Starting ambulance care professionals and critical incidents: a qualitative study on experiences, consequences and coping strategies
Open accessAbstract
Background: Ambulance care professionals are regularly confronted with critical incidents that increase risks for mental health disorders. To minimize these risks, it is important that ambulance care professionals adequately cope with critical incidents. Especially from the perspective of starting ambulance care professionals it is unknown which coping styles they use when experiencing a critical incident and how they are trained to cope with critical incidents. The aim of this study was to gain insight in (a) what starting ambulance care professionals describe as critical incidents, (b) how they experience these critical incidents and their consequences, (c) how they cope with these incidents, and (d) how they are trained and guided to cope with these incidents. Methods: A qualitative design with individual, semi-structured interviews was used. The data was analyzed by using inductive thematic analysis. Results: Twenty-two starting ambulance care professionals were interviewed of which, 11 were male. The age ranged from 23 to 31 years, with 11 participants being 27 years or younger. Three key-themes emerged that make an incident critical: (1) emotional connection versus emotional detachment, (2) feeling loss of control, and (3) incomprehension. All participants experienced several short to middle term physical, psychological and social consequences after encountering a critical incident. Starting ambulance care professionals applied different coping strategies during different phases of the ambulance care process: a mix of depersonification, focus on the medical task, support from colleagues and their own network, seeking confirmation, and distraction. Most starting ambulance care professionals don’t actively remember they received education about coping with critical incidents during their initial educational program. During and after traineeships, the workplace preceptor has a crucial role for starting ambulance care professionals to learn them how to cope with critical incidents. Conclusions: Three key-themes interact to make an incident more critical for starting ambulance care professionals. To cope with these critical incidents, starting ambulance care professionals use a variety of coping strategies. These results can be used to develop training and coaching for starting ambulance care professionals so they can adequately cope with critical incidents.
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Commonly reported job demands among paramedics are environmental, sociocultural and organisational, including critical incidents causing psychological distress, traumatic events concerning patient care, threat of violence from patients and bystanders, risks related to alarm-vehicle driving, uncertain working environments and physical injuries.
“Other commonly reported job demands among paramedics are environmental, sociocultural and organisational; critical incidents causing psychological distress [19]; traumatic events concerning patient care [20]; the threat of violence from patients and bystanders [21]; and the risks related to alarm-vehicle driving [22], uncertain working environments [8] and physical injuries [23, 24].”
From Paramedics’ perceptions of job demands and resources in Finnish emergency medical services: a qualitative study (2022) · cites this paper as [19]
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- Authors
- Loef, J., Vloet, L. C. M., Vierhoven, P.-H., van der Schans, L., Neyman-Lubbers, Y., de Vries-de Winter, C., & Ebben, R. H. A.
- Affiliations
- HAN University of Applied Sciences (NL)
- Corresponding author
- Loef, Jorik
- Venue
- BMC Emergency Medicine
- Published
- 2021-10-07
- Volume
- 21
- Issue
- 1
- Pages
- 110-110
- ISSN
- 1471-227X (ISSN-L)
- PMC
- PMC8495434
- OpenAlex
- W3203479858
- Cited by
- 24
- References
- 30
- Citations by year
- 2026: 1 · 2025: 9 · 2024: 4 · 2023: 6 · 2022: 4
- FWCI
- 2.39
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- BMC Emergency Medicine (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, other-oa)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Radboud Repository (Radboud University) (submittedVersion)
- Radboud Repository (Radboud University) (submittedVersion, other-oa)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Health Sciences › Health Professions › General Health Professions › Healthcare professionals’ stress and burnout
- Social Sciences › Psychology › Social Psychology › Stress and Burnout Research
- Keywords
- critical incidents, coping strategies, prehospital care, emotional detachment, loss of control, coping skills training, mental health risk
- MeSH terms
- Adaptation, Psychological, Adult, Allied Health Personnel, Ambulances, Emotions, Female, Humans, Male, Workplace, Qualitative Research, Young Adult
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