EMS seems to have this chronic problem of not putting their people out there enough and recognizing them for the vital role they play in their community each day.  Sure, there are organizations out there such as the American Ambulance Association which takes great EMS providers and puts them in front of members of congress as examples of what an EMS provider should be, but it seems to me that those instances are few and far between.

It should be noted that if someone gets into this field looking for ticker tape parades and medals to be pinned on their chests, they’ve definitely gotten into the wrong field.  EMS is 90% routine, and 10% action.  Sadly though, it is that 10% action that seems to be recognized 1% of the time.  The public isn’t going to care that Pat the Paramedic took care of thirty chest pain patients last month, but they should care that when Pat walks in the door of their home, they are going to have a caring, and compassionate provider standing in front of them.

There are a few things that I feel hold us back from really getting our people out there, and they’re all internal:

1.  The “It’s your job” mentality — Some leaders in EMS overlook consistent performance, citing that the person is doing what they are supposed to do.  While that statement might be accurate, reward and praise for consistency is a must.  Chances are, if this person meets the expectations set for them every day, they are frequently exceeding them, so praising them might actually go a long way.  If it seems like you have a number of people that are failing to meet the standards you are setting from them, take a good look at how they are being relayed to your people.  Chances are, they aren’t out there enough, or aren’t fully understood.

2.  Not enough eyes — In larger services, it’s not always easy to see and understand everything that is going on in the field.  Patient interactions can frequently go overlooked, and great employees can be overshadowed by that 5% of the employee base that takes up 90% of your time.  Give your employees a way to let you know what their coworkers have done.  Some places do this with an “I saw what you did” form.  My service has adopted something called a Kudos Email address.  The idea came to us from a class a colleague and I took at EMS Today taught by a manager from MedStar in Fort Worth, Texas.  The concept is simple: see someone do something that goes above and beyond?  Email management, and let us know so we can give them the recognition they deserve.

The response here has been overwhelming.  We probably get five or six emails a week right now of people talking about how they appreciate their relief coming in on time, or how a crew helped them clean their truck after a call, or someone going above and beyond for a patient in need.  Not only do we post these for all of our employees to see, but we also post who submitted them, giving them a chance to thank their coworker for saying what they did.

3.  The lack of a PIO — The Public Information Officer is one of the most important roles in an organization.  They are responsible not only for communicating during tragedies and responding to press inquiries, but they are also there to do community outreach.  They’re there to let the public know what we are doing, and how we are doing it.  One constant failure of the EMS industry that almost constantly chews away at me is the lack of public education that is out there.  Far too often, we are referred to as “ambulance drivers” or “EMS workers” and that is no one’s fault but our own.  We live under this veil of secrecy, and a perceived fear of HIPAA laws with a mentality that “no news is good news.”  Well, the police department survives even though they seem to be a constant focus of bad press, and a fire department with a strong PIO will be the shining star of a community.

While there are plenty more steps that we could take to better recognize and put our people out there for the public to see, this is a great start.  Set your goals so that your people know what is expected of them.  Give your employees a voice to let you know what they are seeing their workers doing.  Finally, give someone the responsibility of communicating with the public to help put a face on the professionals that will walk through the door in their time of need.

Above all else, remember that those people that step on the trucks are your greatest asset.



  1. Skip Kkirkwood, MS, JD, EMT-P /

    This has been a concern of mine for a long time – I started trying to do something about over 20 years ago, with only moderate success. I noticed that our colleagues in law enforcement and the fire service regularly, formally, and visibly recognize their colleagues who demonstrate outstanding performance. Why not EMS?

    The “It’s your job” mentality is not just a leadership issue – it also exists in front-line staff. Given that most EMS agencies have little in the way of field supervision (“not enough eyes in the field”), opportunities for recognition have to be advanced by peers – and getting one medic to say something good about another medic, never mind actually take action to pass on information about great performance, is next to impossible.

    I still don’t get it. Even after developing a statewide program that has been in existence for 20 years – – and placing similar programs at several agencies, the hardest part of the whole thing is finding out when front-line staff do good (and great).

    Some say that this is a bunch of bunk, but the evidence exists that people who actually are recognized value the recognition. Even when not required, and long after the event, you can still see them wearing the little bars that symbolize the recognition on their shirts.

    This is a culture thing, and if it is going to change, it will take effort from everybody in EMS to start appreciating the good, and the great, that EMS folks to every day. We often hear EMS folk talk about being “second class citizens” and “red-headed step children” – well, how about we stop acting like that, and demonstrate a little pride in what we do?

    • Patrick Leonardo /

      Actions speak louder then words. Often enough in every organization there may be good candid dialogue that happens…every day. The problem, everyone else expects someone else to fix it. Change doesn’t happen by expecting a leader to change your low morale. That’s a personal choice one must make to help create a positive work environment. Don’t tolerate the negative, and sing praise of all the positive attributes this profession has (start with your employees). Like
      Scott mentioned, give them a method to help get their voice heard, and follow up with actionable items so it doesn’t just get labeled as another project that Mgt didn’t follow through on. Skip, I couldn’t agree with you more. Many people do right recognition off as a bunch of bunk, but it’s true that those who get recognized value the recognition, just ask Ken Blanchard. To further elaborate on Scott’s post and to tie in Skips point that recognition is valued I’ll offer a quick story. Bls crew recognizes the need for quick turn around times, they make the CHOICE to be part of the solution and clear up quickly. Communications recognizes their efforts and immediately sends a “kudos” in appreciating their actions. One more point, recognition works best when served hot. Within 10 minutes of the kudos email generated it’s fowarded to the crew by MGT. The crew worked overnight, so a follow up was made the next morning. Crew acknowledged receiving email on smartphone immediately and said ” it was really cool being recognized that fast, it left us with a good feeling the rest of our shift”. Not rocket science but very effective. This even slowly helps to breakdown some barriers between the great wall of Comms/field. It’s definately a culture change but if each of us individually make the commitment to change how we view our selves in EMS we can then project a better professional positive image to our community.

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