Critical incidents, violence, and related stress in prehospital emergency care nurses’ work

Abstract

This study examines the critical incidents encountered by Finnish paramedics and the critical incident-related stress experienced in prehospital emergency care work. The data were collected using a modified EMS Critical Incident Stress questionnaire, which listed 31 critical incidents. Respondents (N = 436) reported the number of critical incidents they encountered during their careers and evaluated the related stress experienced within the last six months. The data was analyzed using logistic regression analysis, chi-square test, Kruskal-Wallis test, and Mann-Whitney U test. The most common critical incidents that posed a threat to paramedics were encountering friends or family at the scene, being in life-threatening danger, being threatened with a weapon, encountering aggressive crowds, and being assaulted. The most frequent patient-related critical incidents experienced included encountering death in many forms, encountering an assaulted adult, a sexually abused adult and neglected elderly people. Encountering various critical incidents became more common as their careers progressed. The working
experience was associated with experiencing being threatened with a weapon and being assaulted. Experiencing violence was associated with the ability to work and recover. The most stressful critical incidents were mistakes made by the paramedic and various crimes and accidents involving children. Such stress was associated with workability and recovery among paramedics. The study concludes that many critical incidents paramedics encounter are caused by intentional and punishable acts, not accidents. There is a need for further, preferably longitudinal research into this phenomenon, specifically related to the nature and frequency of critical incidents, the effects of violent experiences, and prevention or recovery strategies to safeguard paramedics’ well-being and ability to perform their job in the future.