Between sense of mission and professional burnout: Integrating paramedics into healthcare systems

Abstract

Background The rate of Israeli paramedics leaving the profession has been increasing in recent years. Goals: To examine the factors related to paramedics leaving the profession in Israel. Methods 1. Online survey among paramedics who left the profession. Questions included demographics, job satisfaction, and reasons for leaving or remaining in the profession. 2. In-depth interviews with 15 paramedics who left the profession. Results 250 paramedics who left the profession responded (73% left after 5 years after completing training and 93% after 10 years). Choosing the paramedic profession was based mainly on an idealistic sense of mission and eagerness to help, yet extrinsic factors impeded their devotion to the paramedic profession: lack of career options, extensive and strenuous physical demands accompanied by unrewarding salaries, unusually long work hours and shift work that negatively affected their family and personal life. Conclusions Work conditions, mainly the lack of opportunities for promotion, lack of professional prospects and inappropriate compensation for hard work are crucial factors in the paramedics decision to leave the profession. Health Policy Implementation: A joint committee of the Ministries of Health, Justice, Finance and the MDA should be established for the purpose of improving the conditions and modalities of employment of paramedics and providing appropriate emotional support for paramedics who are exposed daily to work under extreme stress and human suffering. The joint effort can greatly reduce rates of leaving, training costs and costs incidental to turnover as well as increase job satisfaction. Moreover, regulating the profession and granting authorization for additional medical procedures/treatments (e.g. physician assistant) can create opportunities for advancement and diversity at work that will help retain paramedics in the profession, not only in pre-hospital settings but also in public health and health promotion sectors. Key messages: Rates of leaving the profession of Israeli paramedics are the highest recorded in the world Better understanding of works' motivation will contribute to better integration of paramedics into healthcare systems, not only in pre-hospital setting