Adopting a 'System of Caring' as a leadership strategy toward professionalisation within South African emergency medical services: A grounded theory

Abstract

Professionalization is a key agenda within South African prehospital care. Emergency Medical Services (EMS) agencies continue to grapple with operationalising the process of professionalising, with a number approaches described in literature. This research presents a System of Caring developed within the context of EMS as an approach to achieving professionalization. Methods: A qualitative research design in the form of constructivist grounded theory design was used. Participants were enrolled using purposive and theoretical sampling. Data were analysed using coding procedures in a constant comparative analysis approach supported by theoretical sensitivity. Analytical diagrams consistent with grounded theory methodology were also employed, primarily in the form of inter-relational diagraphs. Results: Six main categories were established with associated coding lists. Coding lists were used to develop groups of propositions that were then abstracted to construct final analytical labels that captured the elements of the System of Caring. These elements include caring for the leaders, caring for the team, caring for the patient, caring for each other (collegial) and caring for self. The components of each element were also abstracted, and the System of Caring developed. Conclusion: While there are various well-established definitions for the term care, within the context of the perceptions of the participants of this study, care (and caring) means a combination of constructed environmental conditions and people-process practices that recognises the well-being of the people within the processes. This 'System of Caring' offers a practicable way to operationalise caring into the workforce and move toward exploring how to promote professionalism within the workforce, through a 'System of Caring'. While this may have been reasonably extrapolated before, this research allows for a poignant insight into how EMS agencies can promote professionalization within EMS systems within South Africa, through the 'System of Caring'.

Keywords: Paramedics; Professionalism; South Africa; prehospital.

Fig. 1

‘System of Caring’: EMS personnel perceive Good Work as work that is done with care, and EMS personnel perceive ethical leadership as leadership that is done with care, and EMS personnel perceive that the role of ethical leadership in doing good work is that of fostering, promoting and protecting a ‘System of Caring’ that permeates all aspects of the work done. A leadership that is genuinely caring for the workforce will drive the workforce toward caring about doing good work, as leadership acts as the mediating factor within the ‘System of Caring’. The role of leadership in modelling and promoting caring behaviour, through the example that they set, is regarded as essential to being effective leadership that will drive professionalization within an EMS system. This illustrates how using a ‘System of Caring’ as a leadership strategy will promote and support professionalization.