Trends in the paramedic workforce: a profession in transition

Abstract

AMBULANCE SERVICES play a key role in the Australian health system, as the primary providers of pre-hospital clinical care, emergency care and specialised transport. 1 Although at present there is a strong focus on broad health system reform, and health workforce reform specifically, little attention has been paid to the place of prehospital clinical care and the paramedic workforce that provides these services. Despite their significant role in the health system, there is no strategic national approach by government to the development of ambulance services or the paramedic workforce.In this paper, we review current and emerging trends impacting on the paramedic workforce. We examine changes in patterns of ambulance service provision and the nature of clinical work undertaken by paramedics, as well as developments in education, training and career pathways. We focus on the current situation in Victoria to illustrate and identify a number of important implications of current changes, for the profession, service and training providers, and policy makers.

Informing a Canadian paramedic profile: framing concepts, roles and crosscutting themes

“…Is there something we can treat them right here as opposed to you know bringing them to the hospital.”[P-11] These concepts of a clinical proficiency were reflective of current practice models but also of practice models that were evolving. Technical competence [3, 35], being patient-centered [36], having the ability to integrate a patient’s context and functioning in diverse settings with varying levels of clinical support [37] were also features of the discourse in this “Clinician” role. However, given the diverse patient groups and contexts, it wasn’t clear whether specialists or generalists would be most appropriate or what defines competence exactly, only that it was an essential role to be embodied in this system.…”

“…Paramedicine is an autonomous, evolving and ever changing profession with expanding expectations in complex and rich practice contexts [1, 3, 32, 36, 41]. Linked to some extent with other roles (e.g., clinician) many discussed an obligation to be reflective about one’s practice.…”

Review article: Paramedic education opportunities and challenges in Australia

“…In 1994, the first paramedic educational programmes were established at Charles Stuart University and Monash University . Since then paramedic education has been undergoing significant transformation, from an in‐house, post‐employment training model to a university‐based pre‐employment programme . Currently, these two models still exist for paramedic education; however, the former model is being progressively phased out of the system with the national trend in paramedic education moving towards pre‐employment tertiary programmes as a model that will become the sole point of entry to the profession in the future.…”

Transition to work and the career destinations of double degree nurses

“…Nevertheless, these BN/BCP graduates had not ruled out nursing completely as all of them had completed their registration requirements to practise as a nurse. This is likely due to a desire for career fl exibility and/or the fact that positions in paramedicine were not abundant in some areas of Australia due to a glut of paramedic graduates (Joyce, Wainer, Piterman, Wyatt, & Archer, 2009). By the second year post-graduate, the number working in nursing had dropped for both cohorts: to 75% for BN/BECTs and 40% for BN/BCPs.…”