Extending the Career Ladder

This post can also be found at The EMS Leader

I remember the first time that I watched Mother, Juggs, and Speed and saw Larry Hagman walk into F&B Ambulance for the first time, and put his resume on the table.  After barely even looking at his resume, Mr. Fishbine hired him, with barely an interview.  No selection process, no nothing.  A guy with a card, getting a job.  Many might see that as a Hollywood shortcut, but sadly in my experience in many places, especially the private industry, the vetting of prospective employees is far too brief.  You then are introduced to the rest of the “team” at F&B ambulance which includes the veteran, Mother.  The guy who is really in charge, seemingly because he is the guy who has been there the longest.

I point out this great 70’s movie because it was actually the first exposure to EMS that many people who are my age had.  Sure, I’m 35, and this movie came out the same year that i was born, but even nineteen years later when I was a freshman in college we watched it as part of one of our EMS management classes.  Although my two full time jobs have been with pretty large, put together organizations I have plenty of friends who have and do work in the smaller mom and pop sized section of the industry.  I have heard plenty of stories about people being sent out on the street as fast as they come in the door.  It is time for EMS to take a good look at their career ladder and hiring processes.   First though, we need, as an industry, to decide who we want and decide what a career ladder really entails.  Should the evolution of BLS to ALS really be considered part of that ladder, or is it possible to move “up” the chain in EMS without having a paramedic patch on your sleeve?

Can a BLS provider be qualified to be a section leader on a major incident?  Can they receive and utilize the training necessary to deal with day to day personnel and scheduling issues that always seem to pop up?  Far too often, we associate a person’s ability to manage people with their ability to provide care to people and those two do not intersect as much as we think they do.

Think of an example of workers on a production line.  The worker who can do their job fastest and most efficiently might not be the most qualified to step off of the line and manage the company’s books.  The same rings true for EMS.  The best paramedics are not always the best managers, and the best managers are not always the best paramedics.

This provides quite the conundrum for anyone who is seeking to take their opportunity to get off the streets as many of us have done throughout our career.  Sometimes it is quite the challenge to have to wear two thinking caps: one that helps us with drug dosages and extrication techniques, and another that gives us the ability to manage a UHU, or know not what is going on with one patient but what is going on with six, seven, or twenty units you are responsible for.  Twice the learning, twice the responsibility, and twice the headache.

Sounds great, doesn’t it?

Now, here is where the employer comes into play.  The employee, regardless of level, shows an interest.  We cannot as an industry expect them to figure everything out on their own.  They must be let in on whatever trade secrets that a department has, because personally, I feel that there are NO trade secrets.  No secret sauce.  We just choose to lie to ourselves and say that there is.

Giving someone the opportunity to see what goes on behind the scenes and on a more macroscopic level can change their impression of the entire business.  I remember one day I had an employee riding with me on my supervisor unit for a few hours, and when I dropped him back off for his shift, he said “man,  I did not realize how much you actually had to deal with.”  That impression was after just a couple of hours of driving from one end of the city to the other, and a phone ringing off the hook.  Emails were answered, and a complaint or two was handled.  In the time that he was with me, we only made it to one call, and during that time, I did not pick up the radio mic.  I am sure that at least one of my 20 or so units on the street probably thought that I was tucked away hiding somewhere, but in reality I was working my butt off, and frankly, I would come home more tired from a 12 hour supervisor shift than I would a 16 hour ambulance shift.

The moral of this post is we need to remember that when we have that position open up and we are ready to move someone up the chain, whoever throws their hat into the ring might be walking into a position blind.  They can read the job description and requirements all they want but there is so much more to learn and understand, and it is the leader and the manager’s requirement to prepare them for what is to come.