Administration and Leadership

Thoughtful Decision-Making for EMS Managers

Issue 9 and Volume 35.

I work hard like you do. For me, watching a movie is the perfect break from the daily stresses of my job. I like all kinds of movies, but I really enjoy ones that take the main character back in time. The classic It’s a Wonderful Life features a small-town bank officer—Jimmy Stewart—who’s about to commit suicide when an angel shows him how different things would be if he hadn’t been born. Armed with this information, Stewart’s character changes his mind.

Do you ever think about past decisions you’ve made as an EMS manager? I do all the time. If you had a chance to go back and change anything, would you? When I think about some decisions I’ve made, I often wish I had the opportunity to go back in time to make a different choice.

Sometimes, we make judgment calls based on some initial information before we have the complete picture. I’ve been guilty of that, and I’m sure most of you have been as well. But then I realized I’m not on an emergency scene (where I have to make a split-second decision).

Sometimes employees want an immediate answer from you. We have a tendency to feel compelled to give it to them. This can be a big mistake when you don’t yet have all the facts. If you have some discretionary time, make sure you have all the facts before deciding.

We’re all guilty of making emotional decisions, even when we have all the facts and statistics. I’d venture to say that even the person who handles your computer system and all the objective data for your organization makes decisions based on emotions and feelings.

Making a choice fueled by emotion may lead to regret. And, unlike the movies, you can’t go back and change the past.

Appreciate the Art Form
Decision-making is sometimes an art itself. As I pointed out earlier, making a decision starts with having all the information. One of my favorite quotes about decision-making comes from Donald Rumsfeld, Secretary of Defense for the George W. Bush administration.

During a briefing about the Iraq war Rumsfeld said, “There are known knowns. These are things we know that we know. There are known unknowns. That is to say, there are things that we now know we don’t know. But there are also unknown unknowns. There are things we do not know we don’t know.”

Analyze Your Decisions
So, if you had the chance to go back and change one decision you made for your EMS organization, what would it be?

Maybe you regret promoting someone because you thought they were the best choice, but as it turned out, their performance disappointed you.

Or, given the chance, would you still buy that piece of equipment you thought EMS crews would love and adore you for—when in fact, they hate it, complain about it all the time and think you got duped by the salesperson? Perhaps you’re rethinking words you used during an important meeting. If you could take them back, what would you say instead?

Every decision you make helps you grow as an EMS manager. Carefully scrutinize decisions you regret to determine where you went wrong. Then, store that information in your head, so the next time you’re faced with a similar situation, you can call on that information and make a different choice. That’s called experience.

Making the Right Choice
Whenever you make a decision, there are several important things to keep in mind. First, consider the objective. What are you trying to achieve? You should also involve the right people and let opinions be heard. This is part of the process of gathering all the facts prior to making a decision.

Don’t be afraid to ask questions. If somebody is telling you something, and it doesn’t sound right or you don’t understand it, don’t hesitate to ask questions. And you should definitely avoid selecting the first decision that comes to mind. Try to think of other solutions and weigh them against each other to determine which solution is best.

Unfortunately, I haven’t found a time machine yet. Therefore, you and I have to live with our decisions—the good ones and the bad ones.

So make the right ones the first time they’re necessary on scene. And, if you aren’t on an emergency scene and have the luxury of time, gather all the facts, weigh the best options and then come to a final solution. It may save you from wishing you had that time machine. JEMS

 This article originally appeared in September 2010 JEMS as “Decisions, Decisions: Avoid making a choice you’ll regret.”

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