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

• Published in: African Journal of Emergency Medicine Vol. 12; no. 4; pp. 489 - 497
• Main Authors: Mosca, Colin Giovanni, Kruger, Jaco P
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.12.2022; African Federation for Emergency Medicine; Elsevier
• Subjects: Original; Paramedics; prehospital; Professionalism; South Africa; South Africa; prehospital; Professionalism; Paramedics
• DOI: 10.1016/j.afjem.2022.11.001
• ISSN: 2211-419X

•African EMS agencies are grappling with the process of professionalization, with one of the reasons being the ongoing negotiation and formation of professionalism as a meta-ethic within the EMS work systems. African EMS agencies are becoming far more aware of the impact of low staff morale and burnout within the EMS sector.•Research exploring the social interactions and process within African EMS is lacking, which serves as one of the barriers to understanding and developing robust EMS systems within the African setting. This research seeks to contribute to our understanding of how people are interacting as professionals within the African EMS sector and intends to contribute to assisting in the process of developing standards for professionalism as they relate to EMS system work ethic thus contributing to improving the resilence and sustainability of African EMS systems. Introduction: 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’.