My Sunday ritual is a fun one. I am up by nine or ten in the morning, I have a cup of coffee, and I’m usually on my couch by 12:30 or so ready to enjoy a day of football. Most of my day is spent watching NFL Red Zone. If you have not yet experienced this, you need to. Every touchdown in every NFL game is shown. Every time a team gets inside their opponent’s 20 yard line, that game becomes the priority. If no one is in the “red zone” then the most exciting game at that moment is featured. You get to see a lot of football.
Being from Massachusetts, it is a requirement to be a Patriots fan if you live in the state for any more than a couple of years. It’s in the state charter, and it’s a question on your state tax returns. Trust me. When the Pats are not on though, one is free to watch whatever football they like.
A few weeks ago, while indulging in some Red Zone, I was watching a little bit of the Cowboys game and it got me thinking: how do we pick our leaders? Jason Garrett is the head coach of the Cowboys and his career as a player would be described as mediocre at best. He started nine times in his seven year career and played behind two other quarterbacks for most of that time. He did, however, have a great mind for the game.
Or how about the Patriots coach: Bill Belichick. Like him or not, he has been successful in his years in New England. Belichick never played professional football.
Now, take that analogy and apply it to EMS. There is an opening in management, or maybe in a field supervisor position. If a list of paramedics was put in front of a field provider and they were asked, which one would you pick and why? I would bet my paycheck that nine out of ten people who answer the why with “Because he/she is a good paramedic.”
Does a good paramedic translate to someone being a good manager? Does the ability to accurately interoperate a 12-Lead mean that they can effectively manage a budget or create a schedule? Being a manager, being a supervisor, or even just managing a large scene takes a completely different skill set. How do we make sure our leaders of tomorrow are ready to take that on? The answer is something that is referred to as operational transparency.
Those who are interested in moving up the leadership chain need to be given as much access as possible to the inner workings of a service. There should be no secrets and no surprises when they finally are promoted. It is up to the existing leadership of a service to make that happen. Create focus groups, share data, and create mentoring programs. Give your people an opportunity to learn, and do not look at it as training your replacement, but more as creating a more qualified group of candidates for that next position that opens up.
So what about those paramedics and EMTs who have no interest in being part of a service’s leadership? They deserve something too. In order to retain our top performers and not lose them to other professions (fire departments, nursing, PA etc.) we, as a community, need to create an environment that much like nursing has something for everyone. A career of being on the ambulance day in and day out creates burnout. There is no getting around that. Having opportunities to teach, participate in studies, improve a service, or work internal “side jobs” will help lengthen a person’s career. We just need to accept that and be willing to invest the time and money into those that are interested so they will invest their careers in us.
It is time to start restructuring what we do. I am tired of seeing ads for online degrees, or reading articles about how “nursing should be the next step” in my career. As a profession, we do not get the respect we deserve. That is no one’s fault but our own.
So now it is your turn: for those of you who have no interest in moving up the career ladder, what opportunities would you like your employer to provide for you?
Hey Scott!
Well done! I think the biggest problem that we all face in these situations is ego. From a field provider perspective, its being able to step aside and see where you can “do your part” to lead from within. You don’t have to be on the brass list to be a leader. Peer’s will look to you as well. Education is the easiest way that we can provide other avenues within an organization. It is probably one of the largest elephants in the room that needs reform in the EMS industry. We need to close that gap between “book medicine” and “street medicine.” If we foster an enviornment of learning where people want to see the industry grow, not from a operational stand point, but a clinical stand point we need to all be on board.
That change is something that is going to need to happen at level 0. Level 0 is the group that I call the newbies. People that have no taste in their mouth for what EMS is really like. They have that eager ambition to learn and to take on new tasks. It is a group that is full of untapped potential. If we start there and allow them to grow, then eventually the organization will follow suit, either by personal ambition or peer pressure.
It will be a tough battle to fight to appeal to that “affective domain” that drives what we do and why we do it, but with a little cash and some good old fasion elbow grease I think we will be able to accomplish it. Just need a few people to stand up and lead the way. Look at that, we’ve come full circle 😉
Take care man, Talk to ya soon!
Ryan Anderson.
Hi Scott,
I agree with the 9/10 people would say that the best paramedic would be the best candidate for an open supervisor position. I would be that one standout that did not agree with them. The further away from the field that one is in management, the less it matters how good of a field provider they are. In terms of a field supervisor, I believe that anyone in that position should be proficient as their job is to assist road crews on calls, do intercepts, etc. Even with that being said, they need not be that best paramedic, just proficient. A field supervisor’s major job is more of a support role or a “command” role if the situation warrants it. An excellent paramedic who knows every trick but cannot run an incident makes a great FTO, but not a good supervisor.
Private EMS, at least locally, falls well behind the fire service in terms of running major incidents requiring more than a couple ambulances. Sure the online ICS/NIMS classes are required but those only go so far. Private EMS agencies are not recognized or as respected as they should be because of this. There is virtually no communication interoperability in some services between the ambulances, providers, supervisors, etc and the police and firefighters of the communities they work in. While I am digressing a bit, my point is that services should have those capabilities and that field supervisors should have a role in that aspect more than providing direct patient care. A field supervisor should be judged with how they manage an MCI or personnel issue much more than their ability to start an IV on an intercept.
Obviously the higher up the chain of management one goes, generally the less the field medicine aspect matters. This may not be true if one is the director of a stand alone service that provides service to a town of 12,000 and has limited personnel. In terms of a private contractor, the corner office does not need to be the best provider as their job is budgeting, business growth, personnel management, etc. If someone in this role wants to maintain their paramedic certification and makes guest appearances on the road, more power to them. I do believe that even those in upper management should have at least been an EMT (yes, basics are people too) at some point to understand the nature of the business they are dealing with. EMS has some unique personnel with unique issues to say the least and only someone who has been involved first hand would understand.
Thanks for your comments, guys..
So where do you think those 9/10 get their opinion from? Is it a misunderstanding of what the position entails? Is it the hierarchy of respect and “paying your dues” that comes with EMS?
What do you think?
Personally, I think it may be the misunderstanding but also the ego factor. It seems as in services that solely run EMS (i.e. private) and do not have a tremendous working relationship with other “public safety” agencies in their area, there is a tunnel vision on patient care being the only aspect of an incident. Obviously it is extremely important but someone needs to be looking at the big picture while patient care is being provided. In the fire service, personnel are rotated through different assignments and there is a paramilitary atmosphere. They see more of the big picture at an incident.
At the risk of criticizing some co workers (me, never), there seems to be an atmosphere of focused on petty internal issues (i.e. I don’t want to work with a basic, he’s friends with x, etc.) rather than doing what is better for the service. A good amount of it may be the “paying your dues” mentality but there are people that after 20+ years on the road, do not belong budgeting or making personnel decisions. There may be a five year employee much more suited for the position and they should be given it. Senior EMTs (yes, paramedics are a form of EMT contrary to what some would like to think) have a place and should be respected for what they know, their experiences, etc but that may not translate into supervisory or management expertise. It very well could but it is not a given.