When Sean Hackett’s baby boy had to be treated for a heart condition but didn’t receive the best care possible, the Royal Roads University student took to his research to address the issue.
Hackett, who is a paramedic working near Ottawa, began the Master of Arts in Learning and Technology program in 2014 just after his son was born. In 2016, he began research for a thesis looking at stress levels and complacency among paramedics and how mindfulness can mitigate it. This year, Hackett’s thesis was approved for publication.
His son, Archer, has Long QT syndrome: a heart condition that can cause rapid heartbeats leading to fainting spells, seizures and, in some cases, cardiac arrest. Before Archer reached his first birthday, he had a heart attack. He has been transported by land and air ambulance to the hospital and has seen hundreds of health care practitioners from respiratory therapists to cardiologists.
“There were so many people in the system responsible for his care and inevitably, sometimes adverse events happened. I was surprised because I was a paramedic. They have the best education and technology and are all well-intentioned people so why were adverse events happening? That’s when I changed the focus of my thesis,” Hackett said
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An example of the adverse events includes wrong dosages of medications being prescribed to his son or inaccurate air volumes on the ventilator. At one point after feeling nauseous post-surgery, Hackett said his son was prescribed a medication commonly used for nausea but that would worsen conditions for patients with Long QT syndrome.
Hackett said it seemed that in high-stress situations, health care practitioners often fell back on algorithms and no longer used critical judgment to treat patients.
“That’s when I started looking at effects of stress, acute stress and chronic stress and how it affects people’s ability to have a cognitive load,” Hackett said. “Is there a way to mitigate that phenomenon, increase cognitive load, mitigate the effects of stress and give them the confidence to say they’re going to do something different?”
Out of the hundreds of practitioners Hackett came across during his son’s care, a handful stood out. They were in control, calm and thoughtful and didn’t seem to struggle with adverse events. Hackett asked about their practice and discovered four out of five were practicing mindfulness. Mindfulness is the practice of paying attention in the present moment – intentionally and with non-judgment.
He then took to Twitter to put a call out to paramedics in Ontario to see if a mindfulness stress reduction course would help change their practice. Volunteers were rated on a mindfulness attention awareness scale before and after taking the course, and the results were compelling.
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“Quantitatively there is no question there was an improvement in mindfulness for people who took the course,” Hackett said.
Upon interviewing his sources, Hackett found their relationships with family members and partners reportedly improved and that they were able to be self-aware of what stressed them. However, while the participants said they felt they improved as people, they weren’t sure if they improved as paramedics. Hackett is willing to venture that they have.
“Theoretically we know the relationship between stress and performance. Reporting an ability to control that stress could lead to improvements in patient care.”
The Ontario Medical Advisory Committee caught wind of Hackett’s research which has influenced continued professional development for paramedics in the province. Education for paramedics will include how people make decisions and the value treatment choices have, Hackett said.
“They’re starting to look at how decision making occurs.”
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Ornge, an Ontario-based ambulance service where Hackett works, has also introduced education for paramedics that recognizes stress triggers and how to mitigate them before and during an event.
Moving forward, Hackett said he’d like to examine more mindfulness techniques and which ones are effective in changing performance while under duress. He would like to examine paramedics under stressful situations and see mindfulness at work so that others, including his son, receive the best care possible.
“My son has been transported by land ambulance twice and Ornge air critical care three times,” Hackett said. “If my research is able to inspire paramedics to just be aware of their stress triggers and mitigate them then hopefully the next time my son needs a paramedic they’ll be able to respond under duress.”
