Quantifying the prevalence and predictors of burnout in emergency medical services personnel

Recently, burnout has amassed considerable attention because of deleterious effects on workers and the work environment. Frequently, EMS clinicians find themselves prone to experiencing burnout, yet little is known about etiologies in this population.

To estimate prevalence and predictors of burnout in EMS clinicians.

This was a cross-sectional survey study of nine EMS agencies from North Carolina selected based on geography and population. Emergency medical technicians (EMTs), advanced EMTs, and paramedics were included. Emergency medical responders and air medical personnel were excluded if those positions were a primary occupational function. The Professional Quality of Life (ProQOL) Scale was used to assess burnout. Parametric and nonparametric testing was used to assess factors potentially affecting burnout. Factors significant in univariate analyses were included in a hierarchical linear regression model to determine unique predictors of burnout while controlling for confounders. The area under the curve (AUC) of the receiver operating characteristic (ROC) was used to determine model predictability.

A total of 686 EMS clinicians completed the survey. Overall, 57.3% (n = 393) were likely to have burnout. Of the 328 respondents who were likely to have burnout, 254 (77.4%) and 211 (75.1%) also were identified as likely to suffer from compassion fatigue or vicarious trauma, respectively. Overall, 152 (22.2%) were likely to suffer from all three stress disorders, 118 (56.5%) of which scored high enough to potentially produce immune system dysregulation. Prior suicidal thoughts ((sr² = 0.042, p < 0.001), attempts (sr² = 0.025, p < 0.001) or the presence of vicarious trauma (sr² = 0.040, p < 0.001) accounted for 4.2%, 2.5%, and 4.0% of model variance, respectively. Years of field experience (sr² = 0.035, p < 0.001) and credential level (sr² = 0.011, p = 0.005) accounted for 4.6% of model variance. Finally, a respondent's experience or knowledge of debriefing (sr² = 0.008, p = 0.023); experiencing adversity in childhood in the form of familial mental illness, depression, or suicide (sr² = 0.009, p = 0.016); or the incarceration of a family member (sr² = 0.010, p = 0.011) accounted for a combined 2.7% of model variance. Model predictability showed an AUCROC of 81.5%.

This study showed a nearly 60% prevalence of occupational burnout in the group of EMS clinicians surveyed, making burnout of considerable concern in this population. Further study is needed to address occupational factors that contribute to burnout in EMS clinicians.