Ambulance clinicians’ conceptions of responsibility when encountering patients in a suicidal process

• Introduction: Ambulance clinicians encounter patients in both obvious and non-obvious phases of a suicidal process. Regardless of phase, ambulance clinicians could have an important role in suicide prevention. However, the main focus in ambulance care is on emergency medicine while the patient’s mental ill-health is not necessarily included in the clinician’s assessment.  Aim: To describe ambulance clinicians’ conceptions of responsibility when encountering patients in a suicidal process. Method: With a phenomenographic approach, semi structured interviews were conducted with twenty-seven Swedish ambulance clinicians with a variation in competence, working experience, gender and age. Results: Three categories of description were found. Conventional responsibility, in which responsibility mainly concerns emergency medical treatment and assessment. Conditional responsibility, which to a limited extent includes the patient’s mental ill-health in responsibility but only if certain conditions are met. Ethical responsibility emerges from the encounter with the patient and responsibility is understood as providing care based on the patient’s needs, regardless of physical or mental origin. These categories are found on a spectra moving from responding to the call to responding to the patient. Responding to the patient is impaired by language deficiency or tiredness. Working with a supportive colleague, training in mental health and conversations skills were perceived as facilitating responding to the patient. Conclusion: In suicide prevention, ambulance clinicians understanding of responsibility as responding to the call is unfavorable. Responding to the patient is more favorable and means to primarily appear to the patient as fellow human being. Engaging in a relationship with the patient could cause vulnerability in the clinician, however this vulnerability could be reduced with training and education. This could be vital as it is in the relationship that suicidality could be disclosed and understood.  

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Hälsovetenskap -- Omvårdnad (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Health Sciences -- Nursing (hsv//eng)

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Vårdvetenskap

Caring Science

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