In the field of paramedic research, paramedicine has tremendously grown over the years due to the innovations in the medical world. It is defined as a life-saving mechanism that paramedics use to improve the health conditions of patients. It indicates that paramedicine is dynamic and incorporates several professional interventions in order to achieve the objectives. In this literature review, the area of interest related to paramedicine that is focused on is patient care. The essay will critically evaluate the existing research on matters of patient care that is useful for this study. Essentially, patient care is complex, especially when the disease could progress for a long time. Examples include such cases as cancer and diabetes. In such instances, patient care in terms of intervention and treatment will be a combination of management techniques that would require stabilization of the patient, monitoring of the condition, consistent medicine intake, and other factors. During the intervention period, the patient will be placed on continual monitoring and management care in order to observe his/her reactions to the treatment and to avoid further complications. At this stage, the nurse or physician will have the responsibility to inform the patient, family members, and care giver about the procedures used to save the patient’s life and about the progresses so far achieved.

Review and Critique the Articles and Construct a Review of the Material

Doing a literature review in health and social care is very significant because it provides a landscape of what is known about the research topic and identifies gaps upon which the research will be formulated. Basically, a literature review is not simply a summary of other people's work, but it provides a justification for a research project by reviewing and critiquing what has been done before and identifying gaps in the literature. If a researcher has to go ahead and undertake the research, the review would develop an argument for the study. The literature review will also evaluate the work, show the relationships between different pieces of work, and show how each relates to the practice or research.

Current Knowledge about this Topic

Patient care is a widely discussed topic in paramedicine. For example, in most healthcare centers, existing literature indicates that the impact of the high turnover rates influences the way healthcare services are provided at the above mentioned levels. The quality of healthcare is very important as when it is affected, the quality of care is compromised and it puts the lives of patients at risk (Al Dhawi et al., 2007). As postulated in Kitabchi, Umpierrez & Murphy (2001), health systems are dysfunctional, meaning that there are a lot of problems of deprived professional standards when interacting with workmates or handling patients. To make matters worse, rules that govern educational and professional advancement are unfair.

Characteristics of the Key Concepts

Some of the key concepts include “community paramedicine”, “paramedic paradox”, “medical home”, and universal access to EMS (Kitabchi, Umpierrez & Murphy, 2001). The characteristics of these key concepts include the following: they seek to consolidate the provision of healthcare in rural and urban centers and they provide information relevant for the patient-centered medical facilities (Kitabchi, Umpierrez & Murphy, 2001). Paramedic paradox outlines the relationship between distance from the hospital and the availability of healthcare for the patient. Finally, universal access to EMS shows the speed with which patient care is provided.  

The Relationships between These Key Concepts

 One of the relationships is that the concepts used in patient care, especially concerning patient care, relate to each other in different ways. Second, the concepts provide a platform for the comparison of different healthcare services provided for the patient. Third, the concepts provide a proper understanding of the ways in which distance affect medical services for patients. Finally, they show the efficiency of healthcare service provision in different communities.

Existing Theories

Some of the existing theories in patient care include the following. First, self-sufficiency theory was a potentially effective approach in understanding the provision of healthcare services to patients (Al Dhawi et al., 2007). In this regard, discussing theoretical implications on policy creation was a great platform for studying healthcare provision as outlined in the existing research work. The theory is significant in understanding the ways patient care is being articulated in some health facilities. Hill also revised Jean Watson’s caring theory. This theory articulates the best practices for ensuring that patients are properly cared for. On the other hand, Nichols, Davis & Richardson applied Kanter’s empowerment theory to matters relating to patient care. This theory is a comprehensive application of personal empowerment to ensure that patients could have their basic requirements met.

Basically, empowerment theory is more convincing than self-sufficiency theory because it is not easy to achieve self-reliance in medical provision for the sick. If a sick person is empowered, he/she will be able to satisfy basic self demands even in the absence of a health service provider.  On the other hand, Kanter’s empowerment theory advanced on Jean Watson’s caring theory. Perhaps, he understood that mere caring without empowering the patient might not help to achieve the objectives.

Knowledge Inconsistencies

There are a number of inconsistencies and other shortcomings in our knowledge and understanding. For instance, one main challenge facing healthcare in most countries is the inability to create a workforce plan that would effectively address the demands of the health service sector and supply workers continuously in order to care for the patients (Al Dhawi et al., 2007). Nonetheless, although it is a goal for many countries and health centres, very few of them have been able to set up proper strategic plans that could meet the healthcare resource needs. However, many developed countries have considered implementing other short-term policies like increased dependence on individual health service providers. At times, this inconsistency disadvantages developing nations that might not have elaborate workable patient care policies and institutions (Al Dhawi et al., 2007).

Need for Further Research

Views that need to be further tested include the following. First, the need to develop a strategy for the provision of healthcare services to patients calls for further investigation. As Hill mentioned, a strategy developed in 2003 by the World Medical Association says that a country should not entirely depend on immigrating personnel from other countries to supply its medical care service demands (Hill, 2009). In the current position of healthcare recruitment and retention, practices can be figuratively related to the act of pouring water into a bucket with holes. The analogy is very simple to understand (Nichols, Davis & Richardson, 2010). This concept, however, becomes complicated when the analysis of the concept is done critically.

At a glance, the idea of pouring water into a bucket with holes seems to be an understandable metaphor. As the water is poured, the holes work and the reality in the healthcare system becomes clear when water supply diminishes and holes become bigger. The concept is very obvious in Oman because healthcare systems keep on recruiting in a manner similar to the bucket analogy and their hiring decisions are based on the deficiently informed sources, pitiable organizational intelligence, and improperly defined considerations (Nichols, Davis & Richardson, 2010).

All healthcare organizations in the country are at a point when supply is very low, yet the exit is very high just like many holes in the bucket. At this level, it is cheaper and easier to mend the bucket that is the healthcare market rather than to affect the supply. This study will offer a good platform for the reinvention of human resources management practices, leverage of organizational models, culture in the healthcare systems, development of competencies, and development of rewards systems to take care of the problem of egress.

Second, the review of the availability of trained human resources to provide health services to patients is very important and requires further research. The intended study is very important because it will expose the holes in the bucket, i.e. factors that affect the supply, especially turnover factors and those that cause reduced supply. However, the astronomical expenses on the wasted human resources taken away from the resource base are also a factor to be taken into consideration (Hill, 2009). This study will offer simpler analysis for the managers of the healthcare industry in order to comprehend and acknowledge the dynamics. Without this, it would be then impossible to effectively execute the management of human resources. Research has shown that it is true since the incremental and refinements have not been able to provide concrete solutions to the problem and the revolutionary changes still need to have very high level of organization to manage successfully patient care issues (Nichols, Davis & Richardson, 2010).

Evidence that is Lacking

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In the analyzed literature review, evidence that is essential for matters dealing with patient care, but is lacking in this case is the articulation of self-sufficiency. For instance, in the research conducted by Aldossary et al. (2008), the issue of transferring the concept of having enough supply to meet the demand in the healthcare results was not evidenced, yet it presented a reasonable definition of the self-sustainable concept. It means that the healthcare system should have enough domestic ‘stock’ of physicians and nurses who can meet the requirements or needs of the industry to show the level of preparedness (Aldossary et al., 2008). The concept has not, however, incorporated broader elements in improving the quality of care, the productivity of the practitioners, the employee mix, and retention strategies. It breeds a broad range of policy alternatives for attaining self sufficiency that range far beyond the mere increment of enrolment of student nurses and doctors. Thus, they would transform into the issues concerning reducing the degree of patient care.

Important lacking evidence is also the presentation of barriers concerning the effective service delivery to the patients (Aldossary et al., 2008). Therefore, the research will focus on increasing the participation, even though it is a tricky venture and can be achieved through using available technology, elimination of non-nursing duties, and increment of full-time working rates. Finally, it will discuss the increment of participation rates in the Medical care profession.

The need to Study the Research Problem Further

There is a justification for conducting further research of the problem. For instance, the rationale of conducting further research will be to develop a process that investigates innovating and sustaining the core training capability in medical practice. It would be important since it could create efficiency in managing the increasing dependence on the US, UK, and other nations, especially the ones from the developed world, in terms of the trained personnel able to provide effective patient care. In fact, mentioning words like core and moderation of the reliance on others implies that the problems of immigration among physicians and nurses is still hard to be totally eliminated as there are also some human rights in play (Aldossary et al., 2008). Therefore, the research will help to address psychological challenges that patients might face during their medical attention. 

For example, Abualrub article (2007) indicated that it was important for the countries to build their own national self sufficiency for managing their local needs in terms of supply and demand for healthcare services providers. This need concerns developed and developing countries alike and will be addressed in the intended research. Against this backdrop, there is an increased use of the term “self-sufficiency” when addressing the issue of healthcare workforce in the world, which will be researched promptly in the study (Abualrub, 2007). This review will also seek to understand what exactly the meaning of this term can be. The term is used interchangeably with “self-sustainability” and there are many other aspects that relate to it (Abualrub, 2007). These phrases are used in different contexts as well. Sometimes, it is not clear what the phrase means and how it applies to the context of the medical care workforce that provides patient care in various health facilities.

 Apparently, there is no universally agreed concept that guides the process of planning on how self-sustainability could be reached, how the concept could be generally assessed, or whether it could in fact be achievable. These aspects would be addressed in the research that is to be conducted on the issue of patient care. Part of the existing literature review defines the term in the context of the healthcare workforce in developed countries.  In this context, the research will identify and address factors affecting sustainability describing them in terms of those that enable it against the ones that impede its feasibility. Therefore, there is a need for further research of the matter in order to make clarification of some efficient ways that ensure better patient care.

Contribution that the Present Study is expected to Make

In order for the intended research to be conclusive and meet its objectives, the present study findings will be quite significant and likely to provide an insight about the challenges that were encountered in the process of the study.  For instance, there has also been extensive research of the developing nations from Africa, India, and Philippines dealing with patient care in terms of positive steps and challenges faced in this area (Kitabchi, Umpierrez & Murphy, 2001). It means that the research will capitalize on weaknesses and difficulties pointed out in the existing studies. In addition, there has been very little done concerning the problems that have been encountered in the provision of patient care. Therefore, the study will borrow some recommendations from the existing research to develop better ideas that have to be used for making an advance.

As presented in the existing literature, there are areas that have become influential in terms of determining the dynamics of the healthcare workforce. The research will seek to find the best alternatives for creating equal opportunities for the healthcare providers (Kitabchi, Umpierrez & Murphy, 2001). The reason of this argument is that those areas are rich and greatly depend on international recruitment in order to staff their increasing healthcare demands. It also poses a great competition for other places that need personnel to attend to more patients. Apparently, these issues have been identified as challenges in the existing literature. Hence, they will greatly contribute to the development of the research. As posted in the existing research, the demand for physicians and nurses is increasingly growing, yet the matching international supply, on the other hand, has been decreasing. It is an area of concern that will be examined in the intended study.

Unsatisfactory Research Design and Methods

Some research designs or methods that seem to be unsatisfactory include survey, questionnaire, and interview. First, survey will apply both to individuals and entities involved in the patient care (American Diabetes Association, 2008). However, surveys are sometimes biased because a respondent might provide misleading information. Second, both questionnaires and interviews will be used to collect data. Although the questionnaire could be prone to manipulation, participants of the study will fill them by answering structured questions. This method could also lead to misleading information. Moreover, participants will answer questions during one-on-one interview with research assistants (American Diabetes Association, 2008). In this case, research assistants will use both structured and semi-structured questions as interview guides. However, if right people are not interviewed, obtained information will be misleading. In both cases, researcher will avoid making mistakes by getting right participants to fill in the surveys and questionnaires and to respond to interview questions, then by compiling the data and presenting it for the analysis (Kisiel & Marsons, 2009).

How Literature has Relevance for this Practice

The literature is closely related with this practice because it outlines a wide range of agreements in the healthcare profession concerning the need of the developed nations to make sure that they have their local supply of healthcare service providers. It will reduce the degree of their dependence on the developing nations for the supply of medical services. Basically, the research will provide means of promoting patient care services to the sick. When there is a good and effective healthcare human resource plan, it addresses the issue strategically by encouraging investment in creating and training of the professionals in the sector. Such a sustainable strategy would probably meet the demands of every nation.

Gaps in the Research and Areas for Further Research

The main gap in this research is a clear strategy for providing adequate healthcare for patients. Therefore, the major strategy of reaching the goals of this research is to investigate the definition and models of other human health options that cover a large number of patients. In the year 2004, there was carried out a study of the implication of the caregivers’ migration on the contribution of nurses in the provision of the patient care (Abualrub, 2007). In this study, there was a loophole in the provision of this important service to patients. For instance, nurses showed that the most promising strategy for attaining the global stability in the healthcare workforce could not be properly implemented. The gap threatened the patient care service delivery systems in most hospitals, thus calling for further research of the ways for promoting healthy living. It was done to make sure that every nation and health facility had its own sufficient supply and sustainable plan for creating relations between health care providers and patients. It would include developed nations being diligent in training workforce to care for the patients.

In essence, the dependence of developed countries on the foreign-trained health professionals was a clear indication of their own failed workforce policy and poor investment in the healthcare systems (Abualrub, 2007). It necessitated further research to seal the gaps and ensure that the patients got appropriate healthcare. The research would then present an argument that it would be a very wise idea for the developed nations and health facilities to struggle to attain their self-sufficiency in providing better patient care. The reason for this argument is the fact that dependence on the immigrant healthcare providers was a very unstable, unbalanced, and risky venture. The research would focus on ways of promoting the opposite, i.e. self-sufficiency as a much better option both for sound and fair patient care (Abualrub, 2007). 

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