New development: A ‘journey of personal and professional emotions'—emergency ambulance professionals during Covid-19

IMPACTThis article explores the consequences of emotional labour on UK NHS ambulance staff and their response to the Covid-19 pandemic. It highlights the challenges faced by ambulance crews while dealing with their emotional labour within the context of organizational settings. Research findings also explain the importance of emergency responders' psychosocial wellbeing. The article has clear relevance as to how frontline staff manage their emotional labour in other emergency service settings, such as the police and fire and rescue services.Alternate :Managing emotions are essential aspect of many jobs, and frontline healthcare workers have to manage and control their emotions while caring for critically ill patients and working in an emotionally-charged dynamic environment;this was particularly the case during Covid-19. Ambulance workers are an important group in this respect but they are currently under-researched. Evidence behind this article comes from data collected from an NHS ambulance trust in England. One of the key contributions of this article is to highlight how frontline ambulance professionals manage their emotional labour while working within the stipulations of organizational constraints.

The experiences and perceptions of wellbeing provision among English ambulance services staff: a multi-method qualitative study.

BACKGROUND: NHS ambulance service staff are at risk of poor physical and mental wellbeing because of the likelihood of encountering stressful and traumatic incidents. While reducing sickness absence and improving wellbeing support to ambulance staff is a key NHS priority, few studies have empirically documented a national picture to inform policy and service re-design. The study aimed to understand how ambulance service trusts in England deal with staff health and wellbeing, as well as how the staff perceive and use wellbeing services. METHODS: To achieve our aim, we undertook semi-structured telephone interviews with health and wellbeing leads and patient-facing ambulance staff, as well as undertaking documentary analysis of ambulance trust policies on wellbeing. The study was conducted both before and during the UK first COVID-19 pandemic wave. The University of Lincoln ethics committee and the Health Research Authority (HRA) granted ethical approval. Overall, we analysed 57 staff wellbeing policy documents across all Trusts. Additionally, we interviewed a Health and Wellbeing Lead in eight Trusts as well as 25 ambulance and control room staff across three Trusts. RESULTS: The study highlighted clear variations between organisational and individual actions to support wellbeing across Trust policies. Wellbeing leads acknowledged real 'tensions' between individual and organisational responsibility for wellbeing. Behaviour changes around diet and exercise were perceived to have a positive effect on the overall mental health of their workforce. Wellbeing leads generally agreed that mental health was given primacy over other wellbeing initiatives. Variable experiences of health and wellbeing support were partly contingent on the levels of management support, impacted by organisational culture and service delivery challenges for staff. CONCLUSION: Ambulance service work can impact upon physical and mental health, which necessitates effective support for staff mental health and wellbeing. Increasing the knowledge of line managers around the availability of services could improve engagement.

Perceptions and experiences of wellbeing provision for NHS ambulance staff: a qualitative interview study of wellbeing leads and frontline staff

BackgroundThe wellbeing of ambulance staff is critical to their safety and safe care delivery. This study examined the perceptions of English NHS ambulance Trust health and wellbeing leads, and the experiences of UK ambulance staff of workplace wellbeing culture and provision.MethodsSemi-structured telephone interviews were undertaken with staff wellbeing leads for eight NHS ambulance trusts in England and with ambulance staff from three NHS ambulance trusts in England, selected to represent services with high, medium or low relative sickness absence rates. Interviews were subsequently transcribed, coded and analysed using Framework Analysis (FA).ResultsWe interviewed eight wellbeing leads and 25 frontline ambulance staff from April-November 2020. Decisions around what was included in or omitted from wellbeing policies sometimes led to conflict between wellbeing leads and their superiors. Ambulance work was perceived as inherently unhealthy because of work stress and the risk of encountering traumatic incidents. Well-being leads understood the adverse impacts of work on mental health for some staff. Ambulance staff wanted empathy, understanding and practical support from managers, but the reality did not always match these needs, because of variability in provision and experiences of health and wellbeing services, poor behaviours or attitudes from line managers, and a stigmatising rather than open organisational culture. COVID-19 not only impacted significantly on staff health and wellbeing, but also challenged how ambulance trusts support them.ConclusionsThe importance of an open organisational culture and the variable availability and experiences of interventions to support staff to stay well at work means that improvements are needed in both to ensure positive staff mental health and wellbeing. Early interventions, improved training for line managers to support staff at work, bespoke wellbeing services and an open culture are key to delivering effective support to ambulance staff, especially in the light of the COVID-19 pandemic.

Editorial

In our first article, entitled “Mental health patterns during COVID-19 in emergency medical services (EMS)”, Silvia Monteiro Fonseca et al. have explored the patterns of EMS personnel’s mental health regarding their levels of anxiety, depression and stress during COVID-19 pandemic. The study recommendations from this research include, but are not limited to, ensuring a more equitable distribution of protective equipment to paramedics across unevenly funded services and recognizing paramedics face unique and additional stressors in public health emergencies. The study used validated instruments such as the Pittsburg Sleep Quality Index (PSQI), the World Health Organization Quality of Life (WHOQOL) instrument, the Epworth Sleepiness Scale (ESS), the PSS and the post-traumatic stress disorder (PTSD) checklist on a sample of UK police officers. In a fascinating paper, John Hylander et al. explore the collaborative challenge of emergency response to major incidents in road tunnels for the emergency services, emergency dispatch centers and local authorities next.