Sustainable Employment and Emergency Service Workers
Keith Townsend, Rebecca Loudoun, Paula K. Mowbray, and Adrian Wilkinson
All authors are affiliated with:
Department of Employment Relations and Human Resources, Griffith Business School, Centre for
Work, Organisation and Wellbeing, Griffith University, Brisbane Australia
ABSTRACT:
Purpose: While many occupations can induce stress and impact negatively on employee
psychological wellbeing, the nature of the work performed by emergency service workers such as
paramedics and ambulance officers, police and fire fighters means they are particularly at risk.
Exposure to extremely traumatic events is a regular part of the work routine for emergency services
workers, where they witness human suffering and death, with violent and grotesque scenes a common
occurrence (Genest, Levine, Ramsden, & Swanson 1990; McFarlane, Williamson, & Barton 2009).
Chronic exposure to traumatic events increases the risk of psychological strain, and in particular Post
Traumatic Stress Disorder (PTSD). Studies of PTSD in emergency services personnel report between
16 and 34 per cent of employees suffer with PTSD symptoms (Asmundson, Wright, McCreary, &
Pedlar 2003; Bennett et al. 2005; Clohessy & Ehlers 1999; Robinson, Sigman & Wilson 1997), which
is more than three times the lifetime prevalence for the general population (Skogstad et al. 2013;
Slade, Johnston, Oakley Browne, Andrews, & Whiteford 2009). Paramedics, in particular, are reported
as suffering the highest incidences of PTSD of emergency services personnel (Drewitz-Chesney
2012), despite most jurisdictions in Australia providing extensive employee assistance programs
(EAP) in an attempt to minimise occupational risks for PTSD. This study aims to understand the
impact of various elements of HR Systems that apply pressure to, or constrain employee wellbeing
programs and those elements of the HR system that support these programs.
Design/ Methodology: Data were derived from a larger research project conducted in 2015, which
investigated the prevalence and contributors to PTSD amongst paramedics in a state based
organisation in Australia. Data were collected using interviews and surveys from 200 paramedics from
metropolitan Brisbane, provincial cities and rural locales. Individual participant selection was
purposeful, in that paramedics with varying levels of experience, and geographic diversity, age and
gender were targeted. Data gathering was conducted over the phone for interview and survey data.
Participants were initially alerted to the study via their relevant union newsletters and then contacted
by the union call centre after being randomly selected from the membership database. The call centre
explained the purpose of the study and requested their participation; if they agreed the call centre
administered the survey and requested their participation to be contacted by the research team for an
interview. Some members also expressed their agreement to participate in an interview by email.
Key Findings: Findings indicated that many paramedics are reluctant to use the formal EAP provided
by the ambulance service in this jurisdiction because of concerns about confidentiality and the ability
to access the support at the most opportune time. Conversely, the informal support provided by peerto-peer debriefing was perceived as valuable and a way to mitigate the build up of stress that could
otherwise lead to psychological strain or PTSD. However, we found that work intensification reduced
peer-to-peer support and limited the long-term sustainability of the emergency workers’ employment.
1
Discussion and Implications: Given that paramedics have been found to have significantly higher rate
of PTSD than the general population, it is important that their employers consider ways to minimise
their risk of sustaining psychological strain and PTSD. Social support for paramedics has been
identified as a critical mechanism to mitigate the risk of PTSD (Elklit et al. 2011; Maguen et al. 2009;
Pietrzak et al. 2010), however research suggests that paramedics are unlikely to use formal support
mechanisms, such as EAP’s (Laposa et al. 2003), or family support, preferring more informal methods
and the opportunity to debrief with peers (Larocco et al. 1980). Findings revealed that an unintended
consequence of work intensification in this case study organisation has been that peer-to-peer voice
has been limited, an activity which research suggests and paramedics perceive as critical in
ameliorating stress and the likelihood of suffering from post-traumatic stress disorder. As a
consequence we argue that the existing systems of HRM are not leading to sustainable long-term
employment for the staff and this has substantial implications for the workforce of the future.
REFERENCES
Asmundson, GJ, Wright, KD, McCreary, DR & Pedlar, D 2003, 'Post-traumatic stress disorder
symptoms in United Nations peacekeepers: An examination of factor structure in
peacekeepers with and without chronic pain', Cognitive Behaviour Therapy, Vol. 32, no. 1, pp.
26-37.
Bennett, P, Williams, Y, Page, N, Hood, K, Woollard, M, & Vetter, N 2005, 'Associations between
organizational and incident factors and emotional distress in emergency ambulance personnel',
British Journal of Clinical Psychology, Vol. 44, No. 2, pp. 215-226.
Clohessy, S & Ehlers, A 1999, 'PTSD symptoms, response to intrusive memories and coping in
ambulance service workers', British Journal of Clinical Psychology, Vol. 38, No. 3, pp. 251265.
Drewitz-Chesney, C 2012, 'Posttraumatic stress disorder among paramedics: Exploring a new solution
with occupational health nurses using the Ottawa Charter as a framework', Workplace Health
& Safety, Vol. 60, No. 6, pp. 257-263.
Elklit, A, Østergård, KK, Lasgaard, M, & Palic, S 2011, 'Social support, coping and posttraumatic
stress symptoms in young refugees', Torture: Quarterly Journal on Rehabilitation of Torture
Victims and Prevention of Torture, Vol. 22, No. 1, pp. 11-23.
Genest, M, Levine, J, Ramsden, V, & Swanson, R 1990, 'The impact of providing help: Emergency
workers and cardiopulmonary resuscitation attempts', Journal of Traumatic Stress, Vol. 3, No.
2, pp. 305-313.
Laposa, JM, Alden, LE, & Fullerton, LM 2003, 'Work stress and posttraumatic stress disorder in ED
nurses/personnel (CE)', Journal of Emergency Nursing, Vol. 29, No. 1, pp. 23-28.
LaRocco, JM, House, JS, & French Jr, JR 1980, 'Social support, occupational stress, and health',
Journal of Health and Social Behavior, Vol. 21, No. 3, pp. 202-218.
Maguen, S, Metzler, TJ, McCaslin, SE, Inslicht, SS, Henn-Haase, C, Neylan, TC, & Marmar, CR
2009, 'Routine work environment stress and PTSD symptoms in police officers', The Journal
of Nervous and Mental Disease, Vol. 197, No. 10, p. 754.
McFarlane, AC, Williamson, P, & Barton, CA 2009, 'The impact of traumatic stressors in civilian
occupational settings', Journal of Public Health Policy, Vol. 30, No. 3, pp. 311-327.
Pietrzak, RH, Johnson, DC, Goldstein, MB, Malley, JC, Rivers, AJ, Morgan, CA, & Southwick, SM
2010, 'Psychosocial buffers of traumatic stress, depressive symptoms, and psychosocial
difficulties in veterans of Operations Enduring Freedom and Iraqi Freedom: The role of
resilience, unit support, and postdeployment social support', Journal of Affective Disorders,
Vol. 120, No. 1, pp. 188-192.
Robinson, HM, Sigman, MR, & Wilson, JP 1997, 'Duty-related stressors and PTSD symptoms in
suburban police officers', Psychological Reports, Vol. 81, No. 3, pp. 835-845.
2
Skogstad, M, Skorstad, M, Lie, A, Conradi, H, Heir, T, & Weisæth, L 2013, 'Work-related posttraumatic stress disorder', Occupational Medicine, Vol. 63, No. 3, pp. 175-182.
Slade, T, Johnston, A, Oakley Browne, MA, Andrews, G, & Whiteford, H 2009, '2007 National
survey of mental health and wellbeing: Methods and key findings', Australasian Psychiatry,
Vol. 43, No. 7, pp. 594-605.
3