Community Nurse-Paramedics' Sphere of Practice in Primary Care; an ethnographic study

Abstract Background Primary care, the principal function of the healthcare system, needs efforts from the local primary healthcare teams. Community Paramedicine has managed to reduce the use of Emergency Medical Services (EMS) for non-emergent calls. For the paramedic to move from traditional emergency call outs to non-emergency care means new demands. There is a paucity of paramedics’ experiences and perceptions of their novel roles as community paramedics. This study aimed to explore the community nurse-paramedics experiences of their new sphere of practice. Methods A descriptive ethnographic research was conducted collecting data through participant observation (total 317 hours) and semi-structured interviews (N = 24) in three Hospital Districts where the community nurse-paramedics (CNP) have worked at least one year. Both data were combined, organized, and analyzed with inductive content analysis. Results From the inductive content analysis, five themes emerged: the CNP's new way of thinking, the broad group of patients, the demanding way to provide care, the diversity of multi-agency collaboration and management challenges. The CNP needs an appropriate attitude for the care and the broader way of thinking than before, taking care of the patient but also about the family members. The CNPs pointed out as enablers for the way of providing care as challenges for the management of the CNP model. The diversity of multiagency collaboration team can be sensitive while offering new possibilities. Conclusion The CNP's deep involvement in patients' and families' care needs and the challenges of CNPs’ skills and competences. Their professional attitudes and eagerness to develop and maintain the multi-agency collaboration can offer preventive and long-term caring solutions from which the citizens and allied health, safety, and social care providers benefit locally and globally.