Why was the study done?
When developing policies and protocols for a particular group, it is essential that there is an understanding of the current situation of the group members. This project was designed to identify and document the workforce profile and sociodemographic trends of paramedics across Canada.
The information gathered in this study included:
- Sociodemographic data, including items such as age, gender, level of education, and years of work experience;
- Internal workforce trends such as length of shift, coverage area, and how many paramedic services they worked for;
- Health and wellness indicators, which included both mental health and physical fitness measures.
What was done in the study?
The project had three phases.
The first phase consisted of developing and administering the Canadian Paramedic Health and Wellness Survey (CPHWS). This survey combined items from previous paramedic-related surveys with validated survey instruments for mental and physical health measurement. The CPHWS was available in both official languages (English and French), and was made available in electronic and paper formats to paramedics across Canada. Of the estimated 38,000 paramedics across the country 2,557 completed the survey.
In the second phase, in-person focus groups and personal interviews were conducted with paramedics in Nova Scotia, Ontario, Alberta, and British Columbia. One researcher conducted all the interviews, which were audio recorded. The recordings were transcribed verbatim, and the participants were allowed to review the transcripts to ensure that the content was accurate.
In the third phase, individual physical fitness assessments were conducted with paramedics in Nova Scotia, Ontario, and Alberta. The assessments measured body fitness, bi-manual dexterity, and coordination.
What did we find out?
Sociodemographic data and workforce trends (from CPHWS survey):
- The average age of paramedics who participated was 37 years (range: 20-69 years); 64% identified as male, 73% were married, and 60% had a diploma.
- Years of experience ranged from 1–25, 86% of respondents worked for only one service, and 78% worked full-time.
- In terms of hours worked, 79% worked 12-hour shifts, with 64% rotating between day/night/ evening shifts.
- – In terms of overtime (OT), 72% said they do not work additional on-call or stand-by time, 59% do not work voluntary OT, and 77% worked required OT.
- When asked about previous medical leave, 33% had taken medical leave in the last two years, and 12% identified they had specifically taken mental health leave.
- When asked if they planned on leaving the paramedic service, 19% indicated they planned to leave in the next two years. Lack of career advancement, increase in call volume for non-urgent cases, and desire to spend more time with family, were found to be the three primary reasons for wanting to leave the profession
Mental Health and Wellness
- A measure of depression showed that 13% of respondents had mild symptoms, 11% displayed moderate symptoms, and 5% had severe or extreme severe symptoms.
- A measure of anxiety showed that 10% had mild symptoms, 17% had moderate symptoms, and had 12% severe or extreme severe symptoms.
- A measure of stress showed that 6% had mild symptoms, 4% had moderate symptoms, and 3% had severe or extremely severe symptoms.
- Compared to the general population, the paramedics surveyed had higher levels of depression and anxiety, and lower levels of stress.
- Paramedics reported operational issues such as off-load delays, forced OT, lack of time on duty for personal needs (e.g., meals, washroom breaks), poor communication with dispatchers, and lack of staff, as factors affecting their wellness.
- Paramedics reported organizational issues such as poor attitudes of management staff towards mental health issues, lack of support, and lack of leadership as factors affecting their wellness.
- Other reported barriers included: lack of available and/or qualified mental health professionals; a lack of Employee Assistance Programs (EAP) and peer support networks; insurance provider limitations; and complicated insurance processes.
- Paramedics scored lower than the general population on seven dimensions of health. Many did not follow the Canada Food Guide (35-50%, depending on the time of shift), and many did not follow recommended daily activity requirements (23-40%, depending on the time of shift).
- Paramedics reported issues with feeling rested, with 14% reporting that they never feel rested enough to report for duty.
- Participants also reported shorter hours of sleep when they worked night shifts compared to when they worked day shifts (5 hours versus 8 hours).
- When asked about injuries during their career, 64% reported they had been injured on the job, and 78% had taken time off due to a work-related injury.
- The group of paramedics that had individual fitness assessments had fitness levels that where the same, or better, than the average population.
Where do we go from here?
The results of the project provide information needed to describe multiple aspects of the paramedic workforce, including that paramedics are at increased risk of fatigue, burnout, and work-place injury. The results also highlight areas for improvement. There needs to be a national investment in research into paramedic health and wellness, as well as the establishment of a national framework to help develop supports at a local level. National registries of paramedic organizations, individual paramedics, and research groups should be created to enhance information sharing for the paramedic profession. Long term studies must be performed to gain a clearer understanding of paramedic health and wellness.
The original wording of the study was adapted and condensed for the current research summary.
Original Study: Fischer, S. L. & MacPhee, R. S. (2017). Canadian paramedic health and wellness project: Workforce profile and health and wellness trends. Prepared for Defence Research Development Canada (DRDC) / Centre for Security Science (CSS).
Summary prepared by Kossick, E. Reviewed & Edited by Barootes, B. & McPhee, R.