Administration and Leadership

Emotional Intelligence in EMS Leaders

Issue 7 and Volume 42.

Organized prehospital emergency medicine is but a teenager in terms of its lifespan. The profession meandered for many decades as communities around the world realized that the novel services provided by the industry were necessary and valuable. Now as the necessity is well-understood, EMS has experienced an explosive growth.

However, the focus of our industry’s future can’t and must not be reliant on growth. As with all things, unchecked growth is unsustainable and doomed to collapse.1 Just think of the most recent recessions: the dot com bomb and housing market bubble burst. These were both due to growth that was unchecked and unfounded on sustainability.

Our industry is no different. Now that the growth of our industry has dominated the marketplace for most of its history, a paradigm shift from growth to development is occurring. Just look at the emergence of the buzzword “EMS 3.0,” which dominates the leadership tracks at all the major conferences. EMS 3.0 is all about the development of prehospital emergency medicine into a healthcare delivery model that brings greater value to its stakeholders. Simply responding to calls is no longer good enough.

The Case for Emotional Intelligence

There’s little doubt the development of our industry rests in the hands of its leaders. As EMS transitions to a delivery model that’s driven by quality of care, safety of services, innovation and cost containment for consumers, our leaders will be responsible for not only blazing the trail forward, but also inspiring the workforce to faithfully follow.

The ability to lead our industry’s human resource through this paradigm shift is at the crux of our success. This task is daunting and complex. Leaders will need to break ties with business as usual, develop innovative ways of delivering services and unabashedly lead by example. One of the greatest barriers to future success is the memory of past success. It’s this very notion that implores leaders to not only commit to this journey of change, but also inspire everyone else within their scope of influence to achieve it.

Innovating and inspiring change isn’t something that can be demanded of one’s staff. It takes leaders with the desire and ability to meet the frontline staff where they are in life and their profession, fully engage and empathize with the staff’s journey and ultimately temper one’s own ambitions and feelings in lieu of the greater good. Not only is this the very essence of effective leadership, it’s also the core tenet of emotional intelligence (EI).

As new generations come of age and change the fabric of the current workforce, we must also change the dynamics of how we lead them. The days of paternalistic leadership have come to pass.

A leader’s ability to exert control and authority over individuals does little to inspire, compel, and lead our industry into the next chapter of its success. True leaders don’t operate from a place of management and directive force. Instead, leaders operate from the deployment of a high degree of EI.

True leadership is realized by the success of individuals working together to achieve a mission. In other words, leadership is evident by the relationships that people build and utilize to achieve their success, not their obedience to the authority figure driving the processes.2

The Science Behind the Theory

It’s important to realize that EI is a trait and ability that individuals have, not a leadership theory or management style. EI is the measurable ability of an individual to monitor one’s own feelings and emotions, monitor those of the people around them, discriminate among the emotions observed and ultimately use this analysis to direct the leader’s own thinking and actions.3

The existence of EI was born out of the question, “what makes people successful?” By many accounts, up until the late 20th century, most leaders were believed to be successful because they were at least moderately intelligent, if not highly intelligent. However, as research into organizational dynamics began to gain great attention in the second half of the 1900s, so did the study of leaders in many different disciplines like business, politics and industry.

The study of success and leadership began to show that leaders were no longer the smartest people in the room. In fact, many had very average intelligence.

If this is the case, what makes the leaders of today and the recent past successful?

First, let’s think of success in terms of the success equation: Skill + Luck = Success.4 Although this equation is well accepted throughout business and industry, why is it that most leaders who are studied are no more brilliant or skillful than you or I?

Certainly luck can’t be the limiting factor. So, something else is missing. EI is the “it” factor that drives the equation to success. Leaders are only successful if they use EI as the catalyst to propel the success equation forward.5

The reason that a leader fails to make an organization successful usually doesn’t have anything to do with how unintelligent or how unlucky he or she is. Rather, the number one reason that leaders fail is because they fundamentally lack the ability to relate with people.6 One review of more than 500 senior executives found that EI was a much better predictor of success than intelligence alone.7

Theory into Practice

There are two basic questions at the core of practical EI: 1) What do I observe?; and 2) How do I react to what I observe?

The first question examines one’s ability to perceive and understand the nuance of the human experience: emotions and feelings. EI affords an individual with the skills to understand their own emotions and those of the people around them. This isn’t as simple as recognizing that someone
looks mad. Instead, this type of observation requires that a person not only realize what the emotions are in someone else, but also what’s inciting those emotions.

The second question of EI addresses how we respond to our observations. How do we change our behavior in response to our own emotions and the emotions of the people around us? This involves a person being able to adjust their own emotions and behavior in order to motivate, compel and inspire certain behaviors in those around them.

If we then go a step further with these questions, we end up with the four core principles of EI : 1) Self-awareness; 2) Self-management; 3) Empathy; and 4) Relationship management. (See Figure 1.)

Self-awareness is the component of EI that focuses on the appreciation and understanding that a person has for his or her own self. Persons who possess self-awareness operate from a sense of pragmatic confidence and keen emotional discernment. Self-awareness enables a person to know what their own strengths and weaknesses are, act in a way that makes the greatest use of their strengths and ask for help to compensate for their weaknesses.

Self-awareness demands that individuals have a very strong grasp of how their emotions are triggered, how they’re balanced and how they affect their behaviors. Knowing that you’re upset isn’t good enough. You must know that you’re mad, the chain of events that got you mad, how being mad is manipulating your actions and judgement, and how to subdue your anger so that it doesn’t affect the way you interact with others.

Self-management is the second of the personal management principles. However, with self-management, we move from making observations about our emotions to acting within the constraints of those observations.

During times of distress, strong EI allows a person to keep their own emotions in constant check and prevent their emotions from overwhelming a situation.

Because of this inner balancing act, leaders with strong EI are quite resilient. Self-
management enables them to stay calm, collected and focused when placed under extreme pressure and crisis. Additionally, once a person does become upset, they can quickly move on and overcome this emotional state. Finally, self-management enables leaders with EI to motivate themselves in the face of adversity. Despite setbacks, leaders can persevere without needing the encouragement of others.

While self-management and awareness focus on one’s own observations and actions about themselves, we also need to examine how leaders observe and respond to those around them.

Try hard to understand what a person is feeling, why a person is
feeling it and how those feelings are impacting their behaviors.

Dual empathy is the observational component of how a leader with strong EI works with others. There are two basic parts to empathy: Emotional empathy and cognitive empathy. Emotional empathy is the ability to read and understand another person’s emotions quickly and accurately. Cognitive empathy is the ability to understand why people feel the way they do about a subject. Dual empathy not only enables a leader to understand a person’s feelings, but allows them to appreciate the perspectives behind those feelings.

Relationship management is the final and culminating principle of EI. When a leader can effectively manage their relationships, they communicate in a way that compels and motivates people toward a goal. This communication not only serves the goals of the leader, it also empowers others to take ownership of the tasks at hand. EI allows leaders to manage an organization in a way that the staff feels like they’re part of the team. This is most often evidenced by a staff that can laugh together-and perhaps most importantly-can laugh with and in the presence of the leader.

Practice Makes Perfect

In terms of leadership potential, I tend to live by the rule, ‘Experience doesn’t make up for education, and education doesn’t make up for talent.’ The most important factor in that rule is talent, but it’s also the hardest to gauge. It’s hard to qualify someone’s ability to lead an organization without actually hiring them into a leadership position.

In many cases, the talent that we’re talking about here is EI. Does a potential leader have the ability to control themselves in tough situations, relate to people in a meaningful way and motivate a workforce to accomplish its mission?

Upon its initial emergence several decades back, it was thought that EI was organic and intrinsic. As is the case with cognitive intelligence, there will always be others out there who are naturally gifted with a high degree of EI. However, as neuroscientists began to study and understand neuroplasticity, they also discovered that EI is a talent and skill that can be honed.

Reflection allows you to learn from your mistakes and successes,
and improve and strengthen your emotional intelligence.

So then how does one ultimately increase their own EI? Practice. There are three steps that new and emerging leaders can use as they work towards strengthening their EI.

Prior to attempting to strengthen your EI, it’s important that you find an environment where you feel emotionally comfortable. You must be able to take a hard look at what triggers and controls your own emotions. It’s difficult to examine and manage your own emotions if they’re always guarded by the fear of embarrassment. Try working with close friends and family first. Hopefully, these are people that you’re able to let your guard down with and talk genuinely about introspection.

The first step in improving your EI is also the most basic: Think before you act. So much of EI is managing your own emotions and actions. The emotional centers of your brain process stimuli faster than the rational centers. Leaders must constantly restrict the emotional centers of the brain from controlling their actions. When I see or hear someone coming to me in a state that’s highly emotional and volatile, I immediately begin slowing my thoughts down and repeating in my head, “Think it through, think it through.” Volatility is contagious if you’re not prepared for it. Going into a situation with an understanding that you are going to think things through is a great strategy for preventing an emotional, knee-jerk reaction.

Next, empathize with those around you. Actively listen and take a genuine interest in what people are saying. Pay special attention to word choice and nonverbal cues. Try hard to understand what a person is feeling, why a person is feeling it and how those feelings are impacting their behaviors. This takes lots of practice. One of the keys to reading a person’s emotions is being genuinely concerned with the reasons why a person feels the way they do. It’s difficult to read a person’s emotions if you don’t really care.

Lastly, reflect on your interactions with people daily. I can’t tell you the number of times that I’ve looked back on a conversation and said, “Well, I messed that up.” And that’s ok! Being able to examine what you said, why you said it and how others reacted to it is a very crucial skill needed for strengthening your EI. It allows you the chance to reshape and focus your skills. Reflection allows you to learn from your mistakes and successes, and improve and strengthen your EI. Ultimately, you’re trying to relate your behaviors and thoughts to the principles and skills of strong EI. (See Figure 2.)

Putting It All Together

This article has spent a lot of time talking about feelings and emotions. This isn’t something we’re used to in this industry, but we should be. As leaders in an emerging industry that’s at the foundation of so many communities, we must arm ourselves with the tools to lead our workforce into the future.

EI isn’t only a tool to help you motivate an organization toward success and greatness, but it’s also the “it” factor in leadership. It’s what sets people apart.

As science begins to understand what goes into EI, more and more strategies are emerging to improve it.

Our stakeholders rely on us to always be looking and moving forward. Don’t rest on the militarized leadership strategies of yesterday. The ways of the past will keep you and our industry from being propelled to greatness. Leaders with strong EI are able to foster a workforce that’s dedicated, efficient, caring and focused.


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