The Female Emergency Medical Services Experience: A Mixed Methods Study.

BACKGROUND: Emergency Medical Services (EMS) is a challenging profession. Little is known if there are gender differences in the experiences among EMS clinicians. Therefore, our aim was to understand and characterize the occupational experiences of female EMS clinicians. METHODS: A mixed methodological study was conducted among currently licensed female EMS clinicians via focus group and self-report survey data. Three focus groups (n = 5, 4, 13, respectively) were conducted with participants purposively recruited from primarily Northeastern EMS agencies. Through ongoing collaborations, a recruitment advertisement was provided to EMS leadership at respective agencies for distribution among their female staff. Sessions were recorded and transcribed for thematic analysis. A six-phase inductive analytical approach was utilized to evaluate focus group data. Qualitative findings were utilized to inform a cross-sectional, self-report survey consisting of occupational specific experiences, such as harassment and pregnancy, and validated measures of mental wellbeing. Descriptive statistics were used to describe the study sample and female EMS clinician occupational and personal experiences. RESULTS: A total of 22 female EMS clinicians participated across the three focus group sessions. Four major themes were identified: 1) the female EMS experience; 2) impact on personal wellbeing; 3) impact on occupational wellbeing; and 4) coping mechanisms. Each theme had multiple subthemes. There were 161 participants that attempted the 72-item survey, 13 partial and 148 competed surveys. Median age was 32 years (IQR: 25-42), and the majority were EMT-Bs (55.1%). Approximately 70.0% met the criteria for probable anxiety, 53.9% probable depression and 40.9% elevated symptoms of burnout. Almost 73.0% reported workplace harassment, with most experiences being perpetrated by patients and coworkers. Over 61.0% reported reconsideration of their career in EMS. Overall, survey data indicated interactions with peers and leadership, and social support were positive. CONCLUSIONS: Findings highlight the need to improve the occupational experiences of female EMS clinicians to preserve and encourage the continuation of their participation in this workforce. Specifically tailored interventions aimed at protecting and improving their overall wellbeing are critical, particularly considering the increased occupational burden resulting from the pandemic. Future research should aim to understand specific predictors of adverse mental health outcomes among this population.

Predator movements in relation to habitat features reveal vulnerability of duck nests to predation.

Nest predation is the main cause of nest failure for ducks. Understanding how habitat features influence predator movements may facilitate management of upland and wetland breeding habitats that reduces predator encounter rates with duck nests and increases nest survival rates. For 1618 duck nests, nest survival increased with distance to phragmites (Phragmites australis), shrubs, telephone poles, human structures, and canals, but not for four other habitat features. Using GPS collars, we tracked 25 raccoons (Procyon lotor) and 16 striped skunks (Mephitis mephitis) over 4 years during waterfowl breeding and found marked differences in how these predators were located relative to specific habitat features; moreover, the probability of duck nests being encountered by predators differed by species. Specifically, proximity to canals, wetlands, trees, levees/roads, human structures, shrubs, and telephone poles increased the likelihood of a nest being encountered by collared raccoons. For collared skunks, nests were more likely to be encountered if they were closer to canals, trees, and shrubs, and farther from wetlands and human structures. Most predator encounters with duck nests were attributable to a few individuals; 29.2% of raccoons and 38.5% of skunks were responsible for 95.6% of total nest encounters. During the central span of duck nesting (April 17-June 14: 58 nights), these seven raccoons and five skunks encountered >1 nest on 50.8 ± 29.2% (mean ± SD) and 41.5 ± 28.3% of nights, respectively, and of those nights individual raccoons and skunks averaged 2.60 ± 1.28 and 2.50 ± 1.09 nest encounters/night, respectively. For collared predators that encountered >1 nest, a higher proportion of nests encountered by skunks had evidence of predation (51.9 ± 26.6%) compared to nests encountered by raccoons (22.3 ± 17.1%). Because duck eggs were most likely consumed as raccoons and skunks opportunistically discovered nests, managing the habitat features those predators most strongly associated with could potentially reduce rates of egg predation.