Role Identity, Dissonance, and Distress among Paramedics

Abstract

Role identity theory describes the purpose and meaning in life that comes, in part, from occupying social roles. While robustly linked to health and wellbeing, this may become unideal when an individual is unable to fulfill the perceived requirements of an especially salient role in the manner that they believe they should. Amid high rates of mental illness among public safety personnel, we interviewed a purposely selected sample of 21 paramedics from a single service in Ontario, Canada, to explore incongruence between an espoused and able-to-enact paramedic role identity. Situated in an interpretivist epistemology and using successive rounds of thematic analysis, we developed a framework for role identity dissonance wherein chronic, identity-relevant disruptive events cause emotional and psychological distress. While some participants were able to recalibrate their sense of self and understanding of the role, for others, this dissonance was irreconcilable, contributing to disability and lost time from work. In addition to contributing a novel perspective on paramedic mental health and wellbeing, our work also offers a modest contribution to the theory in using the paramedic context as an example to consider identity disruption through chronic workplace stress.

Associations between paramedics' salutogenic health experience and the intention to stay in the profession: A cross‐sectional survey

“…Paramedic education, particularly a broad bachelor's degree, reinforces this identity by focusing on urgent care situations (Ericsson et al, 2022). This role identity differs significantly from that of nurses in other fields (Donnelly et al, 2015;Mausz et al, 2022). Specialized professionals capable of demanding work have options to address the current shortage of nursing personnel.…”

Paramedics’ perceptions of job demands and resources in Finnish emergency medical services: a qualitative study

“…This has the potential to manifest as paramedics' general frustration over 'nonrelevant' or even 'nonsensical' assignments, especially as such assignments may easily be a majority during 12-or 24-h shift, where chances to mentally recuperate between them might be low. Mausz et al (2022) have also noted this form of cognitive dissonance as stemming from the discrepancy in paramedics' expected role and what turns into an espoused paramedic identity, manifesting in such frustrations of nonurgent calls and frequent 'system abusers' [58]. Similar phenomena have been noted by Lazarsfeld-Jensen (2014), who investigate how storytelling and rescue myths imbued on young graduate paramedics might enforce an image of paramedics as rescuers or 'masters of chaotic spaces' , working mostly as live-savers and 'requiring critical events as proving grounds' [11].…”

Identity, positionality and reflexivity: relevance and application to research paramedics

“…However, in the limited body of evidence pertaining to paramedic research methods, these concepts are only briefly mentioned ( Williams, 2012 ). We found several examples of positionality statements and reflexivity considerations in published articles and masters/doctoral theses by paramedics conducting research ( Eaton-Williams et al, 2020 ; Horrocks, 2020 ; Mausz et al, 2022 ; Whitley, 2020 ; Wolff, 2019 ). Often these statements and discussions vary in the detail provided, with many paramedic research outputs not including any discussions around the researcher’s positionality and reflexivity.…”