3. How do we write reflective essays?
Understanding the assignment
Read your assignment guidelines carefully to determine which kind of reflections your lecturer wants and what they expect; and what content, such as an event, experience, reading or process, your lecturer wants you to reflect on.
Structuring your essay
A reflective essay typically follows the familiar organisational pattern: Introduction – Body Paragraphs – Conclusion. In the body paragraphs, reflective writing involves a number of formats, and this guide will sugguest a DIEP approach, that is, to describe , interpret , evaluate and plan (Boud et al., 1985).
· Introduction
o Introduce the topic and the scope (What?)
o Justify the topic (Why?)
o Present the purpose of your essay (Thesis statement)
o Give an overview of what you will cover, i.e., description, interpretation, evaluation and plan (How?)
· Body Paragraphs (DIEP)
o Describe objectively what happened
v Give the details of what happened (Include the necessary who, what, when, where, how and why. You may not need to recall the whole experience, e.g., an incident/ lecture/ reading, but just a key aspect of the experience itself.)
v Answer: “What did you do, read, see, hear, etc.?”
o Interpret what happened
v Explain why things happened in the way they did
v Answer: “What might this experience mean?”
v Answer: “How did it make you feel?”
v Answer: “How does it relate to what you know/ have learned?”
v AbswerL “What new insights have you gained from it?”
v Answer: “What are your hypothesis/ conclusions?”
o Evaluate the effectiveness of the experience
v Make judgments on whether the experience is effective for you and how beneficial and useful the experience has been
v Answer: “What is your opinion about this experience?”
Answer: “Why do you have this opinion?”
Answer: “What is the value of this experience?”
o Plan how this experience might help you in the future
v Outline a plan for how the experience may impact your thinking or behaviour in your course, programme, future career and life in general
v Answer: “How will you transfer or apply your new knowledge and insights in the future?”
v Answer
· Conclusion
o Restate your thesis statement
o Summarise the main ideas of the body paragraphs
o State your overview of the experience regarding its usefulness and effectiveness for you and your future
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Guidance and information on using reflective essays.
The reflective essay is one of the most common reflective assignments and is very frequently used for both formative and especially summative assessments. Reflective essays are about presenting reflections to an audience in a systematic and formal way.
Generally, all good academic practice for assignments applies when posing reflective essays.
Reflective essays tend to deal with a reflective prompt that the essay needs to address. This also often means that the essay will have to draw on a range of experiences and theories to fully and satisfactorily answer the question.
The questions/prompts should not be too vague, for example ‘reflect on your learning’, but should define an area or an aspect relevant to your learning outcomes. This is most easily ensured with thorough guidelines, highlighting elements expected in the essay.
Questions could be something like (not exhaustive):
Reflective essays will often require theoretical literature, but this is not always essential. Reflective essays can be built around a single individual experience, but will often draw on a series of individual experiences – or one long experience, for example an internship, that is broken into individual experiences.
The typical language and structure is formal – for thorough descriptions on this, see ‘Academic reflections: tips, language and structure’ in the Reflectors’ Toolkit, which can be valuable to highlight to students.
Academic reflections: tips, language and structure (within the Reflectors’ Toolkit)
There is no one length that a reflective essay must take. As with all written assignments, the main consideration is that the length is appropriate for evidencing learning, answering the question and meeting the criteria.
Similarly, there is no clear answer for what percentage of the overall mark is attached to the assignment. However, the choice should mirror the required workload for the reflector to complete it, how that fits into your initiative, and the amount of preparation the reflector has had.
For instance, if the student has received formative feedback on multiple pieces of work, a larger proportion of the course mark may be appropriate, compared to if the student had not had a chance to practice. It is important to keep in mind that many students will not have had many chances to practice reflective essays before university.
Back to ‘Components of reflective tasks’
Following Mercury retrograde, Mercury will station direct on Aug. 28, marking the end of a period of reflection and the beginning of forward momentum
As Mercury prepares to station direct on Aug. 28 , you may notice a shift in your energy and mental clarity, as this marks the end of a period of reflection and the beginning of forward momentum, particularly in areas related to communication, daily routines and decision-making.
If you’ve recently felt stuck or misunderstood, exploring what Mercury direct means for your zodiac sign can help you navigate this transition with a fresh mind and renewed perspective. In astrology , Mercury is the planet of communication, transportation and your immediate surroundings. It governs everything from how you think to the way you express yourself intellectually and with your local community. When the messenger planet retrogrades , it slows down, causing delays and disruptions. This notorious phenomenon occurs three to four times a year, triggering misunderstandings, technological glitches and unexpected changes to plans and schedules. On Aug. 5 , Mercury stationed retrograde in Virgo , which can explain the issues surrounding logistics and daily affairs that may have taken place. This Earth sign is known for its methodical, meticulous and analytical nature, so this retrograde likely emphasized the areas of your life that need to be critiqued, improved and re-evaluated. During its backspin, the messenger planet re-entered Leo on Aug. 14, shifting the focus from detail-oriented scrutiny (Virgo) to leadership and self-expression (Leo). While Mercury retrograde in Virgo inspired the need to read the fine print and refine your day-to-day routine, Mercury's re-entry into Leo was a call to implement those newly found insights and revisions into your self-expression in a way that showcases your authenticity and creative passion. As Mercury stations direct on Aug. 28, the lessons learned during its retrograde phase start to come full circle. Remember that while the messenger planet will be moving forward, it will also transit the same degrees it retrograded through in Leo and Virgo. This is known as the post-retrograde shadow phase ; expect more clarity and resolution from this retrograde period between Aug. 28 and Sept. 11.
In the meantime, read on for what Mercury direct means for your zodiac sign.
You're ready to move forward with clarity and purpose, Aries . Upon Mercury stationing direct, you will feel a renewed sense of clarity, especially in your creative pursuits and daily routines. Mercury retrograde encouraged you to reflect on how you manage your time and energy, and now it's time to implement this newfound wisdom with confidence and enthusiasm. Whether it be a passion project or simply creating more time for fun in your day-to-day life, this is a call to tend to your heart's desires.
Put your plans into action by curating a warm and inviting atmosphere for yourself and your loved ones, Taurus . Mercury is officially stationing direct, so expect more clarity in your personal life. This retrograde likely had you revisiting childhood memories or perhaps emphasized your hobbies, creative musings and love affairs. Reconnecting with your inner child and prioritizing your joy now supports and contributes to the harmony of your living space and home life.
Is there something you'd like to get off your chest, Gemini ? With Mercury going direct in Leo, expect a confidence boost in your communication style and more reasons to celebrate with your inner circle. Mercury rules you, so retrogrades tend to affect you more than most. Although you likely dealt with unexpected disruptions with family or regarding the logistics of your living situation, you now have the courage to express yourself and the confidence to address an important situation.
Never undermine your worth or your desire for stability, Cancer . As Mercury stations direct, you will likely notice improvements in your daily affairs that make you feel more secure in your decisions. This retrograde may have caused misunderstandings and delays, especially regarding your finances and value systems. It could've also inspired you to explore creative income streams and consider ways to monetize your talents and skills.
Step into the spotlight, Leo . After taking time to reassess your finances and re-evaluate your personal values and self-worth, Mercury direct encourages you to embrace your authenticity. Mercury retrograde put a spotlight on everything from your money-making abilities to the results brought on by your spending habits. It might have also uncovered triggers surrounding your self-esteem, whether personally or professionally.
Remember who you are, Virgo . Your celestial ruler, Mercury, is stationing direct, encouraging you to trust your instincts and integrate the inner work you've done with your actions moving forward.
This retrograde transit may have had you second-guessing yourself or rethinking your approach to relationships and personal projects. Your ability to take a step back and introspect could've also brought you into alignment with your heart's desires.
Gather with your best pals, Libra . Mercury is going direct, bringing movement and momentum to your social life after prioritizing your healing and spending time in solitude.
Under the influence of Mercury retrograde, unresolved issues from the past may have resurfaced, leading you to go within and explore your inner world and unconscious patterns. Retreating and tending to your needs was likely the refresh you never knew you needed.
You're ready to take the lead with confidence, Scorpio . As Mercury stations direct, you find the courage to make strides in your professional endeavors. You're now confident in your decisions.
Mercury retrograde may have caused delays and confusion regarding your sense of belonging, leading you to rethink your friendships or network affiliations. This lack of certainty may have also contributed to a sense of doubt in your career and social circles.
Honor your newfound sense of direction, Sagittarius . Whether planning a trip or pursuing new ventures outside your comfort zone, Mercury direct gives you the green light to expand and take a leap of faith.
The messenger planet's backspin may have caused delays that left you with no choice but to re-evaluate your long-term goals. If you were contemplating your belief systems or second-guessing yourself in your personal and professional pursuits, you can blame Mercury retrograde.
The coast is clear, Capricorn . As Mercury stations direct, you find the confidence and courage to commit and explore a joint venture even further, whether merging personally or professionally.
Mercury retrograde may have led you to reconsider your beliefs or knowledge around a particular topic. This could have also resulted in you having to set firm boundaries with a significant other or professional employer, specifically regarding investments and financial decisions.
Embrace authenticity in your connections, Aquarius . Mercury is stationing direct, encouraging you to strengthen your partnerships and make decisions regarding your relationships with confidence.
Mercury retrograde likely brought up financial concerns and intimacy issues, as minor details might have contributed to a lack of mutual understanding or commitment. It could've also created feelings of confusion or a hyper-fixation of the details.
Rework your schedule and make the necessary adjustments, Pisces . Mercury direct, along with your attention to detail, brings improvements to the logistics of your routines and personal affairs.
In addition to experiencing brain fog and an influx of information, Mercury retrograde may have caused misunderstandings that led you to rethink and reassess your commitment to others. This can also explain why you may have felt a lack of stability or structure in your daily life.
Samantha Putterman, PolitiFact Samantha Putterman, PolitiFact
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This fact check originally appeared on PolitiFact .
Project 2025 has a starring role in this week’s Democratic National Convention.
And it was front and center on Night 1.
WATCH: Hauling large copy of Project 2025, Michigan state Sen. McMorrow speaks at 2024 DNC
“This is Project 2025,” Michigan state Sen. Mallory McMorrow, D-Royal Oak, said as she laid a hardbound copy of the 900-page document on the lectern. “Over the next four nights, you are going to hear a lot about what is in this 900-page document. Why? Because this is the Republican blueprint for a second Trump term.”
Vice President Kamala Harris, the Democratic presidential nominee, has warned Americans about “Trump’s Project 2025” agenda — even though former President Donald Trump doesn’t claim the conservative presidential transition document.
“Donald Trump wants to take our country backward,” Harris said July 23 in Milwaukee. “He and his extreme Project 2025 agenda will weaken the middle class. Like, we know we got to take this seriously, and can you believe they put that thing in writing?”
Minnesota Gov. Tim Walz, Harris’ running mate, has joined in on the talking point.
“Don’t believe (Trump) when he’s playing dumb about this Project 2025. He knows exactly what it’ll do,” Walz said Aug. 9 in Glendale, Arizona.
Trump’s campaign has worked to build distance from the project, which the Heritage Foundation, a conservative think tank, led with contributions from dozens of conservative groups.
Much of the plan calls for extensive executive-branch overhauls and draws on both long-standing conservative principles, such as tax cuts, and more recent culture war issues. It lays out recommendations for disbanding the Commerce and Education departments, eliminating certain climate protections and consolidating more power to the president.
Project 2025 offers a sweeping vision for a Republican-led executive branch, and some of its policies mirror Trump’s 2024 agenda, But Harris and her presidential campaign have at times gone too far in describing what the project calls for and how closely the plans overlap with Trump’s campaign.
PolitiFact researched Harris’ warnings about how the plan would affect reproductive rights, federal entitlement programs and education, just as we did for President Joe Biden’s Project 2025 rhetoric. Here’s what the project does and doesn’t call for, and how it squares with Trump’s positions.
To distance himself from Project 2025 amid the Democratic attacks, Trump wrote on Truth Social that he “knows nothing” about it and has “no idea” who is in charge of it. (CNN identified at least 140 former advisers from the Trump administration who have been involved.)
The Heritage Foundation sought contributions from more than 100 conservative organizations for its policy vision for the next Republican presidency, which was published in 2023.
Project 2025 is now winding down some of its policy operations, and director Paul Dans, a former Trump administration official, is stepping down, The Washington Post reported July 30. Trump campaign managers Susie Wiles and Chris LaCivita denounced the document.
WATCH: A look at the Project 2025 plan to reshape government and Trump’s links to its authors
However, Project 2025 contributors include a number of high-ranking officials from Trump’s first administration, including former White House adviser Peter Navarro and former Housing and Urban Development Secretary Ben Carson.
A recently released recording of Russell Vought, a Project 2025 author and the former director of Trump’s Office of Management and Budget, showed Vought saying Trump’s “very supportive of what we do.” He said Trump was only distancing himself because Democrats were making a bogeyman out of the document.
The Harris campaign shared a graphic on X that claimed “Trump’s Project 2025 plan for workers” would “go after birth control and ban abortion nationwide.”
The plan doesn’t call to ban abortion nationwide, though its recommendations could curtail some contraceptives and limit abortion access.
What’s known about Trump’s abortion agenda neither lines up with Harris’ description nor Project 2025’s wish list.
Project 2025 says the Department of Health and Human Services Department should “return to being known as the Department of Life by explicitly rejecting the notion that abortion is health care.”
It recommends that the Food and Drug Administration reverse its 2000 approval of mifepristone, the first pill taken in a two-drug regimen for a medication abortion. Medication is the most common form of abortion in the U.S. — accounting for around 63 percent in 2023.
If mifepristone were to remain approved, Project 2025 recommends new rules, such as cutting its use from 10 weeks into pregnancy to seven. It would have to be provided to patients in person — part of the group’s efforts to limit access to the drug by mail. In June, the U.S. Supreme Court rejected a legal challenge to mifepristone’s FDA approval over procedural grounds.
WATCH: Trump’s plans for health care and reproductive rights if he returns to White House The manual also calls for the Justice Department to enforce the 1873 Comstock Act on mifepristone, which bans the mailing of “obscene” materials. Abortion access supporters fear that a strict interpretation of the law could go further to ban mailing the materials used in procedural abortions, such as surgical instruments and equipment.
The plan proposes withholding federal money from states that don’t report to the Centers for Disease Control and Prevention how many abortions take place within their borders. The plan also would prohibit abortion providers, such as Planned Parenthood, from receiving Medicaid funds. It also calls for the Department of Health and Human Services to ensure that the training of medical professionals, including doctors and nurses, omits abortion training.
The document says some forms of emergency contraception — particularly Ella, a pill that can be taken within five days of unprotected sex to prevent pregnancy — should be excluded from no-cost coverage. The Affordable Care Act requires most private health insurers to cover recommended preventive services, which involves a range of birth control methods, including emergency contraception.
Trump has recently said states should decide abortion regulations and that he wouldn’t block access to contraceptives. Trump said during his June 27 debate with Biden that he wouldn’t ban mifepristone after the Supreme Court “approved” it. But the court rejected the lawsuit based on standing, not the case’s merits. He has not weighed in on the Comstock Act or said whether he supports it being used to block abortion medication, or other kinds of abortions.
“When you read (Project 2025),” Harris told a crowd July 23 in Wisconsin, “you will see, Donald Trump intends to cut Social Security and Medicare.”
The Project 2025 document does not call for Social Security cuts. None of its 10 references to Social Security addresses plans for cutting the program.
Harris also misleads about Trump’s Social Security views.
In his earlier campaigns and before he was a politician, Trump said about a half-dozen times that he’s open to major overhauls of Social Security, including cuts and privatization. More recently, in a March 2024 CNBC interview, Trump said of entitlement programs such as Social Security, “There’s a lot you can do in terms of entitlements, in terms of cutting.” However, he quickly walked that statement back, and his CNBC comment stands at odds with essentially everything else Trump has said during the 2024 presidential campaign.
Trump’s campaign website says that not “a single penny” should be cut from Social Security. We rated Harris’ claim that Trump intends to cut Social Security Mostly False.
Project 2025 does propose changes to Medicare, including making Medicare Advantage, the private insurance offering in Medicare, the “default” enrollment option. Unlike Original Medicare, Medicare Advantage plans have provider networks and can also require prior authorization, meaning that the plan can approve or deny certain services. Original Medicare plans don’t have prior authorization requirements.
The manual also calls for repealing health policies enacted under Biden, such as the Inflation Reduction Act. The law enabled Medicare to negotiate with drugmakers for the first time in history, and recently resulted in an agreement with drug companies to lower the prices of 10 expensive prescriptions for Medicare enrollees.
Trump, however, has said repeatedly during the 2024 presidential campaign that he will not cut Medicare.
The Harris campaign said Project 2025 would “eliminate the U.S. Department of Education” — and that’s accurate. Project 2025 says federal education policy “should be limited and, ultimately, the federal Department of Education should be eliminated.” The plan scales back the federal government’s role in education policy and devolves the functions that remain to other agencies.
Aside from eliminating the department, the project also proposes scrapping the Biden administration’s Title IX revision, which prohibits discrimination based on sexual orientation and gender identity. It also would let states opt out of federal education programs and calls for passing a federal parents’ bill of rights similar to ones passed in some Republican-led state legislatures.
Republicans, including Trump, have pledged to close the department, which gained its status in 1979 within Democratic President Jimmy Carter’s presidential Cabinet.
In one of his Agenda 47 policy videos, Trump promised to close the department and “to send all education work and needs back to the states.” Eliminating the department would have to go through Congress.
In the graphic, the Harris campaign says Project 2025 allows “employers to stop paying workers for overtime work.”
The plan doesn’t call for banning overtime wages. It recommends changes to some Occupational Safety and Health Administration, or OSHA, regulations and to overtime rules. Some changes, if enacted, could result in some people losing overtime protections, experts told us.
The document proposes that the Labor Department maintain an overtime threshold “that does not punish businesses in lower-cost regions (e.g., the southeast United States).” This threshold is the amount of money executive, administrative or professional employees need to make for an employer to exempt them from overtime pay under the Fair Labor Standards Act.
In 2019, the Trump’s administration finalized a rule that expanded overtime pay eligibility to most salaried workers earning less than about $35,568, which it said made about 1.3 million more workers eligible for overtime pay. The Trump-era threshold is high enough to cover most line workers in lower-cost regions, Project 2025 said.
The Biden administration raised that threshold to $43,888 beginning July 1, and that will rise to $58,656 on Jan. 1, 2025. That would grant overtime eligibility to about 4 million workers, the Labor Department said.
It’s unclear how many workers Project 2025’s proposal to return to the Trump-era overtime threshold in some parts of the country would affect, but experts said some would presumably lose the right to overtime wages.
Other overtime proposals in Project 2025’s plan include allowing some workers to choose to accumulate paid time off instead of overtime pay, or to work more hours in one week and fewer in the next, rather than receive overtime.
Trump’s past with overtime pay is complicated. In 2016, the Obama administration said it would raise the overtime to salaried workers earning less than $47,476 a year, about double the exemption level set in 2004 of $23,660 a year.
But when a judge blocked the Obama rule, the Trump administration didn’t challenge the court ruling. Instead it set its own overtime threshold, which raised the amount, but by less than Obama.
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“As I sat down to write this article, memories flooded back, each one a brushstroke in the painting of my past…”
That could be the beginning of your personal narrative. Writing it lets you turn your memories and experiences into stories that click with others. This type of writing goes beyond school assignments or essays for college applications; it’s a chance to get really good at sharing your life's events in ways that matter.
In this article, we're going to explore what personal narratives are all about and guide you through a simple seven-step process to create your own. You’ll learn how to pull out moments that make your story stand out and how to tweak your writing until it’s just right. We’ve got practical examples for you to follow along, making sure you have everything you need to tell your story.
A personal narrative is a way to tell your own story. It's a style of writing that puts your experiences front and center, inviting readers into your world. Teachers often assign personal narratives to encourage free, expressive writing.
The personal narrative definition is wider than academic settings, though. . These narratives can also show potential employers who you are beyond your resume. At its core, writing a personal narrative is a form of storytelling, using a first-person perspective to bring real-life tales to life. Whether it's for a grade, a job, or just for fun, it's about getting your story out there.
Let our experts refine your personal narrative, making sure every detail shines and your story is both clear and impactful.
In this section, we'll break down the process into manageable steps, starting with how to zero in on the right topic that speaks about who you are.
The first step in crafting your personal narrative is picking the perfect topic. It should be something meaningful to you, something that has not just happened, but also shaped who you are or has a significant story behind it. Here’s how to frame your personal narrative ideas:
When putting together your personal narrative, starting with a solid outline can help keep your story on track. Here's how you can lay it all out:
If you're looking for help crafting your personal narrative, consider checking out some legit essay writing services to get professional guidance.
Now let’s move on to the fun part! Don't worry about getting everything perfect right away — the first draft’s goal is to let your story flow naturally:
Once the first personal narrative draft is done, set it aside for a bit before revisiting it with fresh eyes.
Once the first personal narrative draft is done, set it aside for a bit before revisiting it with fresh eyes:
As you polish your personal narrative, focus on making it uniquely yours. You can include personal reflections on your experiences. For example, if you’re writing about a challenging project, discuss not just the struggle but how it impacted you personally and professionally.
Besides, add unique details that only you can share. Instead of generic descriptions, use specific anecdotes or sensory details, like how the scent of freshly baked cookies from your grandmother's kitchen made you feel nostalgic.
Last but not least, incorporate dialogues or direct quotes from people involved in your story to add authenticity and depth. For instance, if your mentor gave you advice, include their exact words to capture the moment’s impact. This approach will help you understand how to write a personal narrative that is both engaging and deeply personal.
Not sure where to begin? You can always buy a narrative essay from experts who can help shape your story.
When you’re editing your personal narratives, the goal is to make sure everything flows smoothly and makes sense. Here’s how to get it just right:
Oh, and read your narrative out loud. This can help you spot any awkward phrases or spots where the story might be a bit choppy. It’s a great way to catch any issues and make those final tweaks to get everything just right.
Here are ten personal narrative prompts to get you thinking about different moments in your life:
Topic | Prompt |
---|---|
🏆 Facing Challenges | Think about a tough situation you faced and how you got through it. Maybe you conquered a big project or overcame a personal hurdle. Share what happened and what you learned from it. |
🌟 A Big Change | Write about something that changed your life or perspective. This could be anything from a life-changing trip to a meaningful conversation that made you see things differently. |
🎓 School Memories | Share a standout moment from your school years that made a big impact on you. It might be a memorable class, a special event, or something else that stuck with you. |
🚀 Achieving Goals | Talk about a goal you set and achieved. Explain what it was, how you worked towards it, and what reaching this goal meant to you. |
🤝 Helping Others | Describe a time when you helped someone out. What did you do, and how did it make you feel? It could be anything from assisting a friend to volunteering in your community. |
💪 Your Strengths | Reflect on a personal strength or skill you're proud of. Share how you discovered it, developed it, and how it's helped you in different areas of your life. |
🎉 Fun Times | Write about a fun or exciting experience you had. It could be a family celebration, a personal achievement, or just a memorable day that made you smile. |
📚 Influential Media | Think about a book or movie that had an impact on you. Describe what it was and how it changed the way you think or feel. |
✈️ Travel Adventures | Share a memorable travel experience. Whether it’s the places you visited or the people you met, talk about how the trip affected you or what you learned from it. |
💬 Meaningful Conversations | Write about a conversation that really stuck with you. Who were you talking to, what was it about, and how did it make a difference in your life? |
Need more tips on how to get started? Check out this guide on how to start a narrative essay to kick off your writing with a strong opening.
Here are a few personal narrative beginnings to spark your creativity. These snippets are designed to get you started and inspire your own storytelling.
As you finish up your story, think about how those moments shaped who you are today. It's not just about what happened, but how it changed you. When learning how to write a personal narrative, it’s important to focus on the moments that truly matter to you and tell them in your own voice. This way, your narrative can really connect with others.
Remember, the best stories come straight from the heart, so trust yourself and let your experiences shine through!
If you're working on a personal statement, you might want to explore a personal statement service that can help you create a compelling narrative.
Let us transform your experiences into a beautifully crafted narrative that stands out and makes an impact.
Can a personal narrative be about anything, what is the format of a personal narrative.
Daniel Parker
is a seasoned educational writer focusing on scholarship guidance, research papers, and various forms of academic essays including reflective and narrative essays. His expertise also extends to detailed case studies. A scholar with a background in English Literature and Education, Daniel’s work on EssayPro blog aims to support students in achieving academic excellence and securing scholarships. His hobbies include reading classic literature and participating in academic forums.
is an expert in nursing and healthcare, with a strong background in history, law, and literature. Holding advanced degrees in nursing and public health, his analytical approach and comprehensive knowledge help students navigate complex topics. On EssayPro blog, Adam provides insightful articles on everything from historical analysis to the intricacies of healthcare policies. In his downtime, he enjoys historical documentaries and volunteering at local clinics.
BMC Emergency Medicine volume 24 , Article number: 152 ( 2024 ) Cite this article
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As first responders, paramedics are an extremely important part of the care chain. COVID-19 significantly impacted their working circumstances. We examined, according to the experiences and observations of paramedics, (1) what kinds of emotions the Emergency Medical Service (EMS) personnel experienced in their new working circumstances, and (2) what work-related factors became resources for the well-being of EMS personnel during the initial months of the COVID-19 pandemic.
This qualitative study utilized reflective essay material written by experienced, advanced-level Finnish paramedics ( n = 30). The essays used in this study were written during the fall of 2020 and reflected the period when Finland had declared a state of emergency (on 17.3.2020) and the Emergency Powers Act was implemented. The data was analyzed using an inductive thematic analysis.
The emotions experienced by the EMS personnel in their new working circumstances formed three themes: (1) New concerns arose that were constantly present; (2) Surviving without proper guidance; and (3) Rapidly approaching breaking point. Three themes were formed from work-related factors that were identified as resources for the well-being of the EMS personnel. These were: (1) A high level of organizational efficiency was achieved; (2) Adaptable EMS operations; and (3) Encouraging atmosphere.
Crisis management practices should be more attentive to personnel needs, ensuring that managerial and psychological support is readily available in crisis situations. Preparedness that ensures effective organizational adaptation also supports personnel well-being during sudden changes in working circumstances.
Peer Review reports
At the onset of the COVID-19 pandemic, healthcare personnel across the globe faced unprecedented challenges. As initial responders in emergency healthcare, paramedics were quickly placed at the front lines of the pandemic, dealing with a range of emergencies in unpredictable conditions [ 1 ]. The pandemic greatly changed the everyday nature of work [ 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 ]. Those working on the front line were suddenly forced to adjust to personal protective equipment (PPE) requirements [ 9 , 10 ] and rapidly changing instructions that caused significant adjustments to their job description [ 11 , 12 ]. For instance, it has been reported that during the initial stages of the COVID-19 pandemic, Emergency Medical Services (EMS) personnel, including paramedics working in prehospital emergency care, experienced a significant increase in stress [ 10 , 13 ] due to several reasons, such as the lack of protection and support, increased demands, lack of personnel, fear of exposure to COVID-19 during missions, concerns of spreading the virus to family members, and frustration over quickly changing work policies [ 11 , 14 , 15 ].
With the unprecedented challenges posed by the COVID-19 pandemic, some research has been directed toward identifying available resources that help in coping with such situations. For example, Sangal et al. [ 15 ] underscored the association between effective communication and reduced work stress and burnout, and emphasized the critical need for two-way communication, consistent messaging, and the strategic consolidation of information prior to its dissemination. In parallel, Dickson et al. [ 16 ] highlight the pivotal role of leadership strategies in fostering a healthful work environment. These strategies include being relationally engaging, visibly present, open, and caring for oneself and others, while embodying core values such as compassion, empathy, courage, and authenticity. Moreover, Awais et al. [ 14 ] identify essential measures to reduce mental distress and support EMS personnel’s overall well-being in pandemic conditions, such as by providing accessible mental health and peer support, ensuring a transparent information flow, and the implementation of clear, best-practice protocols and guidelines. As a lesson learned from COVID-19, Kihlström et al. (2022) add that crisis communication, flexible working conditions, compensation, and allowing for mistakes should be part of crisis management. They also emphasize the importance of psychological support for employees. [ 12 ]
Overall, the COVID-19 pandemic had a multifaceted impact on EMS personnel, highlighting the necessity for comprehensive support and resilience strategies to safeguard their well-being [ 11 , 17 , 18 ] alongside organizational functions [ 12 , 19 ]. For example, in Finland, it has been noted in the aftermath of COVID-19 that the availability and well-being of healthcare workers are key vulnerabilities of the resilience of the Finnish health system [ 12 ]. Effective preparedness planning and organizational resilience benefit from learning from past events and gaining a deeper understanding of observations across different organizational levels [ 12 , 19 , 20 ]. For these reasons, it is important to study how the personnel experienced the changing working circumstances and to recognize the resources, even unexpected ones, that supported their well-being during the initial phase of the COVID-19 pandemic [ 12 , 19 ].
The aim of this study was to examine the emotions experienced and the resources identified as supportive of work well-being during the initial months of the COVID-19 pandemic, from the perspective of the paramedics. Our research questions were: According to the experiences and observations of paramedics, (1) what kinds of emotions did the EMS personnel experience in the new working circumstances, and (2) what work-related factors became resources for the well-being of EMS personnel during the initial months of the COVID-19 pandemic? In this study, emotions are understood as complex responses involving psychological, physiological, and behavioral components, triggered by significant events or situations [ 21 ]. Resources are understood as physical, psychological, social, or organizational aspects of the work that help achieve work goals, reduce demands and associated costs [ 22 ].
This qualitative study utilized reflective essay material written in the fall of 2020 by experienced, advanced-level paramedics who worked in the Finnish EMS during the early phase of the pandemic, when Finland had declared (March 17, 2020 onward) a state of emergency and implemented the Emergency Powers Act. This allowed for new rules and guidelines from the government to ensure the security of healthcare resources. Some work rules for healthcare personnel changed, and non-urgent services were limited.
This study is part of a broader, non-project-based research initiative investigating the work well-being of paramedics from various perspectives, and the data was collected for research purposes from this standpoint. The data collection for this study was conducted at the South-Eastern Finland University of Applied Sciences as part of the Current Issues in EMS Management course. The course participants were experienced, advanced-level Finnish paramedics who were students of the master’s degree program in Development and Management of Emergency Medical Services. A similar data collection method has been utilized in other qualitative studies [for example, 23 , 24 ].
The South-Eastern Finland University of Applied Sciences granted research permission for the data collection on August 20, 2020. The learning platform “Learn” (an adapted version of Moodle [ 25 ]) was used to gather the data. A research notice, privacy statement, and essay writing instructions were published on the platform on August 21, 2020. The paramedics were asked to write about their own experiences and observations regarding how the state of emergency impacted the work well-being of EMS personnel. They were instructed not to use references but only their own reflections. Three guiding questions were asked: “What kind of workloads did EMS personnel experience during the state of emergency?” “How has this workload differed from normal conditions?” and “What effects did this workload have on the well-being of the EMS personnel?”. The assignment did not refer solely to paramedics because the EMS field community may also include individuals with other titles (such as EMS field supervisors or firefighters performing prehospital emergency care); hence the term “EMS personnel” was used.
The essay was part of the mandatory course assignments, but submitting it for research purposes was voluntary. The paramedics were informed that their participation in the study would not affect their course evaluations. They had the freedom to decline, remove parts of, or withdraw the essay before analysis. None of the paramedics exercised these options. They were also informed that the last author removes any identifying details (such as names, places, and organizational descriptions that could reveal their workplace) before sharing the data with other, at the time unnamed, researchers. The last author (female) is a senior researcher specializing in EMS and work well-being topics, a principal lecturer of the respective course, and the head of the respective master’s program, and familiar to all of them through their studies. The paramedics were aware that the essays were graded by the last author on a pass/fail scale as part of the course assessment. However, comprehensive and well-reasoned reflections positively influenced the course grade. The evaluation was not part of this study. The paramedics had the opportunity to ask further questions about the study directly from the last author during and after the essay writing process and the course.
The paramedics wrote the essays between August 23, 2020, and November 30, 2020. Thirty-two paramedics (out of 39) returned their essays using the Learn platform during this timeframe. Thus, seven of the course completions were delayed, and the essays written later were no longer appropriate to include in the data due to the time elapsed since the initial months of the COVID-19 pandemic.
All 32 gave their informed consent for their essays to be included in the study. Essays written by paramedics who had not actively participated in EMS field work during exceptional circumstances were excluded from the material ( n = 2), because they wrote the essay from a different perspective, as they could not reflect on their own experiences and observations. Thus, a total of 30 essays were included in the study. The total material was 106 pages long and comprised 32,621 words in Finnish.
Thirty advanced-level paramedics from Finland participated in this study. They all had a bachelor’s degree in emergency care or nursing with additional emergency care specialization. At the time of the study, they were pursuing their master’s studies. Thirteen of them were women, and seventeen were men. The average age of the participants was 33.5 years among women and 35.9 years among men. Women had an average of 8.7 years of work experience, and men had 8.8 years. All the participating paramedics worked in EMS in different areas across Finland (except northern Finland) during their studies and the early phase of the pandemic.
The data was analyzed with a thematic analysis following the process detailed by Braun & Clarke [ 26 ]. First, the two researchers thoroughly familiarized themselves with the data, and the refined aim and research questions of the study were formulated inductively in collaboration based on the content of the data (see [ 26 ], page 84). After this, a thorough coding process was mainly carried out by the first author (female), who holds a master’s degree, is an advanced-level paramedic who worked in EMS during the pandemic, and at the time of the analysis was pursuing her doctoral studies in a different subject area related to EMS. Generating the initial codes involved making notes of interesting features of anything that stood out or seemed relevant to the research question systematically across the entire dataset. During this process, the original paragraphs and sentences were copied from the essay material into a table in Microsoft Word, with each research question in separate documents and each paragraph or sentence in its own row. The content of these data extracts was then coded in the adjacent column, carefully preserving the original content but in a more concise form. Then, the content was analyzed, and codes were combined to identify themes. After that, the authors reviewed the themes together by moving back and forth between the original material, the data in the Word documents, and the potential themes. During this process, the authors worked closely and refined the themes, allowing them to be separated and combined into new themes. For example, emotions depicting frustration and a shift to indifference formed their own theme in this kind of process. Finally, the themes were defined into main, major and minor themes and named. In the results, the main themes form the core in response to the research questions and include the most descriptions from the data. The major themes are significant but not as central as the main themes. Major themes provide additional depth and context to the results. One minor theme was formed as the analysis process progressed, and it provided valuable insights and details that deepened the response to the research question. All the coded data was utilized in the formed themes. The full content of the themes is reported in the Results section.
The emotions experienced by the EMS personnel in their new working circumstances formed three themes: New concerns arose that were constantly present (main theme); Surviving without proper guidance (major theme); and Rapidly approaching breaking point (major theme) (Fig. 1 ). Work-related factors identified as resources for the well-being of EMS personnel formed three themes: A high level of organizational efficiency was achieved (main theme); Adaptable EMS operations (major theme); and Encouraging atmosphere (minor theme) (Fig. 2 ).
Emotions experienced by the EMS personnel in their new working circumstances
The main theme included several kinds of new concerns. In the beginning, the uncertainty about the virus raised concerns about work safety and the means to prevent the spread of the disease. The initial lack of training and routines led to uncertainty. In addition, the decrease in the number of EMS missions raised fears of units being reduced and unilateral decisions by the management to change the EMS personnel’s work responsibilities. The future was also a source of uncertainty in the early stages. For example, the transition to exceptional circumstances, concerns about management and the supervisors’ familiarity with national guidelines and lack of information related to sickness absence procedures, leave, personal career progression, and even the progress of vaccine development, all contributed to this feeling of uncertainty. The initial uncertainty was described as the most challenging phase, but the uncertainty was also described as long-lasting.
Being on the front line with an unknown, potentially dangerous, and easily transmissible virus caused daily concerns about the personnel’s own health, especially when some patients hid their symptoms. The thought of working without proper PPE was frightening. On the other hand, waiting for a patient’s test result was stressful, as it often resulted in many colleagues being quarantined. A constant concern for the health of loved ones and the fear of contracting the virus and unknowingly bringing it home or transmitting it to colleagues led the EMS personnel to change their behavior by limiting contact.
Being part of a high-risk group , I often wondered , in the case of coronavirus , who would protect me and other paramedics from human vanity and selfishness [of those refusing to follow the public health guidelines]? (Participant 25)
The EMS personnel felt a weight of responsibility to act correctly, especially from the perspective of keeping their skills up to date. The proper selection of PPE and aseptic procedures were significant sources of concern, as making mistakes was feared to lead to quarantine and increase their colleagues’ workloads. At the same time, concerns about the adequacy of PPE weighed on the personnel, and they felt pressure on this matter to avoid wastage of PPEs. The variability in the quality of PPE also caused concerns.
Concerns about acting correctly were also tied to ethical considerations and feelings of inadequacy when the personnel were unable to explain to patients why COVID-19 caused restrictions on healthcare services. The presence of students also provoked such ethical concerns. Recognizing patients’ symptoms correctly also felt distressing due to the immense responsibility. This concern was also closely tied to fear and even made some question their career choices. The EMS personnel were also worried about adequate treatment for the patients and sometimes felt that the patients were left alone at home to cope. A reduction in patient numbers in the early stages of the pandemic raised concerns about whether acutely ill individuals were seeking help. At the same time, the time taken to put on PPE stressed the personnel because it increased delays in providing care. In the early phase of the pandemic, the EMS personnel were stressed that patients were not protected from them.
I’m vexed in the workplace. I felt it was immediately necessary to protect patients from us paramedics as well. It wasn’t specifically called for , mostly it felt like everyone had a strong need to protect themselves. (Participant 30)
All these concerns caused a particularly heavy psychological burden on some personnel. They described feeling more fatigued and irritable than usual. They had to familiarize themselves with new guidelines even during their free time, which was exhausting. The situation felt unjust, and there was a looming fear of the entire healthcare system collapsing. COVID-19 was omnipresent. Even at the base station of the EMS services, movement was restricted and social distancing was mandated. Such segregation, even within the professional community, added to the strain and reduced opportunities for peer support. The EMS personnel felt isolated, and thoughts about changing professions increased.
It was inevitable that the segregation of the work community would affect the community spirit , and a less able work community has a significant impact on the individual level. (Participant 8)
At the onset of the pandemic, the job description of the EMS personnel underwent changes, and employers could suddenly relocate them to other work. There was not always adequate support for familiarizing oneself with the new roles, leading to a feeling of loss of control. The management was described as commanding and restricting the personnel’s actions. As opportunities to influence one’s work diminished, the sense of job satisfaction and motivation decreased.
Some felt that leadership was inadequate and neglectful, especially when the leaders switched to remote work. The management did not take the situation seriously enough, leaving the EMS personnel feeling abandoned. The lack of consistent leadership and failure to listen to the personnel caused dissatisfaction and reduced occupational endurance. In addition, the reduced contact with colleagues and close ones reduced the amount of peer support. The existing models for psychological support were found to be inadequate.
Particularly in the early stages, guidelines were seen as ambiguous and deficient, causing frustration, irritation, and fear. The guidelines also changed constantly, even daily, and it was felt that the information did not flow properly from the management to the personnel. Changes in protection recommendations also led to skepticism about the correctness of the national guidance, and the lack of consistent guidelines perplexed the personnel. Internalizing the guidelines was not supported adequately, but the necessity to grasp new information was described as immense and cognitively demanding.
At times , it felt like the work was a kind of survival in a jungle of changing instructions , one mission at a time. (Participant 11)
Risking one’s own health at work caused contentious feelings while concurrently feeling angry that management could work remotely. The arrogant behavior of people toward COVID-19 left them frustrated, while the EMS personnel had to limit their contacts and lost their annual leave. There were fears about forced labor.
Incomplete and constantly changing guidelines caused irritation and indifference, as the same tasks had to be performed with different levels of PPE within a short time. Some guidelines were difficult to comply with in practice, which was vexing.
Using a protective mask was described as distressing, especially on long and demanding missions. Communication and operation became more difficult. Some described frustration with cleaning PPE meant for single use.
Ensuring the proper implementation of a work pair’s aseptic and equipment maintenance was burdensome, and explaining and repeating guidelines was exhausting. A feeling of indifference was emphasized toward the end of a long shift.
After the initial stage, many began to slip with the PPE guidelines and found the instructions excessive. COVID-19 information transmitted by the emergency center lost its meaning, and instructions were left unheeded, as there was no energy to believe that the patient would have COVID-19, especially if only a few disease cases had been reported in their area.
It was disheartening to hear personnel being labeled as selfish for demanding higher pay during exceptional circumstances. This lack of recognition eroded professionalism and increased thoughts of changing professions.
However , being a doormat and a human toilet , as well as a lack of appreciation , undermines my professionalism and the prolonged situation has led me to seriously consider a different job , where values other than dedication and constant flexibility carry weight. I have heard similar thoughts from other colleagues. None of us do this for money. (Participant 9)
Work-related factors identified as resources for the well-being of EMS personnel
The main theme held several different efficient functions. In the early stages of the pandemic, some felt that the information flow was active. Organizations informed the EMS personnel about the disease, its spread, and its impact on the workplace and emergency care activities.
Some felt that managers were easily accessible during the pandemic, at least remotely. Some managers worked long days to be able to support their personnel.
The response to hate and uncertainty was that one of the supervisors was always present in the morning and evening meetings. Supervisors worked long hours so as to be accessible via remote access. (Participant 26)
The organizations took effective steps to control infections. Quick access to COVID-19 tests, clear guidelines for taking sick leave, and permission to take sick leave with a low threshold were seen as positive things. The consideration of personnel belonging to risk groups by moving them to other work tasks was also perceived as positive. In addition, efforts were made to prevent the emergence of infection chains by isolating EMS personnel in their own social facilities.
Established guidelines, especially on the correct use of protective measures, made it easier to work. Some mentioned that the guidelines were available in ambulances and on phones, allowing the protection guidelines to be checked before going on a mission.
The employers took into account the need for psychological support in a diverse manner. Some organizations provided psychological support such as peer debriefing activities, talking therapy with mental health professionals, actively inquiring about their personnel’s feelings, and training them as support workers. The pandemic situation also caused organizations to create their own standard operating models to decrease mental load.
Fortunately , the problem has now been addressed actively , as a peer-to-peer defusing model was built up at our workplace during the crisis , and group defusing has started , the purpose of which is to lighten the work-related mental load. (Participant 3)
There were several different resources that clarified mission activities. The amount of protective and cleaning equipment was ramped up, and the treatment equipment was quickly updated to meet the demands brought about by the pandemic and to enable safety distances for the EMS personnel. In addition, various guidelines were amended to reduce exposure. For example, personnel on the dedicated COVID-19 ambulances were separated to work without physical contact with others, and field supervisors joined the EMS missions less often than before. Moreover, people at the scene were contacted by phone in advance to ensure that there would be no exposure risk, which also allowed other occupational safety risks to be identified. New practices resulted from the pandemic, such as cleaning communication equipment during shift changes and regularly using PPE with infected patients. All of these were seen as positive resources for efficient work.
At the end of each shift , all keys , telephones , etc., were cleaned and handed over to the next shift. This practice was not previously established in our area , but this will become a permanent practice in the future and is perceived by everyone in our work community as a positive thing. (Participant 10)
Some stated that access to PPE was sufficient, especially in areas where the number of COVID-19 infections was low. PPE was upgraded to make it easier to wear. Further, organizations acquired a variety of cleaning equipment to speed up the disinfection of ambulances.
Organizations hired more employees to enable leave and the operation of dedicated COVID-19 ambulances. The overall number of ambulances was also increased. Non-urgent missions were handled through enhanced phone services, reducing the unnecessary exposure of EMS personnel to COVID-19.
Five extra holiday substitutes were hired for EMS so that the employer could guarantee the success of agreed leave , even if the Emergency Preparedness Act had given them opportunities to cancel or postpone it. (Participant 12)
Peer support from colleagues, a positive, comfortable, pleasant work environment, and open discussion, as well as smooth cooperation with other healthcare employees were felt to be resources for work well-being by reducing the heavy workload experienced. Due to the pandemic, the appreciation of healthcare was felt to increase slightly, which was identified as a resource.
One factor affecting resilience in the healthcare sector is certainly that in exceptional circumstances , visibility and appreciation have somewhat increased. (Participant 23)
This study examined, according to the experiences and observations of paramedics, (1) what kinds of emotions the Emergency Medical Service (EMS) personnel experienced in their new working circumstances, and (2) what work-related factors became resources for the well-being of EMS personnel during the initial months of the COVID-19 pandemic. Each research question was answered with three themes.
Previous studies have shown that the pandemic increased the workload of paramedics, prompting changes in their operating models and the function of EMS to align with new pandemic-related requirements [ 9 , 27 ]. Initially, the paramedics in the current study described facing unclear and deficient guidelines and feeling obligated to follow instructions without adequate support to internalize them. Constantly changing instructions were linked to negative emotions in various ways. Moreover, the overwhelming flood of information was heavily connected to this, although the information flow was also perceived as a resource, especially when it was timely and well-structured. The study by Sangal et al. [ 15 ] has raised similar observations and points out the importance of paying special attention to the personnel working in the frontline, as in EMS, who might be more heavily impacted by too much information and anxiety about it. They also discovered that three factors are crucial for addressing the challenges of information overload and anxiety: consolidating information before distributing it, maintaining consistent communication, and ensuring communication is two-way. McAlearney et al. [ 11 ] found that first responders, including EMS personnel, reported frustration regarding COVID-19 information because of inconsistencies between sources, misinformation on social media, and the impact of politics. A Finnish study also recognized that health systems were not sufficiently prepared for the flood of information in the current media environment [ 12 ]. Based on these previous results and our findings, it can be concluded that proper implementation of crisis communication should be an integral part of organizations’ preparedness in the future, ensuring that communication effectively supports employee actions in real-life situations. Secondly, this topic highlights the need for precise guidelines and their implementation. With better preparedness, similar chaos could be avoided in the future [ 17 ].
Many other factors also caused changes in work. The EMS mission profile changed [ 3 , 4 , 5 , 6 ], where paramedics in this study saw concerns. To prevent infection risk, the number of pre-arrival calls increased [ 7 ], the duration of EMS missions increased [ 8 , 9 ], and the continuous use of PPE and enhanced hygiene standards imposed additional burdens [ 9 , 10 ]. In Finland, there was no preparedness for the levels of PPE usage required in the early stages of the pandemic [ 12 ]. In this study, paramedics described that working with potentially inadequate PPE caused fear and frustration, which was increased by a lack of training, causing them to feel a great deal of responsibility for acting aseptically and caring for patients correctly. Conversely, providing adequate PPE, information and training has been found to increase the willingness to work [ 28 ] and the sense of safety in working in a pandemic situation [ 29 ], meaning that the role of precise training, operating instructions and leadership in the use of PPE is emphasized [ 30 ].
The paramedics in this study described many additional new concerns in their work, affecting their lives comprehensively. It has been similarly described that the pandemic adversely affected the overall well-being of healthcare personnel [ 31 ]. The restrictions implemented also impacted their leisure time [ 32 ], and the virus caused concerns for their own and their families’ health [ 11 , 28 ]. In line with this, the pandemic increased stress, burnout [ 10 , 33 ], and anxiety among EMS personnel and other healthcare personnel working on the frontline [ 11 , 14 , 34 , 35 ]. These kinds of results underscore the need for adequate guidance and support, a lack of which paramedics reported experiencing in the current study.
Personnel play a crucial role in the efficient operation of an organization and comprise the main identified resource in this study. Previous studies and summaries have highlighted that EMS personnel did not receive sufficient support during the COVID-19 pandemic [ 11 , 14 , 17 , 18 ]. Research has also brought to light elements of adequate support related to the pandemic, such as a review by Dickson et al. [ 16 ] that presents six tentative theories for healthful leadership, all of which are intertwined with genuine encounter, preparedness, and information use. In this current study, the results showed numerous factors related to these contexts that were identified as resources, specifically underlined by elements of caring, effective operational change, knowledge-based actions, and present leadership, similarly described in a study by Eaton-Williams & Williams [ 18 ]. Moreover, the paramedics in our study highlighted the importance of encouragement and identified peer support from colleagues as a resource, which is in line with studies in the UK and Finland [ 12 , 23 , 37 ].
In the early stages of the pandemic, it was noted that the EMS personnel lacked adequate training to manage their mental health, and there was a significant shortage of psychosocial support measures [ 14 ], although easy access to support would have been significant [ 18 ]. In the current study, some paramedics felt that mental health support was inadequate and delayed, while others observed an increase in mental health support during the pandemic, seeing it as an incentive for organizations to develop standard operating models for mental support, for example. This awakening was identified as a resource. This is consistent, as providing psychological support to personnel has been highlighted as a core aspect of crisis management in a Finnish study assessing health system resilience related to COVID-19 [ 12 ]. In a comprehensive recommendation commentary, Isakov et al. [ 17 ] suggest developing a national strategy to improve resilience by addressing the mental health consequences of COVID-19 and other occupational stressors for EMS personnel. This concept, applicable beyond the US, supports the view that EMS organizations are becoming increasingly aware of the need to prepare for and invest in this area.
A fundamental factor likely underlying all the described emotions was that changes in the job descriptions of the EMS personnel due to the pandemic were significant and, in part, mandated from above. In this study, paramedics described feelings of concern and frustration related to these many changes and uncertainties. According to Zamoum and Gorpe (2018), efficient crisis management emphasizes the importance of respecting emotions, recognizing rights, and making appropriate decisions. Restoring trust is a significant challenge in a crisis situation, one that cannot be resolved without complete transparency and open communication [ 38 ]. This perspective is crucial to consider in planning for future preparedness. Overall, the perspective of employee rights and obligations in exceptional circumstances has been relatively under-researched, but in Australia, grounding research on this perspective has been conducted with paramedics using various approaches [ 39 , 40 , 41 ]. The researchers conclude that there is a lack of clarity about the concept of professional obligation, specifically regarding its boundaries, and the issue urgently needs to be addressed by developing clear guidelines that outline the obligation to respond, both in normal day-to-day operations and during exceptional circumstances [ 39 ].
Complex adaptive systems (CAS) theory recognizes that in a resilient organization, different levels adapt to changing environments [ 19 , 20 ]. Barasa et al. (2018) note that planned resilience and adaptive resilience are both important [ 19 ]. Kihlström et al. (2022) note that the health system’s resilience was strengthened by a certain expectation of crisis, and they also recognized further study needs on how effectively management is responding to weak signals [ 12 ]. This could be directly related to how personnel can prepare for future changes. The results of this study revealed many negative emotions related to sudden changes, but at the same time, effective organizational adaptation was identified as a resource for the well-being of EMS personnel. Dissecting different elements of system adaptation in a crisis has been recognized as a highly necessary area for further research [ 20 ]. Kihlström et al. (2022) emphasize the importance of ensuring a healthy workforce across the entire health system. These frameworks suggest numerous potential areas for future research, which would also enhance effective preparedness [ 12 ].
In this study, we utilized essay material written in the fall of 2020, in which experienced paramedics reflected on the early stages of the COVID-19 pandemic from a work-oriented perspective. The essays were approached inductively, meaning that they were not directly written to answer our research questions, but the aim and the research questions were shaped based on the content [ 26 ]. The essays included extensive descriptions that aligned well with the aim of this study. However, it is important to remember when interpreting the results that asking specifically about this topic, for instance, in an interview, might have yielded different descriptions. It can be assessed that the study achieved a tentative descriptive level, as the detailed examination of complex phenomena such as emotions and resources would require various methods and observations.
Although the essays were mostly profound, well-thought-out, and clearly written, their credibility [ 42 ] may be affected by the fact that several months had passed between the time the essays were written and the events described. Memories may have altered, potentially influencing the content of the writings. Diary-like material from the very onset of the pandemic might have yielded more precise data, and such a data collection method could be considered in future research on exceptional circumstances.
The credibility [ 42 ] could also have been enhanced if the paramedics who wrote the essays had commented on the results and provided additional perspectives on the material and analysis through a multi-phase data collection process. This was not deemed feasible in this study, mainly because there was a 2.5-year gap between data collection and the start of the analysis. However, this also strengthened the overall trustworthiness of the study, as it allowed the first author, who had worked in prehospital emergency care during the initial phase of the pandemic, to maintain a distance from the subject, and enabled a comparison of our own findings with previously published research that investigated the same period in different contexts. The comparison was made when writing the discussion, with the analysis itself being inductive and following the thematic analysis process described by Braun & Clarke [ 26 ].
When evaluating credibility [ 42 ], it should also be noted that the participants who wrote the essays, i.e., the data for the study, were experienced paramedics but also students and one of the researchers was their principal lecturer. This could potentially limit credibility if the students, for some reason, did not want to produce truthful content for their lecturer to read. However, this risk can be considered small because the essays’ topics did not concern the students’ academic progress, the essays’ content was quite consistent, and the results aligned with other studies. As a strength, it can be considered that the students shared their experiences without holding back, as the thoughts were not for workplace use, and they could trust the data privacy statement.
To enhance transferability [ 42 ], the context of the study was described in detail, highlighting the conditions prevailing in Finnish prehospital emergency care during the early stages of the pandemic. Moreover, including a diverse range of perspectives from paramedics working in different regions of Finland (except Northern Finland) contributes to the transferability of the study, indicating that the results may be applicable and relevant to a wider context beyond a single specific region.
Dependability [ 42 ] was reinforced by the close involvement of two researchers from different backgrounds in the analysis of the material, but a limitation is that no separate analyses were conducted. However, the original data was repeatedly revisited during the analysis, which strengthened the dependability. Moreover, the first author kept detailed notes throughout the analysis process, and the last author supervised the progress while also contributing to the analysis and reporting. The research process is also reported in detail.
This study highlighted numerous, mainly negative emotions experienced by EMS personnel during the initial months of the COVID-19 pandemic due to new working circumstances. At the same time, several work-related factors were identified as resources for their well-being. The findings suggest that crisis management practices should be more attentive to personnel needs, ensuring that personnel have the necessary support, both managerial and psychological, readily available in crisis situations. Effective organizational adaptation in a crisis situation also supports personnel well-being, emphasizing the importance of effective preparedness. Future research should particularly focus on considering personnel well-being as part of organizational adaptation during exceptional circumstances and utilize these findings to enhance preparedness.
The datasets generated and analyzed during the current study are not publicly available due to the inclusion of sensitive information and the extent of the informed consent provided by the participants.
Complex Adaptive Systems (theory)
Coronavirus Disease 2019
Emergency Medical Services
Personal Protective Equipment
United Kingdom
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Henna Myrskykari
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Study design (HM, HN). Data collection (HN). Methodology (HN). Analysis (HM, HN). Writing (HM, HN). Review and editing (HM, HN). Supervision (HN). Both authors read and approved the final manuscript.
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The study followed the good scientific practice defined by the Finnish National Board on Research Integrity TENK [ 43 ]. The study was conducted in accordance with the Helsinki Declaration and applicable national guidelines. Adhering to the Finnish National Board on Research Integrity (TENK) guidelines on ethical principles of research with human participants and ethical review in the human sciences in Finland, an ethical review statement from a human sciences ethics committee was not required for this type of study. The participants consisted of adult students engaged in regular employment. Their involvement in the research was grounded on informed consent. The study did not involve concerns regarding the participants’ physical integrity, nor were they subjected to exceptionally strong stimuli. The potential for causing mental harm was not beyond what is typically encountered in everyday life, and their participation did not pose any safety risks [ 44 ].
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Anatoly Liberman's column on word origins, The Oxford Etymologist , appears on the OUPblog each Wednesday. Subscribe to Anatoly Liberman’s weekly etymology articles via email or RSS .
For a long time, I have been trying to learn something about the source of the idiom to spill the beans “to divulge a secret” but discovered nothing. Though the Internet is full of vague suggestions, no one knows the origin of this phrase (which, incidentally, is a fairly common case with idioms). As just indicated, neither do I. Yet at the end of this essay, a rather disappointing hypothesis will be offered, and in the absence of more substantive ideas I thought it might be reasonable to touch on the origin of bean , a word that perhaps presents more interest than the evasive idiom.
The great sixth-century scholar Isidore of Seville was the author of a book titled Etymologiae , that is, “Etymologies,” one of the most famous works written in the Middle Ages. After Isidore, etymology as a branch of linguistics had to wait for more than a thousand years before turning into some semblance of science. However, we read ancient and medieval theories of word origins, from Plato on, with interest, because the tortuous history of human thought is not less instructive than the achievements of our time and because occasionally old scholars guessed well. In Isidore’s days (as well as before and long after him), learned people derived all words of European languages from Hebrew, Greek, or Latin.
As regards bean , or rather Latin faba , Isidore derived it from Greek phago – “eat(ing).” English speakers know phago – from the compounds sarcophagus and esophagus . Isidore’s idea outlived him by many centuries. Yet it inspires little confidence. Significant is only his comment: “Because beans are the first vegetables for humans.” In this respect, he was certainly right: beans have accompanied people through their entire history. Those who doubt it should read or reread John Steinbeck ’s charming story “ Tortilla Flat , ” as well as the immortal fairy tale Jack and the Beanstalk . Finally, pay attention to the Latin name Fabius, which means “grower of beans.” One does not get such a name for nothing. By the way, Isidore consumed the beans, today known as Vicia faba , while our variety is called Phaseolus vulgaris and stems from America.
As far as English is concerned, let us first note that the same word for “bean” has been recorded in all the Old Germanic languages (the differences are due only to the vagaries of historical phonetics): Old English bēan , Old High German bōna (the modern form is Bohne ), Middle Dutch bone (Modern Dutch boon ), and Old Norse baun . Plinius mentioned the Frisian island Baunonia, apparently, “Land of beans.” The Common Germanic form must have sounded baun -.
Why, centuries and centuries ago, did people call this vegetable baun -? Similar forms have been recorded all over the place. For instance, the Slavic word for “bean” is somewhat like the Germanic one, namely bob . It has been suggested that bob is a sound-imitative word (like English phut or pooh – pooh ). Presumably, beans split with some noise. In the Grimms’ tale “ Straw, Coal, and Bean ,” the bean splits with laughter at seeing its companions perish. Why this event tickled the bean to death is a special subject, but we may assume that some noise did accompany the splitting. Anyway, a tailor who happened to be close by sowed the patient together (hence, we are told, to this day, a black seam appears in the middle of all beans).
Bob (the Slavic form) may have gone back to some form like bha-bh(a) . Monosyllables beginning with and ending in the same stop , such as dud , tut , gig , tut , kick , pop (and bob !) do look like onomatopoeic creations. But Germanic baun – is unlike the Slavic word bob – in that it lacks the second b . Attempts to reconstruct some ancient Indo-European protoform like babn-o , with the loss of the second b in Germanic, are among the many sterile exercises plaguing etymological algebra. Conversely, initial f in Latin and initial b in Germanic are a regular match: both go to the consonant b h .
Rather probably, the two forms ( baun -, its root being bau -, and bob -) emerged independently, even if the impulse that produced them was similar. Considering the fact that beans were known to Germanic speakers very long ago, one wonders whether the name of the vegetable might be borrowed from some indigenous speakers, that is, from the people who inhabited their land before the Germanic invaders (we may call them newcomers, because we have no evidence testifying to an invasion) and whose language is now lost beyond recovery. Such words taken over from an unknown language are covered by the term substrate . In our case, this guesswork is unproductive, because we have no information about that hypothetical language or about the previous settlers.
Let me finish this part of the essay with a bit of humor. Two phrases have been recorded in British dialects: Bob’s a dying and kick up Bob’s a-dying . Both mean “boisterous merriment; to make a great noise.” No one knows their origin, but it may not be quite fortuitous that the proper name Bob was chosen for the occasion (not Jack, let alone Tom, Dick, or Harry): perhaps it still evokes the idea of ruckus. I am now returning to the proverbial saying. Why do we say to spill the beans ? Everything is puzzling about it. The phrase surfaced late: no attestation in print before the beginning of the twentieth century. It looks like an American coinage (in any case, the first examples are from American media). And we don’t know what situation inspired the idiom. Who in real life used to spill beans and thus “leak” precious information? Even the image of beans being spilled is far from clear.
I have no answer to the riddle, but it is curious how often beans appears in idioms. An amusing British regional saying, which was current at least as early as the eighteen-thirties, sounded so: “To know how many beans make five,” that is, to be fully aware of one’s interests (a reference to some forgotten game?), while not to know beans still means “to be ignorant.” “Not to care a bean” is a synonym for “not to care a thing, a fig, a brass farthing” (or “a hill of beans”!), and so forth. To get beans means “to be punished,” to give somebody beans “to beat to a pulp,” and so it goes down to cool beans “great job.” This environment provides no clue to the phrase that interests us, but it shows that beans has long been a favorite element of idiomatic sayings (even more so than nuts ). Beans is also ubiquitous in the context of sex. This is surprising, seeing that beans, even though, as noted above, have played an outstanding role in human history, are no longer the most important part of our diet, while all the idioms with beans are or seem to be recent. (Incidentally, when Russian speakers draw blank, they are said to be left on (the) beans. Why? The phrase is ostat’sia na bobakh .)
Perhaps the phrase to spill the beans simply joined many others containing the overused word. Oscar Wilde once wrote a tale titled “ Sphinx without a Secret .” The tale is not one of his masterpieces, but the title is brilliant. Isn’t our idiom such a sphinx? You get beans, you give somebody beans, you spill beans. Why bother? I conclude: no need crying over spilled beans.
Featured image by Elizabeth Tyler Wolcott, Digital Commonwealth via Wikimedia Commons . Public domain.
Anatoly Liberman is the author of Word Origins And How We Know Them , An Analytic Dictionary of English Etymology: An Introduction , and Take My Word For It: A Dictionary of English Idioms .
Anatoly's latest book, Origin Uncertain: Unraveling the Mysteries of Etymology (OUP, 2024), is available to pre-order.
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That some “don’t know beans” suggests others do know beans. Positive and negative also apply in bean brain versus use you bean. Beans grow in pods. If the pods get wet and then dry, beans spill. Someone who does know beans can be encouraged to spill them.
“Anyway, a tailor who happened to be close by sowed the patient together”
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