Photo provided by Chuck Gipson MA, NRP / CCP
What's the best way to motivate and encourage first responders?
Knowing and studying engagement can yield some great techniques to encourage engagement with your staff but nothing beats firsthand knowledge of what motivates your staff. When we started asking this of the crews, we had some of the same questions that others may have. What would make anyone in their right mind run into, rather than away from, a stressful and possibly dangerous situation day after day to altruistically care for others? Some of the answers are what you would expect and others were somewhat of a surprise. Many of the usual answers of why our staff was motivated to come to work was the great partner that they had, the good equipment they had to use, the desire to be part of something bigger than themselves and do something for others. Some of them are engaged to come to work simply to collect a paycheck and pay their bills. Many of them were engaged by not knowing what was going to happen next in their course of work, appreciating the excitement of the unknown, as well as the varied work environment.
We started with asking our crews face to face during some mandatory training to anonymously write down on a sheet of paper what engages them. There was some discussion with the crews on what do we mean by engagement? Definition #1, which was not especially helpful, stated that engagement was the “act of engaging or being engaged.” A search for synonyms yielded further descriptions such as participating, taking part, commitment, sharing and, involvement.1 The search for clarity led to a refined definition of engagement - “what makes you want to come to work every day,” and “why do you enjoy your job.” Then the answers came flowing in. It seemed to become a moment that was similar to the movement by the American Heart Association of “Life is why2”, and it was great to listen as our crews started sharing their “why.”
Many of the crews said that they liked the varied challenges of critical calls, with the ability to step in, perform, and change a life. Although a number were motivated to choose EMS as a career for the chance to run hard, achieve an adrenaline rush, become a hero and save a life, our people readily identified that the opportunity to save a life on a call was less common than the opportunity to change a life.
Life-changers rather than life savers? In one word –absolutely. As population health emerges, our mindset has slowly shifted from saving lives to changing lives-our patient’s and our own. Resilient, savvy EMS providers use resources to create opportunity to interact with their communities to put them in contact or to connect patients with resources to help transform them from a high utilizer of an EMS system to a productive citizen. Interestingly, some of our people said it was more stressful to go on several low-priority calls than fewer high-priority calls. Spirited peer discussions led to the realization that successful and engaged providers find ways to make the best of every one of those low priority calls, connecting with the patient, maintaining compassion, and even reinventing themselves when there seems little reason to do so. It makes sense; an engaged, active caregiver can help improve his or her career satisfaction by reducing the chances of burnout out from high stress environments, a potential breeding ground for poor performance and low engagement. Engagement relies on the presence of an energetic state in in which we are dedicated to excellent performance and confident in our effectiveness3. It stands to reason that those who report satisfaction with their jobs are typically high performers, also described as engaged employees.
Environment also influences engagement. There are many small things that leaders can do to make a workplace the best possible. Outside of the actual physical environment, people should know that they are infinitely more important than another piece of expensive equipment. A critical resource with great influence on internal and external stakeholders through every action they make, engaged employees serve as a very influential and public organization ambassadors.
It is a fact that communication is the critical link in all things and can make or break a situation, such as a great working environment. Little things like providing feedback on the outcome of a patient can help to lower stress, provide meaning to their work as well as inspire our providers to do more for more patients as they see the true difference they can make. And don’t forget the staff that doesn’t get as much recognition as the EMS Providers; call takers and dispatchers, fleet and logistics personnel and the valuable folks in the business office. As the first, first responders they serve as a critical link in the chain of survival, performing lifesaving pre-arrival instructions only to hang up the phone to ponder the outcome of that caller. When the field crews have a life-saving experience, recognize all the people in your organization that contributed to the successful outcome, such as, the call taker and dispatcher who took and dispatched the call, the fleet tech who assured the vehicle made it safely to the scene, and the logistics tech who stocked the ambulance. Providing that feedback helps make everyone feel a part of the team that saved the life.
Simply being appreciated goes a long way to help your personnel stay engaged and perform well. Make sure that we are providing timely, appropriate feedback when someone performs well in addition to poorly, and celebrate when you “catch” him or her doing something right! If a family or patient sends a note, or calls to show their appreciation for the care that was provided to them, make sure to let your staff know about the great job they did, in addition to recognizing the praise both within and outside of the company. Post it on workplace bulletin boards, web sites and social media pages. Many involved in Human Resources use employee engagement models as an attempt to develop employees to the help them be more effective and efficient, which creates better organizational benefits and performance4.
It is a fairly easy task to ask staff what they like about their jobs and what gets them up and going for their shift while you sit back and let them tell you many great things. It is much more difficult to ask them what they don’t like or what they would change if given the chance. This reveals a much different reply that requires leadership to thicken up their skin, accepting the bad with the good. Truly providing an engaging workplace is to celebrate the great things and take a sincere approach to take what is less than ideal and make an effort to change it for the better with input from the staff. Many of them will improve their engagement by simply being heard and having the opportunity give input to make something better. As mentioned earlier, EMS providers are resourceful and creative. By inviting your staff to help improve a process, they will not only increase their engagement, but will also yield some great ideas for improvement.
Great ideas come in several packages. Engage staff by opening a photo contest with a few rules for some new company photos. Results will be a boost in engagement, as well as some beautiful artwork for your people to enjoy. Print and frame the pictures in poster size with photo credits, and decorate spaces to showcase and personalize their efforts, further improving engagement.
During our engagement discussions, we were surprised to find that leadership was one of the topics that our employees brought up. When we questioned this further we heard that employees appreciated leaders who “have their back,” listen to their concerns, and lead from the front. An engaged medical director who will also have their back and support their care when needed but also redirects them as appropriate also shows how much they are cared for. It is common for the terms “leader” and “manager” to be used interchangeably. Someone who is good at it is able to be both when needed, acting as a manager only when necessary. Business journals and texts note that processes are managed, while people are led. At times people must be managed as well but it should be a rarity. Leading inspires and leaders have to have followers to be effective and engaging. Transactional leaders ensure that process are completed and expectations are met, in comparison to transformational leaders who motivate their followers to perform beyond expectations5. For example, leadership cannot eliminate call volume on a busy day, but showing appreciation by recognizing and appreciating their hard work, in addition to even providing a meal or snack for your crews can go a long way to let them know you understand and care.
What other things can make a work environment better? A multitude of gestures, as long as they are sincere in nature, can make your employees feel valued and respected. The celebration of employee and company milestones through company newsletters, and even media releases can generate some proud moments. Family events, such as picnics, bowling or pool parties, help to develop camaraderie and build relationships. Community open house events allow employees to bring their families and friends to their work, give tours of their workplace, and even celebrate their chosen profession. Annual awards celebrations to honor those who go above and beyond are also ways to not only recognize, but thank your high performing employees.
Leaders can, and must engage their people by making a consistent and sincere effort to get to know them. “Management by wandering around” is a great way to connect with your staff to understand, and help them with their needs, whether professional or personal. Be the type of cheer ”leader” who readily offers available services to your partners and staff including behavioral help, stress management, and relationship counseling. We do all of those things for each other to get through the day and helps us to connect. Knowing what makes each staff member wants and needs helps to tailor a program of engagement to each of them, as a one-size fits all approach learned from the latest seminar is ineffective at best6. Human Resource professionals spend a significant amount of time trying to find a way to create an engaging workforce and have moved away from the one-size-fits-all and continue to migrate towards a customized and individualized approach.
As leaders, it is important, but often overlooked, to remember that the staff doing the work are the ones immediately caring for the customers as well as all of our internal and external stakeholders. Leaders should take the approach that the staff does not work for the leadership but rather the leaders work for the staff, making sure they have the resources they need to work effectively and efficiently. Servant leadership7 is a way to show staff how much they are needed and appreciated, creating an environment of teamwork and all members of the team are of equal importance.
Questions that were discussed included the obvious question that we ask every prospective employee, which is: “Why did you choose to get into EMS?” The answers we get back are varied, and employee candidates usually have some personal story that connects them to the profession. Better questions for discussion might be: “Why do you stay in EMS?” Asking what makes their day great and what makes their day miserable will allow you to accentuate the positives and work to eliminate or reduce the negatives. As mentioned previously, asking, “What could be better?” requires thick skin to accept the feedback you asked for without bias. Inspirational leaders recognize events that happen in the workplace with the “window and mirror” approach. When things go well, leaders look out the window to recognize the person responsible, and when things do not go well, the same leaders look into the mirror to take responsibility.
Many services have training or mentorship programs that allow EMS students to ride with their crews to complete their training program. This is a great opportunity to allow potential employee candidates an inside look at your organization, and well as a great opportunity for you to evaluate them as a prospective employee candidate. The more engaged your people are, the better experience the student will have during the mentorship program, which can essentially be an informal, but very important employment interview for both parties.
Engagement is a highly customized process and connection and caring for staff is imperative to being successful. There is no magic bag of beans to grow your program, which takes time, effort, and sincere caring for your people and their families. Remember, your staff want to be not only heard, but understood. A quote from President Theodore Roosevelt that has stood the test of time is: “Nobody cares how much you know, until they know how much you care8.”
The following is a “Top 10” list of ways to encourage employee engagement. Implement as many of the following item as possible as soon as possible if they are not currently being done in your organization.
1. Survey the staff; ask them what engages them to come to work. Ask what they like and what they don’t like about work, remember you asked for the input.
2. Encourage staff to continually reinvent themselves to battle the opportunity to experience burnout.
3. Communicate candidly and often while involving staff from the beginning to build trust.
4. Tell staff how important they are and remind them that they are not just another piece of ambulance equipment.
5. Show staff how much what they do and who they are is appreciated in some way, large or small. Many employees leave jobs for lack of appreciation.
6. Celebrate successes, clinically, personally and, professionally.
7. Involve the medical director in all clinical aspects of the job to redirect when needed as well as praising staff when you catch them doing it right.
8. Engage with the staff and challenge them to perform at their best, make it meaningful.
9. Take time to listen to what the staff has to say, listening and understanding goes a long ways to show them you care.
10. Be a servant leader to the staff and remember that as leaders, we work for them.
We set out conducting research to write this article with the intent to find the bag of magic beans to share with everyone. Some of the research conducted included gathering first hand survey information from our staff and asking partner organizations to share their top-secret engagement intel, as well as digesting peer reviewed journal articles on the topic.
3. Cole, M., Walter, F., Bedeian, A., & O’Boyle, E. (2012). Job Burnout and Employee Engagement: A Meta-Analytic Examination of Construct Proliferation. Journal of Management, 38(5), 1550–1581. https://doi.org/10.1177/0149206311415252
4. Kumar, R., & Sia, S. (2012). Employee Engagement: Explicating the Contribution of Work Environment. Management and Labour Studies, 37(1), 31–43. https://doi.org/10.1177/0258042X1103700104
5. Breevaart, K. , Bakker, A. , Hetland, J. , Demerouti, E. , Olsen, O. K. and Espevik, R. (2014), Daily transactional and transformational leadership and daily employee engagement. J Occup Organ Psychol, 87: 138-157. doi:10.1111/joop.12041
6. Nolan, S. (2011). Employee engagement. Strategic HR Review, 10(3), 3-4. Retrieved from http://ezproxy.liberty.edu/login?url=https://search-proquest-com.ezproxy.liberty.edu/docview/868575920?accountid=12085
7. Ebener, D. (2010) Servant Leadership for your Parrish. New York, NY; Paulist Press