Burnout in frontline ambulance staff

Background: Staff retention is a significant issue for ambulance services across the globe. Exploratory research, although minimal, indicates that stress and burnout, in particular, influence attrition within the paramedic profession. These need to be understood if their impact on retention is to be addressed. Aims: To determine the presence of and contributory factors for burnout in the ambulance service to inform recommendations for positive change. Methods: A two-phased survey approach was adopted using an adapted Maslach Burnout Inventory and Copenhagen self-assessment burnout questionnaire, to measure levels of burnout, depersonalisation (cynicism) and personal achievement. Open-ended questions explored factors that influenced these. Demographic and comparative analysis identified trends and thematic analysis was carried out on the qualitative data. Results: Ninety-four per cent of ambulance staff in this study (n=382) reported a sense of personal achievement within their professional role; however, more than 50% were experiencing varying levels of burnout with 87% displaying moderate or high levels of depersonalisation towards their work. Causes of stress were complex: themes attributed were a perceived lack of management support, the public's misuse of the ambulance service, involuntary overtime and a poor work-life balance. Conclusions: Burnout poses a genuine threat to retention in the ambulance service and needs addressing. Proactive screening, better communication between practice staff and management and access to counselling services are recommended. This problem of burnout is beginning to be acknowledged but further evidence is needed to understand it in more depth in order for effective solutions to be developed.

‘Menopause affects us all . . .’: menopause transition experiences of female ambulance staff from a UK ambulance service

Background: There is limited research regarding the menopause transition in the emergency services; however, all women will experience this life phase, which can have a significant impact on personal well-being, workplace attendance and performance. The aim of this survey was to explore personal and work impacts of the menopause for all female staff in the ambulance setting.Methods: A purpose-designed, 20-question survey, based on the Menopause Rating Scale and British Menopause Survey, was developed to understand menopausal symptoms and their impact on female staff in one UK ambulance service. Disseminated during 1‐31 July 2019, it resulted in a convenience sample of 522 responses, which were analysed using descriptive statistics and thematic approaches.Results: Typically, respondents were either pre-menopausal or peri-menopausal, with approximately a third being menopausal or post-menopausal. Over half worked in emergency operational delivery, and typically worked shifts or unsocial hours. For those who had experienced menopause symptoms, the most commonly reported were tiredness or low energy levels, difficulty sleeping (including insomnia) and mood changes (including anxiety or depression). Symptoms impacted respondents’ well-being, work and home life. Most had not expected the symptoms they experienced. The majority of respondents did not feel supported at work, with lack of menopausal symptom awareness and personal impact, working times and patterns, and sense of embarrassment of most concern. Other issues included lack of managerial and peer support, inadequate working environment and uniform, lack of dignity and choice, and no dedicated menopause policy.Conclusions: It is understood that this is the first survey to explore female ambulance staff menopause experiences. The impact of menopausal symptoms can be significant. Menopause awareness in this ambulance service is lacking and there is clear scope for initiatives for improved staff support and well-being. Further research is warranted to explore how best to support ambulance staff with the menopause transition.