ORCID

0000-0003-3040-4930

Date of Award

Spring 2025

Language

English

Embargo Period

4-25-2025

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

College/School/Department

Department of Communication

Program

Communication

First Advisor

Annis Golden

Committee Members

Rukhsana Ahmed, Piotr Szpunar

Keywords

structuration theory, emergency medical services, qualitative methods, ambiguous regionalization, work-life boundaries

Subject Categories

Emergency Medicine | Health Communication | Organizational Communication

Abstract

Work-life interrelationships and boundaries are common areas of study in communication research. While some scholars maintain that the domains of work and personal lives and their boundaries are static and exist in designated times and spaces, others argue that domains are constructed around situated contexts and through the performance of situated activities that not only produce a time and place for the domain but call upon enactment of an identity appropriate for managing the domain and the boundaries around it. The people who work in emergency medical services (EMS), emergency medical services professionals (EMSPs) face special challenges in managing work-life interrelationships. They perform as knowledge and skilled workers while they are on the clock in times and places that closely, if not identically, resemble the times and places they experience while off the clock. Unlike other high-reliability organization (HRO) members (e.g., firefighters or law enforcement officers), much of their critical, lifesaving work (e.g., performing cardiopulmonary resuscitation or hemorrhage control) can be performed without special equipment. EMSPs are also integral members of the healthcare system and, given the nature of their jobs of responding to where people need help, they are used to performing their work in any location, unlike other healthcare practitioners (e.g., physicians or nurses) who typically enact their work-related behaviors in specific locations (e.g. a hospital or clinic). In this study, I sought to understand how EMSPs’ work permeates their off-duty times and spaces, and how they construct and communicatively manage the boundaries of their work-related identities while off duty. I performed semi-structured interviews with 52 people – 39 EMSPs and 13 relevant others (ROs), who identified as people with whom the EMSPs spend time outside of work – through video or phone call between January and June 2022. The interviews were transcribed and analyzed through data immersion and iterative organizing and reflecting until there were robust responses explanations of how EMSPs and their ROs view EMSPs’ work-related permeations while off the clock. I identified seven categories of permeations which I arranged along a continuum reflecting the proportion of work- and personal-related identity involved. The continuum ranged from triaging (evaluating people for presence and severity of medical or traumatic conditions) without intervening (with very little work-related identity enacted) to physically performing care (with very little personal identity enacted). Using Giddens’ (1979; 1984) structuration theory and its concept of spatiotemporal regions and Scott, Corman, and Cheney’s (1998) framework for organizational identification and its concept of identity regions, I explain how these work-related identities are constructed in both spatiotemporal and identity regions and how these regions are related. I explain how EMSPs can enact front (identification) or back (disidentification) region occupational or organizational identities as responses to their situated contexts. I also use an adaptation of Giddens’ (1979; 1984) levels of consciousness and rules and resources to depict how EMSPs appear to enact their work-related identities while they are off the clock, both consciously and unconsciously. My findings suggest that there are rewards and harms associated with these identity enactments and that EMSPs may attempt to erect and manage boundaries to manage conflict. Implications of work-related identity enactments in off-duty spatiotemporal regions include increasing stress and burnout on EMSPs, causing tension in interpersonal relationships, and impacting the EMS workforce. The findings of this study contribute to structurationally informed communication research on work-life interrelationships, communication research on HRO socialization, and EMSP stress and burnout literature. I also identify implications for practice for individuals, organizations, and the profession.

License

Creative Commons Attribution 4.0 International License
This work is licensed under a Creative Commons Attribution 4.0 International License.

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