Demand for the emergency medical technician (EMT) is 2 times greater than that of all other occupations. Sustainability of ambulance services (AS) personnel is dependent upon the recruitment of EMTs into the industry. The purpose of this multiple case study was the exploration of the recruiting strategies that AS administrators used to increase the number of EMTs. Herzberg's 2-€factor theory of motivation was the conceptual framework for this study. The data collection instrument included semistructured interviews with 6 AS company executives in southeastern New Mexico and southwestern Texas. Secondary data and document from each state's emergency medical services personnel and websites related to EMTs were reviewed. Data were analyzed using thematic analysis alignment between the recruiting strategies and the conceptual framework. Two key themes emerged: AS administrators have minimal data-€driven recruitment tracking mechanisms and recruiting strategies for EMTs must align with the motivational aspects of growth, advancement, recognition, and responsibility in the AS business to entice people into the industry. The implications of this study for social change include the potential for AS executives to identify recruiting strategies they might use to increase the recruitment of EMTs to meet patient and community needs for medical transport while reducing the demand for EMTs nationwide.

I takt med att psykisk ohälsa i samhället ökar, möter ambulanssjukvården patientgruppen allt oftare. I tidigare studier har det konstaterats att cirka 40 procent av samtal inkomna till SOS Alarm kan knytas till psykisk ohälsa, vilket medför att ambulanssjukvården i högre omfattning bedömer och vårdar dessa patienter. Studien har genomförts genom en kvantitativ enkätstudie, där alla medarbetare som innehar sjuksköterskelegitimation eller specialistkompetens samt arbetade inom ambulanssjukvården Södra Älvsborgs Sjukhus (SÄS) inkluderades i studien. Insamlingen av enkäterna skedde inom SÄS upptagningsområde, och pågick från perioden 24 december 2022 till 1 mars 2023 och alla ambulansstationer i SÄS upptagningsområdet deltog i studien. Sjuksköterskorna fyllde i enkäten med 16 frågor efter genomfört uppdrag av patienter med befarad psykisk ohälsa. Totalt samlades 113 enkäter in och analyserades. Syftet med studien var att kartlägga hur patienter med befarad psykisk ohälsa bedömts och vårdats av sjuksköterska i ambulans för att eventuellt påvisa och synliggöra brister och/eller styrkor. Resultatet visade bland annat att sjuksköterskans bedömning i ambulansen av patienter med befarad psykisk ohälsa inte genomförts enligt de riktlinjer som finns inom SÄS vilket avviker från behandlingsriktlinjerna. Vidare påvisades styrkor specifikt för området då personal med högre kompetens inom psykiatrin kontaktades i större utsträckning än tidigare studier påvisat. / As mental illness in the society increases, the ambulance service meets this group of patients more and more often. In previous studies, it has been established that approximately 40 percent of calls received by SOS can be linked to mental illness, which means that the ambulance service assesses and cares for these patients to a greater extent. The study was carried out through a quantitative survey study, where all employees who were a registered nurse or specialist nurse and worked in the ambulanceservice at Södra Älvsborgs Hospital (SÄS) were considered for inclusion in the study. The collection of the questionnaires took place within the SÄS area, and lasted from the 24th of December 2022 until 1st of March 2023, and all ambulance stations in the SÄS area participated in the study. The nurses filled in the questionnaire with 16 questions after completing the assignment of patients with suspected mental illness. A total of 113 questionnaires were collected and analyzed. The aim of the study was to describe how patients with suspected mental illness were assessed and cared for by nurses in an ambulance in order to detect potential weaknesses and/or strengths. The result showed that the nurse's prehospital assessment of patients with suspected mental illness was not in agreement with the present guidelines within SÄS. A strength was on the other hand that personnel with a higher competence in psychiatry were contacted by the ambulance nurse to a higher extent than previous studies had shown.

Background: One of the ambulance nurse's six core competences is safe care. Safe care meansto conduct care without any unwanted consequences for the patient, their next of kin or anypersonnel from the ambulance team. The environment in the prehospital setting is complex andcontains physical challenges for the ambulance nurse. There is a lot of research on how theambulance nurses safety is affected by their physical ability but there is a lack of research onhow the patient safety is affected. Aim: To explore how patient safety is affected by thephysical ability of the ambulance nurse. Method: A qualitative interview study based on acontent analysis. The participants were eight nurses specializing in ambulance care. Results:The results show that the ambulance nurse's different physical conditions had both positive andnegative effects on patient safety. It was of great importance to have self-awareness of one'sphysical conditions in order to avoid performing risky actions. When the physical ability wasinsufficient, methods such as mobility equipment and help from colleagues were used topreserve the patient safety. Conclusion: It is difficult for ambulance nurses to have a physicalability that meets all patient needs, thus the ambulance nurse was faced with situations wherethe patient care risked not being patient safe. In the case of time-critical patients, they thereforeneeded to weigh up whether the risk of injury during the patient care was less than delaying thetime at the scene in the event of serious injury or illness.

Bakgrund: Kommunikationen över radio och på skadeplats har en avgörande roll för kvaliteten på samverkan mellan blåljuspersonal. Utbildning och övning är nödvändigt för att upprätthålla och förbättra förmågan till kommunikation i syfte att kunna hantera allvarliga händelser.  Motiv: Behovet av god samverkan mellan ambulanspersonal och polis ökar. En god samverkan främjar patientsäkerheten och minskar patientmortaliteten på skadeplats.  Syfte: Kartlägga ambulanspersonalens och polisers uppfattning om hur kommunikationen fungerar mellan dem under samverkansuppdrag.  Metod: Studien är en kvantitativ webbaserad enkätstudie. Studien inkluderade personal från Polismyndigheten och ambulanssjukvården i Stockholm samt Dalarna. Totalt deltog 200 respondenter. Variabler som yrkesroll, region/område, kön, yrkeserfarenhet, kommunikation över radio och på skadeplats samt antalet samverkansövningar respondenterna medverkat i studerades. Data analyserades i SPSS Statistics och presenteras beskrivande med medianer och procentsatser samtjämförande med Chi2-test.  Resultat: Majoriteten av respondenterna ansåg att kommunikationen över radio (n=129, 64,5%) samt på skadeplats (n=151, 75,5%) mellan organisationerna var välfungerande under samverkansuppdrag. Majoriteten (n=144, 72%) ansåg att svarsfrekvensen av den andra organisationen över radio var bristande. Samband påvisades mellan yrkesroll och hur kommunikationen uppfattades på skadeplats (p<0,001) samt uppfattningen av att liknande radiospråk/begrepp används (p=0,009). Samband påvisades mellan antal samverkansövningar och uppfattningen om svarsfrekvensen över radio av den andra organisationen (p=0,007).  Konklusion: Kommunikationen mellan ambulanspersonal och poliser uppfattades mestadels som välfungerande av båda organisationerna. Samband påvisades mellan yrkesroll och uppfattningen av kommunikation samt mellan samverkansövningar och svarsfrekvensen över radio. Kunskapen om kommunikation mellan organisationerna kan förhoppningsvis ge upphov till att Polismyndigheten och ambulanssjukvården ser över hur de arbetar för en välfungerande kommunikation mellan organisationerna samt de metoder de använder för att främja den. Mer forskning behövs för att avgöra vad som påverkar kommunikationen samt hur den kan främjas under samverkansuppdrag. / Background: Communication has a decisive role for the quality of collaboration between first responders. Education and training are necessary to maintain and improve the ability to communicate in order to handle serious incidents.  Motive: The demand for good collaboration between paramedics and police officers is increasing. A good collaboration between first responders increases patient safety and reduces patient mortality at the scene of the accident.  Aim: The aim of the study is to identify how the communication between paramedics and police officers works during cooperation.  Methods: The study is a quantitative web-based survey study. The study included personnel from the Police Authority and the ambulance service in Stockholm and Dalarna (Sweden). 200 respondents participated in the study. Variables that were studied were professional role, region/area, gender, work experience, communication through the radio and at the scene of the accident and the amount of cooperation exercises the respondents participated in. Data were analyzed using SPSS Statistics and presented descriptively with medians and percentages and comparatively with Chi-squared tests.  Result: The majority of the respondents indicated that the communication through the radio (n=129, 64,5%) and at the scene of the accident (n=151, 75,5%) was well-functioning. The majority (n=144, 72%) also stated that the response rate from the other organization through the radio was lacking. A relation was discovered between profession and how communication was experienced at the scene of the accident (p<0,001) likewise the experience of similar radio-language/terms being used (p=0,009). A relation was indicated between the amount of collaboration exercises and the perceived response rate through the radio (p=0,007).  Conclusion: The communication between paramedics and police officers was broadly perceived as well-functioning by both organizations. A relation was demonstrated between profession and how the communication was perceived, likewise the amount of collaborative exercises and the response rate through the radio. This knowledge of communication between the organizations will hopefully contribute to an evaluation of the methods used for well-functioning communication between the Police Authority and the ambulance service. More research is needed to determine what influences and promotes communication during cooperative missions.

Given that the rates of post-traumatic stress disorder (PTSD) are increasing in today’s society, it is important to gain a better understanding of how organizational factors shape the work experiences of those who have suffered or suffer from PTSD. Paramedics constantly face hazardous situations on the job and thus it is reasonable to argue that many of these situations may have lasting negative impacts on their mental health such as depression, anxiety, and alienation. The purpose of my research is to explore the understanding and experiences of workers in these professions who have experienced PTSD either directly or indirectly. I hypothesize that the supports that emergency first responders receive for PTSD are largely based on organizational factors that shape these professions. For example, the inherent masculine culture associated with this line of work, and the emotional and physical labour that is associated with the job. In exploring the aspects of support received by paramedics, a deeper understanding of why the workers in these professions are not talking about PTSD, seeking or offering support will be gained. It will be shown that the support paramedics receive, whether it be through family, friends, doctors, and/or co-workers, determines how PTSD is addressed and viewed within these professions. It is hoped that through this research PTSD within emergency first response professions will be better understood as an occupational illness. / Thesis / Master of Arts (MA)

Bakgrund: Prehospital förlossning är ett ovanligt uppdrag för sjuksköterskan i ambulanssjukvården. Utbildningen inom obstetrik är begränsad för allmänsjuksköterskor och ambulanssjuksköterskor. Ambulanspersonalen har en viktig roll i det första vårdmötet och behöver vara beredd på att möta det oväntade. Syfte: Att undersöka sjuksköterskors upplevelser av prehospital förlossning. Metod: En kvalitativ empirisk intervjustudie. Fyra allmänsjuksköterskor och fem specialistsjuksköterskorintervjuades. Data analyserades genom kvalitativ innehållsanalys. Resultat: I resultatet framkom fyra kategorier: utmaningar i arbetet, betydelsefull förberedelse, att ge och ta stöd samt snabbt växlande känslor. Resultatet visade att informanterna upplevde bristande erfarenhet och begränsad utbildning. Patientsäkerheten äventyras och det finns svårigheter med att vårda två patienter. Informanterna förbereder sig på det värsta och belyser vikten av förberedelser. Informanterna upplever att anhöriga har ett behov av stöd samt att informanterna själva söker stöd hos barnmorskor och kollegor. Den prehospitala förlossningen upplevs som en känslomässig berg- och dalbana. Konklusion: Den prehospitala förlossningen medför varierade känslor hos sjuksköterskor i ambulansen. Förslag på förbättring har framkommit för att öka patientsäkerheten och arbetsmiljön för sjuksköterskorna. Vikten av kollegialt stöd samt information har identifierats. / Background: Prehospital childbirth is an unusual task for the nurse in the ambulance. Education in obstetrics for general nurses and ambulance nurses is limited. The ambulance staff have an important role in the first care encounter and need to be prepared for the unexpected. Aim: To examine nurse's experiences of prehospital childbirth. Method: A qualitative empirical interview study. Four general nurses and five specialist nurses were interviewed. The data was analyzed through qualitative content analysis. Findings: In the result, four categories emerged: challenges at work,significant preparations, to give and take support and rapidly changing emotions. The results showed that the informants experienced lack of experience and limited education. Patient safety is compromised and there are difficulties in caring for two patients. The informants prepare for the worst and illustrate the importance of preparation. The informants experience that relatives have a need for support and that the informants themselves seek support from midwives and colleagues. The prehospital childbirth is experienced as an emotional roller coaster. Conclusion: Prehospital childbirth causes different feelings for nurses in the ambulance. Suggestions for improvement have emerged to increase patient safety and the working environment for nurses. The importance of peer support and information was identified.

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The diploma thesis deals with the identification of risks which threaten students in the fields of Radiology Assistant, General Nurse and Paramedic. The aim of the thesis is to map the knowledge of risks during providing health care in students of selected fields at the Faculty of Health and Social Studies at the University of South Bohemia. Four hypotheses were set in the thesis. Hypothesis no. 1 saying that there are statistically significant differences in risk knowledge between students of the first and last year of individual fields of health care. Hypothesis no. 2 that there are statistically significant differences in stress perception as a risk-enhancing factor between paramedics and general nurses. Hypothesis no. 3 states that there is a statistically significant difference in the knowledge of the risk of ionizing radiation between radiological assistants and general nurses and hypothesis no. 4 that paramedics will call their future occupation more risky than general nurses. To achieve the objectives and verify the hypotheses, a questionnaire was prepared, a questionnaire survey was conducted and everything was evaluated using graphic and statistical methods. The questionnaire contained 23 questions and the research sample consisted of 105 respondents from the studied fields. The results show that hypothesis no. 1 was confirmed in the fields of Radiology Assistant and Paramedic and rejected by the General Nurse. Hypothesis no. 2 was also confirmed. Hypothesis no. 3 was rejected and hypothesis no. 4 was also rejected. The contribution of the thesis is a complex picture of the knowledge of risks during providing health care in the studied fields. The results can serve the faculty to further more effective teaching.