EMS leaders have the toughest jobs in the world. Nobody I can think of has so much responsibility for so many things. Or answers to so many people, with so little job-specific education or support.
I don’t think it needs to be that way, Life-Saver. I think we complicate a lot of things that are actually pretty simple—like the way we expect people to memorize their way through 40-step patient assessments and the way we try to regulate their behaviors with 300-page ops manuals.
I think leading people begins with how we select them, and that’s a topic all its own. Beyond that, the simplest and most universal strategy for leading people is to see ourselves serving others willingly and even joyfully. I don’t think anyone can make you want to do that; it’s a matter of the heart. You either have it or you don’t; and nobody can fake it. Your overarching goal is to make their jobs seem as reasonable, sensible and safe as you can.
Think that sounds too simple? Well, it works, and it has a name: servant leadership. Some of the greatest leaders in history pioneered it. You may have heard of them: Gandhi, Nelson Mandela, Buddha and Jesus.
I think it’s the reason why so many of us respected JEMS founder Jim Page. If you want people to serve others well, you have to show them how it feels to be served well.
However, servant leadership won’t work for you unless your bosses support it. If they don’t, you’re headed for a scrap because eventually, you’ll see one another as adversaries. Being their subordinate, you’re the one they’ll blame as a “poor fit.” And you’re no dummy, right? Forfeiting a perfectly good job as a medic for a “promotion” that makes no sense is plain goofy.
Robert Greenleaf coined the term servant leadership in 1970. In 1988, quality guru Tom Peters clarified it in a book called In Search of Excellence. Peters said if your job isn’t taking care of the public, then it’s taking care of the people who do. That concept challenged the whole pecking order of leaders and subordinates.
I don’t know if Greenleaf or Peters ever met an EMS provider, much less understood how much talent that role requires. (If you don’t either, you should.)
Imagine you’re kneeling in front of somebody’s grandpa who’s denying his chest pain. As an EMT, you need to be able to quickly sense that he’s indeed having chest pain, that it’s non-pleuritic, that he’s in grave trouble (because he’s diaphoretic), that he’s also having shortness of breath (because he’s speaking two syllables per sentence) and that the lady sitting on the couch next to him is scared to death she’s never going to sleep next to him again. Then, easing her fear and harnessing her as an advocate, you need to inspire his confidence, his participation in his own care and his acceptance of transport in, say, five minutes. It ain’t easy, and that’s a fact.
To do this work, you have to have the heart for it. Diesel mechanics can’t do it. Architects can’t. Neither can attorneys, nor can some physicians I’ve known. This is the work of a caregiver born with the gifts of a caregiver, and taught how to use those gifts by caregivers.
To lead caregivers, you need to maintain a constant sense of how valuable they are. They don’t do what they do for money, so you need to remind them often that they’re valuable (so, their safety matters). You need to understand their responsibilities better than anybody else; you need to honestly like them, like what they do for a living and like the stuff they laugh about. (They’ll know if you do, and they’ll know if you don’t.)
Most importantly, when your crews’ families send them off to you in the morning, you need to understand what they expect from you. They expect you to recognize, care deeply about and act immediately on situations that threaten the health, safety and careers of their loved ones.
Whatever your rank, imagine yourself facing the families. Make sure you can look them in the eye and explain how any decision you make is the best thing you can think of. If you can take on that attitude of servitude, you can be an EMS leader. And you probably deserve to. JEMS
This article originally appeared in April 2011 JEMS as “Facing the Families: Could you be a leader?”