Paramedic experiences of interacting with residential aged-care staff: a descriptive phenomenological study

Introduction Paramedics routinely respond to residential aged care facilities (RACF) for health issues. Paramedics then interact with RACF staff to obtain information regarding the resident and the health issue. There are few studies investigating the paramedic perspective of attending RACF and interacting with staff. Our study focuses on the Australian paramedic perspective of the inter-professional relationship and its potential influence on decision-making and resident outcomes. Methods Seven paramedics, employed by four different Australian jurisdictional ambulance services, were interviewed online. Using a descriptive phenomenological methodology, the essential structure of the phenomenon was developed using the method described by Giorgi and Giorgi. Results The paramedic experiences of attending RACF are predicated on a preconception of an ideal encounter. This includes expectations of a valid reason for the call, that staff appropriately manage acute health issues and that handover of resident information was timely and accurate. Interactions not meeting these standards resulted in a loss of professional trust and sometimes a default decision to hospital transport, irrespective of clinical need. Extrinsic and intrinsic factors influenced paramedic decision-making, including other stakeholders wishes and an avoidance of conflict. Greater professional experience and training led to an adjustment of the ideal concept and a more positive experience. Conclusion The inter-professional relationship that paramedics have with RACF staff is influenced by preconceived expectations that dictate what should happen during any interaction. This imagined ideal has a negative effect on the relationship and potentially impacts paramedic decision-making and, by extension, the outcomes of the resident.