Monday, October 3, 2022

Leo McCann's "The Paramedic at Work"

Leo McCann is Professor of Management at the University of York, having previously worked at Cardiff University and the University of Manchester. His research and teaching draws on historical and sociological perspectives in the study of organizations and professions, especially as regards white-collar and uniformed occupations. He has conducted research into a range of professions, including healthcare, financial services, military forces, and corporate leadership. His current research focuses on the history of management as a profession, specifically in the context of North American approaches to systems analysis and operations research developed during the Cold War.

McCann applied the Page 99 Test to his new book, The Paramedic at Work: A Sociology of a New Profession, and reported the following:
A reader jumping in at page 99 will find themselves in the second of four empirical chapters of the book. These chapters illuminate the working world of paramedics working in the English ambulance service. This is done via liberal reporting of paramedics’ experiences, stories and viewpoints, counterpoised with the author’s interpretations as an academic observer learning about a complex, often alien, world. Page 99 features two National Health Service paramedics, ‘Karen’ and ‘Simon’, who at this point discuss a critically important area, that of paramedic autonomy and clinical skills.

This page does a pretty good job of representing the contents and purpose of the book as a whole. From just two sets of quotations and anecdotes, we learn that paramedics’ clinical skills have broadened in recent years as their role moves from being ‘an occupation’ to ‘a profession’. This development is the driving theme of the book as a whole. What is particularly useful here is that Karen and Simon describe improvements to their working lives alongside some serious limitations. They talk of their growing discretion to provide treatment without the kinds of clearance a nurse would need in a hospital setting: ‘We have to get on with it’, ‘I pride myself on making brave decisions when I have to’. For all this, they feel under-resourced and under-rewarded for their growing clinical expertise and the clinical risk it entails. ‘We’re very underpaid for the autonomy we have’, ‘We deserve Band 6, but who’s gonna pay for it?’ This theme - of paramedic work becoming simultaneously more advanced and autonomous yet also continually underappreciated and restricted – is returned to frequently across the book. In that sense, the ‘page 99 test’ works well.

On the other hand, The Paramedic at Work reflects the huge variety and unpredictability of emergency ambulance work. A single page cannot possibly represent the book as a whole. An earlier chapter provides the theoretical grounding of the book in academic sociology of work. Another describes how NHS ambulance work is organized, managed and evaluated. There is a chapter about the culture of paramedic work, featuring everything from gender relations, the informal value hierarchy of calls, and joking, banter and ‘moaning’. There is also an upsetting chapter on burnout, bullying, stress and ill health. But the book ends on an optimistic note, discussing paramedics’ views on how far the role has developed, and the growing opportunities for ambulance personnel to treat their patients with dignity and compassion. Amid all the pressure and strain, paramedics usually described their work as ‘a privilege’. They were committed to continually expanding the clinical expertise of their profession, with a view to providing ever-more advanced and effective care for their patients. Amid the suffering, the work had meaning, and the workers had hope.
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--Marshal Zeringue