Chapter 2: Operational factors

Pre-existing relationships

The paramedic says
Tristan reflects on providing care in small communities where you know the patient and family.(3:22)Video transcript
The paramedic
Nick reflects on the advantages of disadvantages for rural and urban paramedics. (3:22)Video transcript

Especially demanding may be the close ties paramedics have with their community. When you know community members, the lines can blur between personal and professional worlds. This can make it difficult to separate work life from personal life. 

A pre-existing relationship with a patient and family may also contribute to your own grief when the patient dies. Again, this is particularly pronounced in rural and remote communities.

Where everybody knows your name

You may have to navigate situations such as:

  • Responding to calls involving friends, family and people with whom you have a complicated history.

  • Being asked for details of specific calls you attend.

  • Attending the funeral of someone for whom you provided care.
  • Seeing a family repeatedly in social situations after a call went badly or didn’t meet their expectations. 

  • Being pulled into health emergencies out of uniform.

Rural paramedics may need to develop a very close support network with each other to help navigate these situations.

Relationships built during disease trajectory

It's possible that you may see patients and their family members numerous times during an illness and begin to form relationships. This may be more pronounced in rural areas or in settings where you provide additional services in the community to pre-determined populations (community paramedic programs, for example). The transition to providing palliative care for a patient you've come to know well can present special challenges.

For additional information, see Module 7, Responding to the stresses of paramedicine -- Chapter 1, Grief responses to suffering and death -- Personal connections.