Although Healthcare is a very busy sector there are many roles within the NHS which require staff to work alone. Ambulance crews and other first response units alone are an interesting topic within the Lone Working realm of discussions as there are different instances where they would be lone workers.
Bigham et al, (2014) noted that strategies to reduce the incident and impact of violent events towards paramedics have not been well implemented or studied. However, studies into the abuse that paramedics and emergency medical services endure highlight the ideal that this can be improved upon significantly. For example participants in the study which Bigham et al (2014) completed reported that the perpetrators of verbal assault towards emergency medical staff were most often patients and their families.
As both the patients and their families are within a high stress and anxious environment, equipping a paramedic with communication and de-escalation skills may mean that the situation can be resolved easier.
It’s clear through various literature that having an awareness of personal safety skills to work alone is vital in minimising the violence that takes place. Training staff and equipping them with the skills needed to resolve challenging situations whilst working alone would help minimise the risk of the incident escalating into a violent episode. Morken et al (2015) discovered that some participants said they were better prepared due to the education and training in managing threats and violence. Furthermore, examples of useful knowledge were to be aware of one’s own body language; to know how to de-escalate a threatening situation and how to escape if necessary.
However, violence towards paramedics can also occur in the back of an ambulance whilst transporting the patient. This form of violence was most often perpetrated by patients and described as including sexual assault such as groping, fondling and attempts to pull the paramedic on top of the stretcher (Bigham et al., 2014). Although the study concerns sexual assaults arising in the back of an ambulance, it opens up the discussion for other potential situations. If a patient is irritated and abusive toward medical staff in the back of an ambulance, what is the procedure?
If paramedics are not trained sufficiently to handle the challenging situations they face on a daily basis there may be a decrease in empathy and patience with patients and colleagues (Bigham et al., 2014).
With the lessened empathy and the increased stress from an uncontrollable environments, the emergency care givers may give off the wrong body language.
Paramedics and other emergency medical service providers work in a unique healthcare setting which requires care to be delivered in locations that can be uncontrolled and occasionally dangerous (Bigham et al., 2014). Furthermore, Clompus and Albarran (2016) also highlighted that as frontline staff, they experience high levels of stress-related absenteeism, applying interventions and reviewing support mechanism seems to be a pressing imperative. Discussing the importance of an internal support structure, Morken et al (2015) noted that Emergency Healthcare staff members feel that the manager’s attitude was crucial in dealing with the aftermath.
If a staff member does not feel supported by their manager, they are less likely to come forward or feel confident in situations going forward. Morin, Jenvald and Thorstensson, (2000) reported that safety of emergency responders must be considered a priority because, in addition to assuming responsibility of the people they save, the emergency workers are confronted with unexpected, complex and changeable situations. Furthermore, the emergency responders are set precise time limits which exert pressure on workers and require a correct timing of decisions and actions (Prati and Piertrantoni, 2011).
Although, workplace violence unfortunately happens across different areas within Healthcare services, there is a clear correlation with violence occurring when staff are working alone and not prepared for handling challenging situations; especially in the high pressure and stressful environment outside of the hospital.
To avoid this is it important that staff who will be working alone whether that be completely alone or alone for periods of time whilst other colleagues are not with them, are aware how to read the signs and interpret the possibility of violence and how to defuse the situation.