-19 pandemic in April 2022. Out of 1881 respondents, 46% ( n = 857) experienced conflict and 79% ( n = 674) provided free-text descriptions of their experience. The responses were analyzed for themes using qualitative content analysis, and they were then sorted into codes using word unit sets. Code counts, frequencies, and rankings were tabulated, enabling quantitative comparisons of the codes. Of the fifteen codes to emerge, stress (a precursor of burnout) and burnout-related fatigue were the key factors contributing to EMS workplace conflict. We mapped our codes to a conceptual model guided by the National Academies of Sciences, Engineering, and Medicine (NASEM) report on using a systems approach to address clinician burnout and professional well-being to explore implications for addressing conflict within that framework. Factors attributed to conflict mapped to all levels of the NASEM model, lending empirical legitimacy to a broad systems approach to fostering worker well-being. Our findings lead us to propose that active surveillance (enhanced management information and feedback systems) of frontline clinicians’ experiences during public health emergencies could increase the effectiveness of regulations and policies across the healthcare system. Ideally, the contributions of the occupational health discipline would become a mainstay of a sustained response to promote ongoing worker well-being. The maintenance of a robust EMS workforce, and by extension the health professionals in its operational sphere, is unquestionably essential to our preparedness for the likelihood that pandemic threats may become more commonplace.

Suggested Citation

  • Halia Melnyk & Gennaro Di Tosto & Jonathan Powell & Ashish R. Panchal & Ann Scheck McAlearney, 2023. "Conflict in the EMS Workforce: An Analysis of an Open-Ended Survey Question Reveals a Complex Assemblage of Stress, Burnout, and Pandemic-Related Factors Influencing Well-Being," IJERPH, MDPI, vol. 20(10), pages 1-13, May.
    • Handle: RePEc:gam:jijerp:v:20:y:2023:i:10:p:5861-:d:1150134
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    References listed on IDEAS

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    1. Jih-Shuin Jerng & Szu-Fen Huang & Huey-Wen Liang & Li-Chin Chen & Chia-Kuei Lin & Hsiao-Fang Huang & Ming-Yuan Hsieh & Jui-Sheng Sun, 2017. "Workplace interpersonal conflicts among the healthcare workers: Retrospective exploration from the institutional incident reporting system of a university-affiliated medical center," PLOS ONE, Public Library of Science, vol. 12(2), pages 1-13, February.
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    3. Irene M. W. Niks & Guido A. Veldhuis & Marianne H. J. van Zwieten & Teun Sluijs & Noortje M. Wiezer & Heleen M. Wortelboer, 2022. "Individual Workplace Well-Being Captured into a Literature- and Stakeholders-Based Causal Loop Diagram," IJERPH, MDPI, vol. 19(15), pages 1-20, July.
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