Breaking with tradition for Spotlight on Research, instead of reviewing a current study, I have selected a paper from 1983!
A little known piece of work undertaken by Palmer provides a really strong example of a classic ethnography which is of interest— not just from a methodological perspective to learn more about the challenges of ethnographic research, but also in relation to its contribution to a rich description of working life for this group of ambulance service personnel.
This ethnography describes the day-to-day experiences and organizational culture of a group of paramedics and emergency medical technicians (EMTs) working in an urban area in the US in the 1980s.
Data collection included prolonged engagement in the setting including participant observation; interviews, listening to work-related radio calls; informal conversations and analysis of written documentation.
The findings are constructed into a narrative illustrating some of the strategies adopted by the participants to make sense of and manage their occupational environment.
Clearly, the participants were confronted with diverse situations and varying amounts of pressure within their daily work depending on the nature of the calls they were responding to, with some situations having similarities to those attended by emergency ambulance staff today.
Certain practices such as informal categorization of the ‘call’ by the staff based on their perceived value of the job/patient were in evidence, with the labelled ‘211’ calls (requiring more than one ambulance) being positively valued, and the ‘puke’ calls (deemed as not requiring an emergency response) being negatively valued by the participants.
Palmer emphasizes that this type of strategy is found in a whole variety of workplaces as many people do not like absolutely every aspect of their work and so they may label some parts of their job as interesting and others as a waste of time—this practice does not only happen in prehospital care settings.
However, the impact of this type of labelling in any healthcare environment may have more far reaching consequences than if it occurs in some other working environments.
It is an interesting paper on several levels e.g. identification of clinical practices; influence of organizational culture on healthcare provision, and methodological issues—but it is up to the reader to determine what, if any, of its content is transferable across time and culture.
So if you have an interest in this type of research or the topic area, or if you ever need to produce an example of a classic ethnography relevant to paramedic practice (perhaps you are undertaking a research module), this is a rare find!
