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. 2018 Nov;19(6):987-995.
doi: 10.5811/westjem.8.39034. Epub 2018 Sep 19.

Burnout and Exposure to Critical Incidents in a Cohort of Emergency Medical Services Workers from Minnesota

Lori L Boland  1   2 , Tyler G Kinzy  1 , Russell N Myers  1 , Karl M Fernstrom  2 , Jonathan W Kamrud  1 , Pamela J Mink  2 , Andrew C Stevens  1
Affiliations

Burnout and Exposure to Critical Incidents in a Cohort of Emergency Medical Services Workers from Minnesota

Lori L Boland et al. West J Emerg Med. 2018 Nov.

Abstract

Introduction: Very little quantitative data on occupational burnout and exposure to critical incidents are available from contemporary United States emergency medical services (EMS) cohorts. Given that burnout has been associated positively with turnover intentions and absenteeism in EMS workers, studies that uncover correlates of burnout may be integral to combating growing concerns around retention in the profession.

Methods: We administered a 167-item electronic survey that included the Maslach Burnout Inventory (MBI) and a modified version of the Critical Incident History Questionnaire (n=29 incident types) to paramedics, emergency medical technicians (EMTs), and dispatchers of a single ambulance service. We defined the presence of burnout as a high score on either the emotional exhaustion or depersonalization subscales of the MBI.

Results: Survey respondents who provided regular 911 response at the time of the survey and completed the MBI portion of the survey were included in our analysis (190 paramedics/EMTs, 19 dispatchers; 54% response). The overall prevalence of burnout was 18%, with prevalence reaching 32% among dispatchers. The seven pediatric critical incident types presented in the survey accounted for seven of the top eight rated most difficult to cope with, and severity ratings for pediatric critical incidents did not differ by parental status (all p>0.30). A significant number of respondents reported that they had been threatened with a gun/weapon (43%) or assaulted by a patient (68%) at least once while on duty. Being over the age of 50, a parent, or in a committed relationship was associated with reduced odds of burnout in unadjusted models; however, these associations did not remain statistically significant in multivariate analysis. Increasing tertile of career exposure to critical incidents was not associated with burnout.

Conclusion: Medical dispatchers may be an EMS subgroup particularly susceptible to burnout. These data also demonstrate quantitatively that in this EMS agency, responders find pediatric critical incidents especially distressing and that violence against responders is commonplace. In this study, a simple measure of career exposure to potentially critical incidents was not associated with burnout; however, individual reactions to incidents are heterogeneous, and assessment tools that more accurately enumerate encounters that result in distress are needed.

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Conflict of interest statement

Conflicts of Interest: By the WestJEM article submission agreement, all authors are required to disclose all affiliations, funding sources and financial or management relationships that could be perceived as potential sources of bias. No author has professional or financial relationships with any companies that are relevant to this study. There are no conflicts of interest or sources of funding to declare.

References

    1. Graham NK. Done in, fed up, burned out: too much attrition in EMS. JEMS. 1981;6(1):24–9. - PubMed
    1. Boudreaux E, Mandry C. Sources of stress among emergency medical technicians (Part I): What does the research say? Prehosp Disaster Med. 1996;11(4):296–301. - PubMed
    1. Grisby DW, McKnew MA. Work-stress burnout among paramedics. Psychol Rep. 1988;63(1):55–64. - PubMed
    1. Neale AV. Work stress in emergency medical technicians. J Occup Med. 1991;33(9):991–7. - PubMed
    1. Blau G, Chapman S. Retrospectively exploring the importance of items in the decision to leave the emergency medical services (EMS) profession and their relationships to life satisfaction after leaving EMS and likelihood of returning to EMS. J Allied Health. 2001;40(2):e29–32. - PubMed