Paramedics have extremely high rates of occupational violence (OV). In 2013-2014 there were 3,774 occurrences of patient or bystander aggression recorded in patient information records, although only 314 of these incidents were reported through the occupational health and safety system of Ambulance Victoria (VAGO, 2015). These high rates of OV highlight the importance of studying paramedic work. Further, the nature of paramedic work presents a special context relative to certain models of OV, including being heavily externally-oriented.


Paramedics face high levels of demand, with the extra complication of time-to-arrival pressures. Once on-site paramedics then have higher proportions of patients under the influence of alcohol or other drugs and have to conduct work in a relatively uncontrolled setting. With the unusual nature of paramedic work and high number of OV incidents, this study investigates the common drivers of occupational violence among paramedics.

Method

The project involved 24 Convergent Interviews (Dick 1990; Jepsen & Rodwell 2008) with current Ambulance Victoria (AV) employees. Convergent interviewing is a qualitative research method that combines features of structured and unstructured interviews and uses a systematic process to refine and analyse the information collected. Convergent interviewing has been documented in the literature as a useful qualitative approach for under-researched areas (e.g., Rao & Perry, 2003).

Findings
This study has derived a model of the drivers of occupational violence among paramedics that reflects an interconnected system across levels from industry issues to organisational issues, the paramedic, especially their skills, and the interaction itself. The results could inform both primary and secondary interventions (Tetrick et al., 2005). In the short term the results indicate that training programs may have a large impact, although in the medium term enhancing the value-added capability of the information systems and call centre activities (e.g., demand management, enhancements to call-out information) could make further, cumulative, improvements.


















References

Demir, D. & Rodwell, J. (2012). Psychosocial antecedents and consequences of workplace aggression for hospital nurses. Journal of Nursing Scholarship, 44 (4), 376-384.

Dick, R. (1990). Convergent Interviewing (3rd Edn). Brisbane: Interchange.

Einarsen, S., Hoel, H., Zapf, D. and Cooper, C. L. (2011), The concept of bullying and harrassment at work: The European tradition. In S. Einarsen, H. Hoel, D. Zapf and C. L. Cooper (Eds.), Bullying and Harrassment in the Workplace: Developments in Theory, Research and Practice (2nd ed., pp. 3-39). Boca Raton: CRC Press.

Hesketha. K., Duncana, S., Estabrooksa., A., Reimerc., M., Giovannettia., P., Hyndmand., K., Acornd., S. (2003). Workplace violence in Alberta and British Columbia hospitals
Health Policy 63 (3), 311–321

Jepsen,D. M. & Rodwell, J. (2008). Convergent interviewing: A diagnostic technique for researchers. Management Research News, 31, (9&10), 650-658.

Rao, S., Perry, C. (2003). Convergent interviewing to build a theory in under‐researched areas: principles and an example investigation of Internet usage in inter‐firm relationships, Qualitative Market Research: An International Journal, 6 (4) 236 – 247.


Tetrick, L. E., Quick, J. C. and Quick, J. D. (2005). Prevention perspectives in occupational health psychology. In A-S. G. Antoniou & C. L. Cooper (Eds) Research Companion to Organizational Health Psychology (pp. 209-217). Edward Elgar: Cheltenham, UK.