Paramedics' understandings of managing personal reactions during emergency responses : a thesis presented in partial fulfillment of the requirements for the degree of Master of Science in Psychology at Massey University, Albany, New Zealand
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Date
2011
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Massey University
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Abstract
The repeated exposure to potentially traumatic experiences is inherent within the field
of emergency response work. Traditionally research focuses on what responders do to
‘cope’ with their reactions during emergency responses, and attempts to predict which
‘personality types’ may ‘cope’ better with this repeated exposure. This type of research
leads to recommendations of ‘best practice coping’, which are often based on theoretical
models of emotional processing and devoid of contextual relevance. This study
investigated further than what responders do to manage reactions, and sought to
understand how and why. It utilised individual interviews, focus groups and ambulance
shift observation to explore how a group of St John paramedics constructed managing
their reactions during and after emergency response situations. The study examined how
reaction management is understood, and what options are perceived to be accessible
when social, historical and cultural contexts are considered. The findings revealed that
the paramedics’ discursive constructions regarding reaction management related to four
key areas of understanding. These areas corresponded to the chronological process of
emergency responding. The paramedics’ constructions started with conceptualisations
of their job role and the expectations that came with it, then evolved through to incident
response, post-incident reflection, and finally to support-seeking. The findings across
these areas suggest that strategies described in previous research as ‘negative’ or ‘risky’
are oversimplifications. These individual strategies often exist as a component of a
broader strategy to facilitate functioning in a response situation. It was concluded that
the most important element of reaction management for the paramedics was ability to
find acceptance for response incident outcomes. This understanding shifted the
‘problem area’ into the post-incident timeframe and onto issues of accessibility and
acceptability of using peer and psychological support to facilitate acceptance. The
implications of this research include understanding the necessity for tailored psychoeducation
regarding reaction management at St John which is both functionally and
contextually relevant. Additionally, the research highlights the need to address the
‘social risks’ attached to support-seeking at the St John organisation.
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Keywords
Emergency response work, Coping, Resilience, Trauma, Paramedics, Emotional reactions, Reaction management