Administration and Leadership

What Keeps EMS Managers Up at Night?

Issue 8 and Volume 36.

In interviews, business-related articles and talk shows, I always seem to come across a question that’s applicable to EMS managers: What keeps you up at night?

As an EMS manager, many things can keep you up at night. After all, you’re charged with overseeing an operation that’s responsible for other people’s lives—not only the lives involved in the calls your service responds to, but also your employees. The safety of your personnel should be a top priority. (See “EMS Culture of Safety,” October 2010 EMS Insider: More on health and safety:

What else are you losing sleep over?

You might be one of many EMS managers who are currently maneuvering your way through political minefields. Does your agency’s political environment rival the days of Rome and its Senate—when treachery, backstabbing and deceit were part of everyday business?

Although I’ve never had this experience, from my observations and in talking to others, the toughest political environment managers can find themselves in occurs when they report to a board of elected officials. Most people have only one boss they have to keep happy. When you report to a board, you have to keep anywhere from three to 11 people happy, depending on the board’s makeup.

Also, if you operate in an elected-board environment, have you ever had employees who go over your head—straight to a board member—with issues? Then, the next thing you know, you have a board member questioning you about something, or trying to tell you to do something, when they have only the employee’s perspective of the issue.

Unfortunately, many elected board members don’t understand their roles. Instead of setting the strategic agenda, they end up micro-managing the operation. The unfortunate truth is that many elected board members have no EMS background or experience running an EMS operation. But they still want to tell EMS managers how to manage an operation.

In a board member’s defense, it’s probably easy to get bogged down in the weeds and start inserting yourself into the day-to-day operations when issues come in front of you. But it would certainly be easier for the EMS manager if they didn’t.

These days, I don’t run into many EMS managers who tell me their organizations are flush with cash. So maybe you up worry about the budget and how you can run your operation in a time when many others are either not increasing their budgets or are reducing them.

Many successful EMS managers have found innovative ways to deal with budgets and avoid layoffs. One EMS manager I know now tries to fill recently vacated positions with part-time paramedics from other services. By doing so, he avoids paying a benefits package to additional full-time employees. When you consider that the benefits package for this EMS organization costs about 35% of an employee’s salary, he’s saving quite a bit of his budget and doesn’t have to reduce services to the community or lay off people. He tells me that when the economy gets better, he’ll be able to fill the positions with full-time staff.

The Personal Side
Maybe what keeps you up at night has nothing to do with your EMS organization. Maybe your problems are at home, which have nothing to do with your organization or job. The unfortunate side of these problems is that we have a tendency to bring them to the job site and our work reflects the fact that our minds are preoccupied with our problems at home.

No matter what keeps you up at night, the question that needs to be asked is: “What are you doing about it?”

The definition of insanity, as attributed to Albert Einstein, is doing the same thing over and over again and expecting different results. If you don’t deal with the problems and allow them to continue unabated, chances are they won’t go away.

The Bottom Line
As an EMS manager, whether you’re having a problem within the organization or a problem at home, you need to devise a solution to that problem. It may be complicated and involve many steps, but you have to come up with a game plan if you want to change your current situation.

I’ve faced many challenges during my career, and some have been unpleasant—the kind you wish would just go away. Unfortunately, they usually don’t. Follow the advice presented by Stephen Covey in his book, The 7 Habits of Highly Effective People, and work toward your solution by beginning “with the end in mind.” JEMS

This article originally appeared in August 2011 JEMS as “What Keeps You Up at Night? An EMS manager’s concerns from safety to politics.”