Shauna Speers, Melissa Vose, Maria Cirstea and Jennifer Bolster
Gender Representation in Emergency Health Services (EHS)
In contrast to gender equality, which assumes that men and women benefit equally from the same support structures, gender equity recognizes that each gender has their own set of circumstances and aims to provide each group with the appropriate tools and opportunities for success. Since the 1960s, women’s participation in the workforce has steadily increased, including women entering vocations traditionally held by men. With this change, more women are choosing to become paramedics, a profession that up until the last decade has been male-dominated. However, while paramedicine is experiencing this numerical feminization, women still struggle to achieve gender equity within various levels of the prehospital workplace. To ensure equity, strategies and measures must be available to compensate for women’s historical and social disadvantages that prevent women and men from operating on a level playing field.
In British Columbia (BC), for example, women currently comprise nearly 40% of the BC Emergency Health Services (BCEHS) workforce: 47% of Emergency Medical Responders (EMRs), 38% of Primary Care Paramedics (PCPs), 19% of Advanced Care Paramedics (ACPs), and 12% of Critical Care Paramedics (CCPs).(1) Women make up approximately 30% of Patient Care Delivery leadership positions with recent restructuring and hiring resulting in an increase in female representation. These numbers are consistent with and seen throughout other organisations and sectors across Canada, where, despite the majority of women participating in Canada’s workforce, only 25% of vice-president positions are held by women, and a mere 15% of CEO positions are held by women. (2)
McKinsey & Company and LeanIn.org have described a “broken rung” at the first step to managerial positions where women see far fewer promotions than men: only 86 women are promoted to manager for every 100 men promoted. This results in men significantly outnumbering women at the manager level, and even fewer women are promoted to more senior levels, leaving women dramatically underrepresented at the levels with the most power. (3) A contributing factor in this “broken rung” phenomenon is the insidious nature of gender-based violence and the prevalence of harmful workplace cultures that still exist for women. Gender-based violence involves perpetrators’ attempts at exercising power and control, and can include both sexual harassment and gender discrimination.(4) Being subject to this harm leads not only to low morale, safety concerns, diminished learning opportunities, and decreased productivity, but it can also drive women out of their fields entirely, which has long-term impacts on their earnings and career attainments.(5)
BC Women in Paramedicine Special Interest Group
With these troubling statistics in mind, and inspired by the recently founded Australasian College of Paramedicine Women In Paramedicine Special Interest Group, two female BC paramedics, Shauna and Jen, came together on a mountain bike ride to brainstorm ways to improve workplace culture. That bike ride was the catalyst for the creation of a group to advocate for gender equity in the workforce. Two of their passionate female colleagues, Melissa and Maria, were brought on board and that group of four created the BC Women in Paramedicine Special Interest Group (WIP SIG). Each one of the women had their own unique experiences with discrimination, sexism, and sexual harassment in the workplace, but it wasn’t until they started talking to other women within the organization that they discovered how deeply rooted the problem is.
The BC WIP SIG mission is to bring gender equity to the forefront of BCEHS by creating long-lasting policies and procedures that remove obstacles for women and support them in obtaining fulfilling careers within the organisation. This includes advocating for robust sexual harassment, gender discrimination, and gender sensitivity policies, as well as advocating for a safe, standardized reporting process for sexual harassment and discrimination within the organization.
One of the first steps BC WIP SIG took was to host a focus group with other female colleagues to facilitate discussion around harassment and discrimination in the workplace. Several main themes that emerged from the focus group discussion echoed the findings of the 2021 Independent Review of Ambulance Victoria (Australia).(6) These included but were not limited to participants experiencing sexual harassment and assault at work, discrimination hindering career progression, and lack of victim-centered reporting processes. Every woman who attended the BC WIP SIG focus group indicated they had experienced workplace sexual harasment and/or sexual assault during their career.
The founding members of BC WIP SIG paired insights from the focus group with relevant research and met with the BCEHS Senior Leadership Committee (SLC) to present their findings. As a result of this meeting, BCEHS is now taking a hard look at gender equity and discrimination within the organization. The BCEHS SLC has outlined a goal of creating a positive, respectful work culture among their frontline staff, and has welcomed the BC WIP SIG project with enthusiasm.
To date, BCEHS does not have robust data on the incidence or impact of discrimination or harassment within its ranks, nor is there an easy explanation for the gender disparity seen within higher license and leadership roles. One of the major outcomes from the BC WIP SIG meeting with the BCEHS SLC was a commitment to an independent review to better understand the current state as it relates to important issues such as harassment, inclusion, cultural awareness, bullying, and discrimination at BCEHS. This independent review will aim to fill the gaps in this data and will hopefully provide insight on how to close the gender gap, reduce the incidence of sexual harassment, and improve overall working conditions and opportunities for women within paramedicine.
Long Term Goals
Looking to the future, the BC WIP SIG aims to work with BCEHS on initiatives to raise awareness around sexual harassment, discrimination, and gender sensitivity for all staff. The hope is for these initiatives to become a foundational culture from which employees can embody positive interactions and be empowered to speak out against inappropriate behaviour in the workplace.
Another long-term goal for the BC WIP SIG is to establish a woman-to-woman mentorship group that provides support and guidance for women paramedics as they enter and transition through the workforce. This degree of mentorship is crucial for career progression. In a 2017 KPMG study on women in leadership, 67% of women report that they have learned the most important lessons about leadership from other women, and 91% indicated that it is important for them to be a positive role model for younger female colleagues within the workplace. (7) The aim of the BC WIP SIG mentorship group is to provide a network and positive support hub for women working in out-of-hospital care as they navigate many of the unique challenges that are faced by women in paramedic careers.
The BC WIP SIG has placed a strong emphasis on creating greater representation of diversity within their group. The founders acknowledge that they are four middle-class, Caucasion, cisgendered women, and that this does not accurately reflect the social, racial, and gender diversity of the prehospital workforce. The BC WIP SIG also cannot accurately represent women if the only voices advocating are those of white women. Recognizing this, the group is committed to a strong focus on intersectionality and diversity as they expand throughout the province.
The group also recognizes that workplace harassment and discrimination is not just a problem for women, but for many other groups within the organization. They are hoping that the framework they create will lay the foundation for future special interest groups within BCEHS that are all able to best advocate for the support and processes they need to succeed.
Since its founding, the BC WIP SIG has had overwhelming support from the BCEHS Senior Executive Leadership Team and colleagues alike. This group is not alone, they are part of a growing global platform of women advocating for women’s equity within the workforce. With their current momentum, worldwide connections, and impassioned team, the BC WIP SIG is poised for a strong year and hope that sharing their journey will inspire other women to become powerful advocates for change within their own organisations.
1. British Columbia Emergency Health Services (CA) 2021
2. Moyser M. Women in Canada: A Gender-based Statistical Report; Women and Paid Work. Statistics Canada; 2017. 38 p.
3. Lean In. Women in the Workplace 2021. McKinsey & Company; 2021. 62 p. https://leanin.org/women-in-the-workplace-2021
4. Government of Canada. Women and the workplace; How employers can advance equality and diversity. Employment and Social Development Canada; 2019. 52 p. https://www.canada.ca/content/dam/canada/employment-social-development/corporate/reports/women-symposium/report-women-symposium-EN.pdf
5. Shaw E, Hegewisch A, Phil M, Hess C. Sexual Harassment and Assault at Work: Understanding the Costs. Institute for Women’s Policy Research; 2018. 12 p. Report IWPR B376 https://iwpr.org/wp-content/uploads/2020/09/IWPR-sexual-harassment-brief_FINAL.pdf
6. Victorian Equal Opportunity & Human Rights Commission. Independent Review into Workplace Equality in Ambulance Victoria. Victorian Equal Opportunity & Human Rights Commission; 2021. Victoria AU. 502 p.
7. Veihmeyer J, Doughtie L, Dayoan S. KPMG Women’s Leadership Study: Moving Women Forward into Leadership Roles; 2017. Delaware US. 25 p. https://assets.kpmg/content/dam/kpmg/ph/pdf/ThoughtLeadershipPublications/KPMGWomensLeadershipStudy.pdf