Female paramedics’ attitudes towards career progression in the ambulance service

Background: Women’s historic under-representation in paramedic roles in theLondon Ambulance Service (LAS) has recently improved, and women and men areequally represented in paramedic roles. However, the gender balance of advancedparamedic practitioners in critical care in the LAS remains unequal, with womenconstituting only 15.1% of this group. Aims: This study aimed to gather the viewsof female paramedics to gain some insight into potential reasons for this underrepresentation. Methods: A feminist pragmatic approach was taken. Qualitative,open-ended surveys were distributed via internal social media and bulletins. Thesesurveys underwent primary thematic analysis to generate lines of enquiry thatinformed semi-structured interview questions. The questions were then posed to amaximum variation, purposeful sample of six women from the LAS. Interviewswere audio-recorded, transcribed and thematically analysed. Findings: Ninety-fourwomen responded to the survey; six were sampled for interviews. The womenvaried by experience, clinical grade, age, work location and societal factors,including whether they were mothers and the number of children they had. A mainoverarching theme was ‘social construction of women and career progressionwithin the ambulance service’. This was informed by three interrelated subthemesof ‘caregiving lifestyle’, ‘perceptions of self’ and ‘gender stereotypes’. Conclusion:Women in the ambulance service have unique challenges that mirror those inwider society. Social constructs may impose unconscious bias and pressures thatprevent women from advancing. Organisational structures and the cultural normsof the LAS may require adapting to improve the gender balance of the workforceand therefore the service it delivers.