As you may know, the Code of Ethics sets out the basic ethical commitments that guide all regulated members of the paramedic profession in Alberta. Each regulated member is required to understand and comply with this Code, but how does this translate in the day-to-day work of EMRs, PCPs and ACPs?
The following scenario will attempt to address responsibility to oneself – maintaining mental and physical capacity.
3.4 Maintain mental and physical capacity
Maintain mental and physical capacity by identifying and seeking treatment for any serious injury; mental, behavioural or physical condition; or any other condition that has immediately or may affect over time, their ability to practice safely and competently, and refraining from practicing while their ability to provide appropriate and competent care is compromised.
Scenario:
An Advanced Care Paramedic (ACP), Jeremy, has been working as a paramedic for several years. A few months ago, Jeremy responded to a particularly traumatic call involving a critically injured child. Although he initially felt that he was coping well, he has started to notice changes in his mental and emotional wellbeing since the call.
Jeremy has started experiencing intrusive memories of the incident and occasionally finds himself thinking about the call while at work. He has begun having nightmares and wakes frequently throughout the night. He is increasingly irritable and finds himself becoming frustrated with his partner and other healthcare professionals over things that normally would not bother him.
Jeremy has also become more withdrawn outside of work. He avoids talking about the incident and has stopped participating in activities he previously enjoyed. He feels constantly “on edge” and is easily startled by unexpected noises. On some calls, particularly those involving children, Jeremy experiences a strong emotional response and has difficulty concentrating on the task in front of him.
Despite these changes, Jeremy continues to report for work. He tells himself that he should be able to handle what he has experienced because he is a paramedic and does not want his colleagues to think that he cannot do his job. He is also concerned about being taken off the road if he tells anyone what he has been experiencing.
During a call involving a pediatric patient, Jeremy notices that he is struggling to focus. He catches himself repeatedly thinking about the previous traumatic incident and realizes that he has missed part of the information his partner is providing. His partner notices that Jeremy seems unusually distracted and asks if everything is okay.
After the call, Jeremy reflects on what has been happening. He recognizes that his symptoms are no longer limited to his personal life and may be affecting his ability to remain focused, make sound clinical decisions and provide safe and competent patient care.
Jeremy decides that continuing to practice while experiencing these symptoms could put both himself and his patients at risk. He speaks with his supervisor and arranges to stop working. He also seeks appropriate professional assessment and treatment to address what he has been experiencing.
By recognizing that his mental health symptoms may be affecting his ability to provide safe and competent care, Jeremy takes action before an incident occurs. His decision to seek treatment, refrain from practicing, and notify the College demonstrates professional accountability and prioritizes patient safety.
Maintaining mental and physical capacity means:
- Recognizing changes in your mental, behavioural, or physical health that may affect your ability to practice safely.
- Paying attention to symptoms such as intrusive memories, nightmares, heightened alertness, emotional distress, avoidance, irritability or difficulty concentrating.
- Recognizing when symptoms begin to affect clinical judgment, concentration, communication, decision-making or interactions with patients and colleagues.
- Seeking appropriate assessment, treatment and support when a condition may affect your ability to practice.
- Refraining from practicing when your ability to provide appropriate and competent care is compromised.
- Contacting the College when a leave from practice may be appropriate and understanding the requirements associated with a self-declared leave.
- Understanding that seeking help and stepping away from practice is part of professional responsibility and does not represent a failure or weakness.
- Taking action early, before a condition contributes to an error, patient harm or unsafe practice.
This scenario demonstrates that maintaining mental and physical capacity is not simply about being physically capable of completing a shift. Regulated members have a responsibility to recognize when their mental or behavioural health may affect their ability to practice safely and competently. By seeking help and formally stepping away from practice, Jeremy demonstrates accountability to himself, his patients, his colleagues, and the profession.
Self-Declared Leave from Practice
Note: Regulated members who are taking a physical or psychological medical leave from practice, where they do not have the capacity to complete CC requirements, can submit a request to the College to have an adjustment made to their CC credit requirements during their time away from practice.