Paramedics On and Off the Streets: Emergency Medical Services in the Age of Technological Governance
In Paramedics On and Off the Streets, Michael K. Corman embarks on an institutional ethnography of the complex, mundane, intricate, and exhilarating work of paramedics in Calgary, Alberta.
Corman’s comprehensive research includes more than 200 hours of participant observation ride-alongs with paramedics over a period of eleven months, more than one hundred first hand interviews with paramedics, and thirty-six interviews with other emergency medical personnel including administrators, call-takers and dispatchers, nurses, and doctors. At the heart of this ethnography are questions about the role of paramedics in urban environments, the role of information and communication technologies in contemporary health care governance, and the organization and accountability of pre-hospital medical services. Paramedics On and Off the Streets is the first institutional ethnography to explore the role and increasing importance of paramedics in our healthcare system. It takes readers on a journey into the everyday lives of EMS personnel and provides an in-depth sociological analysis of the work of pre-hospital health care professionals in the twenty-first century.
- World Rights
- Page Count: 240 pages
- Dimensions: 6.0in x 0.6in x 9.0in
"This is an important book that thoroughly updates and expands the limited sociological literature on emergency ambulance work."
Leo McCann, University of York
Work, Employment, and Society, vol 33: 1
"This is a remarkable book. Corman describes for us just what is involved in doing the work of paramedics. If you’ve ever been taken to hospital by ambulance, this will give you whole new understanding of just what’s involved in getting you there. But more than that, Corman also tells us how paramedical work complements that of emergency nurses and how it is organized by the work of dispatchers, call-takers, and supervisors, and by the digitized information and managerial technologies they work with. We can begin to see yet another layer of organization in systems of managerial accountability aimed at controlling costs. In the vivid precision of his account, Corman also brings into view a contradiction between the particularities and complexities that are the everyday realities of paramedical work, and the standardizing technologies that can never fully take them into account."
Dorothy E. Smith, Department of Sociology, University of Victoria
"Corman’s Paramedics On and Off the Streets helps the reader understand the work of modern paramedicine. He builds a complex picture of EMS as a critical component of the healthcare system which often receives little serious intellectual and academic attention. The reader of this book will truly understand why paramedics and EMS practitioners prefer to not be called ambulance drivers!"
Dug Andrusiek, on behalf of the Canadian EMS Research Network – Réseau canadien de recherche en soins préhospitaliers
"Paramedics On and Off the Streets has the appeal of an out-on-the-streets ethnography with an impressively detailed account of the work of paramedics. It is deeply significant, revealing connections and raising questions about emergency medical work."
Marjorie DeVault, Maxwell School of Citizenship and Public Affairs, Syracuse University
Author InformationMichael K.Corman is a principal advisor in the Department of Health and Wellness for the Government of Prince Edward Island and an adjunct professor in the Department of Sociology & Anthropology and Faculty of Nursing at the University of Prince Edward Island, Canada.
Table of contents
1.1. Opening vignette - Getting Hooked
1.2. Being a “Good” Academic
1.2.1. Historical Roots of EMS and Paramedics
1.2.2. Paramedics’ training and organizational oversight
1.2.3. Paramedics’ Work
1.3. Why Paramedics? Why Now?
1.4. Purpose of the Book
1.4.1. In and out of the field
1.4.2. Overview of book – Summary of Chapters
2. SETTING THE SCENE
2.1. The Station
2.2. The Ambulance
2.3. The Tones
2.4. Assessment Work – “We’re trying to play a chess match, 3, 5 moves ahead”
2.5. “REPAC please”
2.6. The Hospital
2.7. The ePCR
2.8. “One, Two, Three” – Stretcher Work
3. “THE HOSPITAL’S GOING TO COMPLAIN”
3.1. At the Hall
3.2. Hospital Relief
3.3. Lack of Sympathy?
3.4. Downtime – Coffee
3.5. “I’ve been burned several times”
4. “THAT WAS A GOODER”
4.1. “Cold Cocked”
4.2. “That was a Gooder”
4.3. Code Room
4.4. “On our truck, everyone is 36.5”
4.5. Treating the Patient, not the Protocol, not the Machine
4.6. The “Social Stuff”
4.8. Fortying – “You Call, We Haul” – and Convincing Work
5. Epilogue – Overview and Discussion of Chapters 2-4
5.2. A Reflection on the Diversity of Ride-Alongs
5.3. Orienting to the What Ifs
5.4. Taken-for-granted Work: What Counts and What is Being Counted
5.5. Other Players in Emergency Medical Services
6. THE “BRAINS” OF EMS
6.2. EMD and ProQA – “911, for what City?”
6.3. Dispatchers – Alpha 1
6.4. Dispatchers – Alpha 2
6.5. On the Centre’s Floor – Interfacing or Discretionary Work
7. TAMING AND CREATING KNOWLEDGE OF FRONT-LINE WORK
7.2. Protocols and the Targeting of Clinical Practice
7.3. The Electronic Patient Care Record (ePCR)
7.4. Producing Compliance and Quality on the Front Lines
7.5. Business Intelligence – “Analyze and Effect Change”
7.6. Tracing Relations of Governance and Accountability
8. SO WHAT? WHERE DO WE GO FROM HERE?
8.1. Overview of Book
8.2. Cause for Concern?
8.2.1. Doing More With Less
8.2.2. Changing Professional Mandate
8.2.3. Reformation of Time
8.3. Broader Implications
8.4. Closing Remarks
Subjects and Courses