Incidence and impact of incivility in paramedicine: a qualitative study

Abstract

BackgroundIncivility or rudeness is a form of interpersonal aggression. Studies suggest that up to 90% of healthcare staff encounter incivility at work with it being considered ‘part of the job’.MethodsQualitative, in-depth, semistructured interviews (n=14) undertaken between June and December 2019. Purposive sampling was used to identify front-line paramedics working for one NHS Ambulance Trust. Interviews lasted between 16 and 45 min, were audiorecorded, verbatim transcribed and analysed using thematic analysis.ResultsFour themes were identified: paramedics reported a lack of respect displayed both verbally and non-verbally from other professional groups. The general public and interdisciplinary colleagues alike have unrealistic expectations of the role of a paramedic. In order to deal with incivility paramedics often reported taking the path of least resistance which impacts on ways of working and shapes subsequent clinical decision-making, potentially threatening best practice. Finally paramedics report using coping strategies to support well-being at work. They report that a single episode of incivility is easier to deal with but subsequent episodes compound the first.ConclusionsThis study highlights the effect incivility can have on operational paramedics. Incivility from the general public and other health professionals alike can have a cumulative effect impacting on well-being and clinical decision-making.

Would you mind sharing your story? A narrative exploration of incivility experiences in the Information Technology workplace

“…Likewise, Lasiter et al (2012) found that the students' narrative experiences of faculty incivility were majorly reported to have occurred (1) in the presence of others, (2) talking about a student to another, (3) comments making the student feel stupid and (4) comments making the students feel belittled. At the same time, in their qualitative study, the cumulative consequences of paramedical staff's experiences of WI from the general and public and health professionals, according to Credland and Whitfield (2021), affected not only their clinical decision-making but also their well-being. Whereas Clark et al (2011) in the healthcare setting found the incivility escalating factors: (1) considerable gap between nursing education and practice, (2) lack of shared goals, (3) lack of resources and (4) highly stressed work environment.…”

Drivers of unprofessional behaviour between staff in acute care hospitals: a realist review

“…Multiple factors can create workplace disempowerment including (1) organisational hierarchies; (2) unfairness; and (3) the physical environment [ 105 , 125 , 146 , 151 ].…”

“…Loss of confidence If unprofessional behaviours are present in a clinical workplace (C) then staff can experience a loss of passion for work (M28/O1) and desire to leave one’s organisation (O2) because UB causes staff to question their self-worth and experience a loss of confidence in one’s abilities (M24) “… this study suggests that incivility can cause a practitioner to question their actions and ability which can negatively impact on clinical decision- making. Participants suggested that they may ‘take the path of least resistance’ ” [ 105 ] CMOC 16. Reduced psychological safety If unprofessional behaviours are present in a clinical workplace (C) it can cause greater incidence of medical errors (O1) and therefore reduced care quality and safety (O2) because presence of UB can lead to reduced psychological safety (M25) which can inhibit ability to speak up when medical errors occur (M21) “… individuals who engaged with impunity in transgressive or disruptive behaviour—corrupted the conditions of a healthy working environment, resulting in personnel feeling fearful and lacking in psychological safety ” [ 104 ] CMOC 17.…”

Paramediklerin İş Yeri Kültürüne Yönelik Benimsedikleri Kuralların Yarı Yapılandırılmış Görüşmelerle İncelenmesi: Nitel Bir Çalışma

“…Çalışma sonucunda katılımcıların çalışma alanlarında güvenlik konusunda hassas oldukları ve güvenliklerinin sağlanmasına yönelik kurallar benimsedikleri tespit edilmiştir. Araştırmalar sağlık personelinin yaklaşık %90 kadarının iş yerinde nezaketsiz davranışlarla karşılaştığını göstermektedir (26). Bu durumun klinik karar verme, teşhis ve prosedür performansı üzerinde olumsuz sonuçlarının olduğu da gösterilmiştir.…”