“Business is brisk at this time of the year”: Blue-collar professionals, edgework, and extreme work in the UK ambulance service
Dates: | 13 May 2015 |
Times: | 13:00 - 14:00 |
What is it: | Lecture |
Organiser: | Alliance Manchester Business School |
How much: | Free |
Who is it for: | University staff |
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This seminar discusses emergent findings from an ongoing ethnography of front-line NHS paramedics. It focuses specifically on occupational culture and ‘professionalism’; and explores how the meanings of both are unclear and contested. The clinical scope and professional status of paramedic practice are growing as official policy tries to reimagine ambulance trusts as ‘mobile urgent care providers’ which can take pressure off overstretched A&E units and doctors’ surgeries by treating patients on-scene /at home and obviating the need for hospital transport and admission. Paramedics are keen to use their full range of skills in the field. Practically, however, ambulance work remains as demanding as ever, morale is typically low, and the work is ‘degraded’ in numerous ways (by, for example, managerialist performance targets, lack of priority attached to training, little career headroom, and severe resource overstretch).
Partially because of the work’s mobile nature, paramedics’ views about their profession were not confined to their ‘workplace’. Widespread comment was forthcoming not just on a perceived degradation of work but of society at large. According to this discourse patients, call-handlers and managers have ‘no common sense’, ambulance services are threatened by rising litigiousness, and a perceived erosion of family and community structures mean that basic care is being unnecessarily provided by 999 responders. Ambulance crews also reflected on media coverage of their work, that veers from sympathetic and ‘heroic’ discourses to open criticism of ambulance service ‘failings’.
Meanwhile, pressures on the service continue to grow amid ‘the ongoing crisis in A&E’. Austerity measures place increasing strain on budgets. Alongside the development of a ‘more professional’ service, ambulance services are also expected to be ‘more businesslike’, as neoliberal reforms open up ‘blue-light services’ to private contractors.
The challenges to work dignity are often severe. Drawing on concepts of ‘edgework’ (Lyng 2004) and ‘extreme work’ (Granter et al 2015), the paper will illustrate the ways in which ambulance staff negotiate their troublesome but sometimes highly rewarding occupational field. Building on and developing Metz’s (1981) classic notion of the ambulance worker as ‘blue-collar professional’ it seeks to update the sociology of emergency ambulance work in an era of austerity, managerialism, and neoliberalism.
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